In the middle of his time in medical school, Dr. Jacob Wolf learned there was a way he could stay near his wife in Charleston, complete medical school early and guarantee a residency in the field he knew he wanted, all for less money.
The Medical University of South Carolina student would have to skip some of the typical steps medical students take. But he would graduate with the same degree, as a licensed doctor.
"A lot of factors really lined up well for me when this opportunity presented itself," he said.
He was the first medical student at MUSC who had the chance to enroll in the accelerated program, which will open to more students this year. Still, it will never be intended for the majority of students. It might be right for some, however. More of these kinds of degrees appear to be popping up around the state for health professionals as schools work to reduce their students' debt and increase the ranks of caregivers.
Amid rising student debt and a growing need for more nurses and doctors, the state's schools are aiming to train health professionals faster. MUSC is now one of only a dozen or so schools in the country offering a three-year medical degree. Wolf is its only graduate so far.
Shortening the time these young professionals spend in school is not a new idea. Medical schools began waiving the fourth year back in the 1970s, according to a 2017 report from the Association of American Medical Colleges. Then, as now, there was a shortage of physicians.
At the peak of the three-year medical degree's popularity, about a quarter of schools in the country were offering it.
But the number of programs waned as government funding shrank, and the shortage of doctors became less of a concern. The faculty who guided students through the more demanding accelerated programs were also unhappy with the course, according to a 1979 editorial in the Journal of Medical Education. Worse, a survey showed hospital program directors had "a definite bias against three-year program graduates when compared with graduates of four-year programs."
Yet students were shown to perform just as well in the three-year degree as they did in the traditional track.
Today, the shortage of health care providers — especially front-line primary care doctors and nurses — is again of huge concern. Central to talks about how to address this problem is the issue of student debt. Linda Lacey, director of the Office for Healthcare Workforce, said schools have taken on increasing the number of physicians and nurses as something of a social mission.
"If you are concerned about having enough primary care physicians, one of the things that get in the way of that is the debt load," she said.
Graduate nursing students, for instance, will usually have between $40,000 and $54,999 in student loan debt by the time they finish their schooling, according to the American Association of Colleges of Nursing. Medical students owe much more. Attendees of public medical schools graduating in 2017 owed on average $181,000.
MUSC's tuition is low compared with national numbers. The school charges on average a little less than $35,000 per year in tuition to in-state medical students, not including fees. The Association of American Medical Colleges' median cost of both tuition and fees for public schools was about $37,000 in 2017.
Dr. Donna Kern, senior associate dean for medical education, said MUSC worked hard to make itself the least expensive medical school in the state. They will only enroll students in the accelerated program if their grades are excellent and they show they are absolutely sure they plan to follow through on the commitment.
The program works like this: Students who enroll in the three-year degree need to commit to a residency specialty early on, such as orthopedics or pediatrics. They will then secure a spot at one of 13 residency programs at MUSC. That cuts out the need to interview for residency programs across the country during their last year, a huge time and money drain for four-year medical students.
The students can opt out any time before the national match program deadline and choose to switch back to the traditional track. Students will begin enrolling in the coming year, during their second year of the medical program. The three-year students will only take breaks from school in December.
“There are some students who would find this to be really not helpful for their personal wellness," Kern said. "Other students would find this to be invigorating. We have different types of students."
To that point, many of the students who choose the shorter program will be people coming to medical school from another career. They might be older and more sure of their path, Kern said. But the underlying reason behind all the work Kern put into perfecting the accelerated track comes down to the mountains of student debt young physicians are dealing with, and cut down on time spent in school for students who are sure of their career path.
When it comes to the field of nursing, experts are wringing their hands more over expected shortages. South Carolina will have the fourth-worst shortage of nurses in the country by 2030, The Post and Courier reported. Decreasing nursing students' debt load may give them one more reason to choose nursing as a career.
That's why the University of South Carolina hopes to introduce an accelerated program for nursing, too. It will launch next year.
The track would allow students with a bachelor's degree in another field to earn master's level credentials in nursing from USC.
"We are trying to find a more seamless way for nurses to progress to higher levels of education," said Jeannette Andrews, dean of the USC College of Nursing.
Andrews said the program is designed with the school's hospital partners in mind. Students will be trained to work at the bedside, but with a myriad of other useful skills. The curriculum is still going through approval processes, the dean said.
USC would be offering up about 32 of these new kinds of graduates, she said, important because the workforce needs nurses of all kinds of backgrounds and levels of education right now.
"This will be one of several innovations that you’ll see from us," she said.