When NYU announced it was offering full-tuition scholarships, it said it was part of an effort to build three-year medical school programs. The American Medical Association (AMA) says this effort is one element in the movement to modernize medical education, offering a challenge to the four-year model that has been used for a century.

Developing flexible, competency-based pathways—tailoring the time required in medical school to the ability and clinical background of the student—is one theme of the AMA Accelerating Change in Medical Education Consortium the AMA started in 2013.

The AMA Consortium’s efforts reflect a general consensus that medical education “has needed to change in order to address significant gaps in physician training and prepare new doctors to practice effectively in our 21st century health systems,” according to the AMA’s “Creating a Community of Innovation” report.

Evidence-based ways of rethinking the best length of time for physician education come at the right moment for two interrelated problems in health care: A looming physician shortage and six-figure physician education debt.

“Proponents of accelerated pathways highlight the reduction of student debt and the desirability of acceleration for a subset of students who are seeking rapid entry into the workforce as clinicians or clinician–scientists with the ability to impact the worsening physician shortage,” according to a 2017 article in the journal Academic Medicine, which describes nine programs. “Some accelerated programs that focus on primary care also serve a social mission to provide increased physician access to rural and underserved populations.”

The most recent physician workforce estimate by the Association of American Medical Colleges is that the nation could see a shortage of up to 120,000 physicians by 2030. The shortage of primary care physicians alone could be as high as 49,300.

Meanwhile, high medical school debt has long been associated with at least some physicians opting for higher paying specialties than primary care. A 2017 survey from AMA Insurance shows that more than a third of medical students expect to owe more than $200,000, about a fifth will be between $150,000 and $200,000 in debt. One  lessyear of medical school could cut tens of thousands of dollars from those amounts.