Are Medical School Early Assurance Programs (EAP) a good idea?

By Rajkamal Rao  

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The U.S. government's Occupational Outlook for doctors has never been better. Job prospects are expected to be very good because almost all graduates of domestic medical schools are matched to residencies (their first jobs as physicians) immediately after graduating. Prospects should be especially good for physicians who are willing to practice in rural and low-income areas, because these areas tend to have difficulty attracting physicians. Job prospects also should be good for physicians in specialties dealing with health issues that mainly affect aging baby boomers. For example, physicians specializing in cardiology and radiology will be needed because the risks for heart disease and cancer increase as people age.  

EAPs are programs that provide assurance to students that they will be accepted into a college of medicine without having to complete the MCAT or other tedious admission steps. The concern is legitimate. Just over 40 percent of the 53,371 applicants to American medical schools in 2019 secured a spot, according to the New York Times.

There are two kinds of Early Assurance Programs.

EAP after you enter college

EAPs allow undergrads already in four-year institutions to apply to med school, without first completing their degree. If you have completed ten pre-med courses (two courses each in Biology, Chemistry, and Physics - all lab-based; one semester of Math; one semester of Biochemistry, Psychology, and Physiology (or Anatomy)) before the end of your sophomore year in college, you have demonstrated a strong commitment and willingness to pursue a career in medicine. If you maintain at least a 3.5 GPA in these courses, some colleges fast-track you to a medical school within the campus or one that is affiliated with another university, without burdening you to take the MCAT or go through the onerous steps of getting into a college of medicine.

Remember that most traditional medical school students take their MCATs in their late junior or senior year because they are still not certain that they want to become medical doctors. So these EAPs are generally excellent choices for committed students.


The second EAP is the so-called BS/MD program that you enter into right out of high school. Here you will complete your BS degree and the medical school together, in 7-8 years. One of the most common questions I get at public speaking events or when families consult with us is regarding these BS/MD programs.

BS/MD programs have been around for at least 30 years. In the early days, the program was tremendously accelerated. One program in Philadelphia offered high school students a chance to earn a medical degree in just six years. Students had no life whatsoever, taking classes in the summer semester, doing internships, and only getting two weeks off for Christmas. These days, most accelerated programs run for 7 years.

List of BS/MD programs (courtesy: Magoosh)

The online MCAT preparation website Magoosh has compiled a list of colleges that offer the BS/MD program.

  1. University of California San Diego
  2. George Washington University
  3. St. Bonaventure University/George Washington University School of Medicine
  4. Northwestern University
  5. University of Missouri Kansas City
  6. Siena College/Albany Medical College
  7. Union College/Albany Medical College
  8. University of Rochester
  9. East Carolina University
  10. Case Western Reserve University
  11. University of Toledo
  12. University of the Sciences in Philadelphia/Commonwealth Medical College
  13. University of Pittsburgh
  14. Brown University
  15. Texas Tech University
  16. University of Texas Dallas/University of Texas Southwestern
  17. Albany Medical College
  18. Baylor College of Medicine
  19. Boston University of Medicine
  20. Brown University Warren Alpert School of Medicine
  21. California Northstate University School of Medicine
  22. Case Western Reserve University School of Medicine
  23. Drexel University College of Medicine
  24. Florida Atlantic University Charles E. Schmidt College of Medicine
  25. Florida State University College of Medicine
  26. Hofstra North Shore — LIJ School of Medicine
  27. Howard University College of Medicine
  28. Indiana State University
  29. Medical College of Georgia
  30. Meharry Medical College
  31. Northeast Ohio Medical University
  32. Northwestern University Feinberg School of Medicine
  33. Pennsylvania State University College of Medicine
  34. Rosalind Franklin University Chicago Medical School
  35. Rowan University — Cooper School of Medicine
  36. Rutgers New Jersey Medical School
  37. Sidney Kimmel Medical College
  38. State University of New York Downstate Medical Center
  39. Stony Brook University School of Medicine
  40. St. Louis University School of Medicine
  41. Temple University School of Medicine
  42. Texas A&M Health Science Center College of Medicine
  43. Texas Tech University Health Sciences Center School of Medicine
  44. The Commonwealth Medical College
  45. University of Alabama School of Medicine
  46. University of Cincinnati College of Medicine
  47. University of Colorado College of Medicine
  48. University of Connecticut School of Medicine
  49. University of Illinois at Chicago School of Medicine
  50. University of Hawaii School of Medicine
  51. University of Miami School of Medicine
  52. University of Missouri-Kansas City School of Medicine
  53. University of Nevada School of Medicine
  54. University of New Mexico School of Medicine
  55. University of Oklahoma School of Medicine
  56. University of Pittsburgh School of Medicine
  57. University of Rochester School of Medicine and Dentistry
  58. University of South Alabama College of Medicine
  59. University of South Florida College of Medicine
  60. University of Texas Medical School
  61. Wayne State University School of Medicine
  62. Sophie Davis School of Biomedical Education/Various medical colleges
  63. Rensselaer Polytechnic Institute/Albany Medical College

So what is the allure of a BSMD? Forbes magazine summarized it well in an article in Nov 2018.

