Key Features and Outcomes of Accelerated 3-Year MD Programs

On By amroundsIn AM Podcast, AM Podcast Transcript

On this episode of the Academic Medicine Podcast, authors Joan Cangiarella, MD, and Catherine Coe, MD, and medical student Lily Ge join host Toni Gallo to discuss the goals, features, evolution, and outcomes to date of accelerated 3-year MD programs, focusing on the NYU Grossman School of Medicine and the University of North Carolina School of Medicine FIRST Program. They explore the experiences of accelerated program medical students and how these programs fit into broader efforts to improve medical education.

This episode is now available through Apple Podcasts, Spotify, and anywhere else podcasts are available.

A transcript is below.

Read the articles discussed in this episode:

Transcript

Toni Gallo:

Welcome to the Academic Medicine Podcast. I’m Toni Gallo. On today’s episode, I’m joined by Doctors Joan Cangiarella and Catherine Coe, who have authored a number of papers in Academic Medicine on accelerated three-year MD programs. Also joining us is medical student Lily Ge. Today about 20% of medical schools in the United States have an accelerated three-year MD program. And with Joan, Catherine, and Lily we’ll talk specifically about two of those programs today, the NYU Grossman School of Medicine and the UNC School of Medicine FIRST Program. We’ll talk about the unique goals and features of these programs as well as some outcomes to date. And then we’ll get into the experiences of students both in completing an accelerated program and applying for residency from one. And finally, we’ll talk about how accelerated programs fit into broader efforts to improve medical education. So with that, I want to introduce our guests today. Joan, you want to get us started?

Joan Cangiarella:

Sure. So thank you for having us today. My name is Joan Cangiarella and I am the senior associate dean for education and faculty and director of the three-year accelerated pathway at NYU Grossman School of Medicine.

Lily Ge:

Hi everyone. My name is Lily Ge. I’m a third-year medical student at NYU Grossman School of Medicine within the three-year program. I’m an ophthalmology intern to be coming this summer, and I’m very excited to share the student perspective on this issue.

Catherine Coe:

And hey everyone, thanks so much for having us today. I’m Catherine Coe. I’m the assistant dean for the clinical curriculum at the University of North Carolina in Chapel Hill, the former director for our accelerated program, which is the FIRST program, and that unaccronymized stands for the Fully Integrated Readiness for Service program currently led by Dr. Caroline Roberts, but I do still oversee that program in my current role.

Toni Gallo:

Thank you all so much for being on the podcast today. I want to turn to Joan and Catherine. Could you tell us about each of your programs, about the origins, goals for the program, any unique features, and maybe some key outcomes that you’ve measured to date. Joan, you want to get us started?

Joan Cangiarella:

Sure. So we started our program back in 2013 after we had done a revision to the curriculum where we shortened the pre clerkship phase to 18 months and realized that by doing that there was a way of creating what we called individualized pathways. So students could do the traditional four-year pathway, they could do a five-year pathway where it was combined with a dual degree, but then they could also do this accelerated pathway. I think there were a couple of reasons for why we started it. One was debt reduction. We were concerned with the amount of debt that seemed to keep growing over time, and we, as it turned out, were on the path towards the tuition free program. And this was a way of cutting the tuition for a certain part of the class. In addition, we realized students came to us, a lot of them with gap years or interest already known, and they knew their pathway that they were going to take, what career they wanted.

And I think the other concern was the lack of intense curriculum for that fourth year. It seems like many schools were struggling as to what would that fourth year be, and a lot of it turned out to be away electives and vacationing. So it seemed like an expensive path for those who really didn’t need that year. So after deciding to do it, we started this program where we allowed students to enter in at matriculation. So they were accepted first to the medical school and then afterwards, if they were interested, they would apply. And we were one of the first schools in the nation to direct it to any of our 20 residency programs. So they applied to those programs and then it was the residency program that was actually accepting them into the program. And we’ll talk about this a little bit later, but that was part of the buy-in for getting residency program directors involved in the program. So our mission was really reducing debt and individualizing pathways for students.

