An Open Proposal call for comments on the Bridges challenge question "What Should Be UCSF's Response To The Call For A Three-Year Medical School?" was posed to the UCSF Community in November – December 2013. Nineteen UCSF faculty, staff, and learners commented on the proposal.

We have summarized the results into three key findings:

1. Themes for which there was consensus among respondents regardless of whether they agreed with whether UCSF should have a three-year medical school
1. The three year option should be reserved for the few who enter with a clear career path and those who interested and capable of navigating key benchmarks and demonstrating competences.
2. The three year option must provide:
1. Robust, valid, and flexible assessments that closely tracks learner development. This also includes creating a flexible curriculum path.
2. Robust advising system available for learners with extensive faculty development around advising and mentoring.
3. Ability for students to "opt out" of three years.
3. Program has to ensure that learners' health and wellness is safeguarded.
4. Clear understanding of the cost of producing and hosting a three year program, where individual pathways are necessary.
5. Understanding of the impact of a three year curriculum on elective and research opportunities.
2. Themes from those who either supported or did not support the notion of a three-year medical school and reasons why
   • Respondents who did not agree with a three-year medical school, cited the following reasons for their opinion:
     • Concern that clinical experience will be short changed: clinical experience depends on patients seen and there is variability in when certain patient experiences might occur
     • Will not save cost to student
     • Medical school goals should focus on the physician that needs to be developed and not fast tracking
     • Topics such as social and behavioral science and interprofessional education would be eliminated
     • Students need time to reflect and digest experiences as experienced and a shortened experience would not allow for that
     • Students would become less involved in the community and do fewer extracurricular activities. This risks giving students less experiential learning, while also leading to less of a UCSF impact in the surrounding community (UCSF's name wouldn't be heard in as many corners of the community).
   • Respondents who agreed with a three-year medical school, cited the following reasons for their opinion:
     • Timing is right to make this change in medical education. Other schools are offering similar programs.
     • More likely to work for those entering non-competitive specialties and who are willing to stay at home institution for residency
     • Government push to reduce burden of medical education cost
3. Respondents suggested these things should be considered in developing a three-year medical school
   • Learn from six-year programs
   • Revisit pre-med requirements and reduce those
   • Allow option for students to test out of pre-clinical courses
   • Decide first what is core curriculum all students need to experience
   • Do away with division between pre-clinical and clinical year
   • Leverage online/asynchronous learning to make three year medical school happen
   • Develop measures to mitigate the potential negative impact on medical school cohort camaraderie
   • Eliminated summer between 1st and 2nd year and move to year round curriculum (2)
   • Build 2nd year preceptorships into summer experience
   • Build early clinical experiences into curriculum
   • Determine how timing of USMLE would fit in to three year curriculum
   • Reduce length of certain core clinical rotations
   • Create transitional MSIV-Internship year
   • Build in to curriculum 4th year experiences which we know UCSF students find useful
   • Visit alternative ways of funding medical education
   • Involve residency program directors in developing three-year medical school