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







By Rajkamal Rao  

Image Courtesy: Drexel University

One of the most common questions I get at public speaking events or when families consult with us is regarding EAPs for medical school. In fact, it is rarely a question; people would already have made up their minds in favor of EAPs and are usually asking me for a second opinion, hoping to get validation from someone outside of their family!

And each time, I disappoint them. Philosophically, I am opposed to these programs - and in this article, I shall explain why. One caveat: I am not a doctor, so my opinions are based only on my experience as a career and guidance coach.

Medical school EAPs 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.

So what is the allure of an EAP? Forbes magazine summarized it well in an article in Nov 2018. Here are several counterpoints to the Forbes article:

EAP 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, EAP 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?

EAP teenagers are thus foreclosing on hundreds of career opportunities which 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, EAP students can abandon their medical career and pursue these other fields, but the social pressure to not do so is often immense. And, if there's a chance that an EAP 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. 

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. The MCAT is longer, 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 EAPs?  The majority of colleges which offer EAPs - Texas Tech, the University of Oklahoma, Drexel University, the University of Arkansas - never make it to the top of college ranking lists.

EAP 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 EAP 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 EAP 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 to exempt 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 EAP program vanishes. Seven years is seven years, no matter how you spend them in college.




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