Catherine Coe:

And then the UNC experience, our program certainly had seen NYU’s come online and then also looked at Texas Tech who was one of the earlier adopters of an accelerated program as well. Ours was really born out of a mission-driven workforce development pathway. So the state of North Carolina has data from our SHEP Center, which is our health research and service center, that 39% of North Carolina graduates from medical school stayed in the state to practice after graduating. If they did residency, 42% of residents stayed in the state. But if someone had the magical combination of doing both medical school and residency in North Carolina, that percentage increased to 67%. So for us, it was a way of seeing how we could align a pathway, remove barriers to help students meet that mission to a workforce. We also in the state have, we’re actually a pretty rural state once you get outside of the bigger cities and with a large number of our counties that have health profession shortage areas.

And so it was a way for us to build a pathway to help address the maldistribution of care, specifically primary care within the state. And so we started small. We actually started with just one department in the Department of Family Medicine and just with two students initially. Our curriculum had also undergone a similar change to having a shortened preclinical clerkship year. I’ll add a little asterisk. You do not have to have a shortened preclinical clerkship year to make an accelerated pathway work. There are several schools that do it with a two-year preclinical clerkship. It’s tight, they can do it, but ours happened to be shortened as well. And so with that and the buy-in from our residency program, it’s actually the residency program has sort of helped drive this innovation within the school of medicine, that’s when we started. Some features of our program, and you’ll hear this from many of the other programs as well.

We have the summertime between first and second year is an intensive clinical experience for us. For us it’s really important to build the relationship with their future residency of choice. So starting in their first year of medical school, they do once a week, a half day of clinic in their future specialty, initially in family medicine. And I can share how we’ve subsequently grown, but so they get clinical experience a full year earlier than the rest of the traditional cohorts. They get an intensive clinical experience in the summer between their first and second year and then they’re in clinical practice in addition to their core clinical rotations throughout the rest of their third year. And so that’s some of the highlights of our curriculum. But we were really born out of a workforce mission for our accelerated program. Of course we have the added benefits, debt reduction for our students and more individualized pathway and more focus for our students. But the mission was for workforce development.

Joan Cangiarella:

I think you’ll hear a lot of this from the other programs as well. This connection with the department that they are going into. So the establishment of those relationships early on, most of the programs do have this summer experience where that student is within that department and the formation of departmental mentors. So individuals that are in those residencies are going to get these students as residents really make that commitment because they know in three years from now that student’s going to be with them. And building those bridges, not only among the faculty but among the senior residents, I think has also been key piece so that when they transition and you have that transition, which is… we talk so much about the transition to residency and how complicated and challenging it is, this really smooths that transition and I’m sure that Lily can talk more about how she feels among that transition.

Lily Ge:

I am fully in the middle of the transition, finalizing my last year of medical school and in the last coming months before residency starts. Now more than ever I’m feeling that stronger connection between myself and the department and my peers are as well. So like Dr. Cangiarella mentioned from day one, you are connected with so much mentorship and that is mentorship in the form of mentors within the three-year pathway program. We have Dr. Cohen in the school of medicine who is such a godsend in terms of making sure we’re on track with coursework, with Step exams and making sure that all of our board exams are in place, but also just life advice. I think that’s so great that that’s already in place within the three-year pathway. But then from a specialty point of view, you get a department mentor, you also get residency mentors as well.

So there are many residents who have gone through the pathway now that it’s been in existence since 2013. So we have older residents who can walk you through the process of being a medical student within this accelerated pathway. And also you get to know just people in the department. I was pleasantly surprised just how many names I knew even after the first summer. So I did my summer as a part clinical experience and part research experience, and that was really great to get to know more people. And so by the end of those two months, I was on almost a first name basis with everybody. I knew the fellows. And eventually when the fellows graduated, some of them became faculty as well. So even more attendings that you knew, and that just makes you feel so much more comfortable going in as a student and starting projects and asking for more clinical experience. There’s not that sort of barrier that there would be if you came in sort of brand new day one. So now starting intern year, I’m just so excited to now work with those people as a resident. In my mind I’ve started thinking of myself as a resident, thinking of how I’m going to introduce myself to my patients, to my peers. And so that’s been really great as a three-year student.

