In 2013, NYU Grossman School of Medicine decided that when it comes to teaching and training its medical students, less is more. Launching a radical reform to its curriculum, the school began offering select students a pathway to graduate in three years instead of the traditional four. The accelerated three-year MD pathway was designed not only to reduce the burden of educational debt—currently estimated at $250,000 by graduation—but also to give students a head start on their apprenticeships as residents, training that can extend for up to eight years beyond medical school.

“Our three-year students meet all the same milestones and requirements as four-year students at other schools do,” explains Steven Abramson, MD, the Frederick H. King Professor of Internal Medicine at NYU Grossman School of Medicine, chair of the Department of Medicine, and executive vice president and vice dean for education, faculty, and academic affairs, chief academic officer. “And because these students have identified their specialties early on, they’re able to do residency interviews in their third year.”

The accelerated program was originally limited to select students who had already settled on their intended specialty. Leaders at NYU Grossman School of Medicine have since recognized that all students can benefit from this revised approach. As of 2023, every student now graduates in three years or elects to stay for an optional fourth year to pursue research or one of several dual degrees that combine an MD with a master’s degree.

Given the compressed schedule, some residency directors may question whether graduates of a three-year program are as well prepared for the mettle-testing intensity of residency training as their four-year counterparts. However, years of research, including a new study by NYU Grossman School of Medicine researchers, should help put these concerns to rest.

The study, published online October 15 in the journal Academic Medicine, evaluated 136 three-year graduates and 681 four-year graduates of NYU Grossman School of Medicine through medical school and early residency. Across virtually all major measures on tests of skill and knowledge, the school’s accelerated graduates performed as well as or better than their four-year peers. For example, the three-year students scored an average of 84 percent on their preclerkship exams, designed to evaluate their grasp of anatomy, cell biology, biochemistry, and other topics, while their four-year counterparts had a mean score of 83 percent. The two groups also achieved similar marks on medical knowledge exams and on tests of critical thinking and communication skills.

“Our findings suggest that accelerated curricula offer an efficient, cost-effective way to prepare medical students for the next stage of training, without compromising quality,” says study senior author Joan F. Cangiarella, MD, the Elaine Langone Professor of Pathology and senior associate dean for education, faculty, and academic affairs, who serves as director of the three-year MD pathway program.

The success of NYU Grossman School of Medicine’s accelerated program has inspired other medical schools to follow its lead. The school leads a consortium of medical schools, funded by the Josiah Macy Jr. Foundation, that have adopted a three-year curriculum to share best practices and lessons learned. The group, chaired by Dr. Cangiarella, now includes more than 30 medical schools with a three-year program nationwide. In a future study, the researchers plan to expand their investigation to include graduates of other three-year programs.

Melvin G. Rosenfeld, PhD, senior associate dean for medical education, sums up the case for the expansion of programs that enable physicians to begin practicing a year earlier. “How do our three-year students compare to four-year students in residency programs?” he asks. “Extensive data show virtually no difference. They become chief residents at the same rate, they go on to great fellowships, and they become fine doctors.”

How NYU Grossman School of Medicine Made 3 > 4

NYU Grossman School of Medicine has been able to trim the educational span by one year without compromising quality by recognizing that its students have different styles of learning, and by developing a curriculum that’s tailored to meet their individual needs and preferences.

“We’ve moved away from the model that says all students require the fourth year of medical school, replacing it with an emphasis on the continuum of learning from undergraduate to graduate medical education,” explains study co-author Steven Abramson, MD, chair of the Department of Medicine and executive vice president and vice dean for education, faculty, and academic affairs, chief academic officer.

The school’s approach to individualized learning, called Precision Education, leverages the power of advanced technologies and artificial intelligence to provide time-saving tools and resources. Analytics take into account each student’s unique background, experiences, and aptitude, making possible a fully integrated course of study.

In the clinical realm, algorithms draw upon de-identified patient data to help students hone their diagnostic and decision-making skills. A custom-designed navigator app enables students to shadow faculty members in any medical specialty. Beyond this, students benefit from continuous mentoring by a faculty member within their own chosen specialty.

Marc M. Triola, MD, associate dean for educational informatics and director of the Institute for Innovations in Medical Education, explains the benefit of this approach. “Precision Education factors in the complex mechanisms underlying each student’s goals and needs in a way that can help improve learner outcomes and, by extension, patient outcomes,” says Dr. Triola.

Testimonials from Our Three-Year MD Graduates

“Prior to my medical training, I had a strong career in research—a PhD from the Scripps Research Institute and postdoctoral training at Memorial Sloan Kettering Cancer Center. At NYU Grossman School of Medicine, I excelled in my clinical training and identified mentors who supported me along the way. So when I applied for residency in my second year, I was a very attractive candidate, not just for residency but beyond.”

—Cory Rillahan, MD, PhD, class of 2019, a third-year fellow in pediatric oncology at Boston Children’s Hospital/Dana Farber Cancer Institute

“I feel just as well prepared as my fellow residents. The transition to residency is challenging, but I don’t think another year of medical school would have made a difference. At a certain point, you need to start practicing with some independence, which is what residency is about. Most people don’t know I graduated in three years, and they’re surprised when I tell them.”

—Taariq Mohammed, MD, class of 2019, a second-year fellow in vitreoretinal surgery at the University of Iowa, and previously chief resident in ophthalmology at the University of Baltimore