Academic Medicine

<!DOCTYPE html> <html dir="ltr" lang="en-US"> <head> <script type='text/javascript' data-ot-ignore>const otAllowScripts = ['/init.js']; new MutationObserver(function (d) { Array.prototype.forEach.call(d, function (g) { Array.prototype.forEach.call(g.addedNodes, function (e) { try { if ('script' === e.tagName?.toLowerCase() && otAllowScripts.some(s => e.src?.includes(s))) { e.setAttribute('data-ot-ignore', ''); } } catch (err) { console.error(err); } }) }) }).observe(document.documentElement, { childList: !0, subtree: !0, attributes: !0, attributeFilter: ['src'] });</script>  <script type="text/javascript" src="https://cdn.cookielaw.org/consent/7537629c-faa0-40ce-a837-f7b14c0d4e70/OtAutoBlock.js"></script> <script src="https://cdn.cookielaw.org/scripttemplates/otSDKStub.js" type="text/javascript" charset="UTF-8" data-domain-script="7537629c-faa0-40ce-a837-f7b14c0d4e70"></script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/lww-cookiepro.js?v=05.24.00.023"> </script> <title> Academic Medicine </title>   <script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.setAttributeNode(d.createAttribute('data-ot-ignore'));j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-NLR6H6W');</script>  <meta name="GENERATOR" content="Microsoft SharePoint" /><meta http-equiv="Content-type" content="text/html; charset=utf-8" /><meta http-equiv="X-UA-Compatible" content="IE=edge" /><script type="text/javascript">window.NREUM||(NREUM={});NREUM.info = {"beacon":"bam.nr-data.net","errorBeacon":"bam.nr-data.net","licenseKey":"NRJS-310e337bbb542715b7f","applicationID":"1029107228","transactionName":"ZgdWMRZUVkVSBUBbCl9NdTY0GllVUgJRXwxSD1EBDVZRWFZJa1EERQNYCgNGF1tSFUBXF0EDUwBLR11FQwlaQQxHB0QEA1BUV0oJQUZLUBFEHQ==","queueTime":1,"applicationTime":121,"agent":"","atts":""}</script><script type="text/javascript">(window.NREUM||(NREUM={})).init={privacy:{cookies_enabled:true},ajax:{deny_list:["bam.nr-data.net"]},distributed_tracing:{enabled:true}};(window.NREUM||(NREUM={})).loader_config={agentID:"1103305545",accountID:"2792772",trustKey:"1191223",xpid:"VgEOU1FUChABVFNbBgEAVFYJ",licenseKey:"NRJS-310e337bbb542715b7f",applicationID:"1029107228"};;/*! For license information please see nr-loader-spa-1.282.0.min.js.LICENSE.txt */ (()=>{var e,t,r={8122:(e,t,r)=>{"use strict";r.d(t,{a:()=>i});var n=r(944);function i(e,t){try{if(!e||"object"!=typeof e)return(0,n.R)(3);if(!t||"object"!=typeof t)return(0,n.R)(4);const r=Object.create(Object.getPrototypeOf(t),Object.getOwnPropertyDescriptors(t)),o=0===Object.keys(r).length?e:r;for(let a in o)if(void 0!==e[a])try{if(null===e[a]){r[a]=null;continue}Array.isArray(e[a])&&Array.isArray(t[a])?r[a]=Array.from(new Set([...e[a],...t[a]])):"object"==typeof e[a]&&"object"==typeof t[a]?r[a]=i(e[a],t[a]):r[a]=e[a]}catch(e){(0,n.R)(1,e)}return r}catch(e){(0,n.R)(2,e)}}},2555:(e,t,r)=>{"use strict";r.d(t,{Vp:()=>c,fn:()=>s,x1:()=>u});var n=r(384),i=r(8122);const o={beacon:n.NT.beacon,errorBeacon:n.NT.errorBeacon,licenseKey:void 0,applicationID:void 0,sa:void 0,queueTime:void 0,applicationTime:void 0,ttGuid:void 0,user:void 0,account:void 0,product:void 0,extra:void 0,jsAttributes:{},userAttributes:void 0,atts:void 0,transactionName:void 0,tNamePlain:void 0},a={};function s(e){try{const t=c(e);return!!t.licenseKey&&!!t.errorBeacon&&!!t.applicationID}catch(e){return!1}}function c(e){if(!e)throw new Error("All info objects require an agent identifier!");if(!a[e])throw new Error("Info for ".concat(e," was never set"));return a[e]}function u(e,t){if(!e)throw new Error("All info objects require an agent identifier!");a[e]=(0,i.a)(t,o);const r=(0,n.nY)(e);r&&(r.info=a[e])}},9417:(e,t,r)=>{"use strict";r.d(t,{D0:()=>p,gD:()=>m,xN:()=>g});var n=r(3333),i=r(993);const o=e=>{if(!e||"string"!=typeof e)return!1;try{document.createDocumentFragment().querySelector(e)}catch{return!1}return!0};var a=r(2614),s=r(944),c=r(384),u=r(8122);const d="[data-nr-mask]",l=()=>{const e={feature_flags:[],experimental:{marks:!1,measures:!1,resources:!1},mask_selector:"*",block_selector:"[data-nr-block]",mask_input_options:{color:!1,date:!1,"datetime-local":!1,email:!1,month:!1,number:!1,range:!1,search:!1,tel:!1,text:!1,time:!1,url:!1,week:!1,textarea:!1,select:!1,password:!0}};return{ajax:{deny_list:void 0,block_internal:!0,enabled:!0,autoStart:!0},distributed_tracing:{enabled:void 0,exclude_newrelic_header:void 0,cors_use_newrelic_header:void 0,cors_use_tracecontext_headers:void 0,allowed_origins:void 0},get feature_flags(){return e.feature_flags},set feature_flags(t){e.feature_flags=t},generic_events:{enabled:!0,autoStart:!0},harvest:{interval:30},jserrors:{enabled:!0,autoStart:!0},logging:{enabled:!0,autoStart:!0,level:i.p_.INFO},metrics:{enabled:!0,autoStart:!0},obfuscate:void 0,page_action:{enabled:!0},page_view_event:{enabled:!0,autoStart:!0},page_view_timing:{enabled:!0,autoStart:!0},performance:{get capture_marks(){return e.feature_flags.includes(n.$v.MARKS)||e.experimental.marks},set capture_marks(t){e.experimental.marks=t},get capture_measures(){return e.feature_flags.includes(n.$v.MEASURES)||e.experimental.measures},set capture_measures(t){e.experimental.measures=t},capture_detail:!0,resources:{get enabled(){return e.feature_flags.includes(n.$v.RESOURCES)||e.experimental.resources},set enabled(t){e.experimental.resources=t},asset_types:[],first_party_domains:[],ignore_newrelic:!0}},privacy:{cookies_enabled:!0},proxy:{assets:void 0,beacon:void 0},session:{expiresMs:a.wk,inactiveMs:a.BB},session_replay:{autoStart:!0,enabled:!1,preload:!1,sampling_rate:10,error_sampling_rate:100,collect_fonts:!1,inline_images:!1,fix_stylesheets:!0,mask_all_inputs:!0,get mask_text_selector(){return e.mask_selector},set mask_text_selector(t){o(t)?e.mask_selector="".concat(t,",").concat(d):""===t||null===t?e.mask_selector=d:(0,s.R)(5,t)},get block_class(){return"nr-block"},get ignore_class(){return"nr-ignore"},get mask_text_class(){return"nr-mask"},get block_selector(){return e.block_selector},set block_selector(t){o(t)?e.block_selector+=",".concat(t):""!==t&&(0,s.R)(6,t)},get mask_input_options(){return e.mask_input_options},set mask_input_options(t){t&&"object"==typeof t?e.mask_input_options={...t,password:!0}:(0,s.R)(7,t)}},session_trace:{enabled:!0,autoStart:!0},soft_navigations:{enabled:!0,autoStart:!0},spa:{enabled:!0,autoStart:!0},ssl:void 0,user_actions:{enabled:!0,elementAttributes:["id","className","tagName","type"]}}},f={},h="All configuration objects require an agent identifier!";function p(e){if(!e)throw new Error(h);if(!f[e])throw new Error("Configuration for ".concat(e," was never set"));return f[e]}function g(e,t){if(!e)throw new Error(h);f[e]=(0,u.a)(t,l());const r=(0,c.nY)(e);r&&(r.init=f[e])}function m(e,t){if(!e)throw new Error(h);var r=p(e);if(r){for(var n=t.split("."),i=0;i<n.length-1;i++)if("object"!=typeof(r=r[n[i]]))return;r=r[n[n.length-1]]}return r}},5603:(e,t,r)=>{"use strict";r.d(t,{a:()=>c,o:()=>s});var n=r(384),i=r(8122);const o={accountID:void 0,trustKey:void 0,agentID:void 0,licenseKey:void 0,applicationID:void 0,xpid:void 0},a={};function s(e){if(!e)throw new Error("All loader-config objects require an agent identifier!");if(!a[e])throw new Error("LoaderConfig for ".concat(e," was never set"));return a[e]}function c(e,t){if(!e)throw new Error("All loader-config objects require an agent identifier!");a[e]=(0,i.a)(t,o);const r=(0,n.nY)(e);r&&(r.loader_config=a[e])}},3371:(e,t,r)=>{"use strict";r.d(t,{V:()=>f,f:()=>l});var n=r(8122),i=r(384),o=r(6154),a=r(9324);let s=0;const c={buildEnv:a.F3,distMethod:a.Xs,version:a.xv,originTime:o.WN},u={customTransaction:void 0,disabled:!1,isolatedBacklog:!1,loaderType:void 0,maxBytes:3e4,onerror:void 0,ptid:void 0,releaseIds:{},appMetadata:{},session:void 0,denyList:void 0,timeKeeper:void 0,obfuscator:void 0,harvester:void 0},d={};function l(e){if(!e)throw new Error("All runtime objects require an agent identifier!");if(!d[e])throw new Error("Runtime for ".concat(e," was never set"));return d[e]}function f(e,t){if(!e)throw new Error("All runtime objects require an agent identifier!");d[e]={...(0,n.a)(t,u),...c},Object.hasOwnProperty.call(d[e],"harvestCount")||Object.defineProperty(d[e],"harvestCount",{get:()=>++s});const r=(0,i.nY)(e);r&&(r.runtime=d[e])}},9324:(e,t,r)=>{"use strict";r.d(t,{F3:()=>i,Xs:()=>o,Yq:()=>a,xv:()=>n});const n="1.282.0",i="PROD",o="CDN",a="^2.0.0-alpha.17"},6154:(e,t,r)=>{"use strict";r.d(t,{A4:()=>s,OF:()=>d,RI:()=>i,WN:()=>h,bv:()=>o,gm:()=>a,lR:()=>f,m:()=>u,mw:()=>c,sb:()=>l});var n=r(1863);const i="undefined"!=typeof window&&!!window.document,o="undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self.navigator instanceof WorkerNavigator||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis.navigator instanceof WorkerNavigator),a=i?window:"undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis),s="complete"===a?.document?.readyState,c=Boolean("hidden"===a?.document?.visibilityState),u=""+a?.location,d=/iPad|iPhone|iPod/.test(a.navigator?.userAgent),l=d&&"undefined"==typeof SharedWorker,f=(()=>{const e=a.navigator?.userAgent?.match(/Firefox[/\s](\d+\.\d+)/);return Array.isArray(e)&&e.length>=2?+e[1]:0})(),h=Date.now()-(0,n.t)()},7295:(e,t,r)=>{"use strict";r.d(t,{Xv:()=>a,gX:()=>i,iW:()=>o});var n=[];function i(e){if(!e||o(e))return!1;if(0===n.length)return!0;for(var t=0;t<n.length;t++){var r=n[t];if("*"===r.hostname)return!1;if(s(r.hostname,e.hostname)&&c(r.pathname,e.pathname))return!1}return!0}function o(e){return void 0===e.hostname}function a(e){if(n=[],e&&e.length)for(var t=0;t<e.length;t++){let r=e[t];if(!r)continue;0===r.indexOf("http://")?r=r.substring(7):0===r.indexOf("https://")&&(r=r.substring(8));const i=r.indexOf("/");let o,a;i>0?(o=r.substring(0,i),a=r.substring(i)):(o=r,a="");let[s]=o.split(":");n.push({hostname:s,pathname:a})}}function s(e,t){return!(e.length>t.length)&&t.indexOf(e)===t.length-e.length}function c(e,t){return 0===e.indexOf("/")&&(e=e.substring(1)),0===t.indexOf("/")&&(t=t.substring(1)),""===e||e===t}},1687:(e,t,r)=>{"use strict";r.d(t,{Ak:()=>c,Ze:()=>l,x3:()=>u});var n=r(7836),i=r(3606),o=r(860),a=r(2646);const s={};function c(e,t){const r={staged:!1,priority:o.P3[t]||0};d(e),s[e].get(t)||s[e].set(t,r)}function u(e,t){e&&s[e]&&(s[e].get(t)&&s[e].delete(t),h(e,t,!1),s[e].size&&f(e))}function d(e){if(!e)throw new Error("agentIdentifier required");s[e]||(s[e]=new Map)}function l(e="",t="feature",r=!1){if(d(e),!e||!s[e].get(t)||r)return h(e,t);s[e].get(t).staged=!0,f(e)}function f(e){const t=Array.from(s[e]);t.every((([e,t])=>t.staged))&&(t.sort(((e,t)=>e[1].priority-t[1].priority)),t.forEach((([t])=>{s[e].delete(t),h(e,t)})))}function h(e,t,r=!0){const o=e?n.ee.get(e):n.ee,s=i.i.handlers;if(!o.aborted&&o.backlog&&s){if(r){const e=o.backlog[t],r=s[t];if(r){for(let t=0;e&&t<e.length;++t)p(e[t],r);Object.entries(r).forEach((([e,t])=>{Object.values(t||{}).forEach((t=>{t[0]?.on&&t[0]?.context()instanceof a.y&&t[0].on(e,t[1])}))}))}}o.isolatedBacklog||delete s[t],o.backlog[t]=null,o.emit("drain-"+t,[])}}function p(e,t){var r=e[1];Object.values(t[r]||{}).forEach((t=>{var r=e[0];if(t[0]===r){var n=t[1],i=e[3],o=e[2];n.apply(i,o)}}))}},7836:(e,t,r)=>{"use strict";r.d(t,{P:()=>c,ee:()=>u});var n=r(384),i=r(8990),o=r(3371),a=r(2646),s=r(5607);const c="nr@context:".concat(s.W),u=function e(t,r){var n={},s={},d={},l=!1;try{l=16===r.length&&(0,o.f)(r).isolatedBacklog}catch(e){}var f={on:p,addEventListener:p,removeEventListener:function(e,t){var r=n[e];if(!r)return;for(var i=0;i<r.length;i++)r[i]===t&&r.splice(i,1)},emit:function(e,r,n,i,o){!1!==o&&(o=!0);if(u.aborted&&!i)return;t&&o&&t.emit(e,r,n);for(var a=h(n),c=g(e),d=c.length,l=0;l<d;l++)c[l].apply(a,r);var p=v()[s[e]];p&&p.push([f,e,r,a]);return a},get:m,listeners:g,context:h,buffer:function(e,t){const r=v();if(t=t||"feature",f.aborted)return;Object.entries(e||{}).forEach((([e,n])=>{s[n]=t,t in r||(r[t]=[])}))},abort:function(){f._aborted=!0,Object.keys(f.backlog).forEach((e=>{delete f.backlog[e]}))},isBuffering:function(e){return!!v()[s[e]]},debugId:r,backlog:l?{}:t&&"object"==typeof t.backlog?t.backlog:{},isolatedBacklog:l};return Object.defineProperty(f,"aborted",{get:()=>{let e=f._aborted||!1;return e||(t&&(e=t.aborted),e)}}),f;function h(e){return e&&e instanceof a.y?e:e?(0,i.I)(e,c,(()=>new a.y(c))):new a.y(c)}function p(e,t){n[e]=g(e).concat(t)}function g(e){return n[e]||[]}function m(t){return d[t]=d[t]||e(f,t)}function v(){return f.backlog}}(void 0,"globalEE"),d=(0,n.Zm)();d.ee||(d.ee=u)},2646:(e,t,r)=>{"use strict";r.d(t,{y:()=>n});class n{constructor(e){this.contextId=e}}},9908:(e,t,r)=>{"use strict";r.d(t,{d:()=>n,p:()=>i});var n=r(7836).ee.get("handle");function i(e,t,r,i,o){o?(o.buffer([e],i),o.emit(e,t,r)):(n.buffer([e],i),n.emit(e,t,r))}},3606:(e,t,r)=>{"use strict";r.d(t,{i:()=>o});var n=r(9908);o.on=a;var i=o.handlers={};function o(e,t,r,o){a(o||n.d,i,e,t,r)}function a(e,t,r,i,o){o||(o="feature"),e||(e=n.d);var a=t[o]=t[o]||{};(a[r]=a[r]||[]).push([e,i])}},3878:(e,t,r)=>{"use strict";function n(e,t){return{capture:e,passive:!1,signal:t}}function i(e,t,r=!1,i){window.addEventListener(e,t,n(r,i))}function o(e,t,r=!1,i){document.addEventListener(e,t,n(r,i))}r.d(t,{DD:()=>o,jT:()=>n,sp:()=>i})},5607:(e,t,r)=>{"use strict";r.d(t,{W:()=>n});const n=(0,r(9566).bz)()},9566:(e,t,r)=>{"use strict";r.d(t,{LA:()=>s,ZF:()=>c,bz:()=>a,el:()=>u});var n=r(6154);const i="xxxxxxxx-xxxx-4xxx-yxxx-xxxxxxxxxxxx";function o(e,t){return e?15&e[t]:16*Math.random()|0}function a(){const e=n.gm?.crypto||n.gm?.msCrypto;let t,r=0;return e&&e.getRandomValues&&(t=e.getRandomValues(new Uint8Array(30))),i.split("").map((e=>"x"===e?o(t,r++).toString(16):"y"===e?(3&o()|8).toString(16):e)).join("")}function s(e){const t=n.gm?.crypto||n.gm?.msCrypto;let r,i=0;t&&t.getRandomValues&&(r=t.getRandomValues(new Uint8Array(e)));const a=[];for(var s=0;s<e;s++)a.push(o(r,i++).toString(16));return a.join("")}function c(){return s(16)}function u(){return s(32)}},2614:(e,t,r)=>{"use strict";r.d(t,{BB:()=>a,H3:()=>n,g:()=>u,iL:()=>c,tS:()=>s,uh:()=>i,wk:()=>o});const n="NRBA",i="SESSION",o=144e5,a=18e5,s={STARTED:"session-started",PAUSE:"session-pause",RESET:"session-reset",RESUME:"session-resume",UPDATE:"session-update"},c={SAME_TAB:"same-tab",CROSS_TAB:"cross-tab"},u={OFF:0,FULL:1,ERROR:2}},1863:(e,t,r)=>{"use strict";function n(){return Math.floor(performance.now())}r.d(t,{t:()=>n})},7485:(e,t,r)=>{"use strict";r.d(t,{D:()=>i});var n=r(6154);function i(e){if(0===(e||"").indexOf("data:"))return{protocol:"data"};try{const t=new URL(e,location.href),r={port:t.port,hostname:t.hostname,pathname:t.pathname,search:t.search,protocol:t.protocol.slice(0,t.protocol.indexOf(":")),sameOrigin:t.protocol===n.gm?.location?.protocol&&t.host===n.gm?.location?.host};return r.port&&""!==r.port||("http:"===t.protocol&&(r.port="80"),"https:"===t.protocol&&(r.port="443")),r.pathname&&""!==r.pathname?r.pathname.startsWith("/")||(r.pathname="/".concat(r.pathname)):r.pathname="/",r}catch(e){return{}}}},944:(e,t,r)=>{"use strict";function n(e,t){"function"==typeof console.debug&&console.debug("New Relic Warning: https://github.com/newrelic/newrelic-browser-agent/blob/main/docs/warning-codes.md#".concat(e),t)}r.d(t,{R:()=>n})},5475:(e,t,r)=>{"use strict";r.d(t,{Q:()=>i});var n=r(3304);function i(e){if("string"==typeof e&&e.length)return e.length;if("object"==typeof e){if("undefined"!=typeof ArrayBuffer&&e instanceof ArrayBuffer&&e.byteLength)return e.byteLength;if("undefined"!=typeof Blob&&e instanceof Blob&&e.size)return e.size;if(!("undefined"!=typeof FormData&&e instanceof FormData))try{return(0,n.A)(e).length}catch(e){return}}}},5284:(e,t,r)=>{"use strict";r.d(t,{t:()=>c,B:()=>s});var n=r(7836),i=r(6154);const o="newrelic";const a=new Set,s={};function c(e,t){const r=n.ee.get(t);s[t]??={},e&&"object"==typeof e&&(a.has(t)||(r.emit("rumresp",[e]),s[t]=e,a.add(t),function(e={}){try{i.gm.dispatchEvent(new CustomEvent(o,{detail:e}))}catch(e){}}({loaded:!0})))}},8990:(e,t,r)=>{"use strict";r.d(t,{I:()=>i});var n=Object.prototype.hasOwnProperty;function i(e,t,r){if(n.call(e,t))return e[t];var i=r();if(Object.defineProperty&&Object.keys)try{return Object.defineProperty(e,t,{value:i,writable:!0,enumerable:!1}),i}catch(e){}return e[t]=i,i}},6389:(e,t,r)=>{"use strict";function n(e,t=500,r={}){const n=r?.leading||!1;let i;return(...r)=>{n&&void 0===i&&(e.apply(this,r),i=setTimeout((()=>{i=clearTimeout(i)}),t)),n||(clearTimeout(i),i=setTimeout((()=>{e.apply(this,r)}),t))}}function i(e){let t=!1;return(...r)=>{t||(t=!0,e.apply(this,r))}}r.d(t,{J:()=>i,s:()=>n})},3304:(e,t,r)=>{"use strict";r.d(t,{A:()=>o});var n=r(7836);const i=()=>{const e=new WeakSet;return(t,r)=>{if("object"==typeof r&&null!==r){if(e.has(r))return;e.add(r)}return r}};function o(e){try{return JSON.stringify(e,i())??""}catch(e){try{n.ee.emit("internal-error",[e])}catch(e){}return""}}},5289:(e,t,r)=>{"use strict";r.d(t,{GG:()=>o,We:()=>i,sB:()=>a});var n=r(3878);function i(){return"undefined"==typeof document||"complete"===document.readyState}function o(e,t){if(i())return e();(0,n.sp)("load",e,t)}function a(e){if(i())return e();(0,n.DD)("DOMContentLoaded",e)}},384:(e,t,r)=>{"use strict";r.d(t,{NT:()=>o,US:()=>d,Zm:()=>a,bQ:()=>c,dV:()=>s,nY:()=>u,pV:()=>l});var n=r(6154),i=r(1863);const o={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net"};function a(){return n.gm.NREUM||(n.gm.NREUM={}),void 0===n.gm.newrelic&&(n.gm.newrelic=n.gm.NREUM),n.gm.NREUM}function s(){let e=a();return e.o||(e.o={ST:n.gm.setTimeout,SI:n.gm.setImmediate,CT:n.gm.clearTimeout,XHR:n.gm.XMLHttpRequest,REQ:n.gm.Request,EV:n.gm.Event,PR:n.gm.Promise,MO:n.gm.MutationObserver,FETCH:n.gm.fetch,WS:n.gm.WebSocket}),e}function c(e,t){let r=a();r.initializedAgents??={},t.initializedAt={ms:(0,i.t)(),date:new Date},r.initializedAgents[e]=t}function u(e){let t=a();return t.initializedAgents?.[e]}function d(e,t){a()[e]=t}function l(){return function(){let e=a();const t=e.info||{};e.info={beacon:o.beacon,errorBeacon:o.errorBeacon,...t}}(),function(){let e=a();const t=e.init||{};e.init={...t}}(),s(),function(){let e=a();const t=e.loader_config||{};e.loader_config={...t}}(),a()}},2843:(e,t,r)=>{"use strict";r.d(t,{u:()=>i});var n=r(3878);function i(e,t=!1,r,i){(0,n.DD)("visibilitychange",(function(){if(t)return void("hidden"===document.visibilityState&&e());e(document.visibilityState)}),r,i)}},8139:(e,t,r)=>{"use strict";r.d(t,{u:()=>f});var n=r(7836),i=r(3434),o=r(8990),a=r(6154);const s={},c=a.gm.XMLHttpRequest,u="addEventListener",d="removeEventListener",l="nr@wrapped:".concat(n.P);function f(e){var t=function(e){return(e||n.ee).get("events")}(e);if(s[t.debugId]++)return t;s[t.debugId]=1;var r=(0,i.YM)(t,!0);function f(e){r.inPlace(e,[u,d],"-",p)}function p(e,t){return e[1]}return"getPrototypeOf"in Object&&(a.RI&&h(document,f),c&&h(c.prototype,f),h(a.gm,f)),t.on(u+"-start",(function(e,t){var n=e[1];if(null!==n&&("function"==typeof n||"object"==typeof n)){var i=(0,o.I)(n,l,(function(){var e={object:function(){if("function"!=typeof n.handleEvent)return;return n.handleEvent.apply(n,arguments)},function:n}[typeof n];return e?r(e,"fn-",null,e.name||"anonymous"):n}));this.wrapped=e[1]=i}})),t.on(d+"-start",(function(e){e[1]=this.wrapped||e[1]})),t}function h(e,t,...r){let n=e;for(;"object"==typeof n&&!Object.prototype.hasOwnProperty.call(n,u);)n=Object.getPrototypeOf(n);n&&t(n,...r)}},3434:(e,t,r)=>{"use strict";r.d(t,{Jt:()=>o,YM:()=>c});var n=r(7836),i=r(5607);const o="nr@original:".concat(i.W);var a=Object.prototype.hasOwnProperty,s=!1;function c(e,t){return e||(e=n.ee),r.inPlace=function(e,t,n,i,o){n||(n="");const a="-"===n.charAt(0);for(let s=0;s<t.length;s++){const c=t[s],u=e[c];d(u)||(e[c]=r(u,a?c+n:n,i,c,o))}},r.flag=o,r;function r(t,r,n,s,c){return d(t)?t:(r||(r=""),nrWrapper[o]=t,function(e,t,r){if(Object.defineProperty&&Object.keys)try{return Object.keys(e).forEach((function(r){Object.defineProperty(t,r,{get:function(){return e[r]},set:function(t){return e[r]=t,t}})})),t}catch(e){u([e],r)}for(var n in e)a.call(e,n)&&(t[n]=e[n])}(t,nrWrapper,e),nrWrapper);function nrWrapper(){var o,a,d,l;try{a=this,o=[...arguments],d="function"==typeof n?n(o,a):n||{}}catch(t){u([t,"",[o,a,s],d],e)}i(r+"start",[o,a,s],d,c);try{return l=t.apply(a,o)}catch(e){throw i(r+"err",[o,a,e],d,c),e}finally{i(r+"end",[o,a,l],d,c)}}}function i(r,n,i,o){if(!s||t){var a=s;s=!0;try{e.emit(r,n,i,t,o)}catch(t){u([t,r,n,i],e)}s=a}}}function u(e,t){t||(t=n.ee);try{t.emit("internal-error",e)}catch(e){}}function d(e){return!(e&&"function"==typeof e&&e.apply&&!e[o])}},9559:(e,t,r)=>{"use strict";r.d(t,{A5:()=>l,NF:()=>c,tV:()=>u});var n=r(6154),i=r(1863),o=r(5289),a=r(9566),s=r(384);const c="websocket-",u="addEventListener",d={};function l(e){if(d[e.debugId]++)return e;if(!(0,s.dV)().o.WS)return e;class t extends WebSocket{static name="WebSocket";constructor(...t){super(...t);const r=(0,a.LA)(6);this.report=function(t){const r=(0,i.t)();return function(n,...a){const s=a[0]?.timeStamp||(0,i.t)(),u=(0,o.We)();e.emit(c+n,[s,s-r,u,t,...a])}}(r),this.report("new");["message","error","open","close"].forEach((e=>{this.addEventListener(e,(function(t){this.report(u,{eventType:e,event:t})}))}))}send(...e){this.report("send",...e);try{return super.send(...e)}catch(t){throw this.report("send-err",...e),t}}}return n.gm.WebSocket=t,e}},9300:(e,t,r)=>{"use strict";r.d(t,{T:()=>n});const n=r(860).K7.ajax},3333:(e,t,r)=>{"use strict";r.d(t,{$v:()=>u,TZ:()=>n,Zp:()=>i,kd:()=>c,mq:()=>s,nf:()=>a,qN:()=>o});const n=r(860).K7.genericEvents,i=["auxclick","click","copy","keydown","paste","scrollend"],o=["focus","blur"],a=4,s=1e3,c=["PageAction","UserAction","BrowserPerformance"],u={MARKS:"experimental.marks",MEASURES:"experimental.measures",RESOURCES:"experimental.resources"}},6774:(e,t,r)=>{"use strict";r.d(t,{T:()=>n});const n=r(860).K7.jserrors},993:(e,t,r)=>{"use strict";r.d(t,{ET:()=>o,TZ:()=>a,p_:()=>i});var n=r(860);const i={ERROR:"ERROR",WARN:"WARN",INFO:"INFO",DEBUG:"DEBUG",TRACE:"TRACE"},o="log",a=n.K7.logging},3785:(e,t,r)=>{"use strict";r.d(t,{R:()=>c,b:()=>u});var n=r(9908),i=r(1863),o=r(860),a=r(3969),s=r(993);function c(e,t,r={},c=s.p_.INFO){(0,n.p)(a.xV,["API/logging/".concat(c.toLowerCase(),"/called")],void 0,o.K7.metrics,e),(0,n.p)(s.ET,[(0,i.t)(),t,r,c],void 0,o.K7.logging,e)}function u(e){return"string"==typeof e&&Object.values(s.p_).some((t=>t===e.toUpperCase().trim()))}},3969:(e,t,r)=>{"use strict";r.d(t,{Pj:()=>u,TZ:()=>i,XG:()=>c,rs:()=>o,xV:()=>s,z_:()=>a});var n=r(9559);const i=r(860).K7.metrics,o="sm",a="cm",s="storeSupportabilityMetrics",c="storeEventMetrics",u=["new","send","close",n.tV]},6630:(e,t,r)=>{"use strict";r.d(t,{T:()=>n});const n=r(860).K7.pageViewEvent},782:(e,t,r)=>{"use strict";r.d(t,{T:()=>n});const n=r(860).K7.pageViewTiming},6344:(e,t,r)=>{"use strict";r.d(t,{BB:()=>d,G4:()=>o,Qb:()=>l,TZ:()=>i,Ug:()=>a,_s:()=>s,bc:()=>u,yP:()=>c});var n=r(2614);const i=r(860).K7.sessionReplay,o={RECORD:"recordReplay",PAUSE:"pauseReplay",REPLAY_RUNNING:"replayRunning",ERROR_DURING_REPLAY:"errorDuringReplay"},a=.12,s={DomContentLoaded:0,Load:1,FullSnapshot:2,IncrementalSnapshot:3,Meta:4,Custom:5},c={[n.g.ERROR]:15e3,[n.g.FULL]:3e5,[n.g.OFF]:0},u={RESET:{message:"Session was reset",sm:"Reset"},IMPORT:{message:"Recorder failed to import",sm:"Import"},TOO_MANY:{message:"429: Too Many Requests",sm:"Too-Many"},TOO_BIG:{message:"Payload was too large",sm:"Too-Big"},CROSS_TAB:{message:"Session Entity was set to OFF on another tab",sm:"Cross-Tab"},ENTITLEMENTS:{message:"Session Replay is not allowed and will not be started",sm:"Entitlement"}},d=5e3,l={API:"api"}},5270:(e,t,r)=>{"use strict";r.d(t,{Aw:()=>c,CT:()=>u,SR:()=>s});var n=r(384),i=r(9417),o=r(7767),a=r(6154);function s(e){return!!(0,n.dV)().o.MO&&(0,o.V)(e)&&!0===(0,i.gD)(e,"session_trace.enabled")}function c(e){return!0===(0,i.gD)(e,"session_replay.preload")&&s(e)}function u(e,t){const r=t.correctAbsoluteTimestamp(e);return{originalTimestamp:e,correctedTimestamp:r,timestampDiff:e-r,originTime:a.WN,correctedOriginTime:t.correctedOriginTime,originTimeDiff:Math.floor(a.WN-t.correctedOriginTime)}}},3738:(e,t,r)=>{"use strict";r.d(t,{He:()=>i,Kp:()=>s,Lc:()=>u,Rz:()=>d,TZ:()=>n,bD:()=>o,d3:()=>a,jx:()=>l,uP:()=>c});const n=r(860).K7.sessionTrace,i="bstResource",o="resource",a="-start",s="-end",c="fn"+a,u="fn"+s,d="pushState",l=1e3},3962:(e,t,r)=>{"use strict";r.d(t,{AM:()=>o,O2:()=>c,Qu:()=>u,TZ:()=>s,ih:()=>d,pP:()=>a,tC:()=>i});var n=r(860);const i=["click","keydown","submit","popstate"],o="api",a="initialPageLoad",s=n.K7.softNav,c={INITIAL_PAGE_LOAD:"",ROUTE_CHANGE:1,UNSPECIFIED:2},u={INTERACTION:1,AJAX:2,CUSTOM_END:3,CUSTOM_TRACER:4},d={IP:"in progress",FIN:"finished",CAN:"cancelled"}},7378:(e,t,r)=>{"use strict";r.d(t,{$p:()=>x,BR:()=>b,Kp:()=>R,L3:()=>y,Lc:()=>c,NC:()=>o,SG:()=>d,TZ:()=>i,U6:()=>p,UT:()=>m,d3:()=>w,dT:()=>f,e5:()=>A,gx:()=>v,l9:()=>l,oW:()=>h,op:()=>g,rw:()=>u,tH:()=>T,uP:()=>s,wW:()=>E,xq:()=>a});var n=r(384);const i=r(860).K7.spa,o=["click","submit","keypress","keydown","keyup","change"],a=999,s="fn-start",c="fn-end",u="cb-start",d="api-ixn-",l="remaining",f="interaction",h="spaNode",p="jsonpNode",g="fetch-start",m="fetch-done",v="fetch-body-",b="jsonp-end",y=(0,n.dV)().o.ST,w="-start",R="-end",x="-body",E="cb"+R,A="jsTime",T="fetch"},4234:(e,t,r)=>{"use strict";r.d(t,{W:()=>o});var n=r(7836),i=r(1687);class o{constructor(e,t){this.agentIdentifier=e,this.ee=n.ee.get(e),this.featureName=t,this.blocked=!1}deregisterDrain(){(0,i.x3)(this.agentIdentifier,this.featureName)}}},7767:(e,t,r)=>{"use strict";r.d(t,{V:()=>o});var n=r(9417),i=r(6154);const o=e=>i.RI&&!0===(0,n.gD)(e,"privacy.cookies_enabled")},425:(e,t,r)=>{"use strict";r.d(t,{j:()=>j});var n=r(860),i=r(2555),o=r(3371),a=r(9908),s=r(7836),c=r(1687),u=r(5289),d=r(6154),l=r(944),f=r(3969),h=r(384),p=r(6344);const g=["setErrorHandler","finished","addToTrace","addRelease","recordCustomEvent","addPageAction","setCurrentRouteName","setPageViewName","setCustomAttribute","interaction","noticeError","setUserId","setApplicationVersion","start",p.G4.RECORD,p.G4.PAUSE,"log","wrapLogger"],m=["setErrorHandler","finished","addToTrace","addRelease"];var v=r(1863),b=r(2614),y=r(993),w=r(3785),R=r(2646),x=r(3434);const E=new Map;function A(e,t,r,n){if("object"!=typeof t||!t||"string"!=typeof r||!r||"function"!=typeof t[r])return(0,l.R)(29);const i=function(e){return(e||s.ee).get("logger")}(e),o=(0,x.YM)(i),a=new R.y(s.P);a.level=n.level,a.customAttributes=n.customAttributes;const c=t[r]?.[x.Jt]||t[r];return E.set(c,a),o.inPlace(t,[r],"wrap-logger-",(()=>E.get(c))),i}function T(){const e=(0,h.pV)();g.forEach((t=>{e[t]=(...r)=>function(t,...r){let n=[];return Object.values(e.initializedAgents).forEach((e=>{e&&e.api?e.exposed&&e.api[t]&&n.push(e.api[t](...r)):(0,l.R)(38,t)})),n.length>1?n:n[0]}(t,...r)}))}const S={};var N=r(9417),_=r(5603),O=r(5284);const I=e=>{const t=e.startsWith("http");e+="/",r.p=t?e:"https://"+e};let P=!1;function j(e,t={},g,R){let{init:x,info:E,loader_config:j,runtime:C={},exposed:k=!0}=t;C.loaderType=g;const L=(0,h.pV)();E||(x=L.init,E=L.info,j=L.loader_config),(0,N.xN)(e.agentIdentifier,x||{}),(0,_.a)(e.agentIdentifier,j||{}),E.jsAttributes??={},d.bv&&(E.jsAttributes.isWorker=!0),(0,i.x1)(e.agentIdentifier,E);const H=(0,N.D0)(e.agentIdentifier),M=[E.beacon,E.errorBeacon];P||(H.proxy.assets&&(I(H.proxy.assets),M.push(H.proxy.assets)),H.proxy.beacon&&M.push(H.proxy.beacon),T(),(0,h.US)("activatedFeatures",O.B),e.runSoftNavOverSpa&&=!0===H.soft_navigations.enabled&&H.feature_flags.includes("soft_nav")),C.denyList=[...H.ajax.deny_list||[],...H.ajax.block_internal?M:[]],C.ptid=e.agentIdentifier,(0,o.V)(e.agentIdentifier,C),e.ee=s.ee.get(e.agentIdentifier),void 0===e.api&&(e.api=function(e,t,h=!1){t||(0,c.Ak)(e,"api");const g={};var R=s.ee.get(e),x=R.get("tracer");S[e]=b.g.OFF,R.on(p.G4.REPLAY_RUNNING,(t=>{S[e]=t}));var E="api-",T=E+"ixn-";function N(t,r,n,o){const a=(0,i.Vp)(e);return null===r?delete a.jsAttributes[t]:(0,i.x1)(e,{...a,jsAttributes:{...a.jsAttributes,[t]:r}}),I(E,n,!0,o||null===r?"session":void 0)(t,r)}function _(){}g.log=function(e,{customAttributes:t={},level:r=y.p_.INFO}={}){(0,a.p)(f.xV,["API/log/called"],void 0,n.K7.metrics,R),(0,w.R)(R,e,t,r)},g.wrapLogger=(e,t,{customAttributes:r={},level:i=y.p_.INFO}={})=>{(0,a.p)(f.xV,["API/wrapLogger/called"],void 0,n.K7.metrics,R),A(R,e,t,{customAttributes:r,level:i})},m.forEach((e=>{g[e]=I(E,e,!0,"api")})),g.addPageAction=I(E,"addPageAction",!0,n.K7.genericEvents),g.recordCustomEvent=I(E,"recordCustomEvent",!0,n.K7.genericEvents),g.setPageViewName=function(t,r){if("string"==typeof t)return"/"!==t.charAt(0)&&(t="/"+t),(0,o.f)(e).customTransaction=(r||"http://custom.transaction")+t,I(E,"setPageViewName",!0)()},g.setCustomAttribute=function(e,t,r=!1){if("string"==typeof e){if(["string","number","boolean"].includes(typeof t)||null===t)return N(e,t,"setCustomAttribute",r);(0,l.R)(40,typeof t)}else(0,l.R)(39,typeof e)},g.setUserId=function(e){if("string"==typeof e||null===e)return N("enduser.id",e,"setUserId",!0);(0,l.R)(41,typeof e)},g.setApplicationVersion=function(e){if("string"==typeof e||null===e)return N("application.version",e,"setApplicationVersion",!1);(0,l.R)(42,typeof e)},g.start=()=>{try{(0,a.p)(f.xV,["API/start/called"],void 0,n.K7.metrics,R),R.emit("manual-start-all")}catch(e){(0,l.R)(23,e)}},g[p.G4.RECORD]=function(){(0,a.p)(f.xV,["API/recordReplay/called"],void 0,n.K7.metrics,R),(0,a.p)(p.G4.RECORD,[],void 0,n.K7.sessionReplay,R)},g[p.G4.PAUSE]=function(){(0,a.p)(f.xV,["API/pauseReplay/called"],void 0,n.K7.metrics,R),(0,a.p)(p.G4.PAUSE,[],void 0,n.K7.sessionReplay,R)},g.interaction=function(e){return(new _).get("object"==typeof e?e:{})};const O=_.prototype={createTracer:function(e,t){var r={},i=this,o="function"==typeof t;return(0,a.p)(f.xV,["API/createTracer/called"],void 0,n.K7.metrics,R),h||(0,a.p)(T+"tracer",[(0,v.t)(),e,r],i,n.K7.spa,R),function(){if(x.emit((o?"":"no-")+"fn-start",[(0,v.t)(),i,o],r),o)try{return t.apply(this,arguments)}catch(e){const t="string"==typeof e?new Error(e):e;throw x.emit("fn-err",[arguments,this,t],r),t}finally{x.emit("fn-end",[(0,v.t)()],r)}}}};function I(e,t,r,i){return function(){return(0,a.p)(f.xV,["API/"+t+"/called"],void 0,n.K7.metrics,R),i&&(0,a.p)(e+t,[r?(0,v.t)():performance.now(),...arguments],r?null:this,i,R),r?void 0:this}}function P(){r.e(478).then(r.bind(r,8778)).then((({setAPI:t})=>{t(e),(0,c.Ze)(e,"api")})).catch((e=>{(0,l.R)(27,e),R.abort()}))}return["actionText","setName","setAttribute","save","ignore","onEnd","getContext","end","get"].forEach((e=>{O[e]=I(T,e,void 0,h?n.K7.softNav:n.K7.spa)})),g.setCurrentRouteName=h?I(T,"routeName",void 0,n.K7.softNav):I(E,"routeName",!0,n.K7.spa),g.noticeError=function(t,r){"string"==typeof t&&(t=new Error(t)),(0,a.p)(f.xV,["API/noticeError/called"],void 0,n.K7.metrics,R),(0,a.p)("err",[t,(0,v.t)(),!1,r,!!S[e]],void 0,n.K7.jserrors,R)},d.RI?