N.Y.U. and Others Offer Shorter Courses Through Medical School

But now one of the nation’s premier medical schools, New York University, and a few others around the United States are challenging that equation by offering a small percentage of students the chance to finish early, in three years instead of the traditional four.

Administrators at N.Y.U. say they can make the change without compromising quality, by eliminating redundancies in their science curriculum, getting students into clinical training more quickly and adding some extra class time in the summer.

Not only, they say, will those doctors be able to hang out their shingles to practice earlier, but they will save a quarter of the cost of medical school — $49,560 a year in tuition and fees at N.Y.U., and even more when room, board, books, supplies and other expenses are added in.

“We’re confident that our three-year students are going to get the same depth and core knowledge, that we’re not going to turn it into a trade school,” said Dr. Steven Abramson, vice dean for education, faculty and academic affairs at N.Y.U. School of Medicine.

At this point, the effort involves a small number of students at three medical schools: about 16 incoming students at N.Y.U., or about 10 percent of next year’s entering class; 9 at Texas Tech Health Science Center School of Medicine; and even fewer, for now, at Mercer University School of Medicine’s campus in Savannah, Ga. A similar trial at Louisiana State University has been delayed because of budget constraints.

But Dr. Steven Berk, the dean at Texas Tech, said that 10 or 15 other schools across the country had expressed interest in what his university was doing, and the deans of all three schools say that if the approach works, they will extend the option to larger numbers of students.

“You’re going to see this kind of three-year pathway become very prominent across the country,” Dr. Abramson predicted.

The deans say that getting students out the door more quickly will accomplish several goals. By speeding up the production of physicians, they say, it could eventually dampen a looming doctor shortage, although the number of doctors would not increase unless the schools admitted more students in the future.

The three-year program would also curtail student debt, which now averages $150,000 by graduation, and by doing so, persuade more students to go into shortage areas like pediatrics and internal medicine, rather than more lucrative specialties like dermatology.

The idea was supported by Dr. Ezekiel J. Emanuel, a former health adviser to President Obama, and a colleague, Victor R. Fuchs. In an editorial in the Journal of the American Medical Association in March, they said there was “substantial waste” in the nation’s medical education. “Years of training have been added without evidence that they enhance clinical skills or the quality of care,” they wrote. They suggested that the 14 years of college, medical school, residency and fellowship that it now takes to train a subspecialty physician could be reduced by 30 percent, to 10 years.

That opinion, however, is not universally held. Other experts say that a three-year medical program would deprive students of the time they need to delve deeply into their subjects, to consolidate their learning and to reach the level of maturity they need to begin practicing, while adding even more pressure to a stressful academic environment.

“The downside is that you are really tired,” said Dr. Dan Hunt, co-secretary of the Liaison Committee on Medical Education, the accrediting agency for medical schools in the United States and Canada. But because accreditation standards do not dictate the fine points of curriculum, the committee has approved N.Y.U.’s proposal, which exceeds by five weeks its requirement that schools provide at least 130 weeks of medical education.

The medical school is going ahead with its three-year program despite the damage from Hurricane Sandy, which forced NYU Langone Medical Center to evacuate more than 300 patients at the height of the storm and temporarily shut down three of its four main teaching hospitals.

Dr. Abramson of N.Y.U. said that postgraduate training, which typically includes three years in a hospital residency, and often fellowships after that, made it unnecessary to try to cram everything into the medical school years. Students in the three-year program will have to take eight weeks of class before entering medical school, and stay in the top half of their class academically. Those who do not meet the standards will revert to the four-year program.

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DealBook: Cerberus to Sell Manufacturer of Rifle Used in School Shooting

Gretchen Ertl for The New York TimesRemington rifle cartridges at Cabela’s sporting good store in Scarborough, Maine.

The private equity firm Cerberus Capital Management said on Tuesday that it would sell its investment in the gunmaker Freedom Group in response to the school shootings last week in Connecticut.

Cerberus acquired Bushmaster — the manufacturer of the rifle used by the gunman in the Newtown attacks that killed 27 people, including 20 schoolchildren — in 2006.

The private equity giant later merged it with other gun companies to create Freedom Group, which reported net sales of $677.3 million for the nine months that ended in September 2012, a 20 percent increase compared with the same period last year.

“It is apparent that the Sandy Hook tragedy was a watershed event that has raised the national debate on gun control to an unprecedented level,” Cerberus said in a news release.

The private equity firm said it had made the investments in gun manufacturers on behalf of its clients, which include pension funds and other institutional investors. Cerberus added that it was the role of legislators to shape the country’s gun policy.

“We believe that this decision allows us to meet our obligations to the investors whose interests we are entrusted to protect without being drawn into the national debate that is more properly pursued by those with the formal charter and public responsibility to do so,” Cerberus said.

