Six-Year Wonders

How young can a doctor be? Ira Weiss, M.D., 23, is roughly two years younger than the next youngest physician at Boston's famed Massachusetts General Hospital. It doesn't bother Weiss that all his fellow interns have two more calendar years of medical school behind them. "I feel I'm among peers," he says matter-of-factly. So, apparently, do many of the almost 70 other young M.D.s who graduated this year from three U.S. medical campuses that have reduced the normal medical curriculum by two years.

The standard academic path for an aspiring M.D. is four years of premedical schooling in an undergraduate college, then four years in medical school proper. By the time he graduates, he is already 25, with one year of internship still before him and an adequate income even more remote. Considering this heavy investment in both time and tuition costs, bright young high school students are increasingly attracted to the mushrooming physical sciences. There they can expect to get a higher degree in six or seven years and make good money in industry by the age of 25.

Pacing the Brightest. Worried by this trend, Johns Hopkins University launched a new program in 1959, under which about 24 students selected annually spend two years in college, then five years of medical courses. Later, Northwestern University, Boston University and Albany Medical College began similar accelerated programs that vary somewhat in content but run just six years until internship. And, in 1963, Philadelphia's Jefferson Medical College began a program that runs only five years.

During World War II, several medical schools adopted a similar timetable to turn out six-year or even 5 1/2-year wonders. The big difference now, however, is that the new accelerated courses have no "crash" concept behind them. What they have done is lop off many of the nonscientific aspects of a professional education. Most of the courses utilize the summer months, provide about the same training as normal medical-school programs. "These programs are designed to let the bright young man go at his own pace," says Dr. Shevis Smyth of the Association of American Medical Colleges, "to give him the best medical education as fast as he can absorb it." Still, a good deal of time in the first two years is left open for such nonmedical studies as language, sociology, music and philosophy. Even in the final med-school years, accelerated students at Northwestern attend seminars on "Four Plays of Shakespeare" and "Communications Theory."

Concepts v. Cramming. The accelerated programs offer high school seniors another important incentive. Pre-med students normally have no assurance that they will be accepted as medical students at the end of their four undergraduate years. They sweat for grades, or sometimes opt for easy courses, in order not to get low science marks on their academic records. But both the Northwestern and Boston University accelerated programs contain built-in guarantees of admission to med school, provided that the student does not simply flunk out. The result is that the speed-up students can choose courses that suit their interests rather than their records. Says Ira Weiss: "We were able to put more stress on conceptual thinking and ideas than on cramming facts by rote." The accelerated program has meant a cut in total tuition costs of up to $4,500 for many students; it has also brought about a much better utilization of classrooms, laboratories and other teaching facilities.

As far as training goes, the accelerated doctors seem to do well. Young Ira Weiss led his entire class at Northwestern. And, in his class's National Medical Board examinations, 83% of the accelerated students scored 83 or better, as against 38% of the regular medical students. "We were worried that the students would have tunnel vision," says Franklin Ebaugh Jr., dean of the Boson U. School of Medicine. "But they haven't proved to be any different. They are very alert."

The accelerators themselves are self-confident, but not absolutely sure that they haven't missed something along the way. Some feel that they are pointed more toward research than bedside medicine. Many mourn having missed the varied extracurricular life of Joe College. Other students, as well as many of the program's administrators, feel that the special plan is only for those students who are absolutely sure that they want to be doctors. "But how you get absolutely sure, I don't know," says Dr. Paul Allen, 23, a Boston U. graduate. "I know I missed a lot. I wouldn't recommend the program to anyone who isn't willing to give up six years." At B.U., in fact, the dropout rate has hit 38%, though at Northwestern it is only 10%-15%.

Despite such misgivings, the fact is that these students have gained two years of productive professional life. And as Dr. John Cooper of Northwestern says, "It's important to get the students out of school and into the hospitals, where they can do some good before they have their first coronary."

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