(0,u.GG)((()=>P()),!0):P(),g}(e.agentIdentifier,R,e.runSoftNavOverSpa)),void 0===e.exposed&&(e.exposed=k),P=!0}},8374:(e,t,r)=>{r.nc=(()=>{try{return document?.currentScript?.nonce}catch(e){}return""})()},860:(e,t,r)=>{"use strict";r.d(t,{$J:()=>u,K7:()=>s,P3:()=>c,XX:()=>i,qY:()=>n,v4:()=>a});const n="events",i="jserrors",o="browser/blobs",a="rum",s={ajax:"ajax",genericEvents:"generic_events",jserrors:i,logging:"logging",metrics:"metrics",pageAction:"page_action",pageViewEvent:"page_view_event",pageViewTiming:"page_view_timing",sessionReplay:"session_replay",sessionTrace:"session_trace",softNav:"soft_navigations",spa:"spa"},c={[s.pageViewEvent]:1,[s.pageViewTiming]:2,[s.metrics]:3,[s.jserrors]:4,[s.spa]:5,[s.ajax]:6,[s.sessionTrace]:7,[s.softNav]:8,[s.sessionReplay]:9,[s.logging]:10,[s.genericEvents]:11},u={[s.pageViewEvent]:a,[s.pageViewTiming]:n,[s.ajax]:n,[s.spa]:n,[s.softNav]:n,[s.metrics]:i,[s.jserrors]:i,[s.sessionTrace]:o,[s.sessionReplay]:o,[s.logging]:"browser/logs",[s.genericEvents]:"ins"}}},n={};function i(e){var t=n[e];if(void 0!==t)return t.exports;var o=n[e]={exports:{}};return r[e](o,o.exports,i),o.exports}i.m=r,i.d=(e,t)=>{for(var r in t)i.o(t,r)&&!i.o(e,r)&&Object.defineProperty(e,r,{enumerable:!0,get:t[r]})},i.f={},i.e=e=>Promise.all(Object.keys(i.f).reduce(((t,r)=>(i.f[r](e,t),t)),[])),i.u=e=>({212:"nr-spa-compressor",249:"nr-spa-recorder",478:"nr-spa"}[e]+"-1.282.0.min.js"),i.o=(e,t)=>Object.prototype.hasOwnProperty.call(e,t),e={},t="NRBA-1.282.0.PROD:",i.l=(r,n,o,a)=>{if(e[r])e[r].push(n);else{var s,c;if(void 0!==o)for(var u=document.getElementsByTagName("script"),d=0;d<u.length;d++){var l=u[d];if(l.getAttribute("src")==r||l.getAttribute("data-webpack")==t+o){s=l;break}}if(!s){c=!0;var f={478:"sha512-KRtfgYKMWN+I3/ordLh8IXM7nK8gkA0mgtjr91T2Aan3fvyBYIRzkCUpNWoe1PnAUhmGabOZshgcMS2HAR+Q1A==",249:"sha512-kIzHYAyR+GgU7sCcel7SDnEPmUkHZaBakrmc8CWVA5DeKUpUgLpYhOowQ/8mTaWvwEIXdTjn9w8ntmXvRVmghg==",212:"sha512-p5PweTycvyu54QGkYO9R5+ToLp2c4OSR8Ulnoe7TQCCifas1sokfjwioe/WYbhQQcnIh7JDSdNS3JpkXaTb0vg=="};(s=document.createElement("script")).charset="utf-8",s.timeout=120,i.nc&&s.setAttribute("nonce",i.nc),s.setAttribute("data-webpack",t+o),s.src=r,0!==s.src.indexOf(window.location.origin+"/")&&(s.crossOrigin="anonymous"),f[a]&&(s.integrity=f[a])}e[r]=[n];var h=(t,n)=>{s.onerror=s.onload=null,clearTimeout(p);var i=e[r];if(delete e[r],s.parentNode&&s.parentNode.removeChild(s),i&&i.forEach((e=>e(n))),t)return t(n)},p=setTimeout(h.bind(null,void 0,{type:"timeout",target:s}),12e4);s.onerror=h.bind(null,s.onerror),s.onload=h.bind(null,s.onload),c&&document.head.appendChild(s)}},i.r=e=>{"undefined"!=typeof Symbol&&Symbol.toStringTag&&Object.defineProperty(e,Symbol.toStringTag,{value:"Module"}),Object.defineProperty(e,"__esModule",{value:!0})},i.p="https://js-agent.newrelic.com/",(()=>{var e={38:0,788:0};i.f.j=(t,r)=>{var n=i.o(e,t)?e[t]:void 0;if(0!==n)if(n)r.push(n[2]);else{var o=new Promise(((r,i)=>n=e[t]=[r,i]));r.push(n[2]=o);var a=i.p+i.u(t),s=new Error;i.l(a,(r=>{if(i.o(e,t)&&(0!==(n=e[t])&&(e[t]=void 0),n)){var o=r&&("load"===r.type?"missing":r.type),a=r&&r.target&&r.target.src;s.message="Loading chunk "+t+" failed.\n("+o+": "+a+")",s.name="ChunkLoadError",s.type=o,s.request=a,n[1](s)}}),"chunk-"+t,t)}};var t=(t,r)=>{var n,o,[a,s,c]=r,u=0;if(a.some((t=>0!==e[t]))){for(n in s)i.o(s,n)&&(i.m[n]=s[n]);if(c)c(i)}for(t&&t(r);u<a.length;u++)o=a[u],i.o(e,o)&&e[o]&&e[o][0](),e[o]=0},r=self["webpackChunk:NRBA-1.282.0.PROD"]=self["webpackChunk:NRBA-1.282.0.PROD"]||[];r.forEach(t.bind(null,0)),r.push=t.bind(null,r.push.bind(r))})(),(()=>{"use strict";i(8374);var e=i(944),t=i(6344),r=i(9566);class n{agentIdentifier;constructor(){this.agentIdentifier=(0,r.LA)(16)}#e(t,...r){if("function"==typeof this.api?.[t])return this.api[t](...r);(0,e.R)(35,t)}addPageAction(e,t){return this.#e("addPageAction",e,t)}recordCustomEvent(e,t){return this.#e("recordCustomEvent",e,t)}setPageViewName(e,t){return this.#e("setPageViewName",e,t)}setCustomAttribute(e,t,r){return this.#e("setCustomAttribute",e,t,r)}noticeError(e,t){return this.#e("noticeError",e,t)}setUserId(e){return this.#e("setUserId",e)}setApplicationVersion(e){return this.#e("setApplicationVersion",e)}setErrorHandler(e){return this.#e("setErrorHandler",e)}addRelease(e,t){return this.#e("addRelease",e,t)}log(e,t){return this.#e("log",e,t)}}class o extends n{#e(t,...r){if("function"==typeof this.api?.[t])return this.api[t](...r);(0,e.R)(35,t)}start(){return this.#e("start")}finished(e){return this.#e("finished",e)}recordReplay(){return this.#e(t.G4.RECORD)}pauseReplay(){return this.#e(t.G4.PAUSE)}addToTrace(e){return this.#e("addToTrace",e)}setCurrentRouteName(e){return this.#e("setCurrentRouteName",e)}interaction(){return this.#e("interaction")}wrapLogger(e,t,r){return this.#e("wrapLogger",e,t,r)}}var a=i(860),s=i(9417);const c=Object.values(a.K7);function u(e){const t={};return c.forEach((r=>{t[r]=function(e,t){return!0===(0,s.gD)(t,"".concat(e,".enabled"))}(r,e)})),t}var d=i(425);var l=i(1687),f=i(4234),h=i(5289),p=i(6154),g=i(5270),m=i(7767),v=i(6389);class b extends f.W{constructor(e,t,r=!0){super(e.agentIdentifier,t),this.auto=r,this.abortHandler=void 0,this.featAggregate=void 0,this.onAggregateImported=void 0,!1===e.init[this.featureName].autoStart&&(this.auto=!1),this.auto?(0,l.Ak)(e.agentIdentifier,t):this.ee.on("manual-start-all",(0,v.J)((()=>{(0,l.Ak)(e.agentIdentifier,this.featureName),this.auto=!0,this.importAggregator(e)})))}importAggregator(t,r={}){if(this.featAggregate||!this.auto)return;let n;this.onAggregateImported=new Promise((e=>{n=e}));const o=async()=>{let o;try{if((0,m.V)(this.agentIdentifier)){const{setupAgentSession:e}=await i.e(478).then(i.bind(i,6526));o=e(t)}}catch(t){(0,e.R)(20,t),this.ee.emit("internal-error",[t]),this.featureName===a.K7.sessionReplay&&this.abortHandler?.()}try{if(!this.#t(this.featureName,o))return(0,l.Ze)(this.agentIdentifier,this.featureName),void n(!1);const{lazyFeatureLoader:e}=await i.e(478).then(i.bind(i,6103)),{Aggregate:a}=await e(this.featureName,"aggregate");this.featAggregate=new a(t,r),t.runtime.harvester.initializedAggregates.push(this.featAggregate),n(!0)}catch(t){(0,e.R)(34,t),this.abortHandler?.(),(0,l.Ze)(this.agentIdentifier,this.featureName,!0),n(!1),this.ee&&this.ee.abort()}};p.RI?(0,h.GG)((()=>o()),!0):o()}#t(e,t){switch(e){case a.K7.sessionReplay:return(0,g.SR)(this.agentIdentifier)&&!!t;case a.K7.sessionTrace:return!!t;default:return!0}}}var y=i(6630);class w extends b{static featureName=y.T;constructor(e,t=!0){super(e,y.T,t),this.importAggregator(e)}}var R=i(384);var x=i(9908),E=i(2843),A=i(3878),T=i(782),S=i(1863);class N extends b{static featureName=T.T;constructor(e,t=!0){super(e,T.T,t),p.RI&&((0,E.u)((()=>(0,x.p)("docHidden",[(0,S.t)()],void 0,T.T,this.ee)),!0),(0,A.sp)("pagehide",(()=>(0,x.p)("winPagehide",[(0,S.t)()],void 0,T.T,this.ee))),this.importAggregator(e))}}var _=i(9559),O=i(3969);class I extends b{static featureName=O.TZ;constructor(e,t=!0){super(e,O.TZ,t),(0,_.A5)(this.ee),O.Pj.forEach((e=>{this.ee.on(_.NF+e,((...t)=>{(0,x.p)("buffered-"+_.NF+e,[...t],void 0,this.featureName,this.ee)}))})),this.importAggregator(e)}}var P=i(6774),j=i(3304);class C{constructor(e,t,r,n,i){this.name="UncaughtError",this.message="string"==typeof e?e:(0,j.A)(e),this.sourceURL=t,this.line=r,this.column=n,this.__newrelic=i}}function k(e){return M(e)?e:new C(void 0!==e?.message?e.message:e,e?.filename||e?.sourceURL,e?.lineno||e?.line,e?.colno||e?.col,e?.__newrelic)}function L(e){const t="Unhandled Promise Rejection";if(!e?.reason)return;if(M(e.reason))try{return e.reason.message=t+": "+e.reason.message,k(e.reason)}catch(t){return k(e.reason)}const r=k(e.reason);return r.message=t+": "+r?.message,r}function H(e){if(e.error instanceof SyntaxError&&!/:\d+$/.test(e.error.stack?.trim())){const t=new C(e.message,e.filename,e.lineno,e.colno,e.error.__newrelic);return t.name=SyntaxError.name,t}return M(e.error)?e.error:k(e)}function M(e){return e instanceof Error&&!!e.stack}class D extends b{static featureName=P.T;#r=!1;constructor(e,r=!0){super(e,P.T,r);try{this.removeOnAbort=new AbortController}catch(e){}this.ee.on("internal-error",((e,t)=>{this.abortHandler&&(0,x.p)("ierr",[k(e),(0,S.t)(),!0,{},this.#r,t],void 0,this.featureName,this.ee)})),this.ee.on(t.G4.REPLAY_RUNNING,(e=>{this.#r=e})),p.gm.addEventListener("unhandledrejection",(e=>{this.abortHandler&&(0,x.p)("err",[L(e),(0,S.t)(),!1,{unhandledPromiseRejection:1},this.#r],void 0,this.featureName,this.ee)}),(0,A.jT)(!1,this.removeOnAbort?.signal)),p.gm.addEventListener("error",(e=>{this.abortHandler&&(0,x.p)("err",[H(e),(0,S.t)(),!1,{},this.#r],void 0,this.featureName,this.ee)}),(0,A.jT)(!1,this.removeOnAbort?.signal)),this.abortHandler=this.#n,this.importAggregator(e)}#n(){this.removeOnAbort?.abort(),this.abortHandler=void 0}}var K=i(8990);let U=1;const V="nr@id";function F(e){const t=typeof e;return!e||"object"!==t&&"function"!==t?-1:e===p.gm?0:(0,K.I)(e,V,(function(){return U++}))}var G=i(5475),B=i(8139),W=i(7836),z=i(3434);const q={},Z=["open","send"];function Y(t){var r=t||W.ee;const n=function(e){return(e||W.ee).get("xhr")}(r);if(void 0===p.gm.XMLHttpRequest)return n;if(q[n.debugId]++)return n;q[n.debugId]=1,(0,B.u)(r);var i=(0,z.YM)(n),o=p.gm.XMLHttpRequest,a=p.gm.MutationObserver,s=p.gm.Promise,c=p.gm.setInterval,u="readystatechange",d=["onload","onerror","onabort","onloadstart","onloadend","onprogress","ontimeout"],l=[],f=p.gm.XMLHttpRequest=function(t){const r=new o(t),a=n.context(r);try{n.emit("new-xhr",[r],a),r.addEventListener(u,(s=a,function(){var e=this;e.readyState>3&&!s.resolved&&(s.resolved=!0,n.emit("xhr-resolved",[],e)),i.inPlace(e,d,"fn-",y)}),(0,A.jT)(!1))}catch(t){(0,e.R)(15,t);try{n.emit("internal-error",[t])}catch(e){}}var s;return r};function h(e,t){i.inPlace(t,["onreadystatechange"],"fn-",y)}if(function(e,t){for(var r in e)t[r]=e[r]}(o,f),f.prototype=o.prototype,i.inPlace(f.prototype,Z,"-xhr-",y),n.on("send-xhr-start",(function(e,t){h(e,t),function(e){l.push(e),a&&(g?g.then(b):c?c(b):(m=-m,v.data=m))}(t)})),n.on("open-xhr-start",h),a){var g=s&&s.resolve();if(!c&&!s){var m=1,v=document.createTextNode(m);new a(b).observe(v,{characterData:!0})}}else r.on("fn-end",(function(e){e[0]&&e[0].type===u||b()}));function b(){for(var e=0;e<l.length;e++)h(0,l[e]);l.length&&(l=[])}function y(e,t){return t}return n}var X="fetch-",Q=X+"body-",J=["arrayBuffer","blob","json","text","formData"],ee=p.gm.Request,te=p.gm.Response,re="prototype";const ne={};function ie(e){const t=function(e){return(e||W.ee).get("fetch")}(e);if(!(ee&&te&&p.gm.fetch))return t;if(ne[t.debugId]++)return t;function r(e,r,n){var i=e[r];"function"==typeof i&&(e[r]=function(){var e,r=[...arguments],o={};t.emit(n+"before-start",[r],o),o[W.P]&&o[W.P].dt&&(e=o[W.P].dt);var a=i.apply(this,r);return t.emit(n+"start",[r,e],a),a.then((function(e){return t.emit(n+"end",[null,e],a),e}),(function(e){throw t.emit(n+"end",[e],a),e}))})}return ne[t.debugId]=1,J.forEach((e=>{r(ee[re],e,Q),r(te[re],e,Q)})),r(p.gm,"fetch",X),t.on(X+"end",(function(e,r){var n=this;if(r){var i=r.headers.get("content-length");null!==i&&(n.rxSize=i),t.emit(X+"done",[null,r],n)}else t.emit(X+"done",[e],n)})),t}var oe=i(7485),ae=i(5603);class se{constructor(e){this.agentIdentifier=e}generateTracePayload(e){if(!this.shouldGenerateTrace(e))return null;var t=(0,ae.o)(this.agentIdentifier);if(!t)return null;var n=(t.accountID||"").toString()||null,i=(t.agentID||"").toString()||null,o=(t.trustKey||"").toString()||null;if(!n||!i)return null;var a=(0,r.ZF)(),s=(0,r.el)(),c=Date.now(),u={spanId:a,traceId:s,timestamp:c};return(e.sameOrigin||this.isAllowedOrigin(e)&&this.useTraceContextHeadersForCors())&&(u.traceContextParentHeader=this.generateTraceContextParentHeader(a,s),u.traceContextStateHeader=this.generateTraceContextStateHeader(a,c,n,i,o)),(e.sameOrigin&&!this.excludeNewrelicHeader()||!e.sameOrigin&&this.isAllowedOrigin(e)&&this.useNewrelicHeaderForCors())&&(u.newrelicHeader=this.generateTraceHeader(a,s,c,n,i,o)),u}generateTraceContextParentHeader(e,t){return"00-"+t+"-"+e+"-01"}generateTraceContextStateHeader(e,t,r,n,i){return i+"@nr=0-1-"+r+"-"+n+"-"+e+"----"+t}generateTraceHeader(e,t,r,n,i,o){if(!("function"==typeof p.gm?.btoa))return null;var a={v:[0,1],d:{ty:"Browser",ac:n,ap:i,id:e,tr:t,ti:r}};return o&&n!==o&&(a.d.tk=o),btoa((0,j.A)(a))}shouldGenerateTrace(e){return this.isDtEnabled()&&this.isAllowedOrigin(e)}isAllowedOrigin(e){var t=!1,r={};if((0,s.gD)(this.agentIdentifier,"distributed_tracing")&&(r=(0,s.D0)(this.agentIdentifier).distributed_tracing),e.sameOrigin)t=!0;else if(r.allowed_origins instanceof Array)for(var n=0;n<r.allowed_origins.length;n++){var i=(0,oe.D)(r.allowed_origins[n]);if(e.hostname===i.hostname&&e.protocol===i.protocol&&e.port===i.port){t=!0;break}}return t}isDtEnabled(){var e=(0,s.gD)(this.agentIdentifier,"distributed_tracing");return!!e&&!!e.enabled}excludeNewrelicHeader(){var e=(0,s.gD)(this.agentIdentifier,"distributed_tracing");return!!e&&!!e.exclude_newrelic_header}useNewrelicHeaderForCors(){var e=(0,s.gD)(this.agentIdentifier,"distributed_tracing");return!!e&&!1!==e.cors_use_newrelic_header}useTraceContextHeadersForCors(){var e=(0,s.gD)(this.agentIdentifier,"distributed_tracing");return!!e&&!!e.cors_use_tracecontext_headers}}var ce=i(9300),ue=i(7295),de=["load","error","abort","timeout"],le=de.length,fe=(0,R.dV)().o.REQ,he=(0,R.dV)().o.XHR;class pe extends b{static featureName=ce.T;constructor(e,t=!0){super(e,ce.T,t),this.dt=new se(e.agentIdentifier),this.handler=(e,t,r,n)=>(0,x.p)(e,t,r,n,this.ee);try{const e={xmlhttprequest:"xhr",fetch:"fetch",beacon:"beacon"};p.gm?.performance?.getEntriesByType("resource").forEach((t=>{if(t.initiatorType in e&&0!==t.responseStatus){const r={status:t.responseStatus},n={rxSize:t.transferSize,duration:Math.floor(t.duration),cbTime:0};ge(r,t.name),this.handler("xhr",[r,n,t.startTime,t.responseEnd,e[t.initiatorType]],void 0,a.K7.ajax)}}))}catch(e){}ie(this.ee),Y(this.ee),function(e,t,r,n){function i(e){var t=this;t.totalCbs=0,t.called=0,t.cbTime=0,t.end=R,t.ended=!1,t.xhrGuids={},t.lastSize=null,t.loadCaptureCalled=!1,t.params=this.params||{},t.metrics=this.metrics||{},e.addEventListener("load",(function(r){E(t,e)}),(0,A.jT)(!1)),p.lR||e.addEventListener("progress",(function(e){t.lastSize=e.loaded}),(0,A.jT)(!1))}function o(e){this.params={method:e[0]},ge(this,e[1]),this.metrics={}}function s(t,r){e.loader_config.xpid&&this.sameOrigin&&r.setRequestHeader("X-NewRelic-ID",e.loader_config.xpid);var i=n.generateTracePayload(this.parsedOrigin);if(i){var o=!1;i.newrelicHeader&&(r.setRequestHeader("newrelic",i.newrelicHeader),o=!0),i.traceContextParentHeader&&(r.setRequestHeader("traceparent",i.traceContextParentHeader),i.traceContextStateHeader&&r.setRequestHeader("tracestate",i.traceContextStateHeader),o=!0),o&&(this.dt=i)}}function c(e,r){var n=this.metrics,i=e[0],o=this;if(n&&i){var a=(0,G.Q)(i);a&&(n.txSize=a)}this.startTime=(0,S.t)(),this.body=i,this.listener=function(e){try{"abort"!==e.type||o.loadCaptureCalled||(o.params.aborted=!0),("load"!==e.type||o.called===o.totalCbs&&(o.onloadCalled||"function"!=typeof r.onload)&&"function"==typeof o.end)&&o.end(r)}catch(e){try{t.emit("internal-error",[e])}catch(e){}}};for(var s=0;s<le;s++)r.addEventListener(de[s],this.listener,(0,A.jT)(!1))}function u(e,t,r){this.cbTime+=e,t?this.onloadCalled=!0:this.called+=1,this.called!==this.totalCbs||!this.onloadCalled&&"function"==typeof r.onload||"function"!=typeof this.end||this.end(r)}function d(e,t){var r=""+F(e)+!!t;this.xhrGuids&&!this.xhrGuids[r]&&(this.xhrGuids[r]=!0,this.totalCbs+=1)}function l(e,t){var r=""+F(e)+!!t;this.xhrGuids&&this.xhrGuids[r]&&(delete this.xhrGuids[r],this.totalCbs-=1)}function f(){this.endTime=(0,S.t)()}function h(e,r){r instanceof he&&"load"===e[0]&&t.emit("xhr-load-added",[e[1],e[2]],r)}function g(e,r){r instanceof he&&"load"===e[0]&&t.emit("xhr-load-removed",[e[1],e[2]],r)}function m(e,t,r){t instanceof he&&("onload"===r&&(this.onload=!0),("load"===(e[0]&&e[0].type)||this.onload)&&(this.xhrCbStart=(0,S.t)()))}function v(e,r){this.xhrCbStart&&t.emit("xhr-cb-time",[(0,S.t)()-this.xhrCbStart,this.onload,r],r)}function b(e){var t,r=e[1]||{};if("string"==typeof e[0]?0===(t=e[0]).length&&p.RI&&(t=""+p.gm.location.href):e[0]&&e[0].url?t=e[0].url:p.gm?.URL&&e[0]&&e[0]instanceof URL?t=e[0].href:"function"==typeof e[0].toString&&(t=e[0].toString()),"string"==typeof t&&0!==t.length){t&&(this.parsedOrigin=(0,oe.D)(t),this.sameOrigin=this.parsedOrigin.sameOrigin);var i=n.generateTracePayload(this.parsedOrigin);if(i&&(i.newrelicHeader||i.traceContextParentHeader))if(e[0]&&e[0].headers)s(e[0].headers,i)&&(this.dt=i);else{var o={};for(var a in r)o[a]=r[a];o.headers=new Headers(r.headers||{}),s(o.headers,i)&&(this.dt=i),e.length>1?e[1]=o:e.push(o)}}function s(e,t){var r=!1;return t.newrelicHeader&&(e.set("newrelic",t.newrelicHeader),r=!0),t.traceContextParentHeader&&(e.set("traceparent",t.traceContextParentHeader),t.traceContextStateHeader&&e.set("tracestate",t.traceContextStateHeader),r=!0),r}}function y(e,t){this.params={},this.metrics={},this.startTime=(0,S.t)(),this.dt=t,e.length>=1&&(this.target=e[0]),e.length>=2&&(this.opts=e[1]);var r,n=this.opts||{},i=this.target;"string"==typeof i?r=i:"object"==typeof i&&i instanceof fe?r=i.url:p.gm?.URL&&"object"==typeof i&&i instanceof URL&&(r=i.href),ge(this,r);var o=(""+(i&&i instanceof fe&&i.method||n.method||"GET")).toUpperCase();this.params.method=o,this.body=n.body,this.txSize=(0,G.Q)(n.body)||0}function w(e,t){if(this.endTime=(0,S.t)(),this.params||(this.params={}),(0,ue.iW)(this.params))return;let n;this.params.status=t?t.status:0,"string"==typeof this.rxSize&&this.rxSize.length>0&&(n=+this.rxSize);const i={txSize:this.txSize,rxSize:n,duration:(0,S.t)()-this.startTime};r("xhr",[this.params,i,this.startTime,this.endTime,"fetch"],this,a.K7.ajax)}function R(e){const t=this.params,n=this.metrics;if(!this.ended){this.ended=!0;for(let t=0;t<le;t++)e.removeEventListener(de[t],this.listener,!1);t.aborted||(0,ue.iW)(t)||(n.duration=(0,S.t)()-this.startTime,this.loadCaptureCalled||4!==e.readyState?null==t.status&&(t.status=0):E(this,e),n.cbTime=this.cbTime,r("xhr",[t,n,this.startTime,this.endTime,"xhr"],this,a.K7.ajax))}}function E(e,r){e.params.status=r.status;var n=function(e,t){var r=e.responseType;return"json"===r&&null!==t?t:"arraybuffer"===r||"blob"===r||"json"===r?(0,G.Q)(e.response):"text"===r||""===r||void 0===r?(0,G.Q)(e.responseText):void 0}(r,e.lastSize);if(n&&(e.metrics.rxSize=n),e.sameOrigin){var i=r.getResponseHeader("X-NewRelic-App-Data");i&&((0,x.p)(O.rs,["Ajax/CrossApplicationTracing/Header/Seen"],void 0,a.K7.metrics,t),e.params.cat=i.split(", ").pop())}e.loadCaptureCalled=!0}t.on("new-xhr",i),t.on("open-xhr-start",o),t.on("open-xhr-end",s),t.on("send-xhr-start",c),t.on("xhr-cb-time",u),t.on("xhr-load-added",d),t.on("xhr-load-removed",l),t.on("xhr-resolved",f),t.on("addEventListener-end",h),t.on("removeEventListener-end",g),t.on("fn-end",v),t.on("fetch-before-start",b),t.on("fetch-start",y),t.on("fn-start",m),t.on("fetch-done",w)}(e,this.ee,this.handler,this.dt),this.importAggregator(e)}}function ge(e,t){var r=(0,oe.D)(t),n=e.params||e;n.hostname=r.hostname,n.port=r.port,n.protocol=r.protocol,n.host=r.hostname+":"+r.port,n.pathname=r.pathname,e.parsedOrigin=r,e.sameOrigin=r.sameOrigin}const me={},ve=["pushState","replaceState"];function be(e){const t=function(e){return(e||W.ee).get("history")}(e);return!p.RI||me[t.debugId]++||(me[t.debugId]=1,(0,z.YM)(t).inPlace(window.history,ve,"-")),t}var ye=i(3738);const{He:we,bD:Re,d3:xe,Kp:Ee,TZ:Ae,Lc:Te,uP:Se,Rz:Ne}=ye;class _e extends b{static featureName=Ae;constructor(e,t=!0){super(e,Ae,t);if(!(0,m.V)(this.agentIdentifier))return void this.deregisterDrain();const r=this.ee;let n;be(r),this.eventsEE=(0,B.u)(r),this.eventsEE.on(Se,(function(e,t){this.bstStart=(0,S.t)()})),this.eventsEE.on(Te,(function(e,t){(0,x.p)("bst",[e[0],t,this.bstStart,(0,S.t)()],void 0,a.K7.sessionTrace,r)})),r.on(Ne+xe,(function(e){this.time=(0,S.t)(),this.startPath=location.pathname+location.hash})),r.on(Ne+Ee,(function(e){(0,x.p)("bstHist",[location.pathname+location.hash,this.startPath,this.time],void 0,a.K7.sessionTrace,r)}));try{n=new PerformanceObserver((e=>{const t=e.getEntries();(0,x.p)(we,[t],void 0,a.K7.sessionTrace,r)})),n.observe({type:Re,buffered:!0})}catch(e){}this.importAggregator(e,{resourceObserver:n})}}var Oe=i(2614);class Ie extends b{static featureName=t.TZ;#i;#o;constructor(e,r=!0){let n;super(e,t.TZ,r),this.replayRunning=!1,this.#o=e;try{n=JSON.parse(localStorage.getItem("".concat(Oe.H3,"_").concat(Oe.uh)))}catch(e){}(0,g.SR)(e.agentIdentifier)&&this.ee.on(t.G4.RECORD,(()=>this.#a())),this.#s(n)?(this.#i=n?.sessionReplayMode,this.#c()):this.importAggregator(e),this.ee.on("err",(e=>{this.replayRunning&&(this.errorNoticed=!0,(0,x.p)(t.G4.ERROR_DURING_REPLAY,[e],void 0,this.featureName,this.ee))})),this.ee.on(t.G4.REPLAY_RUNNING,(e=>{this.replayRunning=e}))}#s(e){return e&&(e.sessionReplayMode===Oe.g.FULL||e.sessionReplayMode===Oe.g.ERROR)||(0,g.Aw)(this.agentIdentifier)}#u=!1;async#c(e){if(!this.#u){this.#u=!0;try{const{Recorder:t}=await Promise.all([i.e(478),i.e(249)]).then(i.bind(i,8589));this.recorder??=new t({mode:this.#i,agentIdentifier:this.agentIdentifier,trigger:e,ee:this.ee,agentRef:this.#o}),this.recorder.startRecording(),this.abortHandler=this.recorder.stopRecording}catch(e){}this.importAggregator(this.#o,{recorder:this.recorder,errorNoticed:this.errorNoticed})}}#a(){this.featAggregate?this.featAggregate.mode!==Oe.g.FULL&&this.featAggregate.initializeRecording(Oe.g.FULL,!0):(this.#i=Oe.g.FULL,this.#c(t.Qb.API),this.recorder&&this.recorder.parent.mode!==Oe.g.FULL&&(this.recorder.parent.mode=Oe.g.FULL,this.recorder.stopRecording(),this.recorder.startRecording(),this.abortHandler=this.recorder.stopRecording))}}var Pe=i(3962);class je extends b{static featureName=Pe.TZ;constructor(e,t=!0){if(super(e,Pe.TZ,t),!p.RI||!(0,R.dV)().o.MO)return;const r=be(this.ee);Pe.tC.forEach((e=>{(0,A.sp)(e,(e=>{a(e)}),!0)}));const n=()=>(0,x.p)("newURL",[(0,S.t)(),""+window.location],void 0,this.featureName,this.ee);r.on("pushState-end",n),r.on("replaceState-end",n);try{this.removeOnAbort=new AbortController}catch(e){}(0,A.sp)("popstate",(e=>(0,x.p)("newURL",[e.timeStamp,""+window.location],void 0,this.featureName,this.ee)),!0,this.removeOnAbort?.signal);let i=!1;const o=new((0,R.dV)().o.MO)(((e,t)=>{i||(i=!0,requestAnimationFrame((()=>{(0,x.p)("newDom",[(0,S.t)()],void 0,this.featureName,this.ee),i=!1})))})),a=(0,v.s)((e=>{(0,x.p)("newUIEvent",[e],void 0,this.featureName,this.ee),o.observe(document.body,{attributes:!0,childList:!0,subtree:!0,characterData:!0})}),100,{leading:!0});this.abortHandler=function(){this.removeOnAbort?.abort(),o.disconnect(),this.abortHandler=void 0},this.importAggregator(e,{domObserver:o})}}var Ce=i(7378);const ke={},Le=["appendChild","insertBefore","replaceChild"];function He(e){const t=function(e){return(e||W.ee).get("jsonp")}(e);if(!p.RI||ke[t.debugId])return t;ke[t.debugId]=!0;var r=(0,z.YM)(t),n=/[?&](?:callback|cb)=([^&#]+)/,i=/(.*)\.([^.]+)/,o=/^(\w+)(\.|$)(.*)$/;function a(e,t){if(!e)return t;const r=e.match(o),n=r[1];return a(r[3],t[n])}return r.inPlace(Node.prototype,Le,"dom-"),t.on("dom-start",(function(e){!function(e){if(!e||"string"!=typeof e.nodeName||"script"!==e.nodeName.toLowerCase())return;if("function"!=typeof e.addEventListener)return;var o=(s=e.src,c=s.match(n),c?c[1]:null);var s,c;if(!o)return;var u=function(e){var t=e.match(i);if(t&&t.length>=3)return{key:t[2],parent:a(t[1],window)};return{key:e,parent:window}}(o);if("function"!=typeof u.parent[u.key])return;var d={};function l(){t.emit("jsonp-end",[],d),e.removeEventListener("load",l,(0,A.jT)(!1)),e.removeEventListener("error",f,(0,A.jT)(!1))}function f(){t.emit("jsonp-error",[],d),t.emit("jsonp-end",[],d),e.removeEventListener("load",l,(0,A.jT)(!1)),e.removeEventListener("error",f,(0,A.jT)(!1))}r.inPlace(u.parent,[u.key],"cb-",d),e.addEventListener("load",l,(0,A.jT)(!1)),e.addEventListener("error",f,(0,A.jT)(!1)),t.emit("new-jsonp",[e.src],d)}(e[0])})),t}const Me={};function De(e){const t=function(e){return(e||W.ee).get("promise")}(e);if(Me[t.debugId])return t;Me[t.debugId]=!0;var r=t.context,n=(0,z.YM)(t),i=p.gm.Promise;return i&&function(){function e(r){var o=t.context(),a=n(r,"executor-",o,null,!1);const s=Reflect.construct(i,[a],e);return t.context(s).getCtx=function(){return o},s}p.gm.Promise=e,Object.defineProperty(e,"name",{value:"Promise"}),e.toString=function(){return i.toString()},Object.setPrototypeOf(e,i),["all","race"].forEach((function(r){const n=i[r];e[r]=function(e){let i=!1;[...e||[]].forEach((e=>{this.resolve(e).then(a("all"===r),a(!1))}));const o=n.apply(this,arguments);return o;function a(e){return function(){t.emit("propagate",[null,!i],o,!1,!1),i=i||!e}}}})),["resolve","reject"].forEach((function(r){const n=i[r];e[r]=function(e){const r=n.apply(this,arguments);return e!==r&&t.emit("propagate",[e,!0],r,!1,!1),r}})),e.prototype=i.prototype;const o=i.prototype.then;i.prototype.then=function(...e){var i=this,a=r(i);a.promise=i,e[0]=n(e[0],"cb-",a,null,!1),e[1]=n(e[1],"cb-",a,null,!1);const s=o.apply(this,e);return a.nextPromise=s,t.emit("propagate",[i,!0],s,!1,!1),s},i.prototype.then[z.Jt]=o,t.on("executor-start",(function(e){e[0]=n(e[0],"resolve-",this,null,!1),e[1]=n(e[1],"resolve-",this,null,!1)})),t.on("executor-err",(function(e,t,r){e[1](r)})),t.on("cb-end",(function(e,r,n){t.emit("propagate",[n,!0],this.nextPromise,!1,!1)})),t.on("propagate",(function(e,r,n){this.getCtx&&!r||(this.getCtx=function(){if(e instanceof Promise)var r=t.context(e);return r&&r.getCtx?r.getCtx():this})}))}(),t}const Ke={},Ue="setTimeout",Ve="setInterval",Fe="clearTimeout",Ge="-start",Be=[Ue,"setImmediate",Ve,Fe,"clearImmediate"];function We(e){const t=function(e){return(e||W.ee).get("timer")}(e);if(Ke[t.debugId]++)return t;Ke[t.debugId]=1;var r=(0,z.YM)(t);return r.inPlace(p.gm,Be.slice(0,2),Ue+"-"),r.inPlace(p.gm,Be.slice(2,3),Ve+"-"),r.inPlace(p.gm,Be.slice(3),Fe+"-"),t.on(Ve+Ge,(function(e,t,n){e[0]=r(e[0],"fn-",null,n)})),t.on(Ue+Ge,(function(e,t,n){this.method=n,this.timerDuration=isNaN(e[1])?0:+e[1],e[0]=r(e[0],"fn-",this,n)})),t}const ze={};function qe(e){const t=function(e){return(e||W.ee).get("mutation")}(e);if(!p.RI||ze[t.debugId])return t;ze[t.debugId]=!0;var r=(0,z.YM)(t),n=p.gm.MutationObserver;return n&&(window.MutationObserver=function(e){return this instanceof n?new n(r(e,"fn-")):n.apply(this,arguments)},MutationObserver.prototype=n.prototype),t}const{TZ:Ze,d3:Ye,Kp:Xe,$p:Qe,wW:$e,e5:Je,tH:et,uP:tt,rw:rt,Lc:nt}=Ce;class it extends b{static featureName=Ze;constructor(e,t=!0){if(super(e,Ze,t),!p.RI)return;try{this.removeOnAbort=new AbortController}catch(e){}let r,n=0;const i=this.ee.get("tracer"),o=He(this.ee),a=De(this.ee),s=We(this.ee),c=Y(this.ee),u=this.ee.get("events"),d=ie(this.ee),l=be(this.ee),f=qe(this.ee);function h(e,t){l.emit("newURL",[""+window.location,t])}function g(){n++,r=window.location.hash,this[tt]=(0,S.t)()}function m(){n--,window.location.hash!==r&&h(0,!0);var e=(0,S.t)();this[Je]=~~this[Je]+e-this[tt],this[nt]=e}function v(e,t){e.on(t,(function(){this[t]=(0,S.t)()}))}this.ee.on(tt,g),a.on(rt,g),o.on(rt,g),this.ee.on(nt,m),a.on($e,m),o.on($e,m),this.ee.on("fn-err",((...t)=>{t[2]?.__newrelic?.[e.agentIdentifier]||(0,x.p)("function-err",[...t],void 0,this.featureName,this.ee)})),this.ee.buffer([tt,nt,"xhr-resolved"],this.featureName),u.buffer([tt],this.featureName),s.buffer(["setTimeout"+Xe,"clearTimeout"+Ye,tt],this.featureName),c.buffer([tt,"new-xhr","send-xhr"+Ye],this.featureName),d.buffer([et+Ye,et+"-done",et+Qe+Ye,et+Qe+Xe],this.featureName),l.buffer(["newURL"],this.featureName),f.buffer([tt],this.featureName),a.buffer(["propagate",rt,$e,"executor-err","resolve"+Ye],this.featureName),i.buffer([tt,"no-"+tt],this.featureName),o.buffer(["new-jsonp","cb-start","jsonp-error","jsonp-end"],this.featureName),v(d,et+Ye),v(d,et+"-done"),v(o,"new-jsonp"),v(o,"jsonp-end"),v(o,"cb-start"),l.on("pushState-end",h),l.on("replaceState-end",h),window.addEventListener("hashchange",h,(0,A.jT)(!0,this.removeOnAbort?.signal)),window.addEventListener("load",h,(0,A.jT)(!0,this.removeOnAbort?.signal)),window.addEventListener("popstate",(function(){h(0,n>1)}),(0,A.jT)(!0,this.removeOnAbort?.signal)),this.abortHandler=this.#n,this.importAggregator(e)}#n(){this.removeOnAbort?.abort(),this.abortHandler=void 0}}var ot=i(3333);class at extends b{static featureName=ot.TZ;constructor(e,t=!0){super(e,ot.TZ,t);const r=[e.init.page_action.enabled,e.init.performance.capture_marks,e.init.performance.capture_measures,e.init.user_actions.enabled,e.init.performance.resources.enabled];if(p.RI&&(e.init.user_actions.enabled&&(ot.Zp.forEach((e=>(0,A.sp)(e,(e=>(0,x.p)("ua",[e],void 0,this.featureName,this.ee)),!0))),ot.qN.forEach((e=>{const t=(0,v.s)((e=>{(0,x.p)("ua",[e],void 0,this.featureName,this.ee)}),500,{leading:!0});(0,A.sp)(e,t)}))),e.init.performance.resources.enabled&&p.gm.PerformanceObserver?.supportedEntryTypes.includes("resource"))){new PerformanceObserver((e=>{e.getEntries().forEach((e=>{(0,x.p)("browserPerformance.resource",[e],void 0,this.featureName,this.ee)}))})).observe({type:"resource",buffered:!0})}r.some((e=>e))?this.importAggregator(e):this.deregisterDrain()}}var st=i(993),ct=i(3785);class ut extends b{static featureName=st.TZ;constructor(e,t=!0){super(e,st.TZ,t);const r=this.ee;this.ee.on("wrap-logger-end",(function([e]){const{level:t,customAttributes:n}=this;(0,ct.R)(r,e,n,t)})),this.importAggregator(e)}}new class extends o{constructor(t){super(),p.gm?(this.features={},(0,R.bQ)(this.agentIdentifier,this),this.desiredFeatures=new Set(t.features||[]),this.desiredFeatures.add(w),this.runSoftNavOverSpa=[...this.desiredFeatures].some((e=>e.featureName===a.K7.softNav)),(0,d.j)(this,t,t.loaderType||"agent"),this.run()):(0,e.R)(21)}get config(){return{info:this.info,init:this.init,loader_config:this.loader_config,runtime:this.runtime}}run(){try{const t=u(this.agentIdentifier),r=[...this.desiredFeatures];r.sort(((e,t)=>a.P3[e.featureName]-a.P3[t.featureName])),r.forEach((r=>{if(!t[r.featureName]&&r.featureName!==a.K7.pageViewEvent)return;if(this.runSoftNavOverSpa&&r.featureName===a.K7.spa)return;if(!this.runSoftNavOverSpa&&r.featureName===a.K7.softNav)return;const n=function(e){switch(e){case a.K7.ajax:return[a.K7.jserrors];case a.K7.sessionTrace:return[a.K7.ajax,a.K7.pageViewEvent];case a.K7.sessionReplay:return[a.K7.sessionTrace];case a.K7.pageViewTiming:return[a.K7.pageViewEvent];default:return[]}}(r.featureName).filter((e=>!(e in this.features)));n.length>0&&(0,e.R)(36,{targetFeature:r.featureName,missingDependencies:n}),this.features[r.featureName]=new r(this)}))}catch(t){(0,e.R)(22,t);for(const e in this.features)this.features[e].abortHandler?.