Toni Gallo:

You’ve all mentioned this connection between the medical school and the residency programs. I’m curious, at the start, was there buy-in from the residency programs both within your institutions if students stayed, but also with outside residency programs? How has that gone? Has it changed over the years?

Joan Cangiarella:

It’s interesting. So I remember when it was introduced to the chairs and Dean Grossman was very adamant about, this was an experiment in medical education and we were going to go through the experiment and see if it worked or see if it failed, but that everyone was going to buy into it. And the suggestion was to allot 10 to 20% of the slots. So bigger programs allotted more slots, smaller didn’t have that many slots to allot into the program. And I think the biggest challenge for the group was we don’t have any information on these students, especially if you took them early on. We eventually changed it so that there was different times to matriculate. So we have an opportunity at the end of the first year and at the end of the second year, so students had a little bit more, but when they took them at matriculation, they only had their really college record to look at.

And I think that until you had several years where they saw what superstars these students wound up being, like Lily said, they did research, they started these projects and they realized, gee, we have them for 6, 7, 8, 9, however many years that residency is. It’s not really cutting it. It’s actually developing them over their entire career. So I think right now we get an ask for students to go into the program. We have had several students go out. So most of our programs participate in the NRMP, which requires the students have the choice. There’s a few programs in our consortium that has exceptions but most don’t. So the students have the choice to do it. And we have successfully had seven students go out and doing just as well, I think some of them for personal reasons, not wanting to stay in New York, moving other places, some going into programs that we didn’t have in the specialty but have been just as successful as if they stayed internally.

Catherine Coe:

And we had the experience of collaborating with UNC affiliated but not necessarily UNC residency programs. So external residency programs. Our medical students have the opportunity to train across six clinical sites across the state, so out in the west in Asheville. Then we have Charlotte, Greensboro, Chapel Hill, Raleigh, and Wilmington. And each of those have GME programs there. And so our students are naturally there for their third year. We actually had those GME programs then approach us to say, hey, this is a way that we can ensure that we are retaining UNC students who we’ve trained in their clinical years, who know the community, who know the milieu. And one of the things I forgot to mention about our program is that we have three years of service after the residency program. So we’re kind of UME, GME, and CME with the hope of having the students stay in those areas to work afterwards. And so we initially started with family medicine just in Chapel Hill at our main site, but we’ve subsequently expanded to about 20 different GME programs across the site and allow our students to have interface with them throughout their medical school and then certainly in their third year core clinical year, they are approximate to those GME programs. So for us, it’s been sort of an organic natural growth and lots of folks asking to be a part of the program because they see it as a way to build their workforce and their pathway of students.

Toni Gallo:

Lily, I am curious about your experience having one fewer year to decide about specialty and where you wanted to do your residency. How did that go as a student in the program? Did you come in knowing what you wanted to do?

Lily Ge:

Yeah, I came in knowing what I wanted to do. I was one of those matriculated students who was accepted into the three-year program. But as Dr. Cangiarella mentioned, many of my peers have come into the pathway in their first year, at the end of their second year. And I think there’s only growing interest with each passing year with students feeling sort of the drive to choose their specialty as early as possible. As was mentioned in the earlier topic about why residency directors might buy in, students also want that buy-in for that longitudinal connection and that longitudinal relationship. So if we’re going to be here for 6, 7, 8 years, that’s also an opportunity for students to have a longitudinal project, a long-term research project or community service project, whatever it may be. You can start that in medical school and continue that into your training, which is one of those most priceless things.

