Applying to Medical School

The programs discussed below will be of special interest to those seeking admission to only one specific school, minority students, high school students anxious to complete the college-medical school sequence earlier, those interested in becoming physician-scientists, and those seeking a career in primary care.

1. Early Decision Program (EDP) — see page 98.
2. Flexible Curriculum Programs
3. Integrated Degree Programs
4. Combined Programs — see page 131.
5. Interdisciplinary Programs
6. Primary Care Training Programs

Flexible Curriculum Programs

A few schools offer some minority students the possibility of completing the required courses at a slower pace (usually five years). Such students must meet regularly with faculty advisors to demonstrate their progress and they must pass the standard comprehensive examinations for promotion and graduation.

Integrated Degree Programs: BA-MD or BS-MD

These programs permit selected students to participate in combined undergraduate college and medical school curricula thus enabling them to obtain the MD degree in six or eight years from the time they graduate from high school. In such cases, individual students can obtain their baccalaureate degrees while enrolled in medical school. You must realize that the advantage is balanced off by the fact that in these programs you are committed to attend one specific medical school that is linked to the undergraduate institution, and you are locked into a medical career at an early stage in life. Thus, students who find these two significant limitations acceptable, and who have excelled academically, are exceptionally mature, socially adjusted, and able to communicate well, should carefully investigate integrated programs in depth. Consultation with advisors in high school and college as well as with medical school admissions personnel is highly recommended, as is securing adequate exposure to medicine at a medical facility. Beginning the medical phase of these dual programs is obviously important in order to have a successful record as an undergraduate.

The following list includes schools presently offering such programs:

Alabama

University of South Alabama College of Medicine

California

University of California at Riverside with UCLA School of Medicine

University of Southern California with School of Medicine

Connecticut

University of Connecticut School of Medicine

District of Columbia

Howard University with George Washington University School of Medicine

Florida

University of Florida

University of Miami School of Medicine

Ilinois

Illinois Institute of Technology with Chicago Medical School

Northwestern University

University of Illinois at Chicago

Massachusetts

Boston University

Michigan

Michigan State University College of Human Medicine

University of Michigan

Missouri

Drury College with St. Louis University College of Human Medicine.

Drury College with University of Missouri — Columbia School of Medicine

Rockhurst University with St. Louis College of Human Medicine

Southeast Missouri State University with University of Missouri — Columbia

Truman State University with University of Missouri — Columbia School of Medicine

University of Missouri — Columbia School of Medicine

University of Missouri — Kansas City School of Medicine

New Jersey

College of New Jersey with New Jersey Medical School

Drew University with New Jersey Medical School

Montclair State University with New Jersey Medical School

New Jersey Institute of Technology

New Jersey Medical School

Robert Wood Johnson Medical School

Rutgers University with Robert Wood Johnson Medical School

New York

Marist College with New York College of Osteopathic Medicine

New York University

Rensselaer Polytechnical Institute with Albany Medical College

Siena College and Albany Medical College

Sophie Davis School of Biomedical Education — CUNY with Mount Sinai School of Medicine

SUNY Downstate Medical Center, Brooklyn College

SUNY Genesco with New York College of Osteopathic Medicine

SUNY New Paltz with New York College of Osteopathic Medicine

SUNY at Stony Brook School of Medicine

SUNY Syracuse College of Medicine

SUNY Upstate Medical University, Binghamton University

Union College with Albany Medical College

University of Rochester School of Medical and Dentistry

Ohio

Case Western Reserve University

Miami University of Ohio with University of Cincinnati College of Medicine

Northeastern Ohio Universities College of Medicine

Ohio State University College of Medicine

University of Akron with Northwestern Ohio University College of Medicine

University of Cincinnati College of Medicine

Xavier University with University of Cincinnati College of Medicine

Youngstown State University with Northeastern Ohio University College of Medicine