();const r=(0,R.Zm)();delete r.initializedAgents[this.agentIdentifier]?.api,delete r.initializedAgents[this.agentIdentifier]?.features,delete this.sharedAggregator;return r.ee.get(this.agentIdentifier).abort(),!1}}}({features:[pe,w,N,_e,Ie,I,D,at,ut,je,it],loaderType:"spa"})})()})();</script><meta charset="utf-8" /><meta name="viewport" content="width=device-width, initial-scale=1" /><meta http-equiv="Expires" content="0" /><meta name="DCSext.FullHTMLview" content="1" /><meta name="WT.cg_n" content="academicmedicine" /><meta name="WT.cg_s" content="Articles" /><meta name="wkhealth_journal_title" content="Academic Medicine" /><meta name="wkhealth_journal_title_legacy" content="Academic Medicine" /><meta name="wkhealth_issue" content="4" /><meta name="wkhealth_article_publication_date" content="April 2020" /><meta name="wkhealth_volume" content="95" /><meta name="wkhealth_ovid_accession_number" content="00001888-202004000-00021" /><meta name="wkhealth_issn" content="1040-2446" /><meta name="wkhealth_title" content="Evolution of an Accelerated 3-Year Pathway to the MD Degree: The Experience of New York University Grossman School of Medicine" /><meta name="wkhealth_authors" content="Cangiarella, Joan;Cohen, Elisabeth;Rivera, Rafael;Gillespie, Colleen;Abramson, Steven" /><meta name="wkhealth_doi" content="10.1097/ACM.0000000000003013" /><meta name="wkhealth_abstract_html_url" content="https://journals.lww.com/academicmedicine/abstract/2020/04000/evolution_of_an_accelerated_3_year_pathway_to_the.21.aspx" /><meta name="wkhealth_fulltext_html_url" content="https://journals.lww.com/academicmedicine/fulltext/2020/04000/evolution_of_an_accelerated_3_year_pathway_to_the.21.aspx" /><meta name="wkhealth_toc_section" content="Articles" /><meta name="wkhealth_toc_sub_section" /><meta name="wkhealth_eJpId" content="academicmedicine:2020:04000:00021" /><meta name="wkhealth_firstpage" content="534" /><meta name="wkhealth_date" content="April 2020" /><meta name="wkhealth_pdf_url" content="https://journals.lww.com/academicmedicine/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=Other&an=00001888-202004000-00021" /><meta name="Description" content="The revision of the curriculum at New York University Grossman School of Medicine in 2010, with a re" /><meta property="og:site_name" content="LWW" /><meta property="og:type" content="article" /><meta property="og:title" content="Evolution of an Accelerated 3-Year Pathway to the MD... : Academic Medicine" /><meta property="og:description" content="dualizing education, reducing student debt, and integrating undergraduate and graduate medical education. This accelerated 3-year doctor of medicine (3YMD) pathway is the first program of its kind in the United States to offer conditional acceptance to residency programs in all specialties through the National Resident Matching Program. Since inception of the pathway 6 years ago, 81 students have graduated. Critical components to successfully launch and implement the program are described...." /><meta property="og:image" content="https://images.journals.lww.com/academicmedicine/SocialThumb.00001888-202004000-00021.F1.jpeg" /><meta property="og:image:width" content="1200" /><meta property="og:image:height" content="621" /><meta property="og:url" content="https://journals.lww.com/academicmedicine/fulltext/2020/04000/evolution_of_an_accelerated_3_year_pathway_to_the.21.aspx" /><meta property="twitter:card" content="summary" /><meta name="robots" content="index, follow, noarchive" /><meta name="WT.sv" content="ZUSE1PEJPWEB02" /><meta name="Title" content="Academic Medicine" /><style id="SPThemeHideForms" type="text/css">body {opacity:0 !important}</style>  <link href="https://fonts.googleapis.com/css?family=Arvo:400,400i,700|Fira+Sans:300,300i,400,400i,500,500i,600,600i,700,700i&display=swap" rel="stylesheet" /> <script> // temporary workaround for Bug 316328:[Stage][Registration][Regression 05.04] - Omniture events are not displayed for article viewer page // prevents JS exception in Adobe launch.js caused by situation when wkhealth_institution_type meta tag is present while wkhealth_institution_name tag is not in the page head // see this check in Adobe launch.js: null != document.querySelector("meta[name='wkhealth_institution_name']") ... // TODO: implement proper code fix after release 05.04.00 deployment var wkhealth_institution_type = document.querySelector("meta[name='wkhealth_institution_type']"); var wkhealth_institution_name = document.querySelector("meta[name='wkhealth_institution_name']"); console.warn(wkhealth_institution_type); console.warn(wkhealth_institution_name); if (wkhealth_institution_type && !wkhealth_institution_name) { console.warn('Workaround in release 05.04.00 - removing wkhealth_institution_type meta tag if wkhealth_institution_name is not present'); wkhealth_institution_type.remove(); } </script> <link rel="shortcut icon" href="https://cdn.wolterskluwer.io/wk-logos/1.0.x/favicon.png" type="image/vnd.microsoft.icon" id="favicon" /> <link id="ctl00_ctl14_wkfavicon_linkFavIcon" rel="shortcut icon" href="/academicmedicine/PublishingImages/WKfavicon.ico" type="image/x-icon"></link> <meta name="msapplication-TileImage" content="/_layouts/15/images/SharePointMetroAppTile.png" /><meta name="msapplication-TileColor" content="#0072C6" /> <link rel="stylesheet" type="text/css" href="https://lww.com/_layouts/15/1033/styles/Themable/corev15.css?v=05.24.00.023" media="screen" /> <link rel="stylesheet" type="text/css" href="https://lww.com/_layouts/15/oaks.journals/core/bootstrap.min.css?v=05.24.00.023" media="screen" /> <link id="ctl00_ctl14_FontAwesomeStylesheet" rel="stylesheet" type="text/css" href="https://unpkg.com/font-awesome@4.4.0/css/font-awesome.min.css"></link> <link rel="stylesheet" type="text/css" href="https://lww.com/_layouts/15/1033/styles/oaks.journals/bootstrap-overwrites.css?v=05.24.00.023" media="screen" /><link rel="stylesheet" type="text/css" href="https://lww.com/_layouts/15/1033/styles/oaks.journals/tachyons.css?v=05.24.00.023" media="screen" /><link rel="stylesheet" type="text/css" href="/academicmedicine/_layouts/15/1033/styles/oaks.journals/base-main-header.css?v=05.24.00.023" media="screen" /><link rel="stylesheet" type="text/css" href="https://lww.com/_layouts/15/oaks.journals/core/lww-core.css?v=05.24.00.023" media="screen" /><link rel="stylesheet" type="text/css" href="https://lww.com/_layouts/15/oaks.journals/core/ejp.css?v=05.24.00.023" media="screen" /><link rel="stylesheet" type="text/css" href="https://lww.com/_layouts/15/oaks.journals/core/ejp-print.css?v=05.24.00.023" media="print" /><link rel="stylesheet" type="text/css" href="https://lww.com/_layouts/15/oaks.journals/core/jqueryui.css?v=05.24.00.023" media="screen" /> <link rel="stylesheet" type="text/css" href="/academicmedicine/Style%20Library/journal.css?v=05.24.00.023" media="screen" /> <link rel="stylesheet" type="text/css" href="/academicmedicine/Style%20Library/custom.journal.css?v=05.24.00.023" media="screen" /> <script>var WebContext = {"EndPoints":{"ArticleMetricsEndpoint":"//services.journals.lww.com/IntegrationServices/ArticleMetricsService.svc","ThirdPartyRSSFeedServiceEndPoint":"https://services.journals.lww.com/IntegrationServices/ThirdPartyRSSFeedService.svc","JwtTokenServiceEndpoint":"https://journals.lww.com/academicmedicine/_layouts/15/OAKS.Journals/JsonWebToken.svc"}}</script> <script type="text/javascript">// <![CDATA[ var g_SPOffSwitches={}; // ]]> </script> <script type="text/javascript" src="/_layouts/15/1033/initstrings.js?rev=nDf18IVeB%2B72%2BM6Jhf9Utg%3D%3DTAG0"></script> <script type="text/javascript" src="/_layouts/15/init.js?rev=tUeDdv3F0bt%2B53gKekYVYQ%3D%3DTAG0"></script> <script type="text/javascript" src="/_layouts/15/1033/strings.js?rev=ZpwERQVJtz0nJ0TWzlZWYw%3D%3DTAG0"></script> <script type="text/javascript" src="/_layouts/15/theming.js?rev=SuLUbbwTXcxFWOWLFUsOkw%3D%3DTAG0"></script> <script type="text/javascript" src="/_layouts/15/ie55up.js?rev=JyfVJS9cC6zB7iMW4%2BoyXg%3D%3DTAG0"></script> <script type="text/javascript" src="/ScriptResource.axd?d=F7rjznvAP1ZvjwmSYaDR9a3zqrnKFnNGXs7A_cRIg2rplizpOOjwg9eBfW_KxBMLRVN3lzATjzWkisQusj_Iaw7I7xHhM2EsA2p1WTk5lIh-1_uEIMq1sktVYKM3D6Gp5VSqOtDTEnrScqHWTHOzdCPnKDjm2mtJH72pNbP0u4uI_zDnfi9spPAqI_kz3qnF0&t=ffffffffaa493ab8"></script> <script type="text/javascript" src="/_layouts/15/blank.js?rev=aECCBG3EW5w5rcRXMfaDHw%3D%3DTAG0"></script> <script type="text/javascript" src="/ScriptResource.axd?d=yatK8ruofouVZAe4qMCnoohEpb3HRGGjDeZZjZ7kMmC722OeAMhxqxkQCI5Rxx8YROZ4ohEXEd-BY-UzqqqylduXIs6jc38C73kN3lT2QdlwTljpny1fYEjcvvbYSMHNq1-TT-bDa0cFUDuAr5ywhChhEELpPbB_In_xfOO6OlgjpjP86LmsgZzKkXo8aCS90&t=ffffffffaa493ab8"></script> <script type="text/javascript" src="/ScriptResource.axd?d=Fr5k7XDliwj7SPEiKSqb-V3uT_yv_Vc0LBq3yd_m1_Ea8vkvI41fPqtWB8rH7kW9D2--SObxiXOCEDDg2Tv5yxNEAylK5ZpV5j9rD03yPUcCPh8w-y9A8MWLSg0jrQ-0kisGzu4Hba8Ct3e6oiiAj5nLa8lUDGLzNSKFrT8wEzRvrGDuqa6AKloxdLDyhLNb6sYlIjtGIn7oUTXlG_HGsg2&t=596f116c"></script> <script type="text/javascript" src="/ScriptResource.axd?d=LXNyktQiaIpbp533FW-c46OHB30ylIqDlrzk7r3HlWeMLy05SwQ7ZZDsPGq7NzzDRSU0tvewepiuVrszZuoio7QLmOYibhCj6dQNfSL2hGpxpyP-E7et27fbWMHpoIuHecopwN8d_b-WR8rimwUGdbN6akitIdX32lXMez7LH7qkG1jVMDvXf2M0_6gdMpGjpPKlEhmMrNGzYuo05_KLRO4TeTkKykcR_5pPB2fyzgk1&t=596f116c"></script> <script type="text/javascript" src="/ScriptResource.axd?d=UozfgYfgcP8g118ZMoKEWz_x5V51ZaIWOeFUe49mdZ8Yy8frQahBfRlFRNNeizXxYfmbtpE1uZMOMW2QeF7QCWjREvRvpNDSCGO5YICh1GalcUtEGJaGvVObluwmGza6-lV8S-wgb9vDF6UYZlWbyLOo-d94ckB8BN1hUlnIdqL9auDE1qR-ddFC7rw_89VZWQ6uTxR6vOlq2jE0iTr3J_6_Q3a7SLOduMua_ZXDgk7k01lBMUodCwi6dm-oTxLE0&t=596f116c"></script> <script type="text/javascript" src="/ScriptResource.axd?d=ZWgxL8bxzPcm3sf7nBtjnXIE2wsAF-izuHnFdkP9YIwhY40NTQZWAMXXd5_I4JNrdCjHASB5kHO0Yp663zuk5AhL_jRl1k_SY5vnpUrSCkFxyolVdXM4FQlXIKn4Vvw31N76GuK5LU06Z_W9PLwfY2Syw-289UtPxVzBx9gVTRruCab2sQxw8wsPzWwQuzodrorJnIINUBwKL_vl4JpUyg2&t=596f116c"></script> <script type="text/javascript" src="/ScriptResource.axd?d=EBaCwkyF6v0hRUf3ae-93ssVmxQ7oIMqv_PPxkqrb9oreHGbb2-nfpYVrHcdp3m-zVM-7IejfExLCflpv83MelmvDxCP_bfWTqE6qeqNKtnJrC6U7f-VSqzDeiqxeFeQcr2gdWPsj6xuQIL9yofEjL-H9aGyCIOqWIpEBJ7whIjP5cINMF1LSl9sjJQ7m8EzvCkRy97Lv87xdtMaOwsPZQua3oe2eRAfQMy5DfH1rBU1&t=596f116c"></script> <script type="text/javascript" src="/ScriptResource.axd?d=wD8VqdUYdbEDwBKpnhKPdzJbzZckynHSZAFSwtw0pb9xBjjkE5QcyWugHeKYmmlr5VSa3nfGB1Xz7jafz_E7BWSKiwSgokhW7jiO928L_QrPFxF6EUuMyF_R_k74O2ZH3Z2j_4YTihok5YYe4jIHNbXew2ICIYicdQ6t5hTNp6rgynp1DalRocxe5znBs87HZLCu8p1QfDK38eKJRZE968HV31IWzfYmG-OLm0YY--COCDBd2W06gq-Q4GGHyVyR0&t=596f116c"></script> <script type="text/javascript" src="/ScriptResource.axd?d=-7EYqBUD5SBnN9GXen_j6q1vUCHCiGsBm9LG-6jUM7Rd46ySBRRKNEzamKwU97Ev4GNWdvuZGqjKPpTco_vaUnZotagIyWjSOr8Y_YpPpCBN41u1qvqUa_Z3KhaMpFpLnBCVAOGXsZBX0gnLdrWl7SPrwgrfSJovgJOyKQNohnCagrVGRS7D0SajjiwZiBwbRFFXzQUODi-UXS4-R3OUE9NEoYmrfX_DvTq3geTEsrQ1&t=596f116c"></script> <script type="text/javascript" src="/ScriptResource.axd?d=1Bz5XD8diaSe1jTYew43lskkqvoOQ7xUk9zYBR9yPfNI5dG64NIPCYkFSKOHNDL_QVi-dGp62xDY0jGHiOTaybK9bApxYHqJLIbzEwEQB4irPiQPiKBzzY5p7N4f-D0FpCNtiMYBBQwavF6nxBbyIVOMdRyTBQ10Hm9Zmj9z2NOmhfNxDVkOcXNQDwO54qpnA74wIl4P7kqB5Ngz9hx4kY3xEadtMKXSX7uqRVTMzso1&t=596f116c"></script> <script type="text/javascript" src="/ScriptResource.axd?d=2jUlVNSVbehJJ-Lt4PSuX3imkArDDoAUwrw500StXDnRKdoHS2np91egmJiBUG7feIOax9x-3d3eG4JYvatg-8X9LQmJU49eWww19gWY7vSdphyQrCWf_QI352TwlgZkOjBO9SLzCdnP0Rkx2chN2q3GkIbDzjCD2z0q_V19F4FLoBgT9FcKUizcWUqIzBoXhgYN9ZOMKI0YCb0cjcqnIG9l7yUe6eYzolUqVyyoo5k1&t=596f116c"></script> <script type="text/javascript">RegisterSod("require.js", "\u002f_layouts\u002f15\u002frequire.js?rev=bv3fWJhk0uFGpVwBxnZKNQ\u00253D\u00253DTAG0");</script> <script type="text/javascript">RegisterSod("core.js", "\u002f_layouts\u002f15\u002fcore.js?rev=X4uLEufFgYqcOIdgpIhuDA\u00253D\u00253DTAG0");</script> <script type="text/javascript">RegisterSod("menu.js", "\u002f_layouts\u002f15\u002fmenu.js?rev=zERCzIJdrBRUbXplwABKCQ\u00253D\u00253DTAG0");</script> <script type="text/javascript">RegisterSod("mQuery.js", "\u002f_layouts\u002f15\u002fmquery.js?rev=\u00252FXyuxYpmZkrb\u00252F8hr8qAp4A\u00253D\u00253DTAG0");</script> <script type="text/javascript">RegisterSod("callout.js", "\u002f_layouts\u002f15\u002fcallout.js?rev=SXWks4yuc56TLK08Mqi8DQ\u00253D\u00253DTAG0");RegisterSodDep("callout.js", "mQuery.js");RegisterSodDep("callout.js", "core.js");</script> <script type="text/javascript">RegisterSod("clienttemplates.js", "\u002f_layouts\u002f15\u002fclienttemplates.js?rev=8RUHcNWt4aaDq4HzXGpgPQ\u00253D\u00253DTAG0");</script> <script type="text/javascript">RegisterSod("sharing.js", "\u002f_layouts\u002f15\u002fsharing.js?rev=CqmUs94LHGI3QsRmU9Hl4Q\u00253D\u00253DTAG0");RegisterSodDep("sharing.js", "mQuery.js");RegisterSodDep("sharing.js", "clienttemplates.js");RegisterSodDep("sharing.js", "core.js");</script> <script type="text/javascript">RegisterSod("suitelinks.js", "\u002f_layouts\u002f15\u002fsuitelinks.js?rev=k\u00252F45L4VD\u00252Fgl6msDK35hKtQ\u00253D\u00253DTAG0");RegisterSodDep("suitelinks.js", "core.js");</script> <script type="text/javascript">RegisterSod("followingcommon.js", "\u002f_layouts\u002f15\u002ffollowingcommon.js?rev=nxqbG0N9Bxu\u00252F41zqaoZIcA\u00253D\u00253DTAG0");RegisterSodDep("followingcommon.js", "sp.js");RegisterSodDep("followingcommon.js", "userprofile");RegisterSodDep("followingcommon.js", "core.js");RegisterSodDep("followingcommon.js", "mQuery.js");</script> <script type="text/javascript">RegisterSod("profilebrowserscriptres.resx", "\u002f_layouts\u002f15\u002f1033\u002fprofilebrowserscriptres.js?rev=qwf69WaVc1mYlJLXqmZmVA\u00253D\u00253DTAG0");</script> <script type="text/javascript">RegisterSod("inplview", "\u002f_layouts\u002f15\u002finplview.js?rev=bD6deNlE40\u00252F6a2UbjkGcjA\u00253D\u00253DTAG0");RegisterSodDep("inplview", "core.js");RegisterSodDep("inplview", "clienttemplates.js");RegisterSodDep("inplview", "sp.js");</script> <script type="text/javascript">RegisterSod("dragdrop.js", "\u002f_layouts\u002f15\u002fdragdrop.js?rev=d8Tf8wkopFDKzaLlme\u00252Fv7w\u00253D\u00253DTAG0");</script> <script type="text/javascript">RegisterSod("quicklaunch.js", "\u002f_layouts\u002f15\u002fquicklaunch.js?rev=Y7JKqHS8v90gdlTdpIRXTw\u00253D\u00253DTAG0");RegisterSodDep("quicklaunch.js", "dragdrop.js");</script> <script type="text/javascript">RegisterSod("WPAdderClass", "\u002f_layouts\u002f15\u002fwpadder.js?rev=Q6piPtxcFkq3zycHqbG9pQ\u00253D\u00253DTAG0");</script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/jquery.js?v=05.24.00.023"> </script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/bootstrap.bundle.min.js?v=05.24.00.023" defer="true"> </script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/jqueryui.js?v=05.24.00.023"> </script> <link type="text/xml" rel="alternate" href="/academicmedicine/_vti_bin/spsdisco.aspx" /> <link rel="canonical" href="https://journals.lww.com/academicmedicine/fulltext/2020/04000/evolution_of_an_accelerated_3_year_pathway_to_the.21.aspx" /> <noscript> <meta http-equiv="Refresh" content="3;url=/_layouts/1033/OAKS.Journals/Error/JavaScript.html" /> </noscript> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/lww-core.js?v=05.24.00.023"> </script> <script type="text/javascript" src="https://lww.com/_layouts/15/1033/Scripts/wk/journal-navigation.min.js?v=05.24.00.023" defer="true"> </script> <script type="text/javascript" src="https://lww.com/_layouts/15/1033/Scripts/wk/journals_master.min.js?v=05.24.00.023"> </script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/manifest.js?v=05.24.00.023" defer="true"> </script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/ejp.js?v=05.24.00.023" defer="true"> </script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/react-redux-vendors.js?v=05.24.00.023" defer="true"> </script> <script type="text/javascript"> var scpl_time = new Date(); scpl_time = scpl_time.getTime(); window.A8AJQ = jQuery.noConflict(); window.$ = jQuery.noConflict(); </script> <script async type="text/plain" src="https://aim-tag.hcn.health/js/client.js?dl=aimDataLayer&target=ie11" class="optanon-category-C0004"></script> <script> window.aimDataLayer = window.aimDataLayer || []; function aimTag() { aimDataLayer.push(arguments); } aimTag('2429bf11-c05b-409f-b998-8acef505546e', 'pageview'); aimTag('2429bf11-c05b-409f-b998-8acef505546e', 'signal', function (err, success) { if (err) { console.log(err); } else { console.log(success); if (success.identity_type === "AUT") { } } }); </script> <meta name="citation_doi" content="10.1097/ACM.0000000000003013"><meta name="citation_fulltext_world_readable" content="" /></head> <body id="ctl00_BodyTag" class="lww-body lww-article-view"> <span class="js-custom-event" data-config="{"name":"omni:page:view","detail":{"uid":"","uid_src":"None","page_loc":"https://journals.lww.com/academicmedicine/pages/articleviewer.aspx?year=2020&issue=04000&article=00021&type=Fulltext","page_ttl":"Academic Medicine"},"order":2147483647,"config":{"bubbles":true,"cancelable":true,"composed":false}}"></span>  <noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-NLR6H6W"height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>  <div id="imgPrefetch" style="display:none"> <img src="https://cdn.wolterskluwer.io/wk-logos/1.0.x/favicon.png?rev=43" /> <img src="/_layouts/15/images/spcommon.png?rev=43" /> </div> <noscript><div class='noindex'>You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page.</div></noscript> <form method="post" action="/academicmedicine/Fulltext/2020/04000/Evolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx" onsubmit="javascript:return WebForm_OnSubmit();" id="aspnetForm"> <div class="aspNetHidden"> <input type="hidden" name="_wpcmWpid" id="_wpcmWpid" value="" /> <input type="hidden" name="wpcmVal" id="wpcmVal" value="" /> <input type="hidden" name="MSOWebPartPage_PostbackSource" id="MSOWebPartPage_PostbackSource" value="" /> <input type="hidden" name="MSOTlPn_SelectedWpId" id="MSOTlPn_SelectedWpId" value="" /> <input type="hidden" name="MSOTlPn_View" id="MSOTlPn_View" value="0" /> <input type="hidden" name="MSOTlPn_ShowSettings" id="MSOTlPn_ShowSettings" value="False" /> <input type="hidden" name="MSOGallery_SelectedLibrary" id="MSOGallery_SelectedLibrary" value="" /> <input type="hidden" name="MSOGallery_FilterString" id="MSOGallery_FilterString" value="" /> <input type="hidden" name="MSOTlPn_Button" id="MSOTlPn_Button" value="none" /> <input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="" /> <input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="" /> <input type="hidden" name="__REQUESTDIGEST" id="__REQUESTDIGEST" value="noDigest" /> <input type="hidden" name="MSOSPWebPartManager_DisplayModeName" id="MSOSPWebPartManager_DisplayModeName" value="Browse" /> <input type="hidden" name="MSOSPWebPartManager_ExitingDesignMode" id="MSOSPWebPartManager_ExitingDesignMode" value="false" /> <input type="hidden" name="MSOWebPartPage_Shared" id="MSOWebPartPage_Shared" value="" /> <input type="hidden" name="MSOLayout_LayoutChanges" id="MSOLayout_LayoutChanges" value="" /> <input type="hidden" name="MSOLayout_InDesignMode" id="MSOLayout_InDesignMode" value="" /> <input type="hidden" name="_wpSelected" id="_wpSelected" value="" /> <input type="hidden" name="_wzSelected" id="_wzSelected" value="" /> <input type="hidden" name="MSOSPWebPartManager_OldDisplayModeName" id="MSOSPWebPartManager_OldDisplayModeName" value="Browse" /> <input type="hidden" name="MSOSPWebPartManager_StartWebPartEditingName" id="MSOSPWebPartManager_StartWebPartEditingName" value="false" /> <input type="hidden" name="MSOSPWebPartManager_EndWebPartEditing" id="MSOSPWebPartManager_EndWebPartEditing" value="false" /> <input type="hidden" name="listContainerControlstate" id="listContainerControlstate" value="AAEAAAD/////AQAAAAAAAAAEAQAAAA5TeXN0ZW0uQm9vbGVhbgEAAAAHbV92YWx1ZQABAAs=" /> <input type="hidden" name="hiddenDisplayItemView" id="hiddenDisplayItemView" value="Citation" /> <input type="hidden" name="hiddenSortBy" id="hiddenSortBy" value="" /> <input type="hidden" name="__LASTFOCUS" id="__LASTFOCUS" value="" /> <input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="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" /> </div> <script type="text/javascript"> //<![CDATA[ var theForm = document.forms['aspnetForm']; if (!theForm) { theForm = document.aspnetForm; } function __doPostBack(eventTarget, eventArgument) { if (!theForm.onsubmit || (theForm.onsubmit() != false)) { theForm.__EVENTTARGET.value = eventTarget; theForm.__EVENTARGUMENT.value = eventArgument; theForm.submit(); } } //]]> </script> <script src="/WebResource.axd?d=dnaDAFNiQGyAS-8AAnEusSAvRcEvxsZnbowJJdr_Pi9Oz7lzs5k45FStkRo1xlEHk9NeovbY1Hwq_CwXR_md87LXDXM1L2hMpaL8ksMyAA01&t=637811513229275428" type="text/javascript"></script> <script type="text/javascript"> //<![CDATA[ var MSOWebPartPageFormName = 'aspnetForm'; var g_presenceEnabled = true; var g_wsaEnabled = false; var g_correlationId = '962f83a1-9227-f0c3-506d-7ba8ed66af75'; var g_wsaQoSEnabled = false; var g_wsaQoSDataPoints = []; var g_wsaRUMEnabled = false; var g_wsaLCID = 1033; var g_wsaListTemplateId = 850; var g_wsaSiteTemplateId = 'EJOURNALS#1'; var _spPageContextInfo={"webServerRelativeUrl":"/academicmedicine","webAbsoluteUrl":"https://journals.lww.com/academicmedicine","viewId":"","listId":"{593bb495-6a2b-408a-b7e6-ff83e039a739}","listPermsMask":{"High":0,"Low":200769},"listUrl":"/academicmedicine/Pages","listTitle":"Pages","listBaseTemplate":850,"viewOnlyExperienceEnabled":false,"blockDownloadsExperienceEnabled":false,"idleSessionSignOutEnabled":false,"cdnPrefix":"","siteAbsoluteUrl":"https://journals.lww.com/academicmedicine","siteId":"{2a0a2634-33ce-43c8-873b-87c86854430b}","showNGSCDialogForSyncOnTS":false,"supportPoundStorePath":true,"supportPercentStorePath":true,"siteSubscriptionId":null,"CustomMarkupInCalculatedFieldDisabled":true,"AllowCustomMarkupInCalculatedField":false,"isSPO":false,"farmLabel":null,"serverRequestPath":"/academicmedicine/pages/articleviewer.aspx","layoutsUrl":"_layouts/15","webId":"{bd1a5303-11ec-476e-85d0-393f68fe09bb}","webTitle":"Academic Medicine","webTemplate":"20200","webTemplateConfiguration":"EJOURNALS#1","webDescription":"","tenantAppVersion":"0","isAppWeb":false,"webLogoUrl":"/_layouts/images/titlegraphic.gif","webLanguage":1033,"currentLanguage":1033,"currentUICultureName":"en-US","currentCultureName":"en-US","currentCultureLCID":1033,"env":null,"nid":0,"fid":0,"serverTime":"2025-02-20T00:40:30.6277164Z","siteClientTag":"4$$16.0.10416.20026","crossDomainPhotosEnabled":false,"openInClient":false,"Has2019Era":true,"webUIVersion":15,"webPermMasks":{"High":0,"Low":196608},"pageListId":"{593bb495-6a2b-408a-b7e6-ff83e039a739}","pageItemId":212,"pagePermsMask":{"High":0,"Low":200769},"pagePersonalizationScope":1,"userEmail":"","userId":0,"userLoginName":null,"userDisplayName":null,"isAnonymousUser":true,"isAnonymousGuestUser":false,"isEmailAuthenticationGuestUser":false,"isExternalGuestUser":false,"systemUserKey":null,"alertsEnabled":true,"siteServerRelativeUrl":"/academicmedicine","allowSilverlightPrompt":"True","themeCacheToken":"/academicmedicine::5:","themedCssFolderUrl":null,"themedImageFileNames":null,"modernThemingEnabled":true,"isSiteAdmin":false,"ExpFeatures":[480216468,1884350801,1158731092,62197791,538521105,335811073,4194306,34614301,268500996,-1946025984,28445328,-2147475455,134291456,65536,288,950272,1282,808326148,134217873,0,0,-1073217536,545285252,18350656,-467402752,6291457,-2147483644,1074794496,-1728053184,1845537108,622628,4102,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0],"killSwitches":{},"InternalValidAuthorities":["journals.na.lww.com","journals.lww.com","journals.na.lww.com","journals.lww.com","cloud-journals.lww.com","cloud-journals.lww.com"],"CorrelationId":"962f83a1-9227-f0c3-506d-7ba8ed66af75","hasManageWebPermissions":false,"isNoScriptEnabled":false,"groupId":null,"groupHasHomepage":true,"groupHasQuickLaunchConversationsLink":false,"departmentId":null,"hubSiteId":null,"hasPendingWebTemplateExtension":false,"isHubSite":false,"isWebWelcomePage":false,"siteClassification":"","hideSyncButtonOnODB":false,"showNGSCDialogForSyncOnODB":false,"sitePagesEnabled":false,"sitePagesFeatureVersion":0,"DesignPackageId":"00000000-0000-0000-0000-000000000000","groupType":null,"groupColor":"#23874b","siteColor":"#23874b","headerEmphasis":0,"navigationInfo":null,"guestsEnabled":false,"MenuData":{"SignInUrl":"/academicmedicine/_layouts/15/Authenticate.aspx?Source=%2Facademicmedicine%2FFulltext%2F2020%2F04000%2FEvolution%5Fof%5Fan%5FAccelerated%5F3%5FYear%5FPathway%5Fto%5Fthe%2E21%2Easpx"},"RecycleBinItemCount":-1,"PublishingFeatureOn":true,"PreviewFeaturesEnabled":false,"disableAppViews":false,"disableFlows":false,"serverRedirectedUrl":null,"formDigestValue":"0xBD6D66B9ACB966458144940B10463F3BE4D45887B540FDEA9A64111D48FF718FE46173FCC04ABA37A4680F5C912E996AD5A7454BBC5412198D32807A4677FDDA,20 Feb 2025 00:40:30 -0000","maximumFileSize":10240,"formDigestTimeoutSeconds":1800,"canUserCreateMicrosoftForm":false,"canUserCreateVisioDrawing":true,"readOnlyState":null,"isTenantDevSite":false,"preferUserTimeZone":false,"userTimeZoneData":null,"userTime24":false,"userFirstDayOfWeek":null,"webTimeZoneData":null,"webTime24":false,"webFirstDayOfWeek":null,"isSelfServiceSiteCreationEnabled":null,"alternateWebAppHost":"","aadTenantId":"","aadUserId":"","aadInstanceUrl":"","msGraphEndpointUrl":"https://","allowInfectedDownload":true};_spPageContextInfo.updateFormDigestPageLoaded=new Date();_spPageContextInfo.clientServerTimeDelta=new Date(_spPageContextInfo.serverTime)-new Date();if(typeof(define)=='function'){define('SPPageContextInfo',[],function(){return _spPageContextInfo;});}var L_Menu_BaseUrl="/academicmedicine"; var L_Menu_LCID="1033"; var L_Menu_SiteTheme="null"; document.onreadystatechange=fnRemoveAllStatus; function fnRemoveAllStatus(){removeAllStatus(true)};//]]> </script> <script src="https://lww.com/_layouts/15/1033/Scripts/wk/alerts-subscription.min.js?v=05.24.00.023" type="text/javascript"></script> <script type="text/javascript"> //<![CDATA[ Flighting.ExpFeatures = [480216468,1884350801,1158731092,62197791,538521105,335811073,4194306,34614301,268500996,-1946025984,28445328,-2147475455,134291456,65536,288,950272,1282,808326148,134217873,0,0,-1073217536,545285252,18350656,-467402752,6291457,-2147483644,1074794496,-1728053184,1845537108,622628,4102,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0]; (function() { if(typeof(window.SP) == "undefined") window.SP = {}; if(typeof(window.SP.YammerSwitch) == "undefined") window.SP.YammerSwitch = {}; var ysObj = window.SP.YammerSwitch; ysObj.IsEnabled = false; ysObj.TargetYammerHostName = "www.yammer.com"; } )(); var _spWebPartComponents = new Object();function openEmtcIfAuthenticated(resourceId){logCounterDataEmailToColleagueByAN('00001888-202004000-00021', false); window.location.assign('https://journals.lww.com/academicmedicine/pages/login.aspx?ReturnUrl=%2facademicmedicine%2fFulltext%2f2020%2f04000%2fEvolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx');}function slideShow_NavigateToUrl(urlToNavigate) { $('#ArticleImageModal').modal('hide'); logCounterDataImageGalleryByAN('00001888-202004000-00021'); window.location = urlToNavigate; }function HideSlideShow() { $('#ArticleImageModal').modal('hide'); }//]]> </script> <script src="https://lww.com/_layouts/15/1033/Scripts/wk/ListContainerControlBase.js?v=05.24.00.023" type="text/javascript"></script> <script type="text/javascript"> //<![CDATA[ function getSelectedItemsField() { return $get("selectedItems"); }function getCheckBoxListContainer() { return $get("checkBoxListContainer"); }function getListActionsContainerTop() { return $get("listActionsContainerTop"); }function getListActionsContainerBottom() { return $get("listActionsContainerBottom"); }function getSelectedItemsCount() {{ return getSelectedItemsField().value.split(';').length - 1; }}function article_AddSelectedItem(){ addToMyCollectionsLinkClicked('00021'); }function getEmailRegularExpression() { return /^(([a-zA-Z0-9_\-\.]+)@([a-zA-Z0-9_\-\.]+)\.([a-zA-Z]{2,5}){1,25})$/; }function getMultipleEmailsRegularExpression() { return /^(([a-zA-Z0-9_\-\.]+)@([a-zA-Z0-9_\-\.]+)\.([a-zA-Z]{2,5}){1,25})+([;.](([a-zA-Z0-9_\-\.]+)@([a-zA-Z0-9_\-\.]+)\.