Here are several counterpoints to the Forbes article:

BSMD students don't explore as much

A privilege of the U.S. college experience is that students explore various topics for their first two years before deciding on a major. At some colleges, such as Brown  University, you don't declare a major at all. Your entire college experience becomes one of exploration.

Even the Association of American Medical Colleges prescribes a fairly light pre-medical schedule for students considering a traditional medical education - where you obtain a Bachelor's degree first, and then pursue medicine as you would any other professional pathway, such as law or an MBA.

In contrast, BSMD students are committing themselves to a medical education when they're still in high school, based mainly on the experiences of family members and a few forced internships during their summer years.

AAMC does not even have formal shadow program recommendations for high school students - AAMC's guide is only for pre-medical students in college. At most clinics, labs, and hospitals, high school teenagers are refused access to patient records (for privacy reasons). One of the benefits of shadowing is that medical students can sit in on doctor-patient conversations. Here again, teenagers are not permitted this privilege because they are not adults. So how does a teenager know that a medical career is right for him or her?

BSMD teenagers are thus foreclosing on hundreds of career opportunities that exist in the real world. In many situations, students may not want to become medical doctors at all, preferring to pursue other excellent careers in a health field, such as research or biotechnology. True, BSMD students can abandon their medical careers and pursue these other fields, but the social pressure to not do so is often immense. And, if there's a chance that a BSMD student may change his or her mind, why commit to a career in the first place when a world of opportunity awaits?

Oh, the MCAT Headache!

One benefit of EAP programs is that students don't have to take the MCAT, a test administered by the Association of American Medical Colleges.  The Austin College - Texas Tech program is a good example where this fact is prominently stated as an advantage. 

While the MCAT is a hard test, it is still a multiple-choice exam. As such, it is not different from the GRE, the LSAT, or the GMAT in structure, intensity, or impact. There are plenty of resources to prepare for the MCAT, such as Magoosh, Princeton Review, and Kaplan. If you need one-on-one tutoring, you can get it online from students who have taken the MCAT and possess experience - Varsity Tutors is one such site.

The MCAT is longer and grueling, but this should not be an issue for a medical doctor who is expected to spend 30+ hour shifts during their residency programs. Also, the MCAT allows you to repeat the test in case you had a bad testing day the first time.

High school students who take the SAT already take 154 questions on a 4-hour test. The MCAT has 230 questions in a 7½ hour test (with breaks), and medical students generally take it the year they apply to medical school, which is their senior year in college. Undoubtedly, high school students would have matured in their ability to take on a harder, longer test in five years?

Also, what is the message we are sending our teenagers? That they have to fear a test five years down the road?

What about the schools' brand?

Have you noticed that the top medical schools in the country - Harvard, Columbia, Cornell, Johns Hopkins, Duke - don't offer BS/MD programs?  The majority of colleges that offer BSMDs - Texas Tech, the University of Oklahoma, Drexel University, the University of Arkansas - never make it to the top of college ranking lists.

BSMD students who are otherwise gifted in high school may be settling for education at a lower-ranked, open-admission school, simply to have the assurance that they are automatically accepted into a medical program.

If such a student dropped BSMD altogether, is it possible that he or she could get into the nation's top 40 schools for a traditional undergrad degree? Yes, of course! And, using the brand of that degree (and the recommendation letters which come with it), is it possible to get into a top medical school? Again, yes! There are no guarantees, but in career planning, no news is often good news.

What about the cost?

Most BSMD students have already worked extra hard in high school, taking AP and IB courses. Someone with 10 AP courses could exempt them all at most public schools - and save a year in college. We wouldn't recommend students that they exmpt out of pre-med courses (Physics, Chemistry, or Biology) but there's no reason why students can't obtain college credit for AP French or AP Environmental Science.

If you save a year, then, the allure of the accelerated BSMD program vanishes. Seven years is seven years, no matter how you spend them in college.


Are there any visa restrictions?

In general, admission to most BS/MD and EAP programs is limited to U.S. citizens and permanent residents. 

Students who are already in America on H-4 dependent visas will have to convert to F-1 international student visas before they turn 21 to maintain their legal status. Of the 154 institutions in the U.S. that award degrees in medicine, only 48 institutions say that they accept international students (just check the international box in the search). The list of BS/MD programs accepting international students is smaller than 48 because several of the 48 that accept international students do not offer BS/MD (such as Columbia).

It is best to confirm admissions policies with your desired school. Some schools, like the University of Toledo, specifically prohibit students on visas from applying to BS/MD programs, but it may be a good idea to check if exceptions would be made for students on H-4 status who graduated from an American high school. Please let us know if you need help in constructing a letter to contact your school.

Check out AAMC's page on other restrictions for international students, especially those students aiming to enroll in a medical school with an undergraduate degree earned from a college outside the United States.

Alternate pathways

For the many high school families that are considering medicine as a pathway, have you thought of earning a 4-year Doctor of Optometry (OD) degree?

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