N.Y.U. and Others Offer Shorter Courses Through Medical School

But now one of the nation’s premier medical schools, New York University, and a few others around the United States are challenging that equation by offering a small percentage of students the chance to finish early, in three years instead of the traditional four.

Administrators at N.Y.U. say they can make the change without compromising quality, by eliminating redundancies in their science curriculum, getting students into clinical training more quickly and adding some extra class time in the summer.

Not only, they say, will those doctors be able to hang out their shingles to practice earlier, but they will save a quarter of the cost of medical school — $49,560 a year in tuition and fees at N.Y.U., and even more when room, board, books, supplies and other expenses are added in.

“We’re confident that our three-year students are going to get the same depth and core knowledge, that we’re not going to turn it into a trade school,” said Dr. Steven Abramson, vice dean for education, faculty and academic affairs at N.Y.U. School of Medicine.

At this point, the effort involves a small number of students at three medical schools: about 16 incoming students at N.Y.U., or about 10 percent of next year’s entering class; 9 at Texas Tech Health Science Center School of Medicine; and even fewer, for now, at Mercer University School of Medicine’s campus in Savannah, Ga. A similar trial at Louisiana State University has been delayed because of budget constraints.

But Dr. Steven Berk, the dean at Texas Tech, said that 10 or 15 other schools across the country had expressed interest in what his university was doing, and the deans of all three schools say that if the approach works, they will extend the option to larger numbers of students.

“You’re going to see this kind of three-year pathway become very prominent across the country,” Dr. Abramson predicted.

The deans say that getting students out the door more quickly will accomplish several goals. By speeding up the production of physicians, they say, it could eventually dampen a looming doctor shortage, although the number of doctors would not increase unless the schools admitted more students in the future.

The three-year program would also curtail student debt, which now averages $150,000 by graduation, and by doing so, persuade more students to go into shortage areas like pediatrics and internal medicine, rather than more lucrative specialties like dermatology.

The idea was supported by Dr. Ezekiel J. Emanuel, a former health adviser to President Obama, and a colleague, Victor R. Fuchs. In an editorial in the Journal of the American Medical Association in March, they said there was “substantial waste” in the nation’s medical education. “Years of training have been added without evidence that they enhance clinical skills or the quality of care,” they wrote. They suggested that the 14 years of college, medical school, residency and fellowship that it now takes to train a subspecialty physician could be reduced by 30 percent, to 10 years.

That opinion, however, is not universally held. Other experts say that a three-year medical program would deprive students of the time they need to delve deeply into their subjects, to consolidate their learning and to reach the level of maturity they need to begin practicing, while adding even more pressure to a stressful academic environment.

“The downside is that you are really tired,” said Dr. Dan Hunt, co-secretary of the Liaison Committee on Medical Education, the accrediting agency for medical schools in the United States and Canada. But because accreditation standards do not dictate the fine points of curriculum, the committee has approved N.Y.U.’s proposal, which exceeds by five weeks its requirement that schools provide at least 130 weeks of medical education.

The medical school is going ahead with its three-year program despite the damage from Hurricane Sandy, which forced NYU Langone Medical Center to evacuate more than 300 patients at the height of the storm and temporarily shut down three of its four main teaching hospitals.

Dr. Abramson of N.Y.U. said that postgraduate training, which typically includes three years in a hospital residency, and often fellowships after that, made it unnecessary to try to cram everything into the medical school years. Students in the three-year program will have to take eight weeks of class before entering medical school, and stay in the top half of their class academically. Those who do not meet the standards will revert to the four-year program.

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Nets 95, 76ers 92: Nets Make Big Early Lead Hold Up Against 76ers

Shortly before the game, the Nets (14-12) announced that Keith Bogans would be starting in Humphries’s place, with Gerald Wallace sliding over to power forward. The change made sense against a small Philadelphia lineup. After the game, Coach Avery Johnson said it was not a one-time change as the Nets look to switch things up after losing 3 consecutive games and 8 of the last 10 games before Sunday’s win.

Johnson said the change had nothing to do with Humphries’s performance.

“He’s healthy, he’s fine, he’s not in the doghouse,” Johnson said. “We just had to try something else.”

The Nets looked stronger on offense and defense with their adjusted lineup, outshooting the 76ers and committing so few fouls they sent Philadelphia to the line for just 10 free throws.

Wallace, who has experience as a power forward from his time in Charlotte, looked comfortable against Philadelphia’s big players and had a complete game with 14 points, 9 rebounds and a team-leading 6 assists.

The lineup move did not seem to surprise Wallace, who pointed out that the Nets were not the only team in the N.B.A. to switch to a lineup without the traditional positions.

“You look at the teams like Miami and New York, they’re playing small ball,” Wallace said. “It’s giving them more opportunity to get into an up-tempo style play and push the ball.”

Wallace was the first Nets player this season to finish a game with more assists than Deron Williams, who said the change added a dimension to the team as it tried to incorporate some new plays.

“We can get out and run a little more and pose some matchup problems for people,” Williams said. Referring to Wallace, he added, “He’s such a great passer, that to have him at the 4 spot on a lot of our sets makes us more versatile.”

The move was not just about Wallace and Humphries, however, as Bogans, starting for the eighth time, had a season-high 13 points and went 3 for 4 from 3-point range. He also played strong defense against a 76ers team that is known for outside shooting.

“Keith is a great defender, and he makes his money hitting those corner 3s,” Williams said. “When he’s hitting those, it opens a lot of things up for us.”

Many of the players showed enthusiasm for the lineup change, but a subdued Humphries seemed unsure how to proceed, especially because the lineup change resulted in him not entering the game at all.

“I’m obviously frustrated, but it’s about more than just one player,” said Humphries, who signed a two-year, $24 million contract extension during the off-season.

“He wasn’t thrilled,” Johnson said. “I explained to him what I saw on the court. He’s been here with me since Day 1. I really respect him and I really do like him.”

The game started out poorly for the Nets, who were behind by 12-4 when Johnson called a timeout in the first quarter. The team proceeded to go on an 18-0 run that was largely responsible for the win, as the game had only two tie scores and two lead changes.

Joe Johnson led the Nets with 22 points and is now averaging 20.6 over his last seven games, having established himself as the team’s go-to player on offense.

“In the third quarter, he made like eight shots,” Evan Turner said of Johnson. “He also made three tough shots. But that is Joe. He makes tough shots when they need him, and that is it.”

The victory put the Nets two games ahead of the 76ers for second place in the Atlantic Division leading into a Christmas matchup against Boston. Those three teams have stayed bunched together without gathering any real momentum to challenge the Knicks for the division lead.

After the Nets’ hot start to the season, being only two games above .500 may seem disappointing, but Avery Johnson said his team should never have been considered a real contender until it had some sustained success.

“We’ve struggled sometimes when we’ve been talked into thinking that we’re the favorites just because we’ve had this big change,” he said before the game. “The way you become a favorite is you’ve got to be really consistent and you’ve got to really play well. That’s what the N.B.A. and other teams respect, consistency.”

The game got uncomfortably close for the Nets in the fourth quarter, when the 76ers hit a few timely 3-pointers as Williams and Johnson missed some free throws. But Williams sank two from the line with 7.6 seconds left, opening the lead to 4 points and putting the game out of reach.

“Right now, in our situation, we’ll take a win any way we can get it,” Avery Johnson said.

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