([a-zA-Z]{2,5}){1,25})+)*$/; }function getMailMessage() { return 'Thought you might appreciate this item(s) I saw in Academic Medicine.'; }function getImageCountStatus() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_imageCountStatus"); }function getCallshowImage() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_callShowImage"); }function getImageUrl() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_url"); }function getDescription() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_description"); }function getImageSourceTitle() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_sourceTitle"); }function getImageSourceUrl() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_sourceUrl"); }function getImageSourceInfo() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_sourceInfo"); }function getImageKey() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_key"); }function getImageFullSizeUrl() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_fullSizeUrl"); }function getImageGalleryUrl() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_imageGalleryUrl"); }function getEmailTOColleaguePopupID() { return "ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague"; }function image(id, nextImageId, previousImageId, title, description, rolloverUrl, popupUrl, fullSizeUrl, originalUrl, imageGalleryUrl, windowId){this.id = id;this.title = title;this.description = description;this.rolloverUrl = rolloverUrl;this.popupUrl = popupUrl;this.nextImageId = nextImageId;this.previousImageId = previousImageId; this.fullsizeUrl = fullSizeUrl; this.originalUrl = originalUrl;this.imageGalleryUrl = imageGalleryUrl; this.windowId=windowId}function Global_GetImagesCollection(){var images = new Object();images["F1"]=new image("F1","F2","","Figure 1","Accelerated 3-year MD pathway curriculum with entry points, as compared with 4-year curriculum, New York University Grossman School of Medicine. Abbreviations: USMLE, United States Medical Licensing Examination; CCSE, comprehensive clinical skills exam.","https://images.journals.lww.com/academicmedicine/Rollover.00001888-202004000-00021.F1.jpeg","https://images.journals.lww.com/academicmedicine/Gallery.00001888-202004000-00021.F1.jpeg","https://journals.lww.com/academicmedicine/_layouts/oaks.journals/ImageView.aspx?k=academicmedicine:2020:04000:00021&i=F1&year=2020&issue=04000&article=00021&type=Fulltext","https://images.journals.lww.com/academicmedicine/Original.00001888-202004000-00021.F1.jpeg","/academicmedicine/pages/imagegallery.aspx?year=2020&issue=04000&article=00021", "academicmedicine_2020_04000_00021_F1");images["F2"]=new image("F2","","F1","Figure 2","Number of graduating students and available residency positions, New York University Grossman School of Medicine 3YMD pathway, 2016–2019.","https://images.journals.lww.com/academicmedicine/Rollover.00001888-202004000-00021.F2.jpeg","https://images.journals.lww.com/academicmedicine/Gallery.00001888-202004000-00021.F2.jpeg","https://journals.lww.com/academicmedicine/_layouts/oaks.journals/ImageView.aspx?k=academicmedicine:2020:04000:00021&i=F2&year=2020&issue=04000&article=00021&type=Fulltext","https://images.journals.lww.com/academicmedicine/Original.00001888-202004000-00021.F2.jpeg","/academicmedicine/pages/imagegallery.aspx?year=2020&issue=04000&article=00021", "academicmedicine_2020_04000_00021_F2"); return images; }function getPopupImageId() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_popupImageId"); }function getIsExportToPPT() { return $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_IsExportToPPT"); }//]]> </script> <script src="/ScriptResource.axd?d=11ySqNT2t8wJXf-5ynqkHTYVaR0CZPUQDLhFk5-B61-yY4pHK9T4A-OmNoLERHX1OU2F3io32lKHXeNlvH0kpnJP6-ZQm2Ado5OlvNqUwB9TpwuIgMVQBgIz-DSVpHWqDoVFHrt69C9fSrbhF6t9QBuuAcSpa-p9_2de4EnR0aU1&t=2265eaa7" type="text/javascript"></script> <script src="/_layouts/15/blank.js?rev=aECCBG3EW5w5rcRXMfaDHw%3D%3DTAG0" type="text/javascript"></script> <script type="text/javascript"> //<![CDATA[ window.SPThemeUtils && SPThemeUtils.RegisterCssReferences([]); (function(){ if (typeof(_spBodyOnLoadFunctions) === 'undefined' || _spBodyOnLoadFunctions === null) { return; } _spBodyOnLoadFunctions.push(function() { SP.SOD.executeFunc('core.js', 'FollowingDocument', function() { FollowingDocument(); }); }); })();(function(){ if (typeof(_spBodyOnLoadFunctions) === 'undefined' || _spBodyOnLoadFunctions === null) { return; } _spBodyOnLoadFunctions.push(function() { SP.SOD.executeFunc('core.js', 'FollowingCallout', function() { FollowingCallout(); }); }); })();if (typeof(DeferWebFormInitCallback) == 'function') DeferWebFormInitCallback();//]]> </script> <script src="/WebResource.axd?d=ujR-dJ4zUHGN6jELxLVetl199sJpE_qZiBmEfUoaRM4DCmEfpBr9GGhTGo9ZJcfF6mQ45yf4Ik1RnQ9yqZG9_5EcA9R0xynU6JEfYiEh3vA1&t=637811513229275428" type="text/javascript"></script> <script type="text/javascript"> //<![CDATA[ function WebForm_OnSubmit() { UpdateFormDigest('\u002facademicmedicine', 1440000);if (typeof(ValidatorOnSubmit) == "function" && ValidatorOnSubmit() == false) return false;if (typeof(_spFormOnSubmitWrapper) != 'undefined') {return _spFormOnSubmitWrapper();} else {return true;}; return true; } //]]> </script> <div class="aspNetHidden"> <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="F3874316" /> <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION" value="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" /> </div> <script type="text/javascript"> var submitHook = function () { return false; }; theForm._spOldSubmit = theForm.submit; theForm.submit = function () { if (!submitHook()) { this._spOldSubmit(); } }; </script> <span id="DeltaSPWebPartManager"> </span> <script type="text/javascript">$.getJSON("https://login.journals.lww.com/AuthCheck.aspx?Callback=?", null, function (data) { if(data.IsAuthenticated.toLowerCase() == "true") {window.location.replace("https://login.journals.lww.com/?wa=wsignin1.0&wtrealm=urn%3ajournals&wctx=https%3a%2f%2fjournals.lww.com%2facademicmedicine%2f_layouts%2f15%2fAuthenticate.aspx%3fSource%3d%252facademicmedicine%252fFulltext%252f2020%252f04000%252fEvolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx"); } }) </script> <script type="text/javascript"> //<![CDATA[ Sys.WebForms.PageRequestManager._initialize('ctl00$ScriptManager', 'aspnetForm', ['fctl00$WebPartAdderUpdatePanel',''], [], ['ctl00$WebPartAdder','','ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$exportToCitationManager$btnOpenExportDialog',''], 90, 'ctl00'); //]]> </script> <span id="DeltaDelegateControls"> </span>   <div id="ctl00_MicrobarContainer" class="top-microbar-container"> </div>  <a id="HiddenAnchor" href="javascript:;" style="display: none;"></a>  <div id="ctl00_TopAdvertisementContainer" class="advertisement-content_top top-banner"> <div class="top-banner__content--centered top-banner--low-opacity"> <div id="ctl00_ctl49_adContainer" class="ej-advertisement ej-advertisement-topcombo"> <div class="ej-advertisement-content"> <div> <div id="ga_d720cd59-7217-4183-b059-6774f4829bb2" class="ad-slot-container ad-slot-container-ga_d720cd59-7217-4183-b059-6774f4829bb2" data-sizemap="[[[730, 500], [[728, 90]]], [[0, 0], [[300, 50]]]]" data-adpath="/15726702761/Desktop/academicmedicine/Article/Top" data-autoload="yes" data-outofpage="no" data-sticky="yes" data-slottargeting='' data-displayslug="yes" data-sticky-duration="5" data-name="Top"></div> </div> </div> </div> </div> </div> <div class="main-wrapper"> <div id="main-container">  <header class="header"> <div class="header__holder"> <div class="header__layout-top wk-grid-page-container"> <script type="text/javascript" src="https://lww.com/_layouts/15/1033/Scripts/wk/UserToolbarDropdown.js?v=05.24.00.023" defer="true"> </script> <section class="user-action-toolbar"> <ul class="user-menu user-info" role="tablist"> <li id="ctl00_ctl51_Header_UserActionTools_liLogin" class="user-menu__item user-menu__item--popup-container user-menu__item--login-popup-container dib"> <button class="user-menu__link user-menu__link--login js-ejp-login-btn" type="button" data-config="{"eventName":"login","eventDetail":{"source":"Masthead Dropdown"},"isNull":false}"> <i class="fa fa-sign-in"></i> <span>Log in</span> </button> </li> <li id="ctl00_ctl51_Header_UserActionTools_liOr" class="dib or-spacing"><span>or</span></li> <li id="ctl00_ctl51_Header_UserActionTools_liRegister2" class="user-menu__item dib"> <a id="ctl00_ctl51_Header_UserActionTools_RegisterUserPopupLnk" class="user-menu__link js-register-link" data-config="{"eventName":"Register","eventDetail":{"source":"Masthead Dropdown"},"isNull":false}" href="https://journals.lww.com/academicmedicine/pages/register.aspx?ContextUrl=%2facademicmedicine%2fFulltext%2f2020%2f04000%2fEvolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx">Register</a> </li> <li id="ctl00_ctl51_Header_UserActionTools_liSubscribe" role="presentation" class="user-menu__item dib"> <a id="ctl00_ctl51_Header_UserActionTools_lnkSubscribe" class="user-menu__link" href="https://shop.lww.com/p/1040-2446" target="_blank"><i class="fa fa-bars"></i> <span class="hideOnFixed">Subscribe to journal</span><span class="showOnFixed">Subscribe</span></a> </li> <li id="ctl00_ctl51_Header_UserActionTools_liIssueAlerts" class="user-menu__item dib"> <i class="fa fa-envelope"></i> <a rel="nofollow" title href="javascript:javascript: alerts_ShowSubscribeeTOCPopup('Academic Medicine','academicmedicine','eTOC', 'eTOC');;" onclick="javascript: alerts_ShowSubscribeeTOCPopup('Academic Medicine','academicmedicine','eTOC', 'eTOC');" class="user-menu__link"><span id="ctl00_ctl51_Header_UserActionTools_SubscribeToAlertsActionToolLink_defaultText" class="hideOnFixed">Get new issue alerts</span><span id="ctl00_ctl51_Header_UserActionTools_SubscribeToAlertsActionToolLink_stickyText" class="showOnFixed">Get alerts</span></a> </li> </ul> </section> <span id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_dummyTargetControl"></span> <div id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pnlunSubscribeToAlerts" style="display: none;"> <div tabindex="-1" role="dialog" class="wk-modal horizontally-centered small wk-modal-with-overlay wk-modal-small ejp-modal"> <div id="ej-box-modal-style-1"> <div id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pnlMain"> <div id="tocUnsubscribeModal" > <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"></div> <button aria-label="close dialog" class="js-close primary-button wk-button-icon wk-modal-close ejp-modal-close "><i class="fa fa-times"></i></button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <p> <span id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage"></span> </p> <div class="wk-button-bar"> <div class="wk-button-group-left"> <p id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons" Style="display: none;"> <input type="submit" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$btnContinue" value="Yes" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$btnContinue", "", true, "", "", false, false))" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_btnContinue" class="primary-button" /> <input type="button" value="No" id="btnCancel" aria-label="close dialog" class="js-close secondary-button" /> </p> </div> </div> </div> </div> </section> </div> </div> </div> </div> </div> <div id="ej-clear-float"> </div> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnSubscribeAlertType" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnsubscribeJournalId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnsubscribeMessage" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenTopicalCollectionId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenTopicalCollectionId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenOvidId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenOvidId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenJournalId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId" /> <script type="text/javascript"> function alerts_ShowUnSubscribeeTOCPopup(title, alertType, journalId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = alertType; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == null || document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == '') { document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value = journalId; } if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Root(title, journalId, alertType) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = alertType; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Citation(title, journalId, ovidId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = 'Citation'; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenOvidId').value = ovidId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Topical(title, journalId, topicalCollectionId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = 'Topical'; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenTopicalCollectionId').value = topicalCollectionId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == null || document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == '') { document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value = journalId; } if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCSuccessPopup() { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } $('.js-close').on('click', function() { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.hide(); } return false; }); </script> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_dummyTargetControl"></span> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenSubscribeToEtocPopupState" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscribeToEtocPopupState" value="showemail" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenConfirmSubscriptionPageUrl" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenConfirmSubscriptionPageUrl" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenJournalId" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenSubscriptionType" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType" /> <div id="divPopupOverLay" class="Popup-Overlay" style="display: none; position: fixed; left: 0; top: 0; z-index: 3800; width: 1920px; height: 4517px;"></div> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlSubscribeToEtoc" class="etoc-popup ej-box-modal-drop-shadow" style="display: none;"> <div tabindex="-1" role="dialog" class="wk-modal horizontally-centered small wk-modal-with-overlay wk-modal-small ejp-modal"> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlMain" onkeypress="javascript:return WebForm_FireDefaultButton(event, 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_btnContinue')"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblTitle"></span> </div> <button aria-label="close dialog" class="js-close primary-button wk-button-icon wk-modal-close ejp-modal-close "> <i class="fa fa-times"></i> </button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <div class="wk-field-body"> <strong> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblThankYouMessage"></span></strong> </div> <div class="wk-field-body"> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError" style="color:Black;display:none;"> <div class="ej-error-message"> <p class="ej-error-message-icon error-red"> </p> </div> </span> <label for="Email input">Enter your Email address:</label> <div class="wk-field-body"> <input name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$txtEmailAddress" type="text" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress" class="ej-box-modal-style-1-input" /> </div> </div> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="submit" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$btnContinue" value="Continue" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$btnContinue", "", true, "", "", false, false))" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_btnContinue" class="primary-button" /> <input type="button" value="Cancel" id="btnCancel" class="js-close secondary-button" /> </div> </div> </div> <div class="wk-field-item"> <div class="wk-field-body"> <a id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hypPrivacy" href="https://journals.lww.com/academicmedicine/_layouts/oaks.journals/privacy.aspx" target="_blank">Privacy Policy</a> </div> </div> </div> </section> </div> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlAuthenticatedUser" style="display: none;"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"></div> <button aria-label="close dialog" class="js-close primary-button wk-button-icon wk-modal-close ejp-modal-close "><i class="fa fa-times"></i></button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <p> <strong> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblAuthenticatedUserTitle"></span> </strong> </p> </div> <p id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pAuthenticatedUserMessage"> </p> </div> </section> </div> </div> </div> <div id="ej-clear-float"> </div> <script type="text/javascript"> function alerts_SaveSubscriptionTypeInHiddenField(url, subscriptionType, journalId, yearId, issueId, articleId) { if (journalId && yearId && issueId && articleId) { logCounterDataAlertWhenCitedSynchronously(journalId, yearId, issueId, articleId); } $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType').val(subscriptionType); $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId').val(journalId); if (url) window.location = url; else __doPostBack('hypSubscribeToAlerts'); return false; } function alerts_ShowSubscribeeTOCPopup(journalTitle, journalId, subscriptionType, displaySubscriptionType) { $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType').val(subscriptionType); var subscribeToEtocPopup = $find('subscribeToEtoc'); subscribeToEtocPopup.show(); document.getElementsByTagName( 'html' )[0].classList.add('no-scroll'); var modelPopupState = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscribeToEtocPopupState'); var emailTextBox = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress'); var thanksPanel = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlAuthenticatedUser'); var mainPanel = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlMain'); var thankYouMessageUnAuthenticated = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblThankYouMessage'); var thankYouMessageAuthenticated = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblAuthenticatedUserTitle'); if (!displaySubscriptionType) { displaySubscriptionType = subscriptionType; } if (modelPopupState.value == 'showthanksmessage') { thanksPanel.style.display = "block"; mainPanel.style.display = "none"; thankYouMessageAuthenticated.innerHTML = "Thank you for subscribing to the " + displaySubscriptionType + " for " + journalTitle + "."; } if (modelPopupState.value == 'showemail') { thanksPanel.style.display = "none"; mainPanel.style.display = "block"; thankYouMessageUnAuthenticated.innerHTML = "Thank you for choosing to subscribe to the " + displaySubscriptionType + " for " + journalTitle + "."; } if ($('.etoc-popup') != null) { document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId').value = journalId; if (modelPopupState.value == 'showemail') emailTextBox.focus(); } } $('.js-close').on('click', function () { document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress').value = ""; document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError').style.display = "none"; var pageUrl = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenConfirmSubscriptionPageUrl'); var subscribeeTocPopup = $find('subscribeToEtoc'); if (subscribeeTocPopup != null) { subscribeeTocPopup.hide(); document.getElementsByTagName( 'html' )[0].classList.remove('no-scroll'); if (pageUrl.value !== '' && pageUrl.value !== window.location.pathname) window.location = pageUrl.value; } return false; }); </script> <div id="ctl00_ctl51_Header_UserActionTools_eTocTopContainer"> <div id="eTocTop" style="display: none;"> <a rel="nofollow" title href="javascript:javascript: alerts_ShowSubscribeeTOCPopup('Academic Medicine','academicmedicine','eTOC', 'eTOC');;" onclick="javascript: alerts_ShowSubscribeeTOCPopup('Academic Medicine','academicmedicine','eTOC', 'eTOC');"><span id="ctl00_ctl51_Header_UserActionTools_alertLinkControlTop_defaultText" class="hideOnFixed">Subscribe to eTOC</span></a> </div> </div> <script> $(function () { //find recent searches link and move container var recentSearchesControl = $("a[id$='RecentSearches']"); if (recentSearchesControl.length) { recentSearchesControl.click(function (e) { e.stopPropagation(); if ($("#ResentSearchContainer").is(":hidden")) { $("#ResentSearchContainer").slideDown("slow"); recentSearchesControl.addClass('open'); } else { $("#ResentSearchContainer").hide(); recentSearchesControl.removeClass('open'); } }); } var eTocAccountLink = $("ul.js-user-action-toolbar__dropdown>li>a[id='SubscribeToEToc']"); if (eTocAccountLink.length) { eTocAccountLink.parent().html($("#eTocTop>a")); } }); </script> <a class="logo-secondary black" href="http://wolterskluwer.com/" target="_blank"> <h3 class="logo-secondary-text">Secondary Logo</h3> </a> <a href="#" class="sticky-search"><i class="fa fa-search"></i></a> </div> <div class="header__layout-bottom wk-grid-page-container"> <a id="hypJournals" class="logo-main" href="https://journals.lww.com/academicmedicine/pages/default.aspx"> <h3 class="logo-main-text">Journal Logo </h3> </a> <div class="search-v2"> <div class="search-wrapper"> <select name="ctl00$ctl51$Header$SearchTopBoxControl$ddlContentScope" id="ctl00_ctl51_Header_SearchTopBoxControl_ddlContentScope"> <option value="All">All</option> <option selected="selected" value="Articles">Articles</option> <option value="Images">Images</option> <option value="Videos">Videos</option> <option value="Podcasts">Podcasts</option> <option value="Blogs">Blogs</option> </select> <div class="input-group" id="globalSearch"> <input name="ctl00$ctl51$Header$SearchTopBoxControl$txtKeywords" type="text" value="Search" id="ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords" class="form-control searchText" /> <span class="input-group-btn"> <button id="ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearchMagnifier" type="submit" class="btn btn-default"><i class="fa fa-search"></i></button> </span> <input type="hidden" name="ctl00$ctl51$Header$SearchTopBoxControl$IsAutoCompleteEnabled" id="ctl00_ctl51_Header_SearchTopBoxControl_IsAutoCompleteEnabled" value="true" /> <input type="hidden" name="ctl00$ctl51$Header$SearchTopBoxControl$AutocompleteApiUrl" id="ctl00_ctl51_Header_SearchTopBoxControl_AutocompleteApiUrl" value="https://platformservices.wolterskluwerhealth.com/autocomplete/ACMED,JMEDU,JAAMC,BAAMC,MEDED/shingle/" /> </div> </div> <div class="advance-search" style=""> <a id="ctl00_ctl51_Header_SearchTopBoxControl_lnkAdvanceSearch" href="https://journals.lww.com/academicmedicine/pages/advancedsearch.aspx">Advanced Search</a> <input type="submit" name="ctl00$ctl51$Header$SearchTopBoxControl$btnGlobalSearch" value="" id="ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch" disabled="disabled" class="aspNetDisabled btnGlobalSearch" style="display: none;" /> <input name="ctl00$ctl51$Header$SearchTopBoxControl$hfldKeywords" type="hidden" id="ctl00_ctl51_Header_SearchTopBoxControl_hfldKeywords" class="hfldKeywords" value="disableButton" /> </div> </div> <script> $(function() { try { var objSearchBox = { btnGlobalSearchMagnifierId: 'ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearchMagnifier', searchButtonId: 'ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch', txtKeywordsId: 'ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords', hfldKeywordsHiddenId: 'ctl00_ctl51_Header_SearchTopBoxControl_hfldKeywords', defaultSearchText: 'Search' }; new Searchbox(objSearchBox).Init(); } catch (e) { console.error(e); } }); //autocomplete functionality for basic search //this functionality will call the SBA url and start suggesting after typing 3rd character var textKeywords = null; var hiddenAutocompleteApiUrl = null; var buttonGlobalSearch = null; $(function () { try { var objAutocomplete = { hiddenIsAutoCompleteEnabled: $('#ctl00_ctl51_Header_SearchTopBoxControl_IsAutoCompleteEnabled'), textKeywords: $('#ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords'), hiddenAutocompleteApiUrl: $('#ctl00_ctl51_Header_SearchTopBoxControl_AutocompleteApiUrl'), buttonGlobalSearch: $('#ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch'), enableNewAutoComplete: true, newAutoCompleteUrl: 'https://dxg-search-na-prd.wkgposvc.cloud/Query.svc/Query_Expand', newAutoCompleteMaxSuggestions: '10', newAutoCompleteDictionaryIds: 'ovid_sted28_mesh22' }; autoComplete(objAutocomplete); } catch (e) { console.error(e); } }); $(function () { let searchSelect = $('select[id$="ddlContentScope"]');; if (searchSelect.length){ searchSelect.selectize(); } }); </script> </div> <div id="main-nav-container-v2"> <nav id="main-nav" class="navbar navbar-default yamm wk-grid-page-container"> <div class="navbar-header"> <button id="fatJuicy" type="button" class="navbar-hamburger-button navbar-toggle collapsed pull-left" data-bs-toggle="collapse" data-bs-target="#zz1_TopNavigationMenu" aria-expanded="false" aria-controls="navbar"> <span class="visually-hidden">Toggle navigation</span> <span class="icon-bar"></span> <span class="icon-bar"></span> <span class="icon-bar"></span> <span class="navbar-hamburger-button__text"></span> </button> </div> <div id="navActionButtons" class="btn-group navbar-hover-color" role="group" aria-label="..."> <a id="ctl00_ctl51_lnkSubscribe" class="btn btn-default navbar-button" href="https://shop.lww.com/p/1040-2446" target="_blank">Subscribe</a> <a id="ctl00_ctl51_lnkRegister" class="btn btn-default navbar-button" href="https://journals.lww.com/academicmedicine/pages/register.aspx?ContextUrl=%2facademicmedicine%2fFulltext%2f2020%2f04000%2fEvolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx">Register</a> <button class="user-menu__link user-menu__link--login js-ejp-login-btn btn btn-default navbar-button" type="button" data-config="{"eventName":"login","eventDetail":{},"isNull":false}"> <span>Login</span> </button> </div> <div id="ctl00_ctl51_TopNavigationMenuConfiguration" style="display:none" class="js-top-navigation-menu-configuration" data-config="{"browsingHistory":{"isEnabled":true,"serviceUrl":"https://apim-hlrp-ejp-prod.azure-api.net/ee","pdfDownloadUrl":"/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=HistoryTab"}}"></div> <div id="zz1_TopNavigationMenu" class="navbar-collapse collapse js-top-navigation-menu noindex ms-core-listMenu-horizontalBox"> <ul id="zz2_RootAspMenu" class="root ms-core-listMenu-root static"> <li class="static dynamic-children"><span class="static dynamic-children menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode"><span aria-haspopup="true" class="additional-background ms-navedit-flyoutArrow dynamic-children"><span class="menu-item-text">Articles & Issues</span></span></span><ul aria-hidden="true" class="dynamic"> <li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/currenttoc.aspx" accesskey="1"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Current Issue</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/issuelist.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Previous Issues</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/toc/publishahead"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Published Ahead-of-Print</span></span></a></li> </ul></li><li class="static dynamic-children"><span class="static dynamic-children menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode"><span aria-haspopup="true" class="additional-background ms-navedit-flyoutArrow dynamic-children"><span class="menu-item-text">Collections</span></span></span><ul aria-hidden="true" class="dynamic"> <li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/pages/collectiondetails.aspx?TopicalCollectionId=66"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Editorials of Laura Weiss Roberts, MD, MA</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/pages/collectiondetails.aspx?TopicalCollectionId=6"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">AM Last Page</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/pages/collectiondetails.aspx?TopicalCollectionId=72"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Addressing Race and Racism in Medical Education</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/pages/collectiondetails.aspx?TopicalCollectionId=82"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Artificial Intelligence and Academic Medicine</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/pages/collectiondetails.aspx?TopicalCollectionId=81"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Climate Change Education and Sustainability in Academic Medicine</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/pages/collectiondetails.aspx?TopicalCollectionId=99"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Resident and Fellow Unionization</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/pages/collectiondetails.aspx?TopicalCollectionId=79"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">The Role of Academic Medicine in Firearm Injury Prevention</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/eBooks.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">eBooks</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/collections.aspx?Collection=Topical"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">View All</span></span></a></li> </ul></li><li class="static dynamic-children"><span class="static dynamic-children menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode"><span aria-haspopup="true" class="additional-background ms-navedit-flyoutArrow dynamic-children"><span class="menu-item-text">For Authors</span></span></span><ul aria-hidden="true" class="dynamic"> <li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="http://www.editorialmanager.com/acadmed/default.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Submit a Manuscript</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/InformationforAuthors.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Information for Authors</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/_layouts/1033/oaks.journals/editservices.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Language Editing Services</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="https://cdn-tp2.mozu.com/16833-m1/cms/files/Author-Document.pdf?_mzts=636519775710000000"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Author Permissions</span></span></a></li> </ul></li><li class="static dynamic-children"><span class="static dynamic-children menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode"><span aria-haspopup="true" class="additional-background ms-navedit-flyoutArrow dynamic-children"><span class="menu-item-text">Journal Info</span></span></span><ul aria-hidden="true" class="dynamic"> <li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/aboutthejournal.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">About the Journal</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="http://www.aamc.org/about/"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">About the AAMC</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/JournalMasthead.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Journal Masthead</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="http://www.editorialmanager.com/acadmed/"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Submit a Manuscript</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/AdvertisingPolicy.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Advertising Information</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/SubscriptionServices.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Subscription Services</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/reprintsmedicine.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Reprints and Back Issues</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="http://healthjobsplus.com"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Classified Ads</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/_layouts/1033/oaks.journals/rightsandpermissions.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Rights and Permissions</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/forreviewers.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">For Reviewers</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/ForMedia.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">For Media</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/academicmedicine/Pages/fortrainees.