By NextBestFitShorter training: combined undergrad/medical programs
Six-year programs straight from high school, as in most countries.
Draft decision:RejectedConfidence: low · not yet reviewed
Large accreditation change; lower priority.
To review: Could revisit later.
Review ledgerHow this path connects
This path
Shorter training: combined undergrad/medical programs
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Accredit six-year combined programs
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Medical education debt shapes specialty choice
Programs beginning directly after high school reduce tuition by shortening training and allow physicians to start practicing earlier.
- Physician shortage, especially in primary care
Shorter programs beginning after high school allow physicians to start practicing earlier.
What it creates or worsens
- Depends on uncertain evidence or judgments
Programs starting after high school require less mature students to choose their careers earlier.
- Faces political, industry, or legal opposition
Shorter medical programs beginning after high school require changes to accreditation.
Who's affected
Who gains
- Health profession students and trainees
- Medical education debt shapes specialty choice: High debt and low residency pay push graduates toward high-paying specialties.
- Residents of areas with too few health professionals
- Medical education debt shapes specialty choice: Debt-driven specialty choices reduce primary care and rural practice availability.
- Physician shortage, especially in primary care: Physician shortages leave them waiting for appointments.
- Doctors, nurses, and other clinicians
- Physician shortage, especially in primary care: Physician shortages contribute to burnout.
Who loses
- Health financing intermediaries and lenders
- Medical education debt shapes specialty choice: Lenders benefit from medical education borrowing.
- Specialist clinicians and practices
- Medical education debt shapes specialty choice: High-paying specialties benefit from limited competition.
- Physician shortage, especially in primary care: Scarcity supports incumbent specialists’ pay.
Where it has been tried
- UK, Europe: Medical school directly after secondary school.
- New York, United States: A 2024 NYU study found three-year medical graduates averaged 84% on preclerkship exams, compared with 83% for four-year graduates.Sources: NYU Langone Health (2024)