California Experiments With Fast-Tracking Medical School

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Some doctors in the state of California will soon be able to practice after three years of medical school instead of the traditional four. The American Medical Association is providing seed money for the effort in the form of a $1 million, five-year grant to the University of California at Davis.

Student Ngabo Nzigira is in his sixth week of medical school and he's already interacting with patients during training with a doctor at Kaiser Permanente in Sacramento.

In a traditional med school, Nzigira wouldn't be in a clinic until his third year. In this accelerated course, students can shave up to $60,000 off the cost of their medical education. But Nzigira had hesitations.

"I thought, 'Oh man, you want me to put the intensity and stress that is medical school in four years, you want me to condense it down to three years. I'm not sure about that,' " Nzigira says. But after learning more, he became convinced it was a good path for him.

The curriculum cuts out summer vacations, electives and the residency search. It's designed to get primary care physicians into the field faster, says Dr. Tonya Fancher, director of the program, called Accelerated Competency-based Education in Primary Care.

"There's a huge problem, a huge shortage of primary care physicians," Fancher says.

But medical schools aren't producing enough primary care doctors. Students may start med school saying they want to be internists or family practice doctors, but then end up choosing specialties that deliver higher salaries and shorter hours.

"Students come into medical school and they're passionate about patients, passionate about primary care, and then that wanes over time," Fancher says. "Part of it is the debt that they accrue, and part of it is the models of primary care that they're exposed to."

The new UC Davis curriculum is designed to make the choice to study family medicine a lasting one.

And California is not alone in this effort. Texas, Georgia and New York also have three-year medical schools. And both the AMA and the Association of American Medical Colleges support these initiatives as part of the redesign of medical education. The physician groups want students to advance based on their competency, not a set time frame.

That can be done without compromising quality of care, according to an article in JAMA, the journal of the American Medical Association.

Outside the Sacramento health center where Nzigira and other students are getting their first experiences in clinical practice, people were not troubled by the idea of a faster track through medical school. Angela Woodard says even doctors with four years of training may have trouble treating patients.

"There's already consequences on quality of care. So them going to school for a shorter time is not going to make it any worse," Woodard said.

Patient Joe King isn't too concerned either, "as long as they maintain the same criteria of standards that primary care doctors have to meet."

UC Davis' medical students are guaranteed a residency, a final training step that takes three years after medical school for primary care doctors, including pediatricians.

This story is part of a reporting partnership between NPR, Capital Public Radio and Kaiser Health News.

Copyright 2014 Capital Public Radio. To see more, visit http://www.capradio.org.

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