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3-Year Medical Degrees for PCPs? | Medical Blog

100584149More medical schools are turning to a 3-year solution to hedge against the looming primary care physician (PCP) shortage, offering an accelerated program and major savings to future primary care doctors.

The American Association of Medical College Center for Workforce Studies estimates the country will need 45,000 more PCPs and 46,000 more surgeons and medical specialists within the next decade.

A recent post by our guest blogger, Skeptical Scalpel, questions the benefit of a fourth year in medical school entirely in a related blog, Law School Revamps Final Year, Will Med Schools Follow?

One of the roadblocks to careers in primary care is a skyrocketing medical education debt, followed by inferior pay.

Georgia’s Mercer University School of Medicine launched an accredited 3-year accelerated program for students committed to family medicine in hopes of addressing these deterrents. Mercer, Lake Erie College of Osteopathic Medicine (LECOM) and Texas Tech all used similar strategies to consolidate their curricula, cutting most of the fourth year rotations. Supporters of the 3-year program also propose teaching core science courses during undergraduate years.

Robert Pallay, residency director and chair of family medicine at Mercer notes the financial rewards of a condense schedule. He says students “pay one year less of tuition, which saves $40,000 to $50,000,” he says. “They get out a year earlier, so rather than making $50,000 as a resident, they [may] end up earning $200,000-plus as a regular doctor.”

Gaining traction, the 3-year primary care programs are also being planned for East Tennessee, Indian, University of Wisconsin, East Carolina, and Kentucky.

Arguments against it? There are plenty. Some opponents to the idea argue that medicine is more complicated than it has ever been, which requires increased knowledge and experience. Professionally, some feel a 3-year program could put students at a disadvantage when competing in the residency match because programs “not directly linked with three-year medical schools may not consider three-year students equally prepared and experienced, potentially putting the student at a competitive disadvantage in the match with those from four-year schools.”

Our nation needs more doctors—especially PCPs. Is this a solution?

  • R, G. Lacsamana, M.D. says:

    Abbreviating the curriculum for the sake of redicing the debt of medical students is unwise. They will be half-baked students who will be no better than the PAs or ARNPs.

    As noted, there is too much to learn in Medicine to think that
    we can manufacture a lot of them to become primary care physicians. There are better solutions than this, including reducing the current disparities in the payment systemt that favor the specialists. A shortage in PCPs ought not to be an excuse to produce doctors of inferior quality.

  • Rene A. Puig says:

    I guess is a good idea in order to fill out the needs. To those who argue against it, I have one simple question:

    Why nobody ever thought about this when PA programs were
    only 18 months, and those who graduated even under medical su-
    pervision were taking care of patients, prescribing & also taking ca-
    re of the emergencies? Wasn’t that worse? 18 months versus 8
    years for medical school, does that sound right.
    Again there are thousands of doctors in this country without a licen-
    se to practice, but who are being into medicine in their own country
    for 20 or more years. What are you going to teach them about how
    to practice medicine? No chance to practice here in the US just be-
    cause for different reasons as I commented before they haven’t got
    the opportunities that others get?
    Give those doctors a provisional license just to practice as a PCP
    no specialty allowed, and you will have your shortage cut in more
    than 1/2 and will help tremendously the hispanic population.

  • Nicki Tarant says:

    Let’s not downgrade our medical education. Might as well just hire more PAs or NPs. As it is 4 years alone is not enough. One needs at least another year of internship. SO unless you are going to add another year of internship, then lets not be equivalent to PAs and NPs.

  • Debbie says:

    Absolutely! Physicians can come here from foreign medical schools which don’t require a four year undergraduate degree, and they get into excellent residencies and land great jobs. American students are burdened with much more debt and more years of premed classes. How about a six year medical school that begins right out of high school ?

  • TC says:

    How much more incompetent physicians are they going to put out there? How many more lives will have to suffer/loss unnecessarily? I see incompetent docs(ER, PCP, GP, IM, even some surgeons) everyday! Not to mention that we are already liable for the scary PAs & NPs, Politicians (lawyers, Obama alike) had wanted to replace properly trained (quality) physicians with PAs & NPs for a long time. I am afraid to imagine what medicine will be like when the medical profession are filled with “majority” pseudo-physicians. Wrong diagnosis & treatments will prevail as the best, pseudo-science and pseudo-medicine will become the norm. A few years ago, some PA programs (from universities well-known for training primary cares) have changed from 2 years to 4 years program. Another unseemingly related news: Whooping cough outbreak tied to Parents Shunning Vaccines. The underlying cause for the phenomena is not medical, but education failure of that generations of parents, which is due to the failure of the education system. All that can be traced to leadership failure of politicians, who ignore the importance of basic math & science education for many many years. This is just one of the many faces/surfaces showing the underlying broken leadership and system failure. My point is there are far-reaching consequence in physicians education and training, especially if many more are increasingly incompetent.

    Well, of course, I could be wrong, since PCP trainings are different from PAs. I have no doubt that some very talented students could do that. But keep in mind that America’s basic science & math education had significantly eroded. Bill Gate is held as the prime example that one does not even need to go to college, but how many are as capable as him? Wouldn’t it be the American Dream that one day, one can be a physician without going through medical school? When that day come, I will be the tour-guide for all my patients, joining medical tourism.

  • Efren T, MD says:

    To encourage more people to go into primary care, how about
    the state subsidizing the student’s pre-med and med education
    in exchange for the latter to practice in that state for at least
    eight years?

  • Bad idea,I think there is too much to learn, my degree is from the Indian Board of Alternative Medicines and I spent over 50 years in the medical research field and never have been able to obtain a license in the USA. I think if the hospitals licensed PCP they could learn more and there would be better care overall. As long as the government licenses physicians there we be inferior PCP and higher healthcare cost overall.

  • Jeff Oronoco says:

    To everybody scoffing at the idea with the argument of “there is too much to learn” and “we need quality doctors”, please reflect back to how much bang for his/her buck the average medical student gets in the fourth year as they fly all over the country, interview, take rotations of their choosing with the goal of figuring out which specialty they want to work in. Yes, some students take the year and learn a lot, but many consider it to be their “de-stressing” year if they are already set on primary care. Not to mention the 3 months of summer off after the first year. If somebody knew from the start that they wanted to go into primary care, were willing to take fulltime classes during their first summer (this is how these programs work – its 3 years without any breaks), and were fine taking out part of the fourth year to condense it to 3, they would NOT be losing much quality, and it would be at MORE than a 30% cost savings when you figure they’d be working as a doc one year earlier.

    In your dream world where we have all the resources in the world to train people in an inefficient, costly 4th year, you fail to realize that healthcare costs in this country are dragging the entire country down. We no longer have any choice… we have to cut out ALL inefficiencies in the process. In my opinion, the 3 years + residency is sufficient for the role we need them in. To everybody saying “they’d be nothing more than PAs,” don’t forget the biggest difference between docs and PAs is the residency, and docs will still have this. PAs average 28-30 months of full time training (9 to 5pm for PA school vs med school’s 9 to 2pm), so the baseline education of PAs is nothing to scoff at. But again, the residency really condenses a ton of learning into a short time, so the docs will still be ahead of PA grads… no need to worry… you can still consider yourself superior to all of your “assistants”.

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