And you don’t have that… the stress or the worry about where you’re going to be in a couple years, you’re very settled, you know exactly what’s going to happen coming down the road, especially as medicine is such a long road, it’s really important to know that. So I think as I was already accepted in my matriculation year, all of my advisors were so, so helpful in making sure that I was sure about the specialty and recommending that I continue to shadow and explore other specialties. And clerkship year was a great time to do that. And my electives have been a great time to do that, and it’s only strengthened my resolve to do ophthalmology. But I also know peers who maybe needed that extra year, needed that extra two years to do that shadowing, do the exploration, do the research projects in different departments. And that’s why I think it’s so great NYU also has a shadowing compilation, a shadowing database that makes it a lot easier for students to find clinical mentors and clinical people to shadow and spend some time with in order to get that experience and make sure that’s what they want to do.

Joan Cangiarella:

Yeah. I just want to echo what Lily is saying. So in 2023, NYU Grossman School of Medicine decided that it would let all of its students graduate in three years, we again underwent a different curriculum revision where our pre clerkship is only one year, our clerkship is a year, and then the student can graduate in three years. If they stay for four, they’re either doing a dual degree or they’re doing a year of research. So we’ve now put all the curriculum content into three years. So regardless of what you do, you’re only getting three years of curriculum content. You are either doing that master’s or the year of research. I think that did require us to revamp the shadowing, which Lily is talking about, and this is where technology comes into play. Marc Triola here is our director of our Institute of Innovations in Medical Education, creating these apps essentially for linking students with mentors that became system wide and now a student… it’s so easy… you go into the app, you see when an attending has a session, you sign up for it. That got shifted really to the first year. So where traditionally clinical experiences, you’re a third year already doing them, now it’s down to the first year so that they have more opportunity. And I think most of the decision making is about having the opportunity to shadow, especially when you don’t really know what that day-to-day specialty is.

Lily Ge:

And what our school’s really done is paired the classroom learning with the on the job learning, which I think is so great, especially first year. I was one of the first members of that first cohort with the one-year accelerated preclinical curriculum. And I know as year’s gone by, they’ve started linking what we’re learning in the classroom. Things like if we’re on our cardiology unit, opening up more cardiology slots for shadowing and allowing students to go from taking lectures in the morning to then shadowing in the afternoon and seeing exactly how that content is applied to your day-to-day and how being a cardiologist might actually look. It may not look exactly as is taught in the lecture, might be more hands-on, might be less. And having that flexibility and that personalization has been really great.

Catherine Coe:

Yeah, we had also navigated students in their specialty choice. When we first started, when we started small, it came in and you had to be pretty certain that you knew what you wanted to do. We had another program that was still mission oriented, caring for rural and underserved areas of our state but allowed for flexibility in specialty choice. For us because the GME programs have that buy-in, it’s important that a student is fairly certain. Now we’re mindful that if they change their mind, that is okay. They can totally change their mind and they can choose a different specialty. But at least to start out, they have to be pretty certain. And as we’ve had our years of experience, we’ve noticed students who would come up to us after their first summer and maybe they shadowed someone or they had a research program and they’re like, gosh, I wish I had known a year ago, now I’ve sort of missed this opportunity to accelerate with the directed pathway.

And similarly, we had other students who were on the accelerated pathway who for one reason or another chose to revert to the traditional curriculum, and then we sort of lost them in terms of keeping them mission focused to rural and underserved care for the state. So our new curriculum in year 11 now is that we’re going to allow for a secondary acceleration point. We’ve expanded the program, it’s got a new acronym, the Community Health Training Program, and we’re going to allow for anyone who’s interested in rural underserved care in the state to join the cohort, they can accelerate year one if they know what they want to do. But everyone gets the same curriculum in the summertime. So they have the LCME required weeks for graduation, and then after that summertime, if they found their life specialty choice, they have a secondary opportunity to accelerate. And then similarly, if someone decelerates or goes back to the four-year program, we still have the ability to give them special didactics, close mentorship, shadowing opportunities, rural experiences, so lots of flexibility while still allowing it to be individualized and mission critical.

Toni Gallo:

A lot of what you’ve just touched on sort of connects to other kind of big changes happening in medical education. So the move to competency-based education, using precision education, the integration of technology and AI. I’m curious how you all think about accelerated programs in the big picture of everything else that’s happening in medical education.

