Acad Med. 2024 Nov 1;99(11):1267-1277. doi: 10.1097/ACM.0000000000005855. Epub 2024 Aug 23.
Accelerated 3-year programs (A3YPs) at medical schools were developed to address student debt and mitigate workforce shortage issues. This study investigated whether medical school length (3 vs 4 years) was associated with early residency performance. The primary research question was as follows: Are the Accreditation Council for Graduate Medical Education Milestones (MS) attained by A3YP graduates comparable to graduates of traditional 4-year programs (T4YPs) at 6 and 12 months into internship?
The MS data from students entering U.S. medical schools in 2021 and 2022 from the 6 largest specialties were used: emergency medicine, family medicine, internal medicine, general surgery, psychiatry, and pediatrics. Three-year and 4-year graduates were matched for analysis (2,899 matched learners: 182 in A3YPs and 2,717 in T4YPs). The study used a noninferiority study design to examine data trends between the study cohort (A3YP) and control cohort (T4YP). To account for medical school and residency program effects, the authors used cross-classified random-effects regression to account for clustering and estimate group differences.
The mean Harmonized MS ratings for the midyear and end-year reporting periods showed no significant differences between the A3YP and T4YP groups (mean [SE] cross-classified coefficient = 0.01 [0.02], P = .77). Mean MS ratings across internal medicine MS for the midyear and end-year reporting periods showed no significant differences between the A3YP and T4YP groups (mean [SE] cross-classified coefficient = -0.03 [0.03], P = .31). Similarly, for family medicine, there were no statistically significant differences between the A3YP and T4YP groups (mean [SE] cross-classified coefficient = 0.01 [0.02], P = .96).
For the specialties studied, there were no significant differences in MS performance between 3-year and 4-year graduates at 6 and 12 months into internship. These results support comparable efficacy of A3YPs in preparing medical students for residency.
医学院开设加速三年制（A3YP）课程是为了应对学生债务问题并缓解劳动力短缺问题。本研究旨在探讨医学学制（3 年与 4 年）是否与早期住院医师表现相关。主要研究问题如下：在实习 6 个月和 12 个月时，A3YP 毕业生是否达到了研究生医学教育认证委员会（ACGME）里程碑（MS）的要求，与传统 4 年制（T4YP）毕业生的表现相当？
本研究使用了来自美国 2021 年和 2022 年最大的 6 个专业（急诊医学、家庭医学、内科、普通外科、精神病学和儿科学）的学生 MS 数据。对 3 年制和 4 年制毕业生进行了匹配分析（2899 名匹配学习者：A3YP 毕业生 182 人，T4YP 毕业生 2717 人）。本研究采用非劣效性研究设计，考察了研究队列（A3YP）与对照队列（T4YP）之间的数据趋势。为了考虑医学院和住院医师项目的影响，作者采用交叉分类随机效应回归来考虑聚类并估计组间差异。
在中期和期末报告期，A3YP 和 T4YP 组之间的平均协调 MS 评分没有显著差异（交叉分类系数的均值[SE]为 0.01[0.02]，P =.77）。在中期和期末报告期内，内科 MS 的平均 MS 评分在 A3YP 和 T4YP 组之间也没有显著差异（交叉分类系数的均值[SE]为-0.03[0.03]，P =.31）。同样，在家庭医学方面，A3YP 和 T4YP 组之间也没有统计学上的显著差异（交叉分类系数的均值[SE]为 0.01[0.02]，P =.96）。
在所研究的专业中，在实习 6 个月和 12 个月时，3 年制和 4 年制毕业生的 MS 表现没有显著差异。这些结果支持 A3YP 在为医学生准备住院医师培训方面具有相当的疗效。
