Joshua Grosshandler wanted to be a doctor all his life. Right after high school, he entered a combined under-graduate/M.D. program that secured him a spot in medical school and allowed him to finish his undergraduate degree in just two years.
Grosshandler, now a fourth-year at the Northeastern Ohio Universities College of Medicine (NEOUCOM), says he is satisfied with his decision. But some might wonder, what’s the rush? Doctors will have a lifetime of work ahead of them like those in other careers.
“My ultimate goal was to become a doctor,” he says of his drive, “and I knew I wanted to fulfill that goal.”
Each combined program is as unique as the university offering it and not all are accelerated. Dozens of medical schools have these programs, from the University of Rochester to the University of Southern Califor-nia. Several osteopathic medical schools offer such programs, too.
While often called B.S./M.D. programs, the term can be a misnomer, since many programs allow students to pursue any major they choose, including Bachelor of Arts degrees. Requisite science classes are required, though. Many allow students to finish their undergraduate degrees in four years.
Each program’s aims are different. While NEOUCOM requires a more science-based undergraduate edu-cation, the combined program at the University of Missouri—Kansas City School of Medicine (UMKC) is six years and fosters a liberal arts undergraduate education. Some medical school classes are integrated earlier in the program.
At UMKC, half of the participants often choose a Bachelor of Arts major such as English or philosophy. Others might choose a traditional premed major, such as chemistry, says Alice Arredondo, UMKC’s assistant dean for admissions and recruitment.
The University of Cincinnati College of Medicine also allows for any undergraduate major. At perhaps the longest of such programs, its combined M.D. and biomedical engineering degree takes nine years.
Regardless of the number of undergraduate years, combined-program students usually participate in the four full years of medical school alongside traditional students, says Gregory Pence, director of the University of Alabama at Birmingham’s (UAB) Early Medical School Acceptance Program (EMSAP).
Medical schools might partner with other universities to provide the undergraduate education. In the early acceptance program at Drexel University College of Medicine, students can finish their bachelor’s degree at Drexel or Lehigh University. NEOUCOM draws its students from nearby Kent State University, the University of Akron and Youngstown State University, Grosshandler’s alma mater.
Combined programs offer enticing benefits. Often, participants are allowed a lower score on the MCAT (or can skip the test entirely); students in accelerated programs might save a few years of undergraduate tuition; and while they are secured a spot in medical school at their university, programs generally allow students to apply to other medical schools; and perhaps best of all, students are free of premed worries about getting into medical school.
The Association of American Medical Colleges (AAMC) states reasons these programs exist include en-hancing diversity in the educational environment, preparing physician-scientists and developing future health policy leaders. The association is still in the process of developing a system for counting students in these programs, and estimates that roughly 1,700 students are currently enrolled.
Universities can reap tremendous benefits from combined programs. They can cherry-pick some of the best students nationwide right out of high school, often ones who might not have even considered that particular school otherwise.
UAB’s program is especially alluring. Undergraduate tuition is free, and students can finish their undergra-duate degree in four years, studying anything from archaeology to anthropology. And the minimum MCAT score is a relatively low 28.
While most EMSAP students stay at UAB, students are encouraged to apply to their “dream school,” such as Harvard Medical School, Pence says.
When students leave for high-profile schools, it raises the university’s stature and “validates our program.” It also helps with campus diversity in that it attracts some groups, such as Asian and Indian students, to a university in the South that they might otherwise have overlooked.
It is difficult to get into such programs, says Dr. Barbara A. Schindler, vice dean of educational and aca-demic affairs at Drexel’s College of Medicine. When considering a candidate for its combined program, Schindler not only looks for top high-school grades and college board scores, she looks for the attributes of maturity that she would want in traditional medical school applicants.
But with college students famous for changing majors, the question comes up whether such young appli-cants already have the maturity to decide their ultimate career goals.
“You are committing to medical school in high school,” Schindler says.
Pence emphasizes that EMSAP students are still like their undergraduate peers, perhaps away from home for the first time. Some can handle independence better than others, and they can get caught up in playing videogames all night or spending too much time on Facebook, he says.
And after acceptance in a program, it might not be easy to stay because of the rigorous standards, which is why Pence refers to UAB’s program as a “conditional acceptance” to medical school, rather than a “guarantee.”
By the time each class in the program at UAB finishes the undergraduate portion, usually one of the original 10 students has dropped out, another has failed out, and one goes to medical school “in the North.” UAB’s program is tough. About 50 percent of the students end up on academic probation at some point during their undergrad years with regard to the program’s requirements, he says.
Valerie Gribben, a second-year medical student at UAB, says the program allowed her to pursue a Bache-lor of Arts in English without worrying that not having a traditional premed major would hurt her chances to be accepted to medical school.
Without the assurance of already being accepted, “I think that I would have been tempted to stick to chemi-stry or biology,” Gribben says. “EMSAP really allows you to explore.”
She feels it has helped her gain an “enriched” medical education. “I love the rigorous science courses, and I had a passion for Shakespeare, and I saw a lot of interdisciplinary opportunities,” she says.
In taking four years as an undergraduate, Gribben says students had time to do research, study abroad or get papers published. Gribben performed research on Victorian literature in the English department.
NEOUCOM’s compressed schedule attracts program participants who may easily get bored with the aver-age pace of an undergraduate education, and they might not feel challenged enough, says Clint Snyder, the school’s associate dean for health professions education.
Compressed programs might not be a good fit for students who seek to take nonmedical courses to broa-den their education and socialize—all at a stage in life that students can never have back. Grosshandler notes that some students may look back and have regrets.
“There are people who think about it—about ‘what if maybe I’d done it another way, that I am going to be working the rest of my life,’ but not everyone can do the program,” he says. “I think you really have to want it, and you have to be dedicated to medicine.”
Steve Woo is associate editor of The New Physician.
Direct comments regarding this story to tnp@amsa.org.