B.S./M.D. Programs: How Early is Too Early?

by Jonathan Chevinsky • 

How early can you be expected to know that you want to be a doctor? If you ask medical school essay reviewers I’m sure you’ll hear how many thousands of people have known that they wanted to go into medicine ever since they were five years old; but is that too early to actually know? While the average age of acceptance into medical school is 24, suggesting that a significant percentage of students do not matriculate into medical school directly after college, many students begin preparing during high school. That isn’t to say that there’s a nation of ninth grade students studying for the MCAT and writing their personal statements (though in a few years, who knows?) However, students interested in applying to combined undergraduate and medical school programs, more commonly known as BS/MD programs, need to fulfill many of the same requirements as undergraduate students applying to medical school in order to be considered a competitive applicant. The question is whether preparing for a career in medicine during high school makes sense or whether it is impossible to know what you want to do with the rest of your life at such an early age.

I come from a medical family. At least ten of my relatives are involved in medicine, including fields such as nursing, orthopedic surgery, and oncology. Among them, my father, uncle, and sister all attended combined medical programs, making me aware that such a path was an option. I like to believe that hearing about and observing their different experiences gave me enough information to decide that I wanted to pursue medicine at a young age, but perhaps I just conformed to a life in the ‘family business.’ While I’ll never fully know what percentage of the idea was mine, I enjoy it so much that it seems unnecessary to go down the chicken or egg rabbit hole.

With the goal of potentially applying to BS/MD programs, I geared my high school experience toward helping my chances; I took AP Biology and Chemistry, kept up a respectable GPA, brought my SAT score above 1400, and even participated in a weekly program at the University of Medicine and Dentistry of New Jersey called Mini Medical School, which centered on lectures about various medical topics among other extracurricular medical activities. Everything I did either directly helped my chances of getting into a BS/MD program or indirectly helped by bolstering my resume.

Ultimately, I did get into a few programs and am currently going into my junior year of college at one. However, it recently occurred to me that while my program has consumed my past, I am being rewarded for my choices in the present. It dawned on me that BS/MD programs are not inherently great or terrible but represent a unique path for high- schoolers who have decided that they want to pursue medicine at a young age, and therefore focused their studies on medicine before most pre-med students. Considering that in countries like England students normally apply to medical school following their graduation from high school, this is not an outrageous option. Unless you are coerced by family members to apply to a BS/MD program, a legitimate concern of program interviewers, what such a program offers is invaluable: the ability to abridge your undergraduate education and subsequently reduce the exorbitant cost and extensive medical school process. Furthermore, it allows students who want to become physicians to explore other non-medically related interests without having to worry about the medical school application process looming over their heads. For example, a friend of mine who is also in a BS/MD program decided to take a swing dancing class because he had the freedom of knowing a spot was reserved for him in medical school. He no longer felt pressured into allocating all of his time towards medically themed activities. Similarly, I am following one of my passions by majoring in creative writing, a discipline that is not a focus of the average premedical student. In an era in which the well-rounded medical professional is viewed as the prototype—as shown by the recent change in the MCAT to include social sciences, a shift away from the previous focus solely on the natural sciences—such opportunities to broaden one’s horizons should be encouraged.

Another clear advantage is that students in such programs are provided with a host of opportunities specific to them. In my case, the biggest advantage is that BS/MD students are given a separate advisor specific to the program in question. This enables us to have an authority figure whom we can reference concerning any requirements for their particular combined program and whose primary goal is to ensure that we are able to fulfill said requirements. Thanks to our advisors we are given the opportunity to participate certain activates before the rest of the student body such as a seminar class about medical history, hospital internships, and volunteer opportunities. Finally, if recognition and reverence is paramount for a student, being a member of a BS/MD program is usually indicative of an elevated academic status. It is generally understood that such programs are selective, offering a certain level of prestige to their students.

While rewarding, BS/MD programs also have their potential drawbacks. College often represents a time where students are in flux: their major, career plans, and social relationships can change multiple times over the course of four years. It stands to reason that any decision made in high school—a time in which your brain is not yet fully developed and you are not yet fully socialized to be an independent, self-sufficient individual—is subject to change upon further experience in college. If acceptance to BS/MD programs is contingent on participation in medically-focused extracurricular activities from ninth grade onwards, then there is a chance that some will expend the energy to enter a BS/MD program only to realize they are uninterested in becoming doctors. For such individuals, the development of their interests could have been stymied because they pursued a commitment to medicine, not knowing what they really wanted, but hoping to leave that option open. Time spent shadowing a doctor may be more effectively used attending a career fair as many possible professions may have been overlooked.

One problematic trend that I’ve noticed is that BS/MD students don’t feel encouraged to do more than the bare minimum because they already have a guaranteed spot in medical school. While in my experience most students still pursue leadership positions and extracurricular activities, in some cases students have rested on their laurels and accomplished much less over the course of their college careers than their high school careers. In some extreme cases, this has gone as far as to prevent students from meeting the minimum requirements of the program, putting them in a position in which they neither have a reserved spot nor any realistic chance of getting into other medical schools. In such instances, perhaps these students have burnt out from the stress of ensuring that their high school resumes and transcripts were competitive enough to apply to these combined programs.

This returns the discussion to the initial question of how early you can be expected to know that you want to be a doctor. The answer is that insofar as there is no clear consensus about when our career choice must be made and to what extent and at what age others around us influence our decision most, students should be informed about different paths and opportunities, but not coerced into partaking before they are ready. This applies to every career, but most significantly to these combined programs (medicine, pharmaceuticals, engineering, etc.) because they are paths to graduate schools which can provide a student with less stress, more freedom, and more opportunities down the road. That being said, one must be very cautious to avoid a premature decision and if a student is not completely sure about which profession he or she would like to pursue, the safest bet is simply to explore any interests that he or she has and figure it out from there. Students who decide during their senior year of college that they are passionate about medicine and decide to pursue a career as a physician will be much happier than those pushed into medical school only to realize that medicine is not for them. However, for the students who feel secure in their passion for medicine, I strongly believe that combined medical programs are an appropriate option given that such students have had the time and opportunity to explore the medical field before making their decision.

 

PDF available: Jonathan Chevinsky, “BS/MD Programs How Early is too Early,” Voices in Bioethics (2015).

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