In this post, I cover what pre-med does and doesn't mean, best practices for applying to pre-med, what pre-med means for your college search and list, how many pre-med freshmen become physicians, medical school course prerequisites after arriving on campus, and a critical take on combined BS/MD programs.

I argue that any student from any major at any regionally-accredited university can potentially gain admission to any medical school. What you do after arriving on campus matters more than where you earn your bachelor’s. Pre-med considerations should play little to no role in your college search and enrollment decision.

What is and is not pre-med?

Perhaps the most Frequently Asked Question I receive about specific programs is how to apply for pre-med. There are many misconceptions about what applying to and pursuing pre-med or other health professions. Since almost anyone interested in health professions inquires about pre-med, most of this post focuses on pre-med rather than the many other options like pre-dental, pre-pharmacy, etc.

Applying to medical school as a current university student or recent graduate is beyond the scope of this blog post and outside of my professional experiences. Thousands of blog posts and professionals assist with medical school admissions - I’m not one of them.

First, I clarify a few points about what pre-med does and doesn’t mean.

• Pre-med is not a major, and you cannot earn a degree in pre-med.

• Pre-med is housed in the “Health Professions” office that encompasses pre-medical, pre-dental, pre-physician assistant, pre-physical therapy, pre-pharmacy, pre-optometry, pre-veterinary, and pre-occupational therapy, among others.

• All students in the United States must earn a Bachelor’s degree before they can apply for and enroll in medical school.

• Any UT student in any major can pursue pre-med.

• You do not need to major in the Natural Sciences or any sciences to pursue pre-med.

• Any student from any major can attend post-undergraduate school in the Health Professions if they meet the prerequisites, which are courses open to students from all majors.

• Checking “I am interested in pre-med” or other Health Professions on Apply Texas or the Common App makes no admissions differences. Depending on your particular major choice, you will be compared against other applicants for your first-choice major or college/school.

• You can address pre-med or a future health career in your application essays, but you’re arguing for a position in your preferred first-choice major, not pre-med.

• You can receive your undergraduate degree from any university and potentially be competitive for any medical school.

• You do not need to apply to and enroll at medical school immediately following your Bachelor’s degree. Many prospective physicians take time off to research, intern, volunteer, or study abroad.

• You can earn a bachelor’s degree and complete most or all health professions prerequisites later at community college or as a non-degree earning student, although this may depend on your specific health profession and previous degree.

Applying to and pursuing pre-med

The United States is almost exclusively unique in that they require prospective health professions students to earn a bachelor’s degree before they can enroll in medical studies. Nearly every other country in the world allows direct entry into medical, dental, veterinary, etc., immediately after secondary school. Most of these programs take 6-7 years. The same applies to law school where an Australian, for example, can earn their degree and begin practicing law at 22. Consequently, families receiving their higher education outside the United States often lament that the student must earn a four-year degree before pursuing additional post-undergraduate studies. That frustrates some students who feel bewildered that they must earn a degree before entering medical school.

My best advice for students who think they want to attend medical school is to select a major they feel they will enjoy pursuing over the next four or five years. The most common misconception about applying for pre-med is that you must pursue a science major. If you want to earn a biology, biochemistry, or public health degree, great! But this isn’t necessary for medical school eligibility.

Every year, students from all majors apply to and enroll in medical school, including English, sociology, social work, engineering, business, economics, classics, computer science, dance, etc. You can view these three PDFs here for more information on admissions rates, bachelor’s earned, and GPA averages and ranges. (1, 2, 3)

Around 60% of medical school enrollees majored in the biological sciences, so by definition, over one-third do not. You can review official and comprehensive medical school admissions statistics here.

I also recommend consulting this helpful post, “Medical School Acceptance Rate by Major,” along with average undergrad GPAs and MCAT, by BeMo Academic Consulting.

How you should approach pre-med as a High School Senior

Prospective pre-med students' most common mistake is substantially overweighting pre-med in their college search. A related question is “Which university is best for pre-med” or “Is UT good for pre-med?”

Any student, from any major, at any undergraduate university can gain admission to any medical school, assuming they have a strong enough GPA, resume, and MCAT score. All that pre-med means is you have access to advising and other application resources. Essentially all universities will have some pre-med and health professions advising, MCAT preparation, and application coaching. You can also apply to medical school without ever interacting with health professionals or pre-med advising, so even if for some bizarre reason your university doesn’t have pre-med advising, it’s not a big deal.

Here are the premed resource links for UT-Austin, UT-Dallas, Texas A&M, University of Houston, and Texas Tech.

Families attach themselves to the “medical school matriculation” statistic, which means the number of applicants from that university who gain admission to at least one medical program. For example, UT’s matriculation rate is 45% (609 applicants and 275 enrollees), so around half of UT graduates who want to attend medical school are admitted. Rates at Texas A&M, UT-Dallas, the University of Houston, and other Texas publics have similar and even higher med school matriculation rates. The nationwide medical school admissions rate average is around 35%. So, some undergraduate programs have higher entry into medical school, but that statistic in itself indicates little.

It’s also deceiving because some universities exclude applicants with low grades from their data. Medical school applicants are a self-selecting application in that the applicant pool is composed largely of applicants who will already be competitive. Consequently, the “med school admissions rate” is an almost entirely meaningless statistic.

All things equal, medical schools will always prefer a 4.0 student at UT-Dallas than a 3.0 applicant from Harvard or Stanford. You should have medical school options as long as you earn a 3.7 college GPA or higher and score in the top quartile on the MCAT (~500 or higher) and pursue some science interests outside of the classroom.

Perhaps the most meaningful college search variable is access and opportunities for undergraduate research. UT-Austin places a high priority of connecting undergraduates with research opportunities, like the Freshman Research Initