Incorporating the fourth year of medical school into an internal medicine residency: Effect of an accelerated program on performance outcomes and career choice

Background: To counter declining student interest in general internal medicine, New York Medical College and Saint Vincent's Catholic Medical Centers of New York implemented an experimental accelerated internal medicine curriculum that was provisionally approved by the American Board of Internal Medicine. Description: This accelerated program allowed selected 4th-year medical students to obtain credit for their 1st year of an internal medicine residency while completing requirements for the MD degree. Evaluation: Career and performance outcomes for trainees in the accelerated and traditional internal medicine residency programs were compared for 6 classes of graduates. There were no statistically significant differences between the 2 groups in mean scores on the Intern Clinical Evaluation Exercise, standardized in-service exam, monthly attending evaluations, or in Board pass rates. However, graduates of the accelerated program were more likely to be in general internal medicine practice on completion of residency. Conclusions: The accelerated program successfully increased the number of trainees entering generalist practice a year earlier, and maintained academic standards.