Joan Cangiarella:

I think the biggest challenge for an accelerated program just to get buy-in is “are they competent?” Right? I mean, they’re like, you’re taking a year off of school and are they going to be just as good? And I think that that has been the real role of the consortium. So the Consortium of Accelerated Medical Pathway Programs started in 2015 with a grant from the Josiah Macy Foundation. We had eight schools, and then we just kept growing and growing and growing and growing, and the ability of us to really collaborate together has allowed us to publish on larger cohorts. At NYU Grossman, recently in Academic Medicine, we just published our seven years of graduating students, and that was sort of a seminal paper to prove to the world that look, these students are doing just as well. And I think that’s what the medical education community needed to hear because the concerns about that.

But I think all of those other things that you spoke about, it’s always to enhance competency. So again, with Marc Triola’s wizardry, we are doing a lot of precision education. One neat project is a student is on the ward and the computer scans which patients they see that day. And then that next morning it pulls out of all of our resources, whether it be PubMed or some of the things that we buy, AMBOSS and all these other databases that we have for the students, and sends them information. So whether it says, here’s an activity that you can participate in related to congestive heart failure, here’s a paper that… the seminal paper on the treatment and UpToDate information on that particular disease. So using those kinds of tools to really enhance, because today students are so different. They come with different strengths and different weaknesses. And I think until they see what those are, these are ways that enhance them. So at the end of the day, they come out of medical school with a core set of competencies, a lot of things they learn in residency. So what’s that expectation of that base knowledge that they need to succeed in that next phase of their training?

Catherine Coe:

Yeah, you had mentioned the 20% of medical schools having accelerated curricula. We’ve actually formed a consortium called the Consortium of Accelerated Medical Pathway Programs or CAMPP for short. And the group gets together and kind of shares and thinks and works together for outcomes. And so one of our papers that we have was actually looking at the milestone data for our three-year graduates compared to four-year graduates across the schools. And it looked at the specialties where we have the most graduates right now, and they are equally prepared for residency. So to answer the question, are they prepared? And I think that having an accelerated pathway really pushes you to think about competency and really making sure that these students are graduating. And quite honestly, when we look at the traditional four-year curriculum, I would argue that sometimes we just say they’ve graduated and they’ve kind of met the metrics and they’ve done four years and then they’re done. But is that truly competency? And so we have now integrated milestones into our assessments for our UME learners so that way we can build out evaluation across the continuum and really look at competency from first year of medical school through 6, 7, 8 year of residency training.

Lily Ge:

From the student perspective, I’ve really seen over the last three years just what an embracing we’ve done as a community of different resources and different ways of learning. Like Dr. Cangiarella mentioned, I think NYU really emphasizes the idea of the adult learner and you know best how you learn and giving as many resources as possible for each individual learner to learn has been key. And I’ve seen it firsthand as a preclinical student, as a clerkship student, and now post-clinical and about to be a trainee as a resident. And one of those has been those nudges, those clinical nudges that happen on the wards. You’ll put in a diagnosis and the very next morning you’ll get an email in your inbox with both journal articles about that topic, questions from AMBOSS and videos. And so depending on how you learn best. For me, I love practice questions, so I’ll jump right to the practice questions and review what I know about that topic.

And I think that’s also helped students dive into their interested specialties. If you have an interest in let’s say GI gastroenterology, that helps you appear a lot more confident, knowledgeable on the wards and potentially could put you onto that path if you have a great time on your medicine rotation as well. In addition, I know NYU has really embraced AI as a whole for student learners, and we’ve worked closely with the library on exactly how to look up relevant clinical questions on the wards, and that’s been built into our curriculum. So I think that’s really going to help us as a resident, as a fellow, as an attending in the future, knowing how to use AI tools because that’s not going away. That’s going to stay here. And if you’re able to use it smartly, intelligently, if you’re able to use it quickly and efficiently, that’s only going to help your patient care.