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">For Trainees</span></span></a></li> </ul></li> </ul> </div> <div class="search-v2"> <div class="search-wrapper"> <select name="ctl00$ctl51$SearchBox$ddlContentScope" id="ctl00_ctl51_SearchBox_ddlContentScope"> <option value="All">All</option> <option selected="selected" value="Articles">Articles</option> <option value="Images">Images</option> <option value="Videos">Videos</option> <option value="Podcasts">Podcasts</option> <option value="Blogs">Blogs</option> </select> <div class="input-group" id="globalSearch"> <input name="ctl00$ctl51$SearchBox$txtKeywords" type="text" value="Search" id="ctl00_ctl51_SearchBox_txtKeywords" class="form-control searchText" /> <span class="input-group-btn"> <button id="ctl00_ctl51_SearchBox_btnGlobalSearchMagnifier" type="submit" class="btn btn-default"><i class="fa fa-search"></i></button> </span> <input type="hidden" name="ctl00$ctl51$SearchBox$IsAutoCompleteEnabled" id="ctl00_ctl51_SearchBox_IsAutoCompleteEnabled" value="true" /> <input type="hidden" name="ctl00$ctl51$SearchBox$AutocompleteApiUrl" id="ctl00_ctl51_SearchBox_AutocompleteApiUrl" value="https://platformservices.wolterskluwerhealth.com/autocomplete/ACMED,JMEDU,JAAMC,BAAMC,MEDED/shingle/" /> </div> </div> <div class="advance-search" style=""> <a id="ctl00_ctl51_SearchBox_lnkAdvanceSearch" href="https://journals.lww.com/academicmedicine/pages/advancedsearch.aspx">Advanced Search</a> <input type="submit" name="ctl00$ctl51$SearchBox$btnGlobalSearch" value="" id="ctl00_ctl51_SearchBox_btnGlobalSearch" disabled="disabled" class="aspNetDisabled btnGlobalSearch" style="display: none;" /> <input name="ctl00$ctl51$SearchBox$hfldKeywords" type="hidden" id="ctl00_ctl51_SearchBox_hfldKeywords" class="hfldKeywords" value="disableButton" /> </div> </div> <script> $(function() { try { var objSearchBox = { btnGlobalSearchMagnifierId: 'ctl00_ctl51_SearchBox_btnGlobalSearchMagnifier', searchButtonId: 'ctl00_ctl51_SearchBox_btnGlobalSearch', txtKeywordsId: 'ctl00_ctl51_SearchBox_txtKeywords', hfldKeywordsHiddenId: 'ctl00_ctl51_SearchBox_hfldKeywords', defaultSearchText: 'Search' }; new Searchbox(objSearchBox).Init(); } catch (e) { console.error(e); } }); //autocomplete functionality for basic search //this functionality will call the SBA url and start suggesting after typing 3rd character var textKeywords = null; var hiddenAutocompleteApiUrl = null; var buttonGlobalSearch = null; $(function () { try { var objAutocomplete = { hiddenIsAutoCompleteEnabled: $('#ctl00_ctl51_SearchBox_IsAutoCompleteEnabled'), textKeywords: $('#ctl00_ctl51_SearchBox_txtKeywords'), hiddenAutocompleteApiUrl: $('#ctl00_ctl51_SearchBox_AutocompleteApiUrl'), buttonGlobalSearch: $('#ctl00_ctl51_SearchBox_btnGlobalSearch'), enableNewAutoComplete: true, newAutoCompleteUrl: 'https://dxg-search-na-prd.wkgposvc.cloud/Query.svc/Query_Expand', newAutoCompleteMaxSuggestions: '10', newAutoCompleteDictionaryIds: 'ovid_sted28_mesh22' }; autoComplete(objAutocomplete); } catch (e) { console.error(e); } }); $(function () { let searchSelect = $('select[id$="ddlContentScope"]');; if (searchSelect.length){ searchSelect.selectize(); } }); </script> </nav> </div> </div> </header>     <div id="main-container-content" class="wk-grid-page-container"> <div id="DeltaWebPartAdderUpdatePanelContainer" class="ms-core-webpartadder"> <div id="WebPartAdderUpdatePanelContainer"> <div id="ctl00_WebPartAdderUpdatePanel"> <span id="ctl00_WebPartAdder"></span> </div> </div> </div> <div id="notificationArea" class="ms-notif-box"></div> <div id="DeltaPageStatusBar"> <div id="pageStatusBar"></div> </div> <div id="DeltaPlaceHolderMain" class="delta-place-holder-main"> <a id="mainContent" name="mainContent" tabindex="-1"></a> <div id="ctl00_PlaceHolderMain_ResponsivePageLayoutRenderer_responsivePageLayoutContainer" class="main-content ejp-page-container"> <div class="wk-grid-container-no-margin" id="AddRowTopContainer"> </div> <div id="ctl00_PlaceHolderMain_ResponsivePageLayoutRenderer_ResponsiveLayoutRowRepeater_ctl00_ResponsiveLayoutRowContainer" class="wk-grid-container-no-margin"> <div id="ctl00_PlaceHolderMain_ResponsivePageLayoutRenderer_ResponsiveLayoutRowRepeater_ctl00_ResponsiveLayoutRow" class="wk-grid"> <div id="ctl00_PlaceHolderMain_ResponsivePageLayoutRenderer_ResponsiveLayoutRowRepeater_ctl00_ResponsiveLayoutColumnRepeater_ctl00_ResponsiveLayoutColumn" class=" wk-column-12 wk-column-12-m wk-column-12-l wk-column-12-xl wk-column-12-xxl"> <div class="ms-webpart-zone ms-fullWidth"> <div id="MSOZoneCell_WebPartctl00_ctl29_g_bc913801_b991_4ffe_901d_e9b4eb4d268b" class="s4-wpcell-plain ms-webpartzone-cell ms-webpart-cell-vertical-inline-table ms-webpart-cell-vertical ms-fullWidth "> <div class="ms-webpart-chrome ms-webpart-chrome-vertical ms-webpart-chrome-fullWidth "> <div WebPartID="bc913801-b991-4ffe-901d-e9b4eb4d268b" HasPers="false" id="WebPartctl00_ctl29_g_bc913801_b991_4ffe_901d_e9b4eb4d268b" width="100%" class="ms-WPBody noindex " allowDelete="false" style="" ><div id="ctl00_ctl29_g_bc913801_b991_4ffe_901d_e9b4eb4d268b">  <div class="ejp-article-breadcrumb"> <div class="ejp-article-breadcrumb__left"> <a title href="/academicmedicine/toc/2020/04000" class="ejp-article-nav__list-link-back">April 2020 - Volume 95 - Issue 4 </a> </div> <div class="ejp-article-breadcrumb__right"> <nav id="ctl00_ctl29_g_bc913801_b991_4ffe_901d_e9b4eb4d268b__fff0f7a67241ba8d_ArticleNavigator"> <ul class="ejp-article-nav__list"> <li id="ctl00_ctl29_g_bc913801_b991_4ffe_901d_e9b4eb4d268b__fff0f7a67241ba8d_liArticleNavigatorPrev"> <a title href="/academicmedicine/fulltext/2020/04000/finding_greater_value_in_the_fourth_year_of.20.aspx" onmouseover="javascript:Tooltip_Article('Finding Greater Value in the Fourth Year of Medical School: Accelerating the Transition to Residency', 'Pellegrini Vincent D. Jr MD; Franks, Adam M. MD; Englander, Robert MD, MPH', 'Academic Medicine', 'April 2020', '95', '4' , 'p 527-533')" onmouseout="javascript:Tooltip_MouseOut()" class="ejp-article-nav__list-link-prev"> <span>Previous</span> <span class="ejp-article-nav__list-link-mobile-hide">Article</span> </a> </li> <li id="ctl00_ctl29_g_bc913801_b991_4ffe_901d_e9b4eb4d268b__fff0f7a67241ba8d_liArticleNavigatorNext"> <a title href="/academicmedicine/fulltext/2020/04000/two_days_and_twenty_years.22.aspx" onmouseover="javascript:Tooltip_Article('Two Days and Twenty Years', 'Kind Terry MD MPH', 'Academic Medicine', 'April 2020', '95', '4' , 'p 539')" onmouseout="javascript:Tooltip_MouseOut()" class="ejp-article-nav__list-link-next"> <span>Next</span> <span class="ejp-article-nav__list-link-mobile-hide">Article</span> </a> </li> </ul> </nav> </div> </div> </div><div class="ms-clear"></div></div> </div> </div> </div></div> </div> </div> <div id="ctl00_PlaceHolderMain_ResponsivePageLayoutRenderer_ResponsiveLayoutRowRepeater_ctl01_ResponsiveLayoutRowContainer" class="wk-grid-container-no-margin"> <div id="ctl00_PlaceHolderMain_ResponsivePageLayoutRenderer_ResponsiveLayoutRowRepeater_ctl01_ResponsiveLayoutRow" class="wk-grid"> <div id="ctl00_PlaceHolderMain_ResponsivePageLayoutRenderer_ResponsiveLayoutRowRepeater_ctl01_ResponsiveLayoutColumnRepeater_ctl00_ResponsiveLayoutColumn" class=" wk-column-12 wk-column-8-m wk-column-8-l wk-column-8-xl wk-column-8-xxl"> <div class="ms-webpart-zone ms-fullWidth"> <div id="MSOZoneCell_WebPartctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8" class="s4-wpcell-plain ms-webpartzone-cell ms-webpart-cell-vertical-inline-table ms-webpart-cell-vertical ms-fullWidth "> <div class="ms-webpart-chrome ms-webpart-chrome-vertical ms-webpart-chrome-fullWidth "> <div WebPartID="12d8dac7-5f88-4ab8-bca5-dd3f239182b8" HasPers="false" id="WebPartctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8" width="100%" class="ms-WPBody noindex " allowDelete="false" style="" ><div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8">  <script type="text/javascript" src="https://lww.com/_layouts/15/1033/Scripts/wk/article.min.js?v=05.24.00.023"> </script> <link rel="stylesheet" type="text/css" href="https://lww.com/_layouts/1033/OAKS.Journals/MediaElement/mediaelementplayer.css?v=05.24.00.023" media="print" /> <span class="js-custom-event" data-config="{"name":"articleView","detail":{"articleDetails":{"journalName":"Academic Medicine","articleTopicName":"","articleName":"Evolution of an Accelerated 3-Year Pathway to the MD Degree: The Experience of New York University Grossman School of Medicine","publicationDate":"04/01/2020","accessionNumber":"00001888-202004000-00000","doi":"10.1097/ACM.0000000000003013","authors":"Joan Cangiarella, MD; Elisabeth Cohen, MD; Rafael Rivera, MD; Colleen Gillespie, PhD; Steven Abramson, MD","societyName":"","collectionName":"","abstractValues":"The revision of the curriculum at New York Univers","sku":"1040-2446","format":"HTML","articleKeywords":"","articleMetadata":"","systemIndicators":["Free","SDC"],"meshTerms":["Internship and Residency","Curriculum","New York","Students, Medical","Schools","Education, Medical, Graduate","Education, Medical, Undergraduate","Medicine","Schools, Medical","United States"],"pageSource":"ArticleViewer"},"articleDisplayType":"Fulltext"},"order":2147483647,"config":{"bubbles":true,"cancelable":true,"composed":false}}"></span><span class="js-custom-event" data-config="{"name":"omni:article:view","detail":{"viewType":"Fulltext","publisher":"LWW","journalTitle":"Academic Medicine","issueNumber":"04000","volumeNumber":"95","accessionNumber":"00001888-202004000-00021","doi":"10.1097/ACM.0000000000003013","articleTitle":"Evolution of an Accelerated 3-Year Pathway to the MD Degree: The Experience of New York University Grossman School of Medicine","publicationDate":"04/01/2020","flags":"Free, SDC","keywords":"","tocSection":"Articles","firstPage":"534"},"order":2147483647,"config":{"bubbles":true,"cancelable":true,"composed":false}}"></span>  <link rel="stylesheet" type="text/css" href="https://lww.com/_layouts/1033/styles/oaks.journals/print-article.css?v=05.24.00.023" media="print" /> <script type="text/javascript"> var articleContainer = document.getElementById('ArticleContainer'); function getElementReferences() { textDiv = articleContainer; // textDiv = document.getElementById('ArticleContainer'); } function getArticleContainer() { return articleContainer; } $(function () { // Change the '+', '-' icon when panels are collapsed. $('a.toggle-content').click(function () { var isExpanded = $(this).attr('aria-expanded'); var i = $(this).children('i'); if (isExpanded === 'true') { i.removeClass('fa fa-minus-square-o').addClass('fa fa-plus-square-o'); } else { i.removeClass('fa fa-plus-square-o').addClass('fa fa-minus-square-o'); } }); var articleAbstractLink = $('#article-abstract-content4>ul>li>a')[0]; if ($(articleAbstractLink).html() === 'Abstract') { $(articleAbstractLink).click($.proxy(clickAbstractLink, this)); } }); function LogArticleSubTabClickEventToCounterData(subTabType) { var dualAccessHelper = new DualAccess(); if (subTabType === "AISummary") { //handle it for other sub tab types dualAccessHelper.SendCounterDataRequestByAn(dualAccessHelper.EventTypes.Investigation, dualAccessHelper.ContentTypes.AISummary, '00001888-202004000-00021'); } else { dualAccessHelper.SendCounterDataRequestByAn(dualAccessHelper.EventTypes.Investigation, dualAccessHelper.ContentTypes.ArticleTab, '00001888-202004000-00021'); } }; function ArticleTabClickLogToCounterService() { var dualAccessHelper = new DualAccess(); dualAccessHelper.SendCounterDataRequestByAn(dualAccessHelper.EventTypes.Investigation, dualAccessHelper.ContentTypes.ArticleTab, '00001888-202004000-00021'); }; window.addEventListener("load", () => { HighlightSearchTerms(); }); document.addEventListener('DOMContentLoaded', function() { function dispatchCustomEvent(eventName, linkUrl) { document.dispatchEvent(new CustomEvent(eventName, { detail: { link_url: linkUrl } })); } var anchors = { 'omni:articleviewer:buy': document.getElementById('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_hypPurchase'), 'omni:articleviewer:subscribe': document.getElementById('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_hypSubscribe'), 'omni:articleviewer:permission': document.getElementById('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_hypliPatentOrCaregiver'), 'omni:articleviewer:society': document.getElementById('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_hypSociety') }; Object.keys(anchors).forEach(function(eventName) { var anchor = anchors[eventName]; if (anchor) { anchor.addEventListener('click', function(event) { dispatchCustomEvent(eventName, anchor.href); }); } }); }); </script> <script> function closeArticleViewerModalDialog() { $('#articleViewerDialog').hide(); return false; } </script> <div class="ejp-article-wrapper"> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_container" data-article-config="{"title":"ReadAloud: Evolution of an Accelerated 3-Year Pathway to the MD Degree: The Experience of New York University Grossman School of Medicine","doi":"10.1097/ACM.0000000000003013"}" data-read-along="false" data-ppt-event-detail="{"eventName":"PPTDownload","eventDetail":{"url":"https://journals.lww.com:443/academicmedicine/Fulltext/2020/04000/Evolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx?Ppt=Article|academicmedicine:2020:04000:00021|10.1097/acm.0000000000003013|","gating":false},"eventOptions":{"bubbles":true,"cancelable":true,"composed":false},"loginDetail":{"isLoginOptional":true,"promptLogin":false},"isNull":false}" data-has-ce="false" data-is-social-sharing-enabled="false" data-ce-cme-redirect="false" data-ppt-visible="true" data-email-to-colleague-control-id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl" data-images-slideshow-visible="true" data-social-sharing-title="Evolution of an Accelerated 3-Year Pathway to the MD... : Academic Medicine" data-pdf-visible="true" class="js-ejp-article-tools lww-ejp-article-tools" data-ce-cme-url="" data-has-permissions="true" data-epub-enabled="true" data-article-accession-number="00001888-202004000-00021" data-epub-visible="true" data-image-gallery-url="/academicmedicine/pages/imagegallery.aspx?year=2020&issue=04000&article=00021" data-social-sharing-source="https://journals.lww.com/academicmedicine/fulltext/2020/04000/evolution_of_an_accelerated_3_year_pathway_to_the.21.aspx" data-favorites-event-detail="{"eventName":"AddToFavorites","eventDetail":{"items":["Article|academicmedicine:2020:04000:00021|10.1097/acm.0000000000003013|"],"an":"00001888-202004000-00021"},"eventOptions":{"bubbles":true,"cancelable":true,"composed":false},"loginDetail":{"isLoginOptional":false,"promptLogin":true,"loginPromptText":"To save this item, login or register"},"isNull":false}" data-ce-cme-title="" data-is-fulltext="true" data-has-cme="false" data-pdf-enabled="true" data-images-gallery-visible="true" data-pdf-event-detail="{"eventName":"PDFDownloadInit","eventDetail":{"url":"https://journals.lww.com/academicmedicine/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=ArticleViewer&an=00001888-202004000-00021","gating":false},"eventOptions":{"bubbles":true,"cancelable":true,"composed":false},"loginDetail":{"isLoginOptional":true,"promptLogin":false},"isNull":false}" data-epub-event-detail="{"eventName":"EPUBDownload","eventDetail":{"url":"https://journals.lww.com:443/academicmedicine/Fulltext/2020/04000/Evolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx?generateEpub=Article|academicmedicine:2020:04000:00021|10.1097/acm.0000000000003013|","gating":false},"eventOptions":{"bubbles":true,"cancelable":true,"composed":false},"loginDetail":{"isLoginOptional":true,"promptLogin":false},"isNull":false}" data-pdf-url="https://journals.lww.com/academicmedicine/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=ArticleViewer&an=00001888-202004000-00021"> </div> <div style="display: none;"> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_epubContainer"> <a an="00001888-202004000-00021" rel="opener" title href="#epub-link" class="ej-art-as-epub">Article as EPUB</a> </div> <a href="/academicmedicine/Fulltext/2020/04000/Evolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx?Ppt=Article|academicmedicine:2020:04000:00021|10.1097/acm.0000000000003013|" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_lnkExportImagesToPPT_fileLink" rel="nofollow">Export All Images to PowerPoint File</a> <button class="user-menu__link user-menu__link--add-to-favorites js-ejp-login-btn addToMyFavoriteLink" type="button" data-config="{"eventName":"AddToFavorites","eventDetail":{"items":["Article|academicmedicine:2020:04000:00021|10.1097/acm.0000000000003013|"],"an":"00001888-202004000-00021"},"eventOptions":{"bubbles":true,"cancelable":true,"composed":false},"loginDetail":{"isLoginOptional":false,"promptLogin":true,"loginPromptText":"To save this item, login or register"},"isNull":false}"> <span>Add to My Favorites</span> </button> </div> <script type="text/javascript" src="https://lww.com/_layouts/15/1033/Scripts/wk/EmailToColleague.js?v=05.24.00.023" defer="true"> </script> <a id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_hypEmailToColleague" href="javascript:" style="display:none;"></a> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_pnlEmailToColleague" class="wk-modal-table" style="display: none"> <div class="wk-modal-cell"> <div id="ej-box-modal-drop-shadow" class="wk-modal horizontally-centered small wk-modal-with-overlay wk-modal-small ejp-modal email-to-colleague" tabindex="-1" role="dialog" style="position: static;"> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_pnlMain" class="js-main-panel" onkeypress="javascript:return WebForm_FireDefaultButton(event, 'ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_btnSend')"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"> <strong> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_lblEmailToColleague">Email to Colleague</span></strong> </div> <button aria-label="close dialog" class="primary-button wk-button-icon wk-modal-close ejp-modal-close js-close "> <i class="fa fa-times"></i> </button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <div class="wk-field-header"> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_divErrorMessage" class="js-error-message-div ej-error-message-panel" style="display: none; color: red; font-style: italic"> <p class="ej-error-message-icon"> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_lblErrorMessage" class="js-error-message-label">Colleague's E-mail is Invalid</span> </p> </div> </div> </div> <div class="wk-field-item"> <div class="wk-field-header"> Your Name: </div> <div class="wk-field-body"> <input name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$emailToColleagueControl$txtYourName" type="text" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_txtYourName" class="js-name" /> </div> </div> <div class="wk-field-item"> <div class="wk-field-header"> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_lblColleaguesEmail" class="js-collegaues-email-lbl">Colleague's Email:</span> </div> <div class="wk-field-body no-bottom-margin"> <input name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$emailToColleagueControl$txtColleaguesEmail" type="text" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_txtColleaguesEmail" class="js-collegaues-email" /> </div> <div class="wk-field-header"><span class="ej-form-comments">Separate multiple e-mails with a (;).</span></div> </div> <div class="wk-field-item"> <div class="wk-field-header"> Message: </div> <div class="wk-field-body"> <textarea name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$emailToColleagueControl$txtMessage" rows="2" cols="20" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_txtMessage" class="js-message"> Thought you might appreciate this item(s) I saw in Academic Medicine.</textarea> </div> </div> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="submit" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$emailToColleagueControl$btnSend" value="Send" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_btnSend" class="js-send-button primary-button grecaptcha-email-colleague-9caded572e6f401ca299c53dcbcb175d" /> <input type="button" value="Cancel" id="btnCancel" class="secondary-button js-close" /> </div> </div> <div class="wk-field-item wk-email-colleague-captcha-bar"> <div class="wk-field-body"> <div id="div-recaptcha-9caded572e6f401ca299c53dcbcb175d" class="div-recaptcha-container" data-uniqueclassidentifier="grecaptcha-email-colleague-9caded572e6f401ca299c53dcbcb175d" data-sitekey="6LeeoSAUAAAAACFv8yNuINPv8IWyXHJ6uN447qEK" data-callback="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_captchaCallBack" data-badge="inline" data-size="invisible" data-type="image" > </div> </div> </div> </div> </section> </div> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_pnlSuccessMessage" class="js-success-message-panel" style="display: none;"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"></div> <button aria-label="close dialog" class="primary-button wk-button-icon wk-modal-close ejp-modal-close js-close "><i class="fa fa-times"></i></button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <br /> <p> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_lblMessageSent">Your message has been successfully sent to your colleague.</span> </p> <br /> </div> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="button" value="Close Window" id="btnClose" class="primary-button js-close" /> </div> </div> </div> </section> </div> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_pnlErrorMessage" class="js-error-message-panel" style="display: none;"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"></div> <button aria-label="close dialog" class="primary-button wk-button-icon wk-modal-close ejp-modal-close js-close "><i class="fa fa-times"></i></button> </header> <div class="wk-modal-body"> <br /> <div class="wk-field-item"> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_lblInvalidEmail" style="color:Red;">Some error has occurred while processing your request. Please try after some time.</span> </div> <br /> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="button" value="Close Window" id="btnEClose" class="primary-button js-close" /> </div> </div> </div> </section> </div> </div> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$emailToColleagueControl$hiddenEmailToColleague" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_hiddenEmailToColleague" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$emailToColleagueControl$hiddenIsUser" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_hiddenIsUser" /> </div> </div> <script type="text/javascript"> window.emailToColleaguePopups = window.emailToColleaguePopups || []; var ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_captchaCallBack = function () { ejpAnalytics.track('emailColleaguereCAPTCHA'); ejpAnalytics.track('emailColleagueComplete'); __doPostBack('ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$emailToColleagueControl$btnSend','') }; var initEmailToColleaguectl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl = function () { window.emailToColleaguePopups['ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl'] = new EmailToColleagueComponent('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_pnlEmailToColleague', 'div-recaptcha-9caded572e6f401ca299c53dcbcb175d', 'grecaptcha-email-colleague-9caded572e6f401ca299c53dcbcb175d', 'emailToColleaguePopupExtender_682946820', 'ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_hiddenEmailToColleague', 'ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_hiddenIsUser', '00001888-202004000-00021' ); } Sys.WebForms.PageRequestManager.getInstance().add_pageLoaded(initEmailToColleaguectl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl); </script> <script type="text/javascript" src="https://lww.com/_layouts/15/1033/Scripts/wk/ExportToCitationManager.js?v=05.24.00.023" defer="true"> </script> <a id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_hypExportToCitationManager" href="javascript:" style="display:none;"></a> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_pnlExportTo" style="display: none"> <div id="ej-box-modal-drop-shadow"> <div id="ej-box-modal-style-1" tabindex="-1" role="dialog" class="wk-modal wk-modal-with-overlay wk-modal-small ejp-modal horizontally-centered" data-behaviorid="OpenExportToPopupExtender__571253211"> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_pnlMainExport"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"><strong>Export to</strong></div> <button onclick="return closeExportToModalPopUp();" aria-label="close dialog" class="primary-button wk-button-icon wk-modal-close ejp-modal-close "><i class="fa fa-times"></i></button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <fieldset> <table id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_radioBtnExportTypes"> <tr> <td><input id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_radioBtnExportTypes_0" type="radio" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$exportToCitationManager$radioBtnExportTypes" value="EndNote" checked="checked" /><label for="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_radioBtnExportTypes_0">End Note</label></td> </tr><tr> <td><input id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_radioBtnExportTypes_1" type="radio" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$exportToCitationManager$radioBtnExportTypes" value="Procite" /><label for="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_radioBtnExportTypes_1">Procite</label></td> </tr><tr> <td><input id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_radioBtnExportTypes_2" type="radio" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$exportToCitationManager$radioBtnExportTypes" value="ReferenceManager" /><label for="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_radioBtnExportTypes_2">Reference Manager</label></td> </tr> </table> </fieldset> <p> <label for="default"> <input id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_checkBoxSaveMySelection" type="checkbox" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$exportToCitationManager$checkBoxSaveMySelection" /><label for="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_checkBoxSaveMySelection">Save my selection</label> </label> </p> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="submit" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$exportToCitationManager$btnOpenExportDialog" value="Export" onclick="return validateExportType();WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$exportToCitationManager$btnOpenExportDialog", "", true, "", "", false, false))" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_btnOpenExportDialog" class="primary-button" /> <input type="submit" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$exportToCitationManager$btnCancelOpenExportDialog" value="Cancel" onclick="return closeExportToModalPopUp();WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$exportToCitationManager$btnCancelOpenExportDialog", "", true, "", "", false, false))" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_btnCancelOpenExportDialog" class="secondary-button" /> <p id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_pUnsubscribeButtons"> </p> </div> </div> </div> </div> </section> </div> </div> </div> <div id="ej-clear-float"></div> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$ucArticleTools$exportToCitationManager$hiddenExportType" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_hiddenExportType" /> </div> <script type="text/javascript"> var hiddenExportType = $get('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_hiddenExportType'); function getExportPopup() { return $find('OpenExportToPopupExtender__571253211'); } var pnlMainExport = $get('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_pnlMainExport'); document.addEventListener('DOMContentLoaded', function () { function dispatchCustomEvent(eventName) { try { document.dispatchEvent(new CustomEvent(eventName)); } catch (error) { console.error('Error dispatching custom event:', error); } } try { var exportButton = document.getElementById('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_btnOpenExportDialog'); var radioButtons = document.querySelectorAll('#ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_radioBtnExportTypes input[type=radio]'); exportButton.addEventListener('click', function (event) { var selectedRadioButton = Array.from(radioButtons).find(rb => rb.checked); if (selectedRadioButton) { var selectedValue = selectedRadioButton.value; var eventName = ''; switch (selectedValue) { case "Procite": case "ReferenceManager": eventName = 'omni:articletools:cite:ris'; break; case 'EndNote': eventName = 'omni:articletools:cite:endnote'; break; default: eventName = ''; } if (eventName) { dispatchCustomEvent(eventName); } else { console.warn('No event name matched for the selected radio button value:', selectedValue); } } else { console.warn('No radio button selected'); } }); } catch (error) { console.error('Error initializing event listeners:', error); } }); </script> <script type="text/javascript"> $(document).ready(function () { $('p').filter(function () { return this.innerHTML.trim() === "" }).remove(); }); function showPrinterFriendlyView() { open("https://journals.lww.com/academicmedicine/pages/printerfriendly.aspx?year=2020&issue=04000&article=00021&type=Fulltext", ""); } function showExportToCitationPopUp() { return "OpenExportToPopupExtender__571253211"; } function getPermissionsClick() { showRightsLinkPopUp( 'https://s100.copyright.com/AppDispatchServlet', 'WoltersKluwer', 'ACM', 'Evolution of an Accelerated 3-Year Pathway to the MD Degree: The Experience of New York University Grossman School of Medicine', '04012020', 'Joan Cangiarella, Elisabeth Cohen, Rafael Rivera, et al', '95', '4', 'Copyright \u00A9 2019 by the Association of American Medical Colleges', '00001888-202004000-00021', '', true, ''); } </script> <div id="ArticleContainer"> <article id="ej-article-view" class="js-article-view ej-article-view" xmlns:ssr="http://ssr-eus-go-csi.cloudapp.net/v1/assets" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xhtml="http://www.w3.org/1999/xhtml"><section class="ejp-r-article-subsection"><div class="ejp-r-article-subsection__text">Articles</div></section><header class="ejp-article-header"><h1 class="ejp-article-title">Evolution of an Accelerated 3-Year Pathway to the MD Degree: The Experience of New York University Grossman School of Medicine</h1></header><section id="ejp-article-authors"><p id="P7">Cangiarella, Joan MD; Cohen, Elisabeth MD; Rivera, Rafael MD; Gillespie, Colleen PhD; Abramson, Steven MD</p><section><a href="#" id="ejp-article-authors-link"> Author Information <i class="wk-icon-arrow-down-r"></i></a></section></section><section id="ejp-article-authors-info" class="ejp-article-authors-info ejp-article-authors-info--hidden"><div class="ejp-article-authors-info-holder"> <p id=""><strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">J. Cangiarella</strong> is associate dean of education and faculty, associate professor of pathology, and director, Accelerated 3-Year MD Pathway, New York University Grossman School of Medicine, New York, New York.</p> <p id=""><strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">E. Cohen</strong> is professor of ophthalmology and 3-Year MD pathway advisor, New York University Grossman School of Medicine, New York, New York.</p> <p id=""><strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">R. Rivera</strong> is associate dean for admissions and financial aid and assistant professor of radiology, New York University Grossman School of Medicine, New York, New York.</p> <p id=""><strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">C. Gillespie</strong> is director, Division of Education Quality, and associate professor of medicine, New York University Grossman School of Medicine, New York, New York.</p> <p id=""><strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">S. Abramson</strong> is vice dean for education, faculty, and academic affairs and professor and chair of medicine, New York University Grossman School of Medicine, New York, New York.</p> <p id="">Supplemental digital content for this article is available at <span><a href="https://links.lww.com/ACADMED/A757" onclick="javascript:window.open('https://links.lww.com/ACADMED/A757');return false">https://links.lww.com/ACADMED/A757</a></span>.</p> <p id=""><em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">Funding/Support:</em> Josiah Macy Jr. Foundation, B15-04, Consortium of Accelerated Medical Pathway Programs.</p> <p id=""><em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">Other disclosures:</em> None reported.