Duke's 3rd year: a 35-year retrospective

Our purpose was to review and evaluate Duke University School of Medicine's 3rd year.

Duke University School of Medicine instituted a dramatic change in its curriculum 35 years ago by restructuring the 1st, 2nd, and 4th years of medical school so that the entire 3rd year could be devoted to an elective research experience or independent study of the basic sciences. Today this "new curriculum" permits students to work in basic science laboratories or with clinical investigators, work toward a 2nd degree, and participate in basic science courses beyond the core curriculum. Students were surveyed in 1996 and 1998 about their 3rd-year experience. Results showed that 67% and 73%, respectively, believed the 3rd year was very helpful in facilitating their understanding and appreciation of biomedical and clinical research. Students especially valued the experience and availability of their preceptors and the range of opportunities available during the 3rd year. The most frequent critiques by students were the lack of opportunities to pursue clinical interests, difficulty integrating the 3rd year into the remainder of the curriculum, and a tendency to place too much emphasis on coupling the 3rd-year experience with scholarships and residency plans rather than on a specific investigative interest.

Overall, both faculty and students value the 3rd year as a unique positive experience. Duke faculty have noted, however, that no other medical schools have attempted to replicate the Duke experience.