It's not that Raam Venkatesh didn't have one heck of a fun time filling out applications to a dozen colleges, from New York University to UCLA. It's just that, all things being equal, he would be perfectly content not to have a similar experience in three years, when he and other current high-school seniors who have their hearts set on becoming physicians will be applying to medical schools. Venkatesh, who graduated from Lakeside High School in Augusta, Ga., in June 2009, has known since he was a kid that he wanted to be a doctor (he's thinking cardiology), but that doesn't mean he wants his choices about what to study as an undergraduate to be dictated by what medical-school admissions offices expect. So the offer from the University of Alabama at Birmingham was one he couldn't refuse. If he kept up his grades and got decent scores on the MCAT, the med-school admissions test, UAB would guarantee him a place in its well-regarded med school—no application required. "I was really attracted to the program," says Venkatesh, pausing. "But the guarantee was important."
And did I mention that tuition for the UAB program that feeds students into its med school is free? "That you can have a place reserved for you in medical school, and go to college free, is beyond the imagination of many parents," says bioethicist Greg Pence of UAB, director of the school's Early Medical School Acceptance Program. "People ask, 'Why is the best student in Edison, N.J., going to college in Alabama?' EMSAP is why."
The Association of American Medical Colleges lists 43 bachelor's-M.D. programs starting with admission in 2010. They vary in detail, with some offering a curriculum that lets students graduate with both degrees in six years (University of Missouri–Kansas City) or seven (Northwestern and 16 others). But in most, students complete their undergraduate work in the standard four years and then matriculate at the med school associated with that college, including the University of Southern California, Brown, and Rutgers. The programs have been growing in popularity, says the AAMC's Gwen Garrison, with 145 students graduating with the two degrees in 2005 and 282 in 2008.
But acceptance into an undergrad–M.D. program has a cost, literally: the appeal of guaranteed admission to medical school means the undergrad part of the deal generally comes at full price. "Med school is such powerful bait, you don't have to offer scholarships or much financial aid," says Pence. UAB has, of necessity, adopted a different philosophy. "If you're a bright student in L.A. thinking of Harvard and MIT, you're not thinking of college in Birmingham," says Pence. "Some people arrive here expecting the Klan to meet them at the airport. We have to sweeten the pot."
Admission to the UAB program is based on board scores (it's looking for a 34 on the ACT or a 1520 on the math-verbal SAT), an interview at the med school, a solid record of AP courses in math and science, and a strong high-school transcript with a GPA of at least 3.5. It was only in 2007 that UAB began to recruit out-of-state students; in 2009 it accepted 12 students from California, Texas, Missouri, New Jersey, Wisconsin, Georgia, and Michigan, as well as Alabama. All qualify for scholarships that cover tuition and, in some cases, books and housing.
The UAB program includes standard premed fare, with about 10 required courses in organic chemistry, biology, physics, math, statistics, and other premed classics. There are also required seminars in subjects such as bioethics. But the guarantee of admission to med school means students can choose courses, and even majors, that in regular undergrad programs might hurt their chances with the med-school admissions office. UAB's EMSAP students can major in music, Spanish, or anything else as long as they fit in the premed requirements. Jason Lott, who was a freshman in the UAB program in 1998, earned a B.S. in math and a B.A. in philosophy. "I was able to take a lot of classes in a lot of different fields" because he didn't have to sweat med-school admissions, says Lott, who hails from Anniston, Ala. Nor did an untraditional (for a premed) major hurt him in med school.
The freedom to reject a traditional premed major is a big enticement to this year's freshmen, too. "So many students who want to go to medical school focus on being a premed, but I hope to have an opportunity to focus on other things, such as business and ethnic studies," says Allen Young, who graduated from high school in Madison, Wis., in 2009 and is starting the UAB program. "This program lets you keep your options open." That accounts for a lot of its appeal. Michelle Chang, who graduated from high school in Edison, N.J., knows she wants to be a doctor (she job-shadowed a pediatrician during high school) but is not so sure about the traditional premed grind. She is interested in bioethics and arts, especially painting, and expects to pursue those and many other subjects outside the list that med schools look for. For her, the guaranteed admission to med school means her undergrad years will be much less pressured than otherwise. "I didn't want to do the Ivy path and the traditional premed because I'd be with hundreds of other students who'd be competing to go to med school," she says.
That doesn't mean students can coast. Although all the programs, including UAB's, toss around the word "guarantee" when they describe the path to med school, that comes with an asterisk. Students have to maintain a certain GPA, for one thing: at UAB it is 3.6, and if you fall below that you're on probation and have one year to bring it up. If you don't, or fall below that level again, you're out of the program (the average GPA for students admitted to the med school through normal channels to the University of Alabama is 3.85). These days, about 15 percent of students flunk out of UAB's EMSAP, and half are on academic probation during one of their four undergrad years. But the program's rigor, record, and reputation have skyrocketed. Pence, who became director of the program a decade ago, also made the MCAT mandatory. Now EMSAP students have to get a 28 to continue on to Alabama's med school; other med schools have their own minimum. Pence also encourages students to apply to other top medical schools. Although that means that competitors "cherry-pick the best EMSAP students," UAB makes it up at the front end, attracting a caliber of student who might not otherwise consider college in Alabama.
One such student was Lott, who was the first person in his family to attend college. He applied to several medical schools during his undergraduate years at UAB and eventually chose the University of Pennsylvania. "I was more than adequately prepared for med school," he says, something he credits to "the analytical training I got, and learning how to handle large amounts of material."
Other graduates are now fellows or residents at teaching hospitals affiliated with, among other med schools, Harvard, Penn, Yale, Duke, and Baylor, as well as UAB. Joyce Hsu, for instance, went from the UAB program to Vanderbilt medical school and is now doing a residency at Children's Hospital in Boston, one of the Harvard teaching hospitals. Suzanne McCluskey, a 2009 grad, continued on to the University of Alabama School of Medicine. "The security of having a spot reserved for me in medical school takes so much pressure off the undergraduate experience," she says. "I felt I could do everything I wanted, from research to a year abroad [in South America] to courses in human rights—THINGS that are really hard to do with a traditional premed program."
And did I mention it's free?