</p> <p id=""><em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">Ethical approval:</em> Study activities were approved by the New York University Grossman School of Medicine’s institutional review board as part of a broader protocol for evaluating the 3YMD program (#i-16-02152, approved June 9, 2018).</p> <p id="c1">Correspondence should be addressed to Joan Cangiarella, New York University Langone Medical Center, 530 First Ave., Skirball 7N, New York, NY 10016; telephone: (212) 263-5983; email: <span><a href="/cdn-cgi/l/email-protection#503d31393c243f6a1a3f313e7e33313e37393122353c3c31103e29253c313e373f3e357e3f2237" onclick="javascript:window.open('mailto:mailto:Joan.cangiarella@nyulangone.org');return false"><span class="__cf_email__" data-cfemail="8ec4e1efe0a0edefe0e9e7effcebe2e2efcee0f7fbe2efe0e9e1e0eba0e1fce9">[email protected]</span></a></span>.</p> </div></section><section id="article-journal-info"><div class="ej-journal-info"><span class="ej-journal-name">Academic Medicine </span><span id="ej-journal-date-volume-issue-pg"><a href="/academicmedicine/toc/2020/04000">95(4):p 534-539, April 2020.</a></span><span> | </span><span class="ej-journal-doi">DOI: </span>10.1097/ACM.0000000000003013</div></section><section id="ejp-article-indicators" class="ejp-article-indicators"><ul class="ejp-article-indicators__list"> <li id="ej-article-indicators-free" class="ejp-article-indicators__list-item" onmouseover="javascript:Tooltip_Free()" onmouseout="javascript:Tooltip_MouseOut()"><span class="ejp-indicator">Free</span></li> <li id="ej-article-indicators-sam" class="ejp-article-indicators__list-item" onmouseover="javascript:Tooltip_SDC()" onmouseout="javascript:Tooltip_MouseOut()"><a class="ejp-indicator" href="#ej-article-sam-container">SDC</a></li> </ul><button id="openArticleMetricsPopupButton" type="button" class="wk-button wk-button-ghost wk-button-icon-left ejp-article-metrics-btn" data-articleMetricsEndpoint="//services.journals.lww.com/IntegrationServices/ArticleMetricsService.svc" data-articleMetricsDetailsUrl="https://wolterskluwer.altmetric.com/details/" data-doi="10.1097/ACM.0000000000003013" data-suiteId="vrs_woltere_journalsglobalvrs" data-articlePublicationDate="2020-04-01" data-articlePublicationDateString="April 2020" data-receivedDate="" data-revisionReceivedDate="" data-acceptedDate="" data-crossrefRefLinkRoot="https://doi.org/" data-medlineRefLinkRoot="http://www.ncbi.nlm.nih.gov/pubmed/" data-pubMedId="31577593"><i class="wk-icon-filled-chart-r"></i><i class="wk-icon-filled-chart-white-r"></i> Metrics </button></section><section class="ejp-article-tabs" id="abstractWrap"><h2 class="ejp-article-tabs-heading">Abstract</h2> <div class="ejp-article-tabs__tabpanel" id="panel1" role="tabpanel" aria-labelledby="tab1"> <div id="article-abstract-content1"> <div class="ejp-article-text-abstract"> <p>The revision of the curriculum at New York University Grossman School of Medicine in 2010, with a reduction of the preclerkship curriculum to 18 months, made it possible to offer an accelerated 3-year pathway in 2013 for students who know their career path. The goals of the program include individualizing education, reducing student debt, and integrating undergraduate and graduate medical education. This accelerated 3-year doctor of medicine (3YMD) pathway is the first program of its kind in the United States to offer conditional acceptance to residency programs in all specialties through the National Resident Matching Program. Since inception of the pathway 6 years ago, 81 students have graduated. Critical components to successfully launch and implement the program are described.</p> <p>Unwavering commitment to the program as a high institutional priority by the dean and vice dean for education facilitated the support required by department chairs and residency program directors and the flexibility needed for success. Alignment between the 3- and 4-year pathways has made it possible to add points of entry into the 3-year pathway during the second and third years and to shift back into the 4-year pathway, as warranted. Modifications to how 3YMD students are mentored included changing the role of the departmental advisor and adding a dedicated 3YMD pathway advisor who serves as an advocate for both the students and the program. Having a relatively large number of 3YMD students has contributed to the success of the program and facilitated acceptance by the residencies.</p> </div> </div> </div></section><div class="ejp-fulltext-content js-ejp-fulltext-content"><section id="ArticleBody"><p id="JCL-P-7">The concept of a 3-year doctor of medicine (3YMD) pathway is not new. Canadian schools have had them for 3 decades. These programs were common in the United States in the 1970s and 1980s, with their development fueled by governmental financial support and a predicted physician shortage. Their demise occurred when these factors decreased and faculty and student dissatisfaction grew.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R1">1</a></sup></sup> However, in the past decade, there has been a revival in the development of U.S. 3YMD programs, with varied goals. The Consortium of Accelerated Medical Pathway Programs, funded by the Josiah Macy Jr Foundation, has doubled in size since 2015 to 17 medical schools, and the number of 3YMD graduates from these schools is more than 150, compared with fewer than 10 in 2013.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R2">2</a></sup></sup></p> <h2 class="ejp-article-outline-heading" data-level="1" id="JCL0">Motivation</h2> <p id="JCL-P-8">The motivation to create an accelerated 3YMD program varies. At New York University Grossman School of Medicine (NYUSOM), the goals included reducing student debt, individualizing student education, and integrating undergraduate medical education (UME) and graduate medical education (GME) for students who know their career path. This motivation is supported by the Carnegie report,<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R3">3</a></sup></sup> which challenged the conventional Flexnerian model of medical education<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R4">4</a></sup></sup> to focus on competency, standardization of outcomes, and flexible and individualized learning pathways that allowed for shortened training. Other programs focus on training primary care physicians to serve in underserved or rural settings. The lengthening of residency and fellowship training delaying entry into practice and the debatable value of a fourth year of medical school focused on residency application further support accelerated programs.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R5">5</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">,</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R6">6</a></sup></sup></p> <p id="JCL-P-9">In 2010, curriculum reform at NYUSOM shortened the preclerkship curriculum from 2 years to 18 months. This reduction allowed the creation of individualized pathways, enabling students to graduate in 3, 4, or 5 years. Our 3YMD pathway commenced in 2013<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R5">5</a></sup></sup> and was the first program in the United States that included conditional acceptance to any of the NYU Langone Health (NYULH) residency programs through the National Resident Matching Program (NRMP). This continuum of UME and GME training allows integration of medical students in their departments, facilitates transition from UME and GME, and allows tracking of outcomes. We describe what has been of critical importance to successfully implement our innovative accelerated 3YMD pathway, including commitment by institutional leaders, curricular flexibility, robust mentoring, and moderate program size.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R7">7</a></sup></sup></p> <h2 class="ejp-article-outline-heading" data-level="1" id="JCL1">Method</h2> <p id="JCL-P-10">The structure and curriculum are described based on the authors’ involvement in designing and refining the 3YMD pathway over time. Student feedback was collected through informal debriefs as part of ongoing quality monitoring and improvement, and because these qualitative data are anonymous and were not collected for research, the summaries provided here were deemed not to require institutional review. Interviews were conducted with residency program directors (RPDs) involved in the 3YMD program in 2017 (May through June) under an NYUSOM IRB-approved research protocol. All 16 RPDs were recruited by email, and 15 provided consent and completed an in-depth, semistructured interview (conducted by one of the authors, C.G., who is not directly involved with the 3YMD program). The interview was based on a set of guiding questions that focused on program directors’ experience with and reflections on the 3YMD program. (The interview guide is available as Supplemental Digital Appendix 1 at <span><a href="https://links.lww.com/ACADMED/A757" onclick="javascript:window.open('https://links.lww.com/ACADMED/A757');return false">https://links.lww.com/ACADMED/A757</a></span>.) Interview responses were recorded and transcribed, and a simple content analysis of the transcriptions was conducted to identify and describe major themes: After all the transcripts were read and responses to each core question across all RPDs were reread (to highlight areas of shared and divergent experiences and views by residency program), interview responses were then coded in ATLAS based on broad themes. (ATLAS.ti Scientific Software Development GmbH [2011]; ATLAS.ti Qualitative Data Analysis Version 7.0, Berlin, Germany.) Simple counts were used where relevant to describe similarities and differences in views and experiences.</p> <h2 class="ejp-article-outline-heading" data-level="1" id="JCL2">Structure of the 3YMD Pathway</h2> <h3 class="ejp-article-outline-heading" data-level="2" id="JCL3">Admission to the 3YMD pathway and residency</h3> <p id="JCL-P-11">Application to the accelerated 3YMD pathway is offered after acceptance into the traditional 4-year MD program. Interested students complete an additional application describing why they have chosen a specific career path and what experiences they have had to support their decision. Applications are sent to the RPD, who, with the department chair and several faculty members, decides whether to interview and admit the student. Criteria for admittance relate to the strengths of the students in knowing their career path and in being a good fit for the residency program. Admission to the accelerated 3YMD pathway offers conditional acceptance into the residency program through the NRMP on successful completion of medical school. At the outset, the dean of NYUSOM and CEO of NYULH set the expectation that each residency program opens approximately 20% of its slots for students to apply to the 3YMD pathway.</p> <p id="JCL-P-12">MD students can apply for the 3YMD pathway at 3 points: prematriculation, during the spring of their first year of medical school (opt-in 1), or during the spring of their second year (opt-in 2) (<a href="javascript:void(0)" onclick="javascript:showSlideShowByImageID('F1', '00001888-202004000-00021');">Figure 1</a>). All students have an opportunity to shadow and explore specialty interests during their first year and become more familiar with NYUSOM and New York City. Opt-in 2 students have completed the first 4 months of clinical rotations and have interacted in their department. MD-PhD students apply after completion of their PhD, shortening the time to graduate by 1 year. Key to the success of the program is acceptance of students by the department. This acceptance allows early engagement and partnership.</p><section class="ejp-r-article-images"><figure class="ejp-r-article-images__figure"><a href="javascript:void(0)" class="ejp-r-article-images__image-link" onclick="showSlideShowByImageID('F1', '00001888-202004000-00021')"><img class="ejp-r-article-images__img js-lazy-load lazy-load" src="javascript:void(0);" data-src="https://images.journals.lww.com/academicmedicine/ArticleViewerPreview.00001888-202004000-00021.F1.jpeg" data-srcset="https://images.journals.lww.com/academicmedicine/ArticleViewerPreview@2.00001888-202004000-00021.F1.jpeg 2x" srcset="" alt="F1"></a><figcaption class="ejp-r-article-images__figcaption"><a href="javascript:void(0)" class="ejp-r-article-images__figcaption-link" onclick="showSlideShowByImageID('F1', '00001888-202004000-00021')">Figure 1: </a><div class="ejp-r-article-images__figcaption-text">Accelerated 3-year MD pathway curriculum with entry points, as compared with 4-year curriculum, New York University Grossman School of Medicine. Abbreviations: USMLE, United States Medical Licensing Examination; CCSE, comprehensive clinical skills exam.</div></figcaption></figure></section><h3 class="ejp-article-outline-heading" data-level="2" id="JCL4">Curriculum</h3> <p id="JCL-P-13">Another key to the program is the alignment of curriculum of the 3YMD pathway with that of the 4-year pathway. The curriculum for the first 2½ years is similar (<a href="javascript:void(0)" onclick="javascript:showSlideShowByImageID('F1', '00001888-202004000-00021');">Figure 1</a>). The exception is that 3YMD students complete an 8-week experience between years 1 and 2. Prematriculation students also take a 2-week elective before the start of the first year. The alignment of the 3- and 4-year curricula facilitates delayed entry into the program, as well as a shift to the traditional 4-year pathway. The last 5 months are the most different, as students sit for the United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge and Clinical Skills and complete requirements for graduation, including 130 weeks of medical education per the Liaison Committee on Medical Education.</p> <h2 class="ejp-article-outline-heading" data-level="1" id="JCL5">Keys to Successful Implementation</h2> <h3 class="ejp-article-outline-heading" data-level="2" id="JCL6">Definition of success</h3> <p id="JCL-P-14">Success of the 3YMD pathway is determined by its sustainability, satisfaction of students and RPDs, and professional development and competency measures that are comparable to those of 4-year students. Qualitative evidence presented in this article is derived from RPD interviews and from student reports. Quantitative information is being collected and will be published in the future.</p> <h3 class="ejp-article-outline-heading" data-level="2" id="JCL7">Leadership and commitment to mission</h3> <p id="JCL-P-15">Success of an educational program that is new and unprecedented requires strong leadership and engagement from the top. A clear mission and unwavering commitment from the dean and vice dean for education empowered UME leadership to create and sustain the 3YMD pathway. The pathway is a high institutional priority. The mission is not only to reduce student debt but also to advance student-centered education to enable students to enter their chosen fields 1 year earlier and begin post-MD training that will continue for 3 to 10 years. Leaders obtained the support of RPDs and department chairs for the success of the program.</p> <h3 class="ejp-article-outline-heading" data-level="2" id="JCL8">Alignment of 3- and 4-year curricula and impact on program flexibility</h3> <p id="JCL-P-16">The alignment of the 3- and 4-year pathway curriculum for the first 2½ years facilitates a shift to the 4-year pathway, if necessary, as a result of performance issues or a change in career path to a specialty unavailable in the 3-year pathway. It is also expected that some students will shift pathways to train in another location or to participate in a couple’s match.</p> <p id="JCL-P-17">Even though students were committed to a particular program at the time of admission to the 3YMD pathway, some students expressed uncertainty about their career choice. To date, 116 students have been accepted into the accelerated 3YMD pathway and 12 students (10%) have switched specialties, including 7 (6%) who remained in the 3YMD pathway, 4 (3%) who shifted to the 4-year pathway, and 1 (1%) who entered the MD-PhD program. These changes have occurred primarily because students have found another specialty that is more in line with their interests. This decision can be difficult for students, especially those who feel well connected in their department, with strong relationships with faculty mentors.</p> <p id="JCL-P-18">Though the program is structured so that 3YMD students do their residency at NYU, it is understood that they may change their minds, and they are supported in applying elsewhere through the NRMP. Graduation from the 3YMD pathway requires acceptance into a residency, so if one wants to go outside of NYULH for residency, one may need to shift into the 4-year pathway, as 2 students have done. To date, 4 of 5 students who applied elsewhere at the end of 3 years have been successful.</p> <h3 class="ejp-article-outline-heading" data-level="2" id="JCL9">Promotion and remediation</h3> <p id="JCL-P-19">The program is not time-variable competency based, but rather requires a student to achieve all required UME competencies in 3 years. Clear procedures are needed regarding promotion, remediation, and shifting to the 4-year pathway. Given that the first 1.5 years are pass/fail, students are required to pass all modules. They are expected to get honors or high pass in most, if not all, clinical rotations. Performance of all 3YMD students is reviewed monthly by an executive committee for the 3YMD pathway that is led by the vice dean for education.</p> <p id="JCL-P-20">Flexibility and understanding in the review and remediation process are needed. It has been possible for students to be successful despite failing a single exam. When issues related to professionalism arise, the same standards apply to 3- and 4-year students. Shifting to the 4-year pathway has been required for 4 students because of professionalism issues, including reliability, self-improvement, adherence to code of conduct, and relationships with other students and staff.</p> <h3 class="ejp-article-outline-heading" data-level="2" id="JCL10">Mentorship: Advisors for professional development, student advocacy, and wellness</h3> <p id="JCL-P-21">With any new educational program, one needs to offer extra support for students. In addition to mentoring programs in place for all medical students, the development of a unique faculty mentoring program has been crucial. Each 3YMD student has 3 faculty mentors: a career advisor, a departmental advisor, and a 3YMD pathway advisor. The career advisor is the same for 3- and 4-year students, facilitates integration within and among classes, and is an academic coach.</p> <p id="JCL-P-22">3YMD students are assigned a departmental advisor at the time of acceptance into the program, in contrast to 4-year students who are assigned a departmental advisor in their third year. The departmental advisor facilitates early involvement in departmental activities and helps plan the summer program between the first and second years. This advisor introduces students to faculty and residents, encourages them to attend conferences, includes them in celebrations, and provides opportunities to explore clinical and research topics of interest. These activities help to integrate students into the department and solidify their career choice. The departmental advisor, along with the RPD, supports the student in the completing of the residency application. The amount of involvement in the department varies among students and by departments, but students who are more involved describe greater satisfaction with medical school. The departmental advisor may continue to mentor students as they transition into the residency program.</p> <p id="JCL-P-23">The 3YMD pathway advisor is a faculty member who understands the curriculum and logistical needs of an accelerated student and is a facilitator of the dynamic relationship between the students and the program. This advisor provides guidance on student schedules, summer experience after the first year, selection of clerkship order and electives, and meeting the requirements for graduation. Our 3YMD pathway advisor meets individually at least quarterly with each student, and is in contact, as needed, between meetings. Close communication is necessary to clarify the program requirements, encourage shadowing within and outside students’ chosen field to confirm their decision, and seek answers to both student-specific and program-related questions. Monthly lunches enhance connections among 3YMD students in different years of the program. The 3YMD advisor also provides important support for changes in specialty, both those within the 3YMD pathway and those that require shifting to the 4-year pathway. Students also discuss issues with the 3YMD pathway advisor that need to be addressed to enhance the program and medical school experience. This advisor also monitors students’ well-being; is supportive in academic, professional, and personal issues; and refers students for additional help when needed.</p> <p id="JCL-P-24">The coordination of multiple advisor roles occurs through discussions with the student. For example, the departmental advisor helps the student identify a mentor with expertise aligned with the student’s interests and works with the student to design the summer research and clinical experience after the first year; the 3YMD pathway advisor ensures that the student’s needs for this experience are met and that the experience fulfills requirements.</p> <p id="JCL-P-25">In 2014, peer mentoring was added by pairing students with other students ahead of them in the 3YMD pathway in the same or similar specialty. After several years with graduates of the pathway in NYU residencies, peer mentoring includes residents in the same specialty. Students appreciate advice from those ahead of them, and senior students and residents are happy to be helpful.</p> <h3 class="ejp-article-outline-heading" data-level="2" id="JCL11">Size of program</h3> <p id="JCL-P-26">The moderate size of the program has helped it be successful because students do not feel isolated and they interact with residents who are graduates of the program on clinical rotations. With growth every year (<a href="javascript:void(0)" onclick="javascript:showSlideShowByImageID('F2', '00001888-202004000-00021');">Figure 2</a>), 19% of the Class of 2019 graduated through the accelerated 3YMD pathway. These 28 students entered the pathway in approximately equally divided numbers between prematriculation (n = 11, 39%), opt-in 1 (n = 9, 32%), and opt-in 2 (n = 8, 29%), providing evidence of the appeal of multiple entry points to students. As of 2019, there are 81 graduates of the program, including 77 in 21 NYU residencies. With the growth and success of the program, the 3YMD pathway has become an integral part of NYUSOM.</p><section class="ejp-r-article-images"><figure class="ejp-r-article-images__figure"><a href="javascript:void(0)" class="ejp-r-article-images__image-link" onclick="showSlideShowByImageID('F2', '00001888-202004000-00021')"><img class="ejp-r-article-images__img js-lazy-load lazy-load" src="javascript:void(0);" data-src="https://images.journals.lww.com/academicmedicine/ArticleViewerPreview.00001888-202004000-00021.F2.jpeg" data-srcset="https://images.journals.lww.com/academicmedicine/ArticleViewerPreview@2.00001888-202004000-00021.F2.jpeg 2x" srcset="" alt="F2"></a><figcaption class="ejp-r-article-images__figcaption"><a href="javascript:void(0)" class="ejp-r-article-images__figcaption-link" onclick="showSlideShowByImageID('F2', '00001888-202004000-00021')">Figure 2: </a><div class="ejp-r-article-images__figcaption-text">Number of graduating students and available residency positions, New York University Grossman School of Medicine 3YMD pathway, 2016–2019.</div></figcaption></figure></section><h2 class="ejp-article-outline-heading" data-level="1" id="JCL12">Findings Thus Far</h2> <p id="JCL-P-27">In informal debriefs and discussions during the initial year of the program, many students noted that in clinical rotations they were reluctant to admit that they were 3YMD students, concerned that attending physicians and residents would take less interest in them because they had already decided on their specialty. Some students thought they were expected to know more than other students when their preclinical training was the same as 4-year students. In the initial year of the program, during a town hall meeting with students, senior 4-year pathway students vocalized a concern that accelerated 3YMD students took “their” residency positions. This concern has dissipated as opportunities to opt-in to the 3YMD pathway have been implemented. Occasionally, a student would note that when 3- and 4-year students were first-year residents at the same time or first-year residents who were 3YMD graduates were supervising their 4-year classmates, 4-year students questioned the abilities of 3YMD students. These biases have lessened greatly now that there are many 3YMD pathway undergraduate students and graduates in our residencies. Students are generally proud to say that they are part of the accelerated 3YMD pathway, and during webinars to recruit students to the program, 3YMD students report feeling less stressed than do 4-year students, thanks to their conditional acceptance into residency.</p> <p id="JCL-P-28">Positive experiences with 3YMD graduates, who often have a smoother-than-average transition to residency because of involvement during medical school, have made RPDs more enthusiastic about the program. Six graduates have been selected to be chief residents, from among 15 eligible in the first 2 classes, evidence that their performance is at least comparable to other residents. Several department chairs and RPDs have opened additional slots for talented 3YMD applicants, indicating satisfaction with the program. Interviews with RPDs who have 3YMD students (most of whom were interns at the time of the interviews) indicate that there was initial skepticism about the introduction of this pathway because of concerns about being able to select students at admission, the importance of time, and unease with students selecting residency programs so early. However, over time, RPDs generally found the pathway to be a great benefit in attracting students who were very focused from the start and fit well with the program “phenotype.” RPDs quickly realized this pathway was a great way to recruit stellar students into their programs. One RPD noted, “The whole secret is picking the right student from the beginning.” In addition, developing these students early enabled RPDs to ensure the right fit between the student and residency program and to learn what they should look for in a 3YMD student. Initial challenges in rolling out the 3YMD program led some RPDs to note that better communication would have helped them be more aware of changes in the design and implementation of the program. A few RPDs also noted that students occasionally received mixed messages or conflicting advice from their multiple advisors but reported that those conflicts were relatively easy to resolve when they arose. More than half of the RPDs shared their belief that the 3YMD students should focus on being a student—that is, focus on being in medical school—and not to try to be a resident too early. That focus, they felt, was important for students to be sure about their residency choice and to have the foundation that would fully prepare them for day 1 of residency. All 12 of the 15 RPDs who had a 3YMD graduate in their program reported that the intern was indistinguishable from the other interns, except in having greater knowledge of the health care systems and in some specific skill sets (e.g., research, prior clinical experience) where the 3YMD intern was superior.</p> <h2 class="ejp-article-outline-heading" data-level="1" id="JCL13">Summary</h2> <p id="JCL-P-29">Although the initial creation of our accelerated 3YMD pathway was met with some external skepticism,<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R8">8</a></sup></sup> a recent survey showed that 35% of U.S. medical schools have, or are developing, accelerated 3YMD pathways.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R9">9</a></sup></sup> Schools have developed widely different approaches depending on their mission and local environment. The accelerated 3YMD pathway at NYUSOM is now in its seventh year with 123 students, of which 81 are graduates in residency programs. The program is designed for students who know their career path to allow them to enter practice 1 year early. We initially estimated that 25% of students would pursue different careers, but only 10% have changed specialties to date, and more than half of those individuals have been able to remain within the 3YMD pathway. Even with NYU’s tuition-free initiative, earlier entry into practice leads to financial gains from reduced cost of living during medical school and 1 additional year of earnings. Conditional acceptance into residency permits smoother transition across the UME-to-GME continuum with substantial benefits to both students and residency programs.</p> <p id="JCL-P-30">Noted in List 1 are obstacles and requirements for building an effective accelerated program. Designing a successful accelerated program requires strong support on many levels, including from the dean of the medical school, the dean for education and student affairs, department chairs, RPDs, and multiple advisors. High expectations and determination to overcome challenges are critical for success. Flexibility is key because adjustments will be needed to ensure that the program thrives and benefits both students and residency programs. Additional mentoring and student support are necessary. While many of the accelerated 3YMD pathways elsewhere are small, our experience is that a larger cohort is beneficial because students have other 3YMD students and residents to turn to for advice and support.