Pennsylvania

Duquesne University with Temple University School of Medicine

Jefferson Medical College

Lehigh University with Drexel University College of Medicine

Penn State University with Jefferson Medical College

Rosemont College with Drexel University College of Medicine

Villanova University with Drexel University College of Medicine

Widener University with Temple University School of Medicine

Wilkes University with Drexel University College of Medicine

Rhode Island

Brown Medical School

Tennessee

East Tennessee State University

Fisk University with Meharry Medical College

Texas

Baylor University — Waco with Baylor College of Medicine

Rice University with Baylor College of Medicine

Texas A&M University College of Medicine

University of Houston with Baylor College of Medicine

University of North Texas Health Science Center

University of Texas — Panam with Baylor College of Medicine

Virginia

Eastern Virginia Medical School

Old Dominion University with Eastern Virginia Medical School

Virginia Commonwealth University

Wisconsin

University of Wisconsin Medical School

Bottom Line

• • Integrated programs are designed for outstanding high school students who have firmly concluded that medicine should be their career.
• • Integrated programs are designed for those who aim to reduce the lengthy educational process as well as to be accepted early to medical school.
• • Only a tiny fraction (well under 5%) of freshman medical students are enrolled in medical schools by means of integrated programs.
• • Program enrollees are awarded Bachelor of Arts or Sciences and Medical Doctor degrees upon satisfactory completion of prescribed studies at the affiliated undergraduate medical school unit.
• • Eligible applicants for these programs are senior high school through second-year college students.
• • Premed required courses must be completed at the specific undergraduate school affiliates of the medical schools that offer integrated programs. Obviously, the same is true for one's medical studies.
• • If the student demonstrates the program's required level of performance as an undergraduate, he or she basically automatically is eligible to continue studies at the affiliated medical school.
• • Some, but not all, programs require students to take the MCAT prior to finalizing their acceptance into medical school.
• • Each program has its requirements and these should be carefully evaluated before a commitment is made.
• • Being in an integrated program early on may facilitate a student's adjustment to medical school as well as reduce the stress generated by the regular application program.
• • Being enrolled in an integrated program, however, commits you, possibly prematurely, to a medical career.
• • If you are not accepted into the medical school phase of the integrated program, you still have an option of applying to any number of these schools like any regular applicant.

Combined Programs: MD-MS, MD-PhD

These programs permit combined study for an MS or PhD degree in basic medical science, along with study for the MD degree. Average time for these programs ranges from six to seven years. A special Medical Scientist Training Program (MSTP) sponsored by the National Institutes of Health offers annual stipends and full tuition coverage for students accepted into the program at the schools offering it, listed below.

Albert Einstein College of Medicine

Baylor College of Medicine

Case Western Reserve University

Chicago-Pritzker

Columbia University

Cornell University

Duke University

Emory University

Harvard Medical School

Johns Hopkins University

Mount Sinai School of Medicine

New York University

Northwestern University

Pennsylvania State University

Stanford University

SUNY at Stonybrook Health Sciences Center

Tufts University

University of Alabama

University of California — Los Angeles

University of California — San Diego

University of California — San Francisco

University of Colorado

University of Iowa

University of Michigan

University of Minnesota

University of Pennsylvania

University of Rochester

University of Texas, Dallas

University of Virginia

University of Washington

Vanderbilt University

Washington University

Yale University

Currently more than 30 medical schools receive funding and about 75 more launched MD-PhD programs on their own. All told, about 2,500 students are enrolled in such programs. The MSTP was inaugurated by the National Institute of Health (NIH) more than 30 years ago and it has supplied the nation with a significant number of its physician-scientists. Many program graduates have succeeded in securing senior administrative research appointments where they have gained access to investigative grants, laboratory staffs, and other benefits that have furthered their careers. Some have become Nobel laureates. In spite of the seven-to-ten-year length of MD-PhD programs, schools report that the program is as popular with prospective students as ever.

The changes taking place in the health care system have raised questions about the future of the program. This is because research funds are beginning to dry up due to the cutback in funding by the government and in reimbursement by the managed care system. With reduced income for academic medical centers, they have less funds to support in-house research. There has been criticism by some that combined MD-PhD programs are no longer necessary. They argue that these programs emphasize the basic rather than clinical disciplines and that the physician can perform research, as many do, without the PhD component.

The majority of graduates of combined programs ultimately end up with academic careers, being engaged in research, teaching, and perhaps some limited clinical duties. These individuals have met the goals of the original NIH concept. There still is very strong support for the MD-PhD program within the academic community as being a vital approach in generating physician-scientists.

