Cut Med School by One Year

While we're at it, let's let undergraduates with a lot of Advanced Placement credit from high school apply to medical school their third year rather than their fourth.

From the New York Times opinion section:

Make Medical School Three Years

Nov. 10, 2025

By Ezekiel J. Emanuel, Emily K. Kim, and Vitor B. de Souza

The authors are medical experts at the University of Pennsylvania.

This is one of the better ideas I’ve seen bioethicist Ezekiel Emanuel promote, unlike some of his others, such as that nobody over 75 has a good reason to live.

Ezekiel is one of the three Emanuel brothers who show up in my blog now and then. Rahm Emanuel was mayor of Chicago and Hollywood super-agent Ari Emanuel was the inspiration for the character Ari Gold played by Jeremy Piven on Entourage.

… In 2025, the median cost of attending four years of medical school was $297,745 for public schools and over $400,000 for private ones.

… The smartest, fastest and most pragmatic solution is simple: shorten medical school to three years.

The structure of medical education hasn’t fundamentally changed for 115 years. In 1910, the medical education reformer Abraham Flexner helped turn a chaotic landscape of short-term proprietary schools, famous for producing so-called snake-oil salesmen, into today’s standardized, eight-year pipeline: four years of college followed by four years of medical school. At that time, this model made sense. Now it doesn’t.

Today’s students enter medical school with much more extensive preparation in molecular biology, biochemistry, neuroscience and other STEM fields than their early 20th-century predecessors. Consequently, the traditional two years of classroom study in subjects like anatomy and microbiology have largely been condensed to about 15 months, leaving nearly three years for hands-on hospital training.

The hands-on part is of course important. Interestingly, changing medical training away from overwhelmingly classroom lectures to more apprenticeship (e.g., doing rounds trailing behind a senior doctor at a teaching hospital) was a major step forward in American medical education at Johns Hopkins in the late 19th Century.

But, according to these authors, the fourth year of medical school is kind of a waste before interning starts:

The final year of medical school has become a loosely structured period spent applying for residency, taking elective courses, visiting hospitals in other cities or volunteering abroad — all while still paying full tuition. In effect, it is a costly gap year. …

Accelerated programs are hardly new. For the past 60 years, Duke has collected tuition for four years, but the actual medical training only comprises three. There is an intermediary year — that students pay tuition for — dedicated to mandatory research. The University of California, Los Angeles recently adopted a similar structure. New York University’s Grossman School of Medicine piloted a three-year program in 2013 and, across seven classes of graduates, found no compromises in quality and better performance on internal medicine internship milestones. In 2023, N.Y.U. transitioned all students to a three-year curriculum, allowing students the option to add a fourth year for additional degrees or research. …

Is this reasonable?

Paywall here.