</p><article class="article-boxed-text"><h3 class="ejp-article-outline-heading" data-level="2" id="">List 1</h3> <h4 class="ejp-article-outline-heading" data-level="3" id="JCL14">Expected Obstacles and Requirements for Building a Successful Accelerated 3-Year MD Pathway</h4> <h5 class="ejp-article-outline-heading" data-level="4" id="JCL15">Obstacles</h5> <ul id="JCL15-2" class="wk-article__list wk-article__list--bullet"> <li class="wk-article__list-item wk-article__list-item--bullet">Initial biases from faculty and residency program directors</li> <li class="wk-article__list-item wk-article__list-item--bullet">Feelings among accelerated students of being judged differently by faculty and other students</li> <li class="wk-article__list-item wk-article__list-item--bullet">Feelings among fourth-year students of having lost out on residency slots</li> <li class="wk-article__list-item wk-article__list-item--bullet">Changes in career paths by some students in the program</li> </ul> <h5 class="ejp-article-outline-heading" data-level="4" id="JCL16">Requirements</h5> <ul id="JCL16-2" class="wk-article__list wk-article__list--bullet"> <li class="wk-article__list-item wk-article__list-item--bullet">Strong level of leadership and commitment from the dean and undergraduate medical education leaders</li> <li class="wk-article__list-item wk-article__list-item--bullet">Involvement and buy-in from department chairs, residency program directors, and faculty</li> <li class="wk-article__list-item wk-article__list-item--bullet">Alignment of curriculum to allow students to opt in and out of the pathway</li> <li class="wk-article__list-item wk-article__list-item--bullet">Development of a unique mentoring program with a program-specific advisor and early assignment of departmental advisor</li> <li class="wk-article__list-item wk-article__list-item--bullet">Program sized for sustainability</li> <li class="wk-article__list-item wk-article__list-item--bullet">Flexibility, when possible, in allowing students to stay in the accelerated 3-year MD pathway even if they change specialty</li> </ul></article><p id="JCL-P-41">A limitation to the generalizability of our experience to other 3YMD programs is that it may not always be possible or desired to align the curriculum between 3- and 4-year programs. Other approaches to achieve flexibility to serve the best interests of individual students are then needed.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R10">10</a></sup></sup> We think offering all residencies is important for student-centered education but recognize that the mission of other programs may be different. In our experience, however, support by top leadership and robust mentorship are both indispensable.</p> <p id="JCL-P-42">Regarding future directions, in July 2019, the NYU Long Island School of Medicine opened as a 3-year tuition-free medical school associated with primary care residencies.</p> <p id="JCL-P-43">Enthusiasm for our accelerated 3YMD pathway among students, residency programs, and faculty has risen over time, as evidenced by the increased number of students and residency positions (<a href="javascript:void(0)" onclick="javascript:showSlideShowByImageID('F2', '00001888-202004000-00021');">Figure 2</a>). Students tell us they feel ready to graduate and start residency, and the RPDs say they are pleased to welcome familiar students. Lastly, it is our observation that on graduation day, our 3YMD students seem very happy, appreciating the time and expense they have saved.</p></section><section id="article-references" class="article-references js-article-references"><h2 class="ejp-article-outline-heading" data-level="1" id="JCL-L-2">References</h2> <div id="R1" class="article-references__item js-article-reference">1. Schwartz CC, Ajjarapu AS, Stamy CD, Schwinn DA. Comprehensive history of 3-year and accelerated US medical school programs: A century in review. Med Educ Online. 2018;23:1530557.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-7"> Cited Here</a> | </li> <li><a href="https://scholar.google.com/scholar_lookup?title=Comprehensive+history+of+3-year+and+accelerated+US+medical+school+programs%3a+A+century+in+review.&publication_year=2018&author=CC+Schwartz&author=AS+Ajjarapu&author=CD+Stamy&author=DA+Schwinn" onclick="javascript:window.open('https://scholar.google.com/scholar_lookup?title=Comprehensive+history+of+3-year+and+accelerated+US+medical+school+programs%3a+A+century+in+review.&publication_year=2018&author=CC+Schwartz&author=AS+Ajjarapu&author=CD+Stamy&author=DA+Schwinn');return false">Google Scholar</a></li> </ul> </div> </div> <div id="R2" class="article-references__item js-article-reference">2. Cangiarella J, Fancher T, Jones B, et al. Three-year MD programs: Perspectives from the Consortium of Accelerated Medical Pathway Programs (CAMPP). Acad Med. 2017;92:483–490.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-7"> Cited Here</a> | </li> <li><a href="https://scholar.google.com/scholar_lookup?title=Three-year+MD+programs%3a+Perspectives+from+the+Consortium+of+Accelerated+Medical+Pathway+Programs+(CAMPP).&publication_year=2017&author=J+Cangiarella&author=T+Fancher&author=B+Jones" onclick="javascript:window.open('https://scholar.google.com/scholar_lookup?title=Three-year+MD+programs%3a+Perspectives+from+the+Consortium+of+Accelerated+Medical+Pathway+Programs+(CAMPP).&publication_year=2017&author=J+Cangiarella&author=T+Fancher&author=B+Jones');return false">Google Scholar</a></li> </ul> </div> </div> <div id="R3" class="article-references__item js-article-reference">3. Irby DM, Cooke M, O’Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med. 2010;85:220–227.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-8"> Cited Here</a> | </li> <li><a href="https://scholar.google.com/scholar_lookup?title=Calls+for+reform+of+medical+education+by+the+Carnegie+Foundation+for+the+Advancement+of+Teaching%3a+1910+and+2010.&publication_year=2010&author=DM+Irby&author=M+Cooke&author=BC+O%e2%80%99Brien" onclick="javascript:window.open('https://scholar.google.com/scholar_lookup?title=Calls+for+reform+of+medical+education+by+the+Carnegie+Foundation+for+the+Advancement+of+Teaching%3a+1910+and+2010.&publication_year=2010&author=DM+Irby&author=M+Cooke&author=BC+O%e2%80%99Brien');return false">Google Scholar</a></li> </ul> </div> </div> <div id="R4" class="article-references__item js-article-reference">4. Flexner A. Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching. 1910.New York, NY: Carnegie Foundation for the Advancement of Teaching.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-8"> Cited Here</a></li> </ul> </div> </div> <div id="R5" class="article-references__item js-article-reference">5. Abramson SB, Jacob D, Rosenfeld M, et al. A 3-year M.D.-accelerating careers, diminishing debt. N Engl J Med. 2013;369:1085–1087.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-8"> Cited Here</a> | </li> <li><a href="https://scholar.google.com/scholar_lookup?title=A+3-year+M.D.-accelerating+careers%2c+diminishing+debt.&publication_year=2013&author=SB+Abramson&author=D+Jacob&author=M+Rosenfeld" onclick="javascript:window.open('https://scholar.google.com/scholar_lookup?title=A+3-year+M.D.-accelerating+careers%2c+diminishing+debt.&publication_year=2013&author=SB+Abramson&author=D+Jacob&author=M+Rosenfeld');return false">Google Scholar</a></li> </ul> </div> </div> <div id="R6" class="article-references__item js-article-reference">6. Aagaard EM, Abaza M. The residency application process—Burden and consequences. N Engl J Med. 2016;374:303–305.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-8"> Cited Here</a> | </li> <li><a href="https://scholar.google.com/scholar_lookup?title=The+residency+application+process%e2%80%94Burden+and+consequences.&publication_year=2016&author=EM+Aagaard&author=M+Abaza" onclick="javascript:window.open('https://scholar.google.com/scholar_lookup?title=The+residency+application+process%e2%80%94Burden+and+consequences.&publication_year=2016&author=EM+Aagaard&author=M+Abaza');return false">Google Scholar</a></li> </ul> </div> </div> <div id="R7" class="article-references__item js-article-reference">7. Kanter SL. Toward better descriptions of innovations. Acad Med. 2008;83:703–704.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-9"> Cited Here</a> | </li> <li><a href="https://scholar.google.com/scholar_lookup?title=Toward+better+descriptions+of+innovations.&publication_year=2008&author=SL+Kanter" onclick="javascript:window.open('https://scholar.google.com/scholar_lookup?title=Toward+better+descriptions+of+innovations.&publication_year=2008&author=SL+Kanter');return false">Google Scholar</a></li> </ul> </div> </div> <div id="R8" class="article-references__item js-article-reference">8. Goldfarb S, Morrison G. The 3-year medical school—Change or shortchange? N Engl J Med. 2013;369:1087–1089.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-29"> Cited Here</a> | </li> <li><a href="https://scholar.google.com/scholar_lookup?title=The+3-year+medical+school%e2%80%94Change+or+shortchange%3f&publication_year=2013&author=S+Goldfarb&author=G+Morrison" onclick="javascript:window.open('https://scholar.google.com/scholar_lookup?title=The+3-year+medical+school%e2%80%94Change+or+shortchange%3f&publication_year=2013&author=S+Goldfarb&author=G+Morrison');return false">Google Scholar</a></li> </ul> </div> </div> <div id="R9" class="article-references__item js-article-reference">9. Cangiarella J, Gillespie C, Shea JA, Morrison G, Abramson SB. Accelerating medical education: A survey of deans and program directors. Med Educ Online. 2016;21:31794.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-29"> Cited Here</a> | </li> <li><a href="https://scholar.google.com/scholar_lookup?title=Accelerating+medical+education%3a+A+survey+of+deans+and+program+directors.&publication_year=2016&author=J+Cangiarella&author=C+Gillespie&author=JA+Shea&author=G+Morrison&author=SB+Abramson" onclick="javascript:window.open('https://scholar.google.com/scholar_lookup?title=Accelerating+medical+education%3a+A+survey+of+deans+and+program+directors.&publication_year=2016&author=J+Cangiarella&author=C+Gillespie&author=JA+Shea&author=G+Morrison&author=SB+Abramson');return false">Google Scholar</a></li> </ul> </div> </div> <div id="R10" class="article-references__item js-article-reference">10. Leong SL, Cangiarella J, Fancher T, et al. Roadmap for creating an accelerated three-year medical education program. Med Educ Online. 2017;22:1396172.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-41"> Cited Here</a> | </li> <li><a href="https://scholar.google.com/scholar_lookup?title=Roadmap+for+creating+an+accelerated+three-year+medical+education+program.&publication_year=2017&author=SL+Leong&author=J+Cangiarella&author=T+Fancher" onclick="javascript:window.open('https://scholar.google.com/scholar_lookup?title=Roadmap+for+creating+an+accelerated+three-year+medical+education+program.&publication_year=2017&author=SL+Leong&author=J+Cangiarella&author=T+Fancher');return false">Google Scholar</a></li> </ul> </div> </div> <div class="article-references__button-container"></div></section><section id="ej-article-sam-container"><h2 class="ejp-article-outline-heading" data-level="1">Supplemental Digital Content</h2> <ul id="ej-article-sam"> <li class="ej-pdf"><a href="https://links.lww.com/ACADMED/A757" onclick="javascript:window.open('https://links.lww.com/ACADMED/A757','ACADMED_A757');return false">ACADMED_2020_02_05_CANGIARELLA_AcadMed-D-19-00249_SDC1.pdf; [PDF] (113 KB)</a></li> </ul></section><section class="ej-article-copyright">Copyright © 2019 by the Association of American Medical Colleges</section></div><button class="ejp-toggle-fulltext-button js-ejp-toggle-fulltext-button">View full article text</button></article> </div> </div> <div id="article-metrics"> <div id="article-metrics-container"> </div> </div> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_divOutlineHTML"></div> <script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script><script type="text/javascript" src="https://lww.com/_layouts/15/1033/Scripts/wk/SlideShowPopup.js?v=05.24.00.023" defer="true"> </script> <script type="text/javascript" src="https://lww.com/_layouts/15/1033/Scripts/wk/zoom.js?v=05.24.00.023" defer="true"> </script> <script> var sample = 6; var smPos = 153; var spPos = 153; var sW; var sH; var articleImageDialogModal = $('#ArticleImageDialogModal'); function setImage(imageUrl) { var $container = $("#zoom_container"); var width = $container.width(); $container.z("destroy") .css("background-image", "url(/_layouts/1033/images/oaks.journals/preloader.gif)") .z({ width: width, image_url: imageUrl, responsive: true, responsive_maintain_ratio: true, max_WIDTH: '1200', max_HEIGHT: '1200', initial_ZOOM: 100, initial_POSITION: '0,0' }); return false; } </script> <div id="ArticleImageModal" class="wk-modal wk-modal-slideshow horizontally-centered large fixed-vertical ejp-modal" role="dialog" style="display: none;"> <div class="modal-dialog"> <section class="modal-content wk-modal-content wk-modal-slideshow__content"> <header class="wk-modal-header ejp-modal-header"> <button onclick="return displaySlideShowModal(false);" aria-label="close dialog" class="wk-button-icon wk-modal-close ejp-modal-close" data-dismiss="wk-modal"><i class="fa fa-times"></i></button> </header> <div class="modal-body wk-modal-body wk-modal-slideshow__body flex flex-column"> <div id="zoom_container" class="wk-modal-slideshow__zoom-container"></div> <div id="ZoomContainerDetails" class="wk-modal-slideshow__zoom-container-details pa3"> <h3> <div class="wk-modal-slideshow__title"></div> </h3> <div class="wk-modal-slideshow__description"></div> <h4>Source</h4> <div class="wk-modal-slideshow__source-article mb4"> <a href="javascript:void(0);" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_sourceArticleUrl" onclick="HideSlideShow();">Evolution of an Accelerated 3-Year Pathway to the MD Degree: The Experience of New York University Grossman School of Medicine</a> </div> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_citationdiv" class="wk-modal-slideshow__source-citation mb4"> Academic Medicine95(4):534-539, April 2020. </div> </div> </div> <div class="modal-footer wk-modal-footer wk-modal-slideshow__footer pa2 flex flex-column flex-wrap"> <div class="wk-modal-slideshow__zoom-controls flex justify-between items-center mb2"> <div id="zoom_buttons" class="wk-modal-slideshow__zoom-buttons flex justify-between"> <a href="#" onmousedown="$('#zoom_container').z('zoomIn')" onclick="return false" title="Zoom In" class="ph3"><i class="fa fa-plus-square white"></i></a> <a href="#" onmousedown="$('#zoom_container').z('zoomOut')" onclick="return false" title="Zoom Out" class="ph3"><i class="fa fa-minus-square white"></i></a> </div> <div class="wk-modal-slideshow__list-pager flex pr3"> <a href="javascript:void(0);" onclick="MovePrevious();" id="anchorPrev" title="Previous"><i class="fa fa-arrow-circle-left white"></i></a> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_imageCountStatus" class="wk-modal-slideshow__list-pager-text mh3 tc white"></span> <a href="javascript:void(0);" onclick="MoveNext();" id="anchorNext" title="Next"><i class="fa fa-arrow-circle-right white"></i></a> </div> </div> <ul class="wk-modal-slideshow__action-controls flex justify-between"> <li class="pv2 ph3"> <a href="javascript:void(0);" onclick="ShowFullSize('00001888-202004000-00021');" class="white tc"> <i class="fa fa-arrows-alt mb2 db white"></i> <span class="wk-modal-slideshow__action-controls-text">Full-Size</span> </a> </li> <li id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_lnkEmailToColleague" class="pv2 ph3"> <a href="javascript:void(0);" onclick="slideShow_EmailLinkClicked(imageIndex);" class="white tc"> <i class="fa fa-envelope mb2 db white"></i> <span class="wk-modal-slideshow__action-controls-text">Email</span> </a> </li> <li id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_lnkFavorites" class="pv2 ph3"> <button class="user-menu__link user-menu__link--add-to-favorites js-ejp-login-btn white tc" type="button" data-config="{"eventName":"AddToFavoritesFromSlideShow","eventDetail":{"items":["Image|academicmedicine:2020:04000:00021|{0}|"],"an":"00001888-202004000-00021"},"eventOptions":{"bubbles":true,"cancelable":true,"composed":false},"loginDetail":{"isLoginOptional":false,"promptLogin":true,"loginPromptText":"To save this item, login or register"},"isNull":false}"> <i class="fa fa-folder mb2 db white"></i> <span class="wk-modal-slideshow__action-controls-text">+ Favorites</span> </button> </li> <li class="pv2 ph3"> <button class="user-menu__link user-menu__link--ppt-download js-ejp-login-btn" type="button" data-config="{"eventName":"PPTDownload","eventDetail":{"url":"https://journals.lww.com:443/academicmedicine/Fulltext/2020/04000/Evolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx?Ppt=Article|academicmedicine:2020:04000:00021|10.1097/acm.0000000000003013|","gating":false},"eventOptions":{"bubbles":true,"cancelable":true,"composed":false},"loginDetail":{"isLoginOptional":true,"promptLogin":false},"isNull":false}"> <i class="fa fa-file-powerpoint-o mb2 db white"></i> <span class="wk-modal-slideshow__action-controls-text">Export</span> </button> </li> <li class="wk-modal-slideshow__view-gallery pv2 ph3"> <a href="javascript:void(0);" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_imageGalleryUrl" class="white tc" onclick="slideShow_NavigateToUrl('/academicmedicine/pages/imagegallery.aspx?year=2020&issue=04000&article=00021')"> <i class="fa fa-th-large mb2 db white"></i> <span class="wk-modal-slideshow__action-controls-text">View in Gallery</span> </a> </li> </ul> </div> </section> </div> </div> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$callShowImage" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_callShowImage" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$popupImageId" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_popupImageId" value="F1" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$IsExportToPPT" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_IsExportToPPT" value="false" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$keyword" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_keyword" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$image_url" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_url" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$image_description" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_description" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$image_sourceTitle" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_sourceTitle" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$image_sourceUrl" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_sourceUrl" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$image_sourceInfo" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_sourceInfo" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$image_key" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_key" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$image_fullSizeUrl" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_fullSizeUrl" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$slideShowUserControl$image_imageGalleryUrl" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_slideShowUserControl_image_imageGalleryUrl" /> <input type="hidden" id="NoOfImages" name="NoOfImages" value="2" /> <script type="text/javascript" src="https://lww.com/_layouts/15/1033/Scripts/wk/EmailToColleague.js?v=05.24.00.023" defer="true"> </script> <a id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_hypEmailToColleague" href="javascript:" style="display:none;"></a> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_pnlEmailToColleague" class="wk-modal-table" style="display: none"> <div class="wk-modal-cell"> <div id="ej-box-modal-drop-shadow" class="wk-modal horizontally-centered small wk-modal-with-overlay wk-modal-small ejp-modal email-to-colleague" tabindex="-1" role="dialog" style="position: static;"> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_pnlMain" class="js-main-panel" onkeypress="javascript:return WebForm_FireDefaultButton(event, 'ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_btnSend')"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"> <strong> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_lblEmailToColleague">Email to Colleague</span></strong> </div> <button aria-label="close dialog" class="primary-button wk-button-icon wk-modal-close ejp-modal-close js-close "> <i class="fa fa-times"></i> </button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <div class="wk-field-header"> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_divErrorMessage" class="js-error-message-div ej-error-message-panel" style="display: none; color: red; font-style: italic"> <p class="ej-error-message-icon"> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_lblErrorMessage" class="js-error-message-label">Colleague's E-mail is Invalid</span> </p> </div> </div> </div> <div class="wk-field-item"> <div class="wk-field-header"> Your Name: </div> <div class="wk-field-body"> <input name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$emailToColleague$txtYourName" type="text" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_txtYourName" class="js-name" /> </div> </div> <div class="wk-field-item"> <div class="wk-field-header"> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_lblColleaguesEmail" class="js-collegaues-email-lbl">Colleague's Email:</span> </div> <div class="wk-field-body no-bottom-margin"> <input name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$emailToColleague$txtColleaguesEmail" type="text" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_txtColleaguesEmail" class="js-collegaues-email" /> </div> <div class="wk-field-header"><span class="ej-form-comments">Separate multiple e-mails with a (;).</span></div> </div> <div class="wk-field-item"> <div class="wk-field-header"> Message: </div> <div class="wk-field-body"> <textarea name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$emailToColleague$txtMessage" rows="2" cols="20" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_txtMessage" class="js-message"> Thought you might appreciate this item(s) I saw in Academic Medicine.</textarea> </div> </div> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="submit" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$emailToColleague$btnSend" value="Send" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_btnSend" class="js-send-button primary-button grecaptcha-email-colleague-1dc582c1ed904010bea9c1a20b84a3b5" /> <input type="button" value="Cancel" id="btnCancel" class="secondary-button js-close" /> </div> </div> <div class="wk-field-item wk-email-colleague-captcha-bar"> <div class="wk-field-body"> <div id="div-recaptcha-1dc582c1ed904010bea9c1a20b84a3b5" class="div-recaptcha-container" data-uniqueclassidentifier="grecaptcha-email-colleague-1dc582c1ed904010bea9c1a20b84a3b5" data-sitekey="6LeeoSAUAAAAACFv8yNuINPv8IWyXHJ6uN447qEK" data-callback="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_captchaCallBack" data-badge="inline" data-size="invisible" data-type="image" > </div> </div> </div> </div> </section> </div> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_pnlSuccessMessage" class="js-success-message-panel" style="display: none;"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"></div> <button aria-label="close dialog" class="primary-button wk-button-icon wk-modal-close ejp-modal-close js-close "><i class="fa fa-times"></i></button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <br /> <p> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_lblMessageSent">Your message has been successfully sent to your colleague.</span> </p> <br /> </div> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="button" value="Close Window" id="btnClose" class="primary-button js-close" /> </div> </div> </div> </section> </div> <div id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_pnlErrorMessage" class="js-error-message-panel" style="display: none;"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"></div> <button aria-label="close dialog" class="primary-button wk-button-icon wk-modal-close ejp-modal-close js-close "><i class="fa fa-times"></i></button> </header> <div class="wk-modal-body"> <br /> <div class="wk-field-item"> <span id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_lblInvalidEmail" style="color:Red;">Some error has occurred while processing your request. Please try after some time.</span> </div> <br /> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="button" value="Close Window" id="btnEClose" class="primary-button js-close" /> </div> </div> </div> </section> </div> </div> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$emailToColleague$hiddenEmailToColleague" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_hiddenEmailToColleague" /> <input type="hidden" name="ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$emailToColleague$hiddenIsUser" id="ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_hiddenIsUser" /> </div> </div> <script type="text/javascript"> window.emailToColleaguePopups = window.emailToColleaguePopups || []; var ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_captchaCallBack = function () { ejpAnalytics.track('emailColleaguereCAPTCHA'); ejpAnalytics.track('emailColleagueComplete'); __doPostBack('ctl00$ctl29$g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8$ctl00$emailToColleague$btnSend','') }; var initEmailToColleaguectl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague = function () { window.emailToColleaguePopups['ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague'] = new EmailToColleagueComponent('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_pnlEmailToColleague', 'div-recaptcha-1dc582c1ed904010bea9c1a20b84a3b5', 'grecaptcha-email-colleague-1dc582c1ed904010bea9c1a20b84a3b5', 'emailToColleaguePopupExtender_1058785643', 'ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_hiddenEmailToColleague', 'ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_hiddenIsUser', '00001888-202004000-00021' ); } Sys.WebForms.PageRequestManager.getInstance().add_pageLoaded(initEmailToColleaguectl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague); </script> <input type="hidden" id="selectedItems" name="selectedItems" value="" /> </div><div class="ms-clear"></div></div> </div> </div> </div></div> <div id="ctl00_PlaceHolderMain_ResponsivePageLayoutRenderer_ResponsiveLayoutRowRepeater_ctl01_ResponsiveLayoutColumnRepeater_ctl01_ResponsiveLayoutColumn" class=" wk-column-12 wk-column-4-m wk-column-4-l wk-column-4-xl wk-column-4-xxl"> <div class="ms-webpart-zone ms-fullWidth"> <div id="MSOZoneCell_WebPartWPQ1" class="s4-wpcell-plain ms-webpartzone-cell ms-webpart-cell-vertical-inline-table ms-webpart-cell-vertical ms-fullWidth "> <div class="ms-webpart-chrome ms-webpart-chrome-vertical ms-webpart-chrome-fullWidth "> <div WebPartID="abb2447a-c95b-4659-9c40-72d0b343bbfd" HasPers="false" id="WebPartWPQ1" width="100%" class="ms-WPBody noindex " allowDelete="false" style="" ><div id="ctl00_ctl29_g_abb2447a_c95b_4659_9c40_72d0b343bbfd"> <div id="ctl00_ctl29_g_abb2447a_c95b_4659_9c40_72d0b343bbfd_ctl00_adContainer" class="ej-advertisement ej-advertisement-middle"> <div class="ej-advertisement-content"> <div> <div id="ga_09a5a3ad-015c-4d14-b03e-de11a2664933" class="ad-slot-container ad-slot-container-ga_09a5a3ad-015c-4d14-b03e-de11a2664933" data-sizemap="[[[0, 0], [[300, 250]]]]" data-adpath="/15726702761/Desktop/academicmedicine/Article/Right" data-autoload="no" data-outofpage="no" data-sticky="no" data-slottargeting='' data-displayslug="yes" data-sticky-duration="0" data-name="Right"></div> </div> </div> </div> </div><div class="ms-clear"></div></div> </div><div class="ms-PartSpacingVertical"></div> </div><div id="MSOZoneCell_WebPartWPQ2" class="s4-wpcell-plain ms-webpartzone-cell ms-webpart-cell-vertical-inline-table ms-webpart-cell-vertical ms-fullWidth "> <div class="ms-webpart-chrome ms-webpart-chrome-vertical ms-webpart-chrome-fullWidth "> <div WebPartID="bc326d70-5785-4549-985d-290fd946257b" HasPers="false" id="WebPartWPQ2" width="100%" class="ms-WPBody noindex " allowDelete="false" style="" ><div id="ctl00_ctl29_g_bc326d70_5785_4549_985d_290fd946257b"> <div class="js-advanced-recommendation-widget" data-config="{"serviceUrl":null,"displayMode":"ListView","headerText":"Related Articles","hash":"1","itemsPerPage":6,"renderOnServer":false,"showConsoleLog":false,"shouldShowSpeciality":"0","kind":"Article","title":"Evolution of an Accelerated 3-Year Pathway to the MD Degree: The Experience of New York University Grossman School of Medicine","meshTerms":["Internship and Residency","Curriculum","New York","Students, Medical","Schools","Education, Medical, Graduate","Education, Medical, Undergraduate","Medicine","Schools, Medical","United States"],"wkmrid":"JOURNAL/acmed/04.03/00001888-202004000-00021/root/v/2023-10-17T041903Z/r/text-xml","imageHandlerUrl":"https://images.journals.lww.com/academicmedicine","accessionNumber":"00001888-202004000-00021","fontSize":"small","displayImage":false,"showJournalTitle":false,"showPublicationDate":false}"></div> </div><div class="ms-clear"></div></div> </div><div class="ms-PartSpacingVertical"></div> </div><div id="MSOZoneCell_WebPartWPQ3" class="s4-wpcell-plain ms-webpartzone-cell ms-webpart-cell-vertical-inline-table ms-webpart-cell-vertical ms-fullWidth "> <div class="ms-webpart-chrome ms-webpart-chrome-vertical ms-webpart-chrome-fullWidth "> <div WebPartID="a3512fa5-de16-4f95-b5d1-25547169fe74" HasPers="false" id="WebPartWPQ3" width="100%" class="ms-WPBody noindex " allowDelete="false" style="" ><div id="ctl00_ctl29_g_a3512fa5_de16_4f95_b5d1_25547169fe74"> <div id="ctl00_ctl29_g_a3512fa5_de16_4f95_b5d1_25547169fe74_ctl00_adContainer" class="ej-advertisement ej-advertisement-middle"> <div class="ej-advertisement-content"> <div> <div id="ga_acf52f9e-63ff-4ea5-b7cc-c90eb6f1c362" class="ad-slot-container ad-slot-container-ga_acf52f9e-63ff-4ea5-b7cc-c90eb6f1c362" data-sizemap="[[[0, 0], [[300, 250]]]]" data-adpath="/15726702761/Desktop/academicmedicine/Article/Right" data-autoload="no" data-outofpage="no" data-sticky="no" data-slottargeting='' data-displayslug="yes" data-sticky-duration="0" data-name="Right"></div> </div> </div> </div> </div><div class="ms-clear"></div></div> </div><div class="ms-PartSpacingVertical"></div> </div><div id="MSOZoneCell_WebPartWPQ4" class="s4-wpcell-plain ms-webpartzone-cell ms-webpart-cell-vertical-inline-table ms-webpart-cell-vertical ms-fullWidth "> <div class="ms-webpart-chrome ms-webpart-chrome-vertical ms-webpart-chrome-fullWidth "> <div WebPartID="e345f40a-c566-4b24-8a3e-1ed4c903ba2e" HasPers="false" id="WebPartWPQ4" width="100%" class="ms-WPBody noindex " allowDelete="false" style="" ><div id="ctl00_ctl29_g_e345f40a_c566_4b24_8a3e_1ed4c903ba2e"> <div data-config="{"serviceUrl":null,"displayMode":null,"hash":"1","itemsPerPage":40,"renderOnServer":false}"></div><section id="ctl00_ctl29_g_e345f40a_c566_4b24_8a3e_1ed4c903ba2e_ctl01_divRecentActivity" class="content-box cb-collapsible"> <div class="ejp-uc--small"> <header class="ejp-heading-2"> <h2 aria-expanded="false"> Readers Of this Article Also Read </h2> </header> <div id="ej-box-01-body"> <div id="ej-articlesWithTerms"> <ul> <li class="ejp-uc__list-item"> <h3 class='ejp-uc__article-title'><a title href="https://journals.lww.com/academicmedicine/fulltext/2024/04000/the_relationship_between_program_and_applicant.22.aspx" onmouseover="javascript:event.cancelBubble = true;Tooltip_Article('The Relationship Between Program and Applicant Characteristics With Applicant Program Signals in the 2022 Residency Recruitment Cycle: Findings From 3 Specialties', 'LaFemina Jennifer MD; Rosman, Ilana S. MD; Wallach, Sara L. MD; Wise, Paul E. MD; Smink, Douglas S. MD, MPH; Fletcher, Laura PhD', 'Academic Medicine', 'April 2024', '99', '4' , 'p 430-436');" onmouseout="javascript:Tooltip_MouseOut()" class="ejp-uc__article-title-link">The Relationship Between Program and Applicant Characteristics With Applicant...