In reaction to the existing climate, there appears to be a tendency to readjust the ratio of activities of MD-PhD candidates, with increased clinical responsibilities delegated to them. One program mandates a full month of medical work on the wards before even entering the lab. Others require a more equitable sharing of time between clinical and research work. The combined program candidates generally respond positively to this change, even when their research is far removed from patient care.

One of the negative side effects of increasing the clinical obligations of combined-degree candidates at the expense of research is that it will inevitably slow down lab work and thus lengthen the PhD phase of the program. This will further strengthen the voice of critics who claim that the program already takes up too much of the candidate's career development segment.

Besides usually interrupting the candidate's medical education with a three-to five-year research interlude, an additional three to five years of specialty (residency) training usually takes place after receiving the dual degrees. This brings the education-training phase to a minimum of 10 years and maybe more if a postdoctoral fellowship is elected (which can in extreme situations almost double the training time). Critics of the length of the program suggest that medical students interested in research have other options, such as taking a research elective during the school year, spending a summer or even taking off an entire year for research, or doing it on a postdoctorate (MD) level. While these options are feasible, they can't provide the solid background and training that is essential for physician-scientists.

A second major issue raised by the MD-PhD program is the disruption caused by the research phase right in the middle of medical studies. Students find themselves removed from their class (and classmates), where the social environment is supportive, and they are transferred into the relative isolation of the laboratory. Having to transfer back and forth between two radically different academic cultures — medical student, graduate student, then medical student again — can be destabilizing. The medical training is in the context of a hierarchical system, while that of graduate research is basically egalitarian. In response, some schools are allowing candidates greater flexibility in planning their program. Thus, in some cases candidates may start their research immediately or after one year of medical school, or complete either one of the degrees first, or pursue a personalized schedule. Nevertheless, there are, by the program's very nature, built-in social disadvantages that are unavoidable in a combined-degree program.

Critics of the MSTP do not deny its attractiveness in providing candidates with full funding and making them potentially very marketable. They argue that MD's can and do learn how to do sophisticated research, although the start-up time may be longer. With the dual-degree program perhaps being subjected to fiscal pressure, future candidates can anticipate a lower threshold of support.

Interdisciplinary Programs

This arrangement permits a combination medical degree program with a degree in another field such as engineering, statistics, law, physics, chemistry, administration, dentistry, or agriculture. Schools offering such programs are identified in the special features section of their profiles in Chapter 7.

The vast majority of dual degree programs are obviously linked with the biomedical sciences. There are a small number of prospective physician-scholars who set their goal to secure a doctorate in one of the humanities of social sciences. For such individuals, there are a very limited number of formal programs available. The biggest is probably the Illinois Medical Scholars program at the University of Illinois College of Medicine at Urbana-Champaign. It offers PhDs not only in the biomedical and physical sciences but also in subjects ranging from anthropology to philosophy. Similarly, the program in Medicine, Arts, and Social Sciences at the University of Chicago attracts medical students from around the country who pursue PhD's in a wide range of subjects. A third program of note is the Clinical Scholars program at the University of Michigan.

The most popular of the nonscience dual programs, relatively speaking, is the MD-JD program. There are presently at least six medical schools that offer opportunities for interested students who wish to secure a law degree along with an MD. These schools include Chicago-Pritzker, Duke, University of Pennsylvania, University of Illinois Urbana–Champaign, and Yale. Many graduates with this dual degree enter the field of medical malpractice or health policy work. Finally, it may be noted, a master's degree in Public Health is offered by Tufts University School of Medicine.

Primary Care Training Programs

You may be interested in specializing in primary care after graduation from medical school; there are a number of schools whose aim is to train specialists in this area. Shown below are a list of medical schools from whose recent graduating classes more than 60% entered primary care residencies.

Brown University

Case Western Reserve University

East Tennessee State University

Meharry Medical College

Mercer University

Michigan State University

Morehouse School of Medicine

Robert Wood Johnson Medical School

University of Arkansas

University of Hawaii

University of Illinois — Rockford

University of Kansas

University of Missouri — Kansas City

University of Nebraska

University of New Mexico

University of South Alabama

University of Washington

Wright State University

It should be noted that a number of these schools have developed a special program in order to encourage students to enter primary care (family practice or internal medicine). It combines the last year of medical school with the first year of postgraduate training thus accelerating the entire education process.