The private equity firm said it would retain a financial adviser to sell its interests in Freedom Group, and would return the proceeds to investors. Cerberus, based in New York, was founded in 1992 by William Richter and Stephen Feinberg, and has more than $20 billion of assets under management.

Cerberus is one of several private equity firms that have holdings in gun manufacturers. Colt Defense, which was spun out of the maker of the .44-40 Colt revolver, is jointly owned by Sciens Capital Management, a fund advised by the Blackstone Group and another fund operated by Credit Suisse.

Tuesday’s announcement follows a statement from the California State Teachers’ Retirement System, a large pension fund, that it was reviewing its investment in Cerberus in light of the firm’s holding in Freedom Group.

“At this point, our investment branch is examining the Cerberus investment to determine how best to move forward given the tragic events of last Friday in Newtown, Connecticut,” a spokesman for the Californian public pension fund told Reuters on Monday.

Neil Gough contributed reporting from Hong Kong.

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Memo From Washington: After School Tragedy, Partisanship Cools in Washington

While seemingly unrelated — the emotionally wrenching holiday-season massacre of 20 first graders and six of their guardians, and Washington’s mind-numbing fiscal fight to reduce deficits — the first cannot fail to have a salutary effect on the latter, say veterans of Washington’s partisan wars from both parties.

“Members of Congress, when you get down to it, are just people,” said Mickey Edwards, a former House Republican leader. “There are those things that, at least momentarily, trump ideology.”

“I think, at least for a while, it’s going to soften people’s hearts to each other and make people think, we’re a team, we’re all Americans,” said Mr. Edwards, whose new book is called “The Parties Versus the People.” “The greatest problem is that neither side trusts the other side. And that being the case, this could help.”

Many Republicans and Democrats see cause for optimism for reasons that are both personal and political for the players in the White House and the lame-duck Congress. For all their dissimilarities, past horrors — like the 1995 bombing in Oklahoma City, the 1998 killings of two Capitol policemen, the Columbine school murders the following year in Colorado and certainly the terrorist attacks of Sept. 11, 2001 — at least for a time cooled partisan passions that had been high beforehand, and in some cases prompted bipartisan actions on unrelated matters.

Even the usual Washington metaphors about legislative debates — like fights, battles and wars — seem out of place given their association with violence.

President Obama, back from his Sunday night meeting with bereaved parents in Newtown, resumed talks on Monday with Speaker John A. Boehner to meet a year-end deadline for a deal. The two met at the White House for 45 minutes, and by evening the shape of a potential deal had emerged.

In deflecting attention from the fiscal dispute, the impact of the shooting could give the party leaders a little more room to maneuver.

“It takes the fire out of the belly of partisans, just kind of puts everything in perspective and makes people question, well, everything,” said John Feehery, a former adviser to three House Republican leaders. “What’s the point?”

On that, there is bipartisan agreement.

“The American people are going to be sharing in the grief of Connecticut families and will have little patience for political games and finger-pointing,” said Steve Elmendorf, a former top adviser to House Democratic leaders. “I suspect both sides realize that they should tone down the fighting and move to a deal.”

On Friday, after news of the shooting broke, Mr. Obama spoke by phone with Mr. Boehner; the evening before, they had met alone for only the second time since the November election. Reports through the weekend suggested that Mr. Boehner had offered for the first time to support raising the tax rate on high incomes and include an increase in the nation’s debt limit, if the president agreed to more long-term reductions in entitlement programs.

Perhaps only Mr. Obama and Mr. Boehner know whether that small progress was influenced by their emotions, both as national leaders and as fathers. Or was it simply the typical eleventh-hour movement of politicians, who must reach an agreement this week if they have any hope of getting a deal passed by Congress before huge automatic tax increases and spending cuts take effect in January?

“This is something that can’t be overstated: This isn’t just about politics with these guys,” Mr. Feehery said. “Psychologically this puts them in kind of a depressed mood, and so it’s not so much that they’re reacting to what the people think, but that they’re reacting to their own personal experiences. Look, if Obama was crying, you can only imagine what Boehner was doing. Psychologically they have to take it very personally, and I think that has an impact on how they negotiate.”

Tom Daschle, a Democrat and former Senate majority leader, was initially a skeptic among the Democrats and Republicans interviewed, who generally saw a chance for some breakthrough or at least a softening in the bitter budget talks. “Unfortunately, I don’t think it will have a catalytic effect on the fiscal negotiations,” he said. “We are still not at the eleventh hour and 59th minute. That is when a deal is likely to be struck.”

But in a follow-up exchange of e-mails, Mr. Daschle acknowledged some moderating effect. “There might have been some genuine movement over the weekend,” he said.

Mr. Feehery emphasized that lawmakers’ own moods since the school shooting could be an important factor in influencing the debate.

The prospect of party leaders having to call lawmakers back to the Capitol between Christmas and New Year’s Eve to finish the work on the deficit, never a popular move, becomes all but impossible now that members of Congress are likely to value time at home with their own children and grandchildren all the more.

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