</a></h3></li> <li class="ejp-uc__list-item"> <h3 class='ejp-uc__article-title'><a title href="https://journals.lww.com/academicmedicine/abstract/2024/03000/medical_school_rankings__time_to_end_or_time_to.9.aspx" onmouseover="javascript:event.cancelBubble = true;Tooltip_Article('Medical School Rankings: Time to End or Time to Amend?', 'Gabrielson Andrew T. MD; Ziegelstein, Roy C. MD, MACP', 'Academic Medicine', 'March 2024', '99', '3' , 'p 247-250');" onmouseout="javascript:Tooltip_MouseOut()" class="ejp-uc__article-title-link">Medical School Rankings: Time to End or Time to Amend?</a></h3></li> <li class="ejp-uc__list-item"> <h3 class='ejp-uc__article-title'><a title href="https://journals.lww.com/academicmedicine/fulltext/2023/10000/residency_program_directors__views_on_research.25.aspx" onmouseover="javascript:event.cancelBubble = true;Tooltip_Article('Residency Program Directors’ Views on Research Conducted During Medical School: A National Survey', 'Wolfson Rachel K. MD; Fairchild, Paige C. MPH; Bahner, Ingrid PhD; Baxa, Dwayne M. PhD; Birnbaum, Deborah R. MBA; Chaudhry, Sarwat I. MD; Chretien, Katherine C. MD; DeFranco, Donald B. PhD; Deptola, Amber Z. MD; LaConte, Leslie E.W. PhD; Lin, Jenny J. MD, MPH; Petch Lee, Leslie PhD; Powers, Maureen A. PhD; Ropson, Ira J. PhD; Sankaran, Saumya M. PhD; Sawarynski, Kara E. PhD; Sozio, Stephen M. MD, MHS, MEHP', 'Academic Medicine', 'October 2023', '98', '10' , 'p 1185-1195');" onmouseout="javascript:Tooltip_MouseOut()" class="ejp-uc__article-title-link">Residency Program Directors’ Views on Research Conducted During Medical School: ...</a></h3></li> <li class="ejp-uc__list-item"> <h3 class='ejp-uc__article-title'><a title href="https://journals.lww.com/academicmedicine/abstract/2023/09000/understanding_academic_self_concept_and.21.aspx" onmouseover="javascript:event.cancelBubble = true;Tooltip_Article('Understanding Academic Self-Concept and Performance in Medical Education', 'Harrell Kelly M. PhD MPT; Rawls, Meagan MS; Stringer, J.K. IV PhD; Edwards, Cherie D. PhD; Santen, Sally A. MD, PhD; Biskobing, Diane MD', 'Academic Medicine', 'September 2023', '98', '9' , 'p 1032-1035');" onmouseout="javascript:Tooltip_MouseOut()" class="ejp-uc__article-title-link">Understanding Academic Self-Concept and Performance in Medical Education</a></h3></li> <li class="ejp-uc__list-item"> <h3 class='ejp-uc__article-title'><a title href="https://journals.lww.com/academicmedicine/abstract/2023/09000/learning_how_to_learn__an_innovative_medical.20.aspx" onmouseover="javascript:event.cancelBubble = true;Tooltip_Article('Learning How to Learn: An Innovative Medical School Orientation Activity', 'Smith James F. Jr MD DBe; Sinclair, Mary L. MSc; Madhavan, Kiely M. PhD; Eno, Cassie A. PhD; Piemonte, Nicole M. PhD', 'Academic Medicine', 'September 2023', '98', '9' , 'p 1026-1031');" onmouseout="javascript:Tooltip_MouseOut()" class="ejp-uc__article-title-link">Learning How to Learn: An Innovative Medical School Orientation Activity</a></h3></li> </ul> </div> </div> </div> </section> </div><div class="ms-clear"></div></div> </div><div class="ms-PartSpacingVertical"></div> </div><div id="MSOZoneCell_WebPartWPQ5" class="s4-wpcell-plain ms-webpartzone-cell ms-webpart-cell-vertical-inline-table ms-webpart-cell-vertical ms-fullWidth "> <div class="ms-webpart-chrome ms-webpart-chrome-vertical ms-webpart-chrome-fullWidth "> <div WebPartID="3004602f-68d7-446f-ac9b-c26add791af6" HasPers="false" id="WebPartWPQ5" width="100%" class="ms-WPBody noindex " allowDelete="false" style="" ><div id="ctl00_ctl29_g_3004602f_68d7_446f_ac9b_c26add791af6"> <div id="ctl00_ctl29_g_3004602f_68d7_446f_ac9b_c26add791af6_ctl00_adContainer" class="ej-advertisement ej-advertisement-bannercombo"> <div class="ej-advertisement-content"> <div> <div id="ga_fdf81625-ab31-4158-bc88-a91f9f2eabd4" class="ad-slot-container ad-slot-container-ga_fdf81625-ab31-4158-bc88-a91f9f2eabd4" data-sizemap="[[[1050, 200], [[300, 600], [300, 250], [160, 600]]], [[730, 600], [[300, 600], [300, 250]]], [ [ 0, 0 ], [ [300, 250] ] ] ]" data-adpath="/15726702761/Desktop/academicmedicine/Article/Right1" data-autoload="no" data-outofpage="no" data-sticky="no" data-slottargeting='' data-displayslug="yes" data-sticky-duration="0" data-name="Right1"></div> </div> </div> </div> </div><div class="ms-clear"></div></div> </div><div class="ms-PartSpacingVertical"></div> </div><div id="MSOZoneCell_WebPartWPQ6" class="s4-wpcell-plain ms-webpartzone-cell ms-webpart-cell-vertical-inline-table ms-webpart-cell-vertical ms-fullWidth "> <div class="ms-webpart-chrome ms-webpart-chrome-vertical ms-webpart-chrome-fullWidth "> <div WebPartID="495a29f8-cc16-40b0-9a6a-4fbabcb2cbc3" HasPers="false" id="WebPartWPQ6" width="100%" class="ms-WPBody noindex " allowDelete="false" style="" ><div id="ctl00_ctl29_g_495a29f8_cc16_40b0_9a6a_4fbabcb2cbc3"> <div class="js-ejp-universalMostPopular-webpart" data-config="{"serviceUrl":"https://services.journals.lww.com/IntegrationServices/MostPopularDataService.svc/GetMostPopularItems?timeframe=90d&journalIds=academicmedicine&publisher=LWW&results=5&numberOfSymbolsInSubtitle=275&hash=1&displayCustomIndicator=False","headerText":"Most Popular","headerUrl":null,"displayMode":"ListView","hash":"1","shouldShowImage":false,"shouldShowSpeciality":"JournalSpeciality","showArticleDescription":false,"showJournalTitle":false,"viewAllLink":null,"fontSize":"small","showSpecialitySection":false,"showPublicationDate":false,"showIndicators":false}"></div> </div><div class="ms-clear"></div></div> </div> </div> </div></div> </div> </div> <div class="wk-grid-container-no-margin" id="AddRowBottomContainer"> </div> </div> <div style='display:none' id='hidZone'><menu class="ms-hide"> <ie:menuitem id="MSOMenu_Help" iconsrc="/_layouts/15/images/HelpIcon.gif" onmenuclick="MSOWebPartPage_SetNewWindowLocation(MenuWebPart.getAttribute('helpLink'), MenuWebPart.getAttribute('helpMode'))" text="Help" type="option" style="display:none"> </ie:menuitem> </menu></div> </div> <div id="DeltaFormDigest"> <script type="text/javascript">//<![CDATA[ var formDigestElement = document.getElementsByName('__REQUESTDIGEST')[0]; if (!((formDigestElement == null) || (formDigestElement.tagName.toLowerCase() != 'input') || (formDigestElement.type.toLowerCase() != 'hidden') || (formDigestElement.value == null) || (formDigestElement.value.length <= 0))) { formDigestElement.value = '0xBD6D66B9ACB966458144940B10463F3BE4D45887B540FDEA9A64111D48FF718FE46173FCC04ABA37A4680F5C912E996AD5A7454BBC5412198D32807A4677FDDA,20 Feb 2025 00:40:30 -0000';_spPageContextInfo.updateFormDigestPageLoaded = new Date(); } //]]> </script> </div> </div>  <footer class="ejp-footer"> <div class="container wk-grid-page-container"> <a class="ejp-footer__back-to-top-link"><i class="fa fa-angle-up b ejp-footer__back-to-top-link-icon"></i>Back to Top</a> <div class="ejp-footer__main-content">  <div class="ejp-footer__smart-control-section"> <section class="ejp-footer__smart-control-section-wrapper js-section-alert"> <div class="ejp-footer__smart-control-section-image-container"> <img src="https://images.journals.lww.com/academicmedicine/XLargeThumb.00001888-202502000-00000.CV.jpeg" id="ctl00_ctl56_FooterSmartControl_ctl00_imgAlertControl" alt="Current Issue Cover Image" class="" /> </div> <div class="ejp-footer__smart-control-section-text-holder"> <h4 id="ctl00_ctl56_FooterSmartControl_ctl00_headerAlertControl">Never Miss an Issue</h4> <div class="js-section-alert__content"> <span id="ctl00_ctl56_FooterSmartControl_ctl00_spanBodyAlertControl" class="ejp-footer__smart-control-section-info">Get new journal Tables of Contents sent right to your email inbox</span> <input name="ctl00$ctl56$FooterSmartControl$ctl00$userEmailAlertControl" type="text" id="ctl00_ctl56_FooterSmartControl_ctl00_userEmailAlertControl" class="js-section-alert__email" placeholder="Type your email" /> <span class="js-section-alert--error"></span> <button id="ctl00_ctl56_FooterSmartControl_ctl00_buttonAlertControl" type="button" class="js-section-alert__subscribe-button" data-alert-type="Etoc" data-subscribed-msg="You are now subscribed to receive eTOC alerts whenever new issues are published">Get New Issue Alerts</button> </div> </div> </section> <script type="text/javascript"> (function($) { $("#smartWpMostPopularLink").on('click', function() { window.location = "https://journals.lww.com/academicmedicine/pages/viewallmostpopulararticles.aspx?WT.mc_id=HPxADx20100319xMP"; }); })(jQuery); </script> </div> <div class="ejp-footer__info-holder"> <div id="ctl00_ctl56_divLeftColumn" class="ejp-footer__info-left-wrapper"> <div class="ejp-footer__info-block"> <h4 class="ejp-footer__info-block-header">Browse Journal Content</h4> <ul class="ejp-footer__info-block-two-col-list"> <li> <a href='/academicmedicine/pages/viewallmostpopulararticles.aspx' target='' rel="noopener">Most Popular</a> </li> <li> <a href='/academicmedicine/_layouts/1033/oaks.journals/informationforauthors.aspx' target='' rel="noopener">For Authors</a> </li> <li> <a href='/academicmedicine/pages/aboutthejournal.aspx' target='' rel="noopener">About the Journal</a> </li> <li> <a href='/academicmedicine/pages/issuelist.aspx' target='' rel="noopener">Past Issues</a> </li> <li> <a href='/academicmedicine/pages/currenttoc.aspx' target='' rel="noopener">Current Issue</a> </li> <li id="ctl00_ctl56_liRegister"><a id="ctl00_ctl56_lnkRegister" href="https://journals.lww.com/academicmedicine/pages/register.aspx?ContextUrl=%2facademicmedicine%2fFulltext%2f2020%2f04000%2fEvolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx">Register on the website</a></li> <li id="ctl00_ctl56_liSubscribe" role="presentation"><a id="ctl00_ctl56_lnkSubscribe" href="https://shop.lww.com/p/1040-2446" target="_blank">Subscribe</a></li> <li id="ctl00_ctl56_liHyperSubscribeToEtoc"><a rel="nofollow" title href="javascript:javascript: alerts_ShowSubscribeeTOCPopup('Academic Medicine','academicmedicine','eTOC', 'eTOC');;" onclick="javascript: alerts_ShowSubscribeeTOCPopup('Academic Medicine','academicmedicine','eTOC', 'eTOC');"><span id="ctl00_ctl56_alertLinkControl_defaultText" class="hideOnFixed">Get eTOC Alerts</span></a> </li> </ul> </div> </div> <div id="ctl00_ctl56_divRightColumn" class="ejp-footer__info-right-wrapper"> <div id="ctl00_ctl56_divForJournalAuthors" class="ejp-footer__info-block"> <h4 class="ejp-footer__info-block-header">For Journal Authors</h4> <ul> <li class=''> <a href='/academicmedicine/_layouts/15/1033/oaks.journals/informationforauthors.aspx' target='' rel="noopener">Submit an article</a> </li> <li class=''> <a href='https://wkauthorservices.editage.com/' target='_blank' rel="noopener">How to publish with us</a> </li> </ul> </div> <div class="ejp-footer__info-block ejp-footer__info-block--custom-service"> <h4 class="ejp-footer__info-block-header">Customer Service</h4> <div id="liveagent_button_online_5730V0000019KUh" style="display: none; border: 0px none; cursor: pointer" onclick="liveagent.startChat('5730V0000019KUh')" class="live-chat__button live-chat__button--on"> <i class="live-chat__button-icon wk-icon-filled-dialogue-white-r"></i> <span class="live-chat__button-text">Live Chat</span> </div> <div id="liveagent_button_offline_5730V0000019KUh" style="display: none; border: 0px none;" class="live-chat__button live-chat__button--off"> <i class="live-chat__button-icon wk-icon-filled-dialogue-gray-r"></i> <span class="live-chat__button-text">Chat Offline</span> </div> <script type="text/javascript"> if (!window._laq) { window._laq = []; } window._laq.push(function () { liveagent.showWhenOnline('5730V0000019KUh', document.getElementById('liveagent_button_online_5730V0000019KUh')); liveagent.showWhenOffline('5730V0000019KUh', document.getElementById('liveagent_button_offline_5730V0000019KUh')); }); </script> <script type='text/javascript' src='https://c.la1-c1-ia5.salesforceliveagent.com/content/g/js/47.0/deployment.js'></script> <script type='text/javascript'> liveagent.init('https://d.la1-c1-ia5.salesforceliveagent.com/chat', '5720V00000158LL', '00Dd0000000dixc'); </script> <ul> <li class='ejp-footer--show-on-mobile'> <a href='https://lww.com/secure/pages/activatesubscription.aspx?ContextUrl=%2facademicmedicine%2fFulltext%2f2020%2f04000%2fEvolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx' target='' rel="noopener">Activate your journal subscription</a> </li> <li class='ejp-footer--hide-on-mobile'> <a href='https://lww.com/secure/pages/activatesubscription.aspx?ContextUrl=%2facademicmedicine%2fFulltext%2f2020%2f04000%2fEvolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx' target='' rel="noopener">Activate Journal Subscription</a> </li> <li class='ejp-footer--hide-on-mobile'> <a href='https://wkhlrp.my.site.com/LippincottOnlineHelpCenter/s/' target='' rel="noopener">Browse the help center</a> </li> <li class='ejp-footer--show-on-mobile'> <a href='https://wkhealth.force.com/lwwonline/s/topic/0TO0V000001YgLZWA0/lww-online?tabset-ddbfe=2' target='' rel="noopener">Help</a> </li> <li><span class="ejp-footer--show-on-mobile">Contact us at:</span> <ul> <li class="ejp-footer__contacts-wrapper ejp-footer__email-settings"> <div class="ejp-footer--show-on-mobile">Support:</div> <a href="https://www.tfaforms.com/4966570" id="ctl00_ctl56_custSupport" target="_blank">Submit a Service Request</a> </li> <li class="ejp-footer__contacts-wrapper ejp-footer__phone-settings"> <div class="ejp-footer--show-on-mobile ejp-footer__phone-settings--version"> <div id="ctl00_ctl56_telMobileUSA">TEL: (USA):</div> <div id="ctl00_ctl56_telMobileInt">TEL: (Int’l):</div> </div> <div class="ejp-footer__phone-settings--holder"> <div> 800-638-3030 <span class="ejp-footer--hide-on-mobile">(within USA)</span> </div> <div> 301-223-2300 <span class="ejp-footer--hide-on-mobile">(international)</span> </div> </div> </li> </ul> </li> </ul> <ul><li> <button id="ot-sdk-btn" class="ot-sdk-show-settings ot-ejp-btn" onclick="return false;">Cookie Settings</button> </li> </ul> </div> </div> </div> <span id="ctl00_ctl56_FooterConfiguration" class="js-config-provider" data-config="{"loginConfiguration":{"serviceUrl":"https://services.journals.lww.com/IntegrationServices/AccountService.svc/Login","registerUrl":"https://journals.lww.com/academicmedicine/pages/register.aspx?ContextUrl=%2facademicmedicine%2fFulltext%2f2020%2f04000%2fEvolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx","forgotPasswordUrl":"https://journals.lww.com/academicmedicine/pages/forgotpassword.aspx?ContextUrl=%2facademicmedicine%2fFulltext%2f2020%2f04000%2fEvolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx","redirectUrl":"https://journals.lww.com/academicmedicine/pages/login.aspx?ContextUrl=%2facademicmedicine%2fFulltext%2f2020%2f04000%2fEvolution_of_an_Accelerated_3_Year_Pathway_to_the.21.aspx","tokenKey":"AppSsoToken","ssoLoginOptions":[],"customerService":{"customerServiceUSPhone":"(800) 638-3030","customerServiceInternationalPhone":"301-223-2300","customerServiceEmail":"customerservice@lww.com"},"useAlternativeAccountLinks":false},"commonConfiguration":{"commonEndpoints":{"addToFavoritesServiceUrl":"https://journals.lww.com/academicmedicine/_layouts/15/OAKS.Journals/UserCollectionsService.svc/AddToFavorites","saveSearchServiceUrl":"https://journals.lww.com/academicmedicine/_layouts/15/OAKS.Journals/UserCollectionsService.svc/SaveSearch","counterDataServiceUrl":"https://journals.lww.com/academicmedicine/_layouts/15/OAKS.Journals/DualAccessService.svc/SendCounterDataRequestByAN"},"kaltura":{"partnerId":"1315631","playerId":"52253872","kalturaWidgetUrl":"https://cdnapisec.kaltura.com/p/1315631/embedPlaykitJs/uiconf_id/52253872"},"brightCove":{"brightCoveScriptUrl":"https://players.brightcove.net/2324982687001/HyP0JSARx_default/index.min.js","dataAccount":"2324982687001","dataPlayer":"HyP0JSARx"},"math":{"libUrl":"https://cdn.jsdelivr.net/npm/mathjax@3/es5/tex-mml-chtml.js"},"recoWidget":{"journals":[{"Id":"academicmedicine","Version":"04.03","ProductCode":"acmed"},{"Id":"academicmedicine","Version":"04.03","ProductCode":"jmedu"},{"Id":"academicmedicine","Version":"04.03","ProductCode":"jaamc"},{"Id":"academicmedicine","Version":"04.03","ProductCode":"baamc"},{"Id":"academicmedicine","Version":"04.03","ProductCode":"meded"}],"pubFilter":{},"clientId":"ejp_v3","libUrl":"https://assets.ovid.com/widget/v3/widget.js"},"sciteBadge":{"libUrl":"https://cdn.scite.ai/badge/scite-badge-latest.min.js"}}}"></span> </div> <div id="ctl00_ctl56_footerSocialDiv" class="ejp-footer__social-links ejp-footer--dashed-decore"> <ul id="ctl00_ctl56_socialList"> <li class=''> <a href='https://X.com/AcadMedJournal' target='_blank' title="X" aria-label="X" rel="noopener"> <img style='display:none' src=''> <i class='wk-icon-filled-x' aria-hidden="true"></i> </a> </li> <li class=''> <a href='https://www.linkedin.com/showcase/academic-medicine-journal' target='_blank' title="LinkedIn" aria-label="LinkedIn" rel="noopener"> <img style='display:none' src=''> <i class='wk-icon-filled-linkedin' aria-hidden="true"></i> </a> </li> <li class=''> <a href='https://vimeo.com/academicmedicine' target='_blank' title="Vimeo" aria-label="Vimeo" rel="noopener"> <img style='display:none' src=''> <i class='fa fa-vimeo' aria-hidden="true"></i> </a> </li> <li class=''> <a href='https://podcasts.apple.com/us/podcast/academic-medicine-podcast/id1112697692?mt=2' target='_blank' title="Podcast" aria-label="Podcast" rel="noopener"> <img style='display:none' src=''> <i class='fa fa-apple' aria-hidden="true"></i> </a> </li> <li class=''> <a href='http://academicmedicineblog.org/' target='_blank' title="Blog" aria-label="Blog" rel="noopener"> <img style='display:inline-block' src='https://journals.lww.com/academicmedicine/PublishingImages/SocialMedia/BlogAM.png'> <i class='' aria-hidden="true"></i> </a> </li> </ul> </div> <div class="ejp-footer__bottom-links"> <ul class="ejp-footer__useful-links"> <li><a id="ctl00_ctl56_hlkPrivacy" href="https://journals.lww.com/academicmedicine/_layouts/oaks.journals/privacy.aspx">Privacy Policy</a></li> <li><a id="ctl00_ctl56_hlkLegal" href="https://journals.lww.com/academicmedicine/_layouts/oaks.journals/disclaimer.aspx">Legal Disclaimer</a></li> <li><a id="ctl00_ctl56_hlkTermsOfUse" href="https://journals.lww.com/academicmedicine/_layouts/oaks.journals/terms.aspx">Terms of Use</a></li> <li><a id="ctl00_ctl56_hlkNIHPublicAccess" href="https://www.wolterskluwer.com/en/solutions/lippincott-journals/lippincott-open-access">Open Access Policy</a></li> <li class=''> <a href='/academicmedicine/Secure/Pages/feedback.aspx' target=''> <img style='display:none' src='' /> <i class=''></i> Feedback </a> </li> <li class=''> <a href='http://journals.lww.com/academicmedicine/_layouts/1033/oaks.journals/sitemap.aspx' target='blank'> <img style='display:none' src='' /> <i class=''></i> Sitemap </a> </li> <li class=''> <a href='/academicmedicine/_layouts/OAKS.Journals/feeds.aspx' target=''> <img style='display:none' src='' /> <i class=''></i> RSS Feeds </a> </li> <li class=''> <a href='https://lww.com/' target=''> <img style='display:none' src='' /> <i class=''></i> LWW Journals </a> </li> <li><a id="ctl00_ctl56_hlkCAPrivacyChoices" href="https://privacyportal-de.onetrust.com/webform/2217e117-526b-4696-8a98-8c402f8f2b81/5b049ba3-0106-4b77-a7da-5d12238c90a4">Your California Privacy Choices</a> <img src="/_layouts/1033/IMAGES/OAKS.Journals/CAPrivacyPolicy.png" id="ctl00_ctl56_imgCAPrivacyPolicyChoices" class="wk-footer__ca-privacy-logo" alt="California Consumer Privacy Act (CCPA) Opt-Out Icon" /> </li> </ul> <ul class="ejp-footer__copyright-block"> <li><span>Copyright © 2025</span></li> <li><a href="http://www.aamc.org" target="_blank">by the Association of American Medical Colleges</a></li> </ul> </div> </div> </footer> </div> </div>   <script> $(document).on('click', '.yamm .dropdown-menu', function (e) { e.stopPropagation(); }); </script>   <div id="ctl00_ctl59_adContainer" class="ej-advertisement ejp-advertisement-highimpact js-advertisement-highimpact"> <div class="ej-advertisement-content"> <div> <div id="ga_b05bbadf-cafd-4fba-aa54-869b36f44cdb" class="ad-slot-container ad-slot-container-ga_b05bbadf-cafd-4fba-aa54-869b36f44cdb" data-sizemap="[[[992, 500], [[300, 250]]], [[768, 180], [[728, 90]]], [[0, 0], [[300, 50]]]]" data-adpath="/15726702761/Desktop/academicmedicine/HighImpact" data-autoload="yes" data-outofpage="no" data-sticky="yes" data-slottargeting='' data-displayslug="yes" data-sticky-duration="10" data-name="HighImpact"></div> </div> </div> </div>    <div id="ga_Top1" class="ad-slot-container" data-sizemap="" data-adpath="/15726702761/Desktop/academicmedicine/Home/Interstitial" data-autoload="yes" data-outofpage="yes" data-sticky="no" data-slottargeting='' data-displayslug="yes" data-sticky-duration="10" data-name="Interstitial"></div> <script type="text/javascript"> //<![CDATA[ var Page_Validators = new Array(document.getElementById("ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError")); //]]> </script> <script type="text/javascript"> //<![CDATA[ var ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError = document.all ? document.all["ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError"] : document.getElementById("ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError"); ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError.display = "Dynamic"; ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError.validationGroup = "EmailValidationGroup"; ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError.evaluationfunction = "CustomValidatorEvaluateIsValid"; //]]> </script> <script type="text/javascript"> //<![CDATA[ var _spFormDigestRefreshInterval = 1440000;window.SPThemeUtils && SPThemeUtils.ApplyCurrentTheme(true); IsSPSocialSwitchEnabled = function() { return true; };var _fV4UI = true; function _RegisterWebPartPageCUI() { var initInfo = {editable: false,isEditMode: false,allowWebPartAdder: false,listId: "{593bb495-6a2b-408a-b7e6-ff83e039a739}",itemId: 212,recycleBinEnabled: true,enableMinorVersioning: false,enableModeration: false,forceCheckout: false,rootFolderUrl: "\u002facademicmedicine\u002fPages",itemPermissions:{High:0,Low:200769}}; SP.Ribbon.WebPartComponent.registerWithPageManager(initInfo); var wpcomp = SP.Ribbon.WebPartComponent.get_instance(); var hid; hid = document.getElementById("_wpSelected"); if (hid != null) { var wpid = hid.value; if (wpid.length > 0) { var zc = document.getElementById(wpid); if (zc != null) wpcomp.selectWebPart(zc, false); } } hid = document.getElementById("_wzSelected"); if (hid != null) { var wzid = hid.value; if (wzid.length > 0) { wpcomp.selectWebPartZone(null, wzid); } } }; function __RegisterWebPartPageCUI() { ExecuteOrDelayUntilScriptLoaded(_RegisterWebPartPageCUI, "sp.ribbon.js");} _spBodyOnLoadFunctionNames.push("__RegisterWebPartPageCUI");var __wpmExportWarning='This Web Part Page has been personalized. As a result, one or more Web Part properties may contain confidential information. Make sure the properties contain information that is safe for others to read. After exporting this Web Part, view properties in the Web Part description file (.WebPart) by using a text editor such as Microsoft Notepad.';var __wpmCloseProviderWarning='You are about to close this Web Part. It is currently providing data to other Web Parts, and these connections will be deleted if this Web Part is closed. To close this Web Part, click OK. To keep this Web Part, click Cancel.';var __wpmDeleteWarning='You are about to permanently delete this Web Part. Are you sure you want to do this? To delete this Web Part, click OK. To keep this Web Part, click Cancel.';var lblColleaguesEmail = $get('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_lblColleaguesEmail'); var Page_ValidationActive = false; if (typeof(ValidatorOnLoad) == "function") { ValidatorOnLoad(); } function ValidatorOnSubmit() { if (Page_ValidationActive) { return ValidatorCommonOnSubmit(); } else { return true; } } //]]> </script> <script type='text/javascript'>SP.SOD.set_prefetch(0);</script> <script type="text/javascript"> //<![CDATA[ WPSC.Init(document); var varPartWPQ1 = WPSC.WebPartPage.Parts.Register('WPQ1','abb2447a-c95b-4659-9c40-72d0b343bbfd',document.getElementById('WebPartWPQ1')); var varPartWPQ2 = WPSC.WebPartPage.Parts.Register('WPQ2','bc326d70-5785-4549-985d-290fd946257b',document.getElementById('WebPartWPQ2')); var varPartWPQ3 = WPSC.WebPartPage.Parts.Register('WPQ3','a3512fa5-de16-4f95-b5d1-25547169fe74',document.getElementById('WebPartWPQ3')); var varPartWPQ4 = WPSC.WebPartPage.Parts.Register('WPQ4','e345f40a-c566-4b24-8a3e-1ed4c903ba2e',document.getElementById('WebPartWPQ4')); var varPartWPQ5 = WPSC.WebPartPage.Parts.Register('WPQ5','3004602f-68d7-446f-ac9b-c26add791af6',document.getElementById('WebPartWPQ5')); var varPartWPQ6 = WPSC.WebPartPage.Parts.Register('WPQ6','495a29f8-cc16-40b0-9a6a-4fbabcb2cbc3',document.getElementById('WebPartWPQ6')); WPSC.WebPartPage.WebURL = 'https:\u002f\u002fjournals.lww.com\u002facademicmedicine'; WPSC.WebPartPage.WebServerRelativeURL = '\u002facademicmedicine'; var g_clientIdDeltaPlaceHolderMain = "DeltaPlaceHolderMain"; var g_clientIdDeltaPlaceHolderUtilityContent = "DeltaPlaceHolderUtilityContent"; WebForm_AutoFocus('ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_txtYourName');Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","DropShadow":true,"PopupControlID":"ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pnlunSubscribeToAlerts","dynamicServicePath":"/academicmedicine/pages/articleviewer.aspx","id":"unSubscribeToAlerts"}, null, null, $get("ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_dummyTargetControl")); }); Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","DropShadow":true,"PopupControlID":"ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlSubscribeToEtoc","dynamicServicePath":"/academicmedicine/pages/articleviewer.aspx","id":"subscribeToEtoc"}, null, null, $get("ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_dummyTargetControl")); }); document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError').dispose = function() { Array.remove(Page_Validators, document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError')); } g_QuickLaunchControlIds.push("zz1_TopNavigationMenu");_spBodyOnLoadFunctionNames.push('QuickLaunchInitDroppable'); var g_zz1_TopNavigationMenu = null; function init_zz1_TopNavigationMenu() { if (g_zz1_TopNavigationMenu == null) g_zz1_TopNavigationMenu = $create(SP.UI.AspMenu, null, null, null, $get('zz1_TopNavigationMenu')); } if(g_spPreFetchKeys) {{ g_spPreFetchKeys.push('SP.Core.js');}}EnsureScriptFunc('SP.Core.js', 'SP.UI.AspMenu', init_zz1_TopNavigationMenu); Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","PopupControlID":"ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_pnlEmailToColleague","dynamicServicePath":"/academicmedicine/pages/articleviewer.aspx","id":"emailToColleaguePopupExtender_682946820"}, null, null, $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_emailToColleagueControl_hypEmailToColleague")); }); Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","PopupControlID":"ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_pnlExportTo","dynamicServicePath":"/academicmedicine/pages/articleviewer.aspx","id":"OpenExportToPopupExtender__571253211"}, null, null, $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_ucArticleTools_exportToCitationManager_hypExportToCitationManager")); }); Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","PopupControlID":"ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_pnlEmailToColleague","dynamicServicePath":"/academicmedicine/pages/articleviewer.aspx","id":"emailToColleaguePopupExtender_1058785643"}, null, null, $get("ctl00_ctl29_g_12d8dac7_5f88_4ab8_bca5_dd3f239182b8_ctl00_emailToColleague_hypEmailToColleague")); }); //]]> </script> </form> <span id="DeltaPlaceHolderUtilityContent"> </span> <script type="text/javascript">// <![CDATA[ var g_Workspace = "s4-workspace"; // ]]> </script> <div id="ctl00_ctl64_divAdConfig" data-adconfig="{"adTitle":"Advertisement","slotClass":"ad-slot-container","topBanner":{"sticky":"true","stickyDuration":"5000"},"lazyLoadingEnabled":false,"npiHash":"","pageTargeting":{"ArticleId":"00001888-202004000-00021"}}" data-videoadconfig="{"serverURL":"https://pubads.g.doubleclick.net/gampad/ads","sizes":"320x180|640x360","overlayUnitPath":"/15726702761/Desktop/academicmedicine/Video/overlay","prerollUnitPath":"/15726702761/Desktop/academicmedicine/Video/pre-roll","postrollUnitPath":"/15726702761/Desktop/academicmedicine/Video/post-roll"}" class="js-ad-config"> </div> <div id="ctl00_ctl64_divScripts"><script type="text/plain" async="async" src="https://securepubads.g.doubleclick.net/tag/js/gpt.js" class="optanon-category-C0004"></script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/ads.js?v=05.24.00.023" defer="true"> </script> </div>  <script type="text/javascript"> (function($) { if (false) { $(".top-microbar-container").addClass('top-microbar-container-moved').insertAfter(".advertisement-content_top"); } $(function () { if (false) { $( '<div class="top-banner-verify-email">Be sure to check your email to verify your new user account! Thanks!</div>') .insertAfter(".top-microbar-container"); } }); })(jQuery); </script> <script type="text/javascript"> window.twttr = (function(d, s, id) { var js, fjs = d.getElementsByTagName(s)[0], t = window.twttr || {}; if (d.getElementById(id)) return t; js = d.createElement(s); js.id = id; js.src = "https://platform.twitter.com/widgets.js"; fjs.parentNode.insertBefore(js, fjs); t._e = []; t.ready = function(f) { t._e.push(f); }; return t; }(document, "script", "twitter-wjs")); </script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/ee.js?v=05.24.00.023" defer="true"> </script> <script type="text/javascript"> function OTScriptExecutedEventHandler(e) { if (window.WKTracker && window.TrackingSetup) { window.TrackingSetup.api = window.TrackingSetup.api || {}; window.TrackingSetup.api.baseUrl = 'https://apim-hlrp-ejp-prod.azure-api.net/ee'; window.TrackingSetup.api.log = window.TrackingSetup.api.log || {}; window.TrackingSetup.api.resolve = window.TrackingSetup.api.resolve || {}; window.TrackingSetup.gdpr = window.TrackingSetup.gdpr || {}; window.TrackingSetup.gdpr.cookieUsageConsent = window.cookieUsageConsent || false; window.WKTracker.configure(window.TrackingSetup); window.WKTracker.track(); // Remove the event listener window.removeEventListener('OTScriptExecuted', OTScriptExecutedEventHandler); } } window.addEventListener('OTScriptExecuted', OTScriptExecutedEventHandler); </script> <script>(function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'914a721649f4fd36',t:'MTc0MDAxMjAzMS4wMDAwMDA='};var a=document.createElement('script');a.nonce='';a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();</script></body> </html>

CINXE.COM

Academic Medicine