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April 19, 1976

It Takes Four Years

JAMA. 1976;235(16):1689. doi:10.1001/jama.1976.03260420015014

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To the Editor.—  This letter is prompted by the article entitled "It Takes Four Years" (234:387, 1975).The author has correctly identified many problems inherent in the threeyear curriculum. The benefits are even fewer than he suggests. He states: "The three-year curriculum serves to increase the number of graduates by only one class each 12 years." It does not even do that. It only increases the number of physicians that the school produces by one class during the year that the fouryear to three-year transition is made, and two classes are graduated simultaneously. Thereafter, unless the class size is increased, there is no difference in the number of physicians produced. A significant strain is inevitably placed on clinical facilities during the year of double graduation. If at any time in the future a change is made back to a four-year curriculum, the entire gain is lost. A medical school that