Joan Cangiarella:

Yeah, I think educating students in AI, it’s going to become a part of the core curriculum because like Lily said, it’s not going away. And I think how they use it and how it can help them do certain things, I mean, we’re using it in so many ways already in evaluation assessments, in just the large amount of data that you get from your students or that the students send of faculty, just aggregating it together and making it easier to synthesize and go through rather than trailing through hundreds of pages of comments that sometimes things get lost. So the other thing that Marc is really spearheading is this residency assessment. So taking what students shadowed in and then sending to them like, hey, you looked at cardiology. There’s an opening today in cardiovascular surgery. Would you want to take that slot? And pairing them with sort of the information that we have in our education data warehouse for where their strengths are and saying to them, did you ever think about this?

You have a lot of strengths in that area. Taking all of our data from our students and where they’ve matched so that there’s something you can measure yourself against, which is very hard for a student. I mean, there is published data, right? The AAMC does publish sort of metrics that you look at. This is refining it to students that are in our school. So it gives really even a closer view of you’ve gone to this school, you’ve learned this curriculum, this is how well you’ve done, here’s what students ahead of you have done. And I think, again, helping students, really seeing if they’re a fit for that particular specialty, if they have the criteria and the grades for particular specialties, and just really enhancing that experience.

Lily Ge:

The AAMC also has many resources for students to sort of self evaluate what their strengths and weaknesses are. I know when I was looking at all the different specialties, the AAMC had different surveys you could take to see exactly what your character traits might be or your interests might be, and pairing you with a top list of potential specialties. That’s great. I think self-evaluation is very important, but having all those data points, your evaluations, your OSCEs, your clerkships, all of that I think paints a better picture, a more personalized picture. And using computers, using AI to help with that data sorting is going to be a real game changer in the future.

Toni Gallo:

In a few of the papers that you published, there was this comparison to the 1970s when there were a bunch of accelerated programs, many of which closed. And I’m curious, what do you think is different now that is allowing accelerated programs to really thrive and flourish that maybe is different from the seventies when programs were just not as successful?

Catherine Coe:

Yeah, for sure. This is actually I think the third iteration of accelerated programs. There’s one around World War II as well, and largely both of those were driven by evidence of workforce shortages. So you had the war, you needed to produce physician workforce. In the sixties and seventies, there was a GME report that indicated that there was going to be a physician shortage. Each of those times, things went back to the status quo because they said, okay, there’s no longer actually a physician shortage, so we no longer need to kind of accelerate people through. And many of the faculty, even though the data and outcomes suggested that they were equally prepared, the faculty were like, well, it’s not the four years, so they must not be equally prepared. And what you didn’t have back then that you have now is the significant amount of debt burden for our students.

That’s really a focus of many institutions. So back in World War II, a student could pay for their medical education in a summer internship or a summer job. Now, I don’t think that’s possible. And so it’s a way of getting them in and through faster allows them to have an earlier attending salary as well and decreases the debt burden there. So I think we’re just looking at a different milieu for this to be happening. You’ve got the CBME work, the precision education, and I would argue that workforce and pathways to specific communities and areas are another version of precision education. And certainly leveraging data to ensure that the right students or the students who will flourish in those settings and will be there is important as well.

Joan Cangiarella:

And one thing I’d add is it’s not easy to form these programs. You need to have your leadership supporting this. It is tuition dollars, and depending on your health system and how funds flow to the medical school, for some schools, they really need those tuition dollars. And it’s a hard thing to sell to the leadership. Like we said, you need the buy-in of the program directors and the buy-in of the faculty. So it does require, I think, senior leadership getting involved and saying, we want to do this. I think in revisions of curriculum, sometimes it’s more challenging at some schools than others. Again, with motivation behind the reasons for why you are cutting content and looking at that content really thoroughly to make sure that you are training the students in the content that they do need to excel.

Toni Gallo:

So we’re just about at the end of our time. I want to give everybody a chance if you have any final thoughts or if there are any other unique features about accelerated programs generally or each of your programs that you want to talk about. I know Catherine, one of the things I liked reading about was the sort of sense of community that you foster with all of your students, connecting them through to practice too. I thought that was something special. So I’ll give each of you a chance if there’s anything else that you want to talk about or leave listeners with. We’ll go around. Lily, you want to go first?

Lily Ge:

Sure. Being a three-year medical student has been the only way I’ve known medical school, but it is something that I would not change for a second. I have loved every moment of it. I’ve loved the people I’ve met along the way. I love the friends I’ve made in the program. I know you’d mentioned building that sense of community. And with our three-year students, because we know we’re all going to be here for the next 6, 7, 8 years, we’ve really formed a really tight bond. And those connections are something that I keep really close to my heart, but I also keep close all of the academic and professional experiences that this has allowed me to have. Being on this podcast, speaking with you all and getting those research opportunities and forming those closer professional relationships with my specialty have been things that I know that I wouldn’t have been able to without this program.

And I am immensely grateful. I can only recommend it more and more to my friends because I think it is something that if you are relatively certain about the pathway you want going forward, there seemed to be only upsides in my student perspective. The more students that join it, the more schools that join it, the more this rising interest is. And I think that you had mentioned why did it fail in the 1970s and why is it back now? I think because a lot of things are just accelerating, the amount of information we need to know has increased. But similarly, our ways of learning and retaining that information have grown to meet that demand. And we’ve sort of let go of that status quo. People are more willing to embrace innovation, more willing to embrace creative ways to approach the “traditional” medical pathway. And I think us students in the three-year program in the accelerated pathway are evidence of that. So thank you for having me, Toni.

Toni Gallo:

Thank you for joining. Joan?

Joan Cangiarella:

Yeah, I guess what I would say is evidence with Lily right here, these students are phenomenal. I think what we want to get out to the residency programs and across the world that these students have excelled and they’ve done just as well as the traditional four-year student, you are going to see them in your residency programs. Right now we have almost a thousand graduates. It doesn’t sound like a lot, but over time, these programs keep getting bigger and bigger and more schools. So you’ll ultimately come across a student that went to a three-year program. It’s very interesting. I’ve gotten calls from people to say, I didn’t even know they were a three-year student, which is exactly what I want to hear. And I’ve gotten calls from faculty who’ve done the three-year programs in the seventies and eighties who’ve said to me, I’ve read your article and I think it’s phenomenal. And I did this back in the seventies and eighties, and I’ve had a really successful career. So just looking forward to seeing more of these students and more programs join within the consortium.

Catherine Coe:

And I’ll just add, I’ll echo everything that’s already been said and add. When we look at the stress and the experience for medical students right now, so much of the curriculum or what they do is driven by that transition from UME to GME, those getting a match and a slot. And what these pathways do is we foster that transition from UME to GME, and we allow the students to focus on what it is they’re in medical school for, to become a doctor who is patient-centered and competent to care for the community. Because at the end of the day, it is our service to the community that we deliver doctors who are well prepared for it. And so our students report and our faculty say that it really allows them, even when they… like family medicine… when they’re on surgery, they are able to focus on the principles that will support them as a family medicine doctor in the future. And so it really changes the lens by which they’re going through medical school with their outcomes at the forefront. So I think it’s also about an intentional design with the outcomes in mind and building the pathway through there.

Toni Gallo:

Well, I want to thank you all so much for being on the podcast today for a great conversation. And I want to remind our listeners that a number of papers that Joan and Catherine have written are in Academic Medicine, and I’ll put all of the links in the show notes for this episode so you can go read more about outcomes or about different features of other programs and about the consortium. So thanks very much everyone.

Catherine Coe:

Thank you. Thank you for your time.

Toni Gallo:

From Academic Medicine’s website, you can also access the latest articles and our archive dating back to 1926, as well as additional content including article collections. Subscribe to Academic Medicine through the subscription services link under the Journal Info tab, or visit shop.lww.com and enter Academic Medicine in the search bar. Follow us and interact with the journal staff on LinkedIn at Academic Medicine Journal. Subscribe to this podcast anywhere podcasts are available. Be sure to leave us a rating and a review when you do let us know how we’re doing. Thanks so much for listening.