A progressive three-phase innovation to medical education in the United States

Med Educ Online. 2018 Dec;23(1):1427988. doi: 10.1080/10872981.2018.1427988.


The practice of medicine has changed greatly over the past 100 years, yet the structure of undergraduate medical education has evolved very little. Many schools have modified their curricula to incorporate problem-based learning and organ systems-based curricula, but few schools have adequately addressed rising tuition costs. Undergraduate medical education has become cost-prohibitive for students interested in primary care. In the meanwhile, the concept of a separate dedicated intern year is outdated and mired in waste despite remaining a requirement for several hospital-based and surgical specialties. Described here is an innovative approach to medical education which reduces tuition costs and maximizes efficiency, based on principals already employed by several schools. This integrated curriculum, first suggested by the author in 2010, keeps the current USMLE system in place, exposes medical students to patient care earlier, expands and incorporates the 'intern' year into a four-year medical training program, provides more time for students to decide on a specialty, and allows residency programs to acquire fully-licensed practitioners with greater clinical experience than the status quo.

Abbreviations: MCAT: Medical college admission test; USMLE: US medical licensing examination.

Keywords: Accelerated medical curriculum; educational innovation; undergraduate medical education.

MeSH terms

  • Career Choice
  • Clinical Clerkship / organization & administration*
  • College Admission Test
  • Curriculum
  • Education, Medical, Undergraduate / economics
  • Education, Medical, Undergraduate / organization & administration*
  • Efficiency, Organizational*
  • Humans
  • Problem-Based Learning
  • United States

Grant support

No financial support was provided for this study.