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Milestone Attainment of Accelerated 3-Year MD Graduates Compared to Nonaccelerated Graduates in Family Medicine
Allison Macerollo1, Sally A Santen2, Yoon Soo Park3
1Department of Family and Community Medicine, The Ohio State University College of Medicine, Columbus, OH, United States.
Background And Objectives:
Accelerated 3-year programs (A3YPs) for an MD degree offer a condensed medical education pathway to residency, often with directed pathways in primary care. Many programs aim to address workforce shortages and decrease debt. As these programs expand, assessing whether A3YP graduates are as prepared for residency as their peers from traditional 4 year programs is critical. This study evaluates milestone attainment of A3YP postgraduates in Year 1 (PGY-1s) compared to non-A3YP PGY-1s within family medicine residency programs.
Methods:
We analyzed the Accreditation Council for Graduate Medical Education milestone ratings for family medicine PGY-1s from 2021 to 2023. The study included 109 A3YP graduates across 51 family medicine programs and 1,638 non-A3YP PGY-1s (MD, DO, international medical graduate) in those same programs. PGY-1s were compared across milestone competency domains using mixed-effects regression that accounted for clustering by program and subcompetency.
Results:
At midyear, A3YP PGY-1s scored significantly higher in medical knowledge, systems-based practice, and practice-based learning and improvement. Differences were statistically significant but modest. Coefficients ranged from 0.05 for patient care and medical knowledge to 0.10 for practice-based learning and improvement (PBLI; P<0.01). At end-year, A3YP PGY-1s maintained slightly higher scores in medical knowledge, professionalism, PBLI, and communication (coefficients ranged from 0.07 to 0.10; P<0.01).
Conclusions:
A3YP graduates demonstrate equal or minimally higher milestone attainment compared to non-A3YP peers during PGY-1, supporting the viability of accelerated pathways. These findings reassure residency programs of A3YP readiness and highlight their potential to address workforce shortages and reduce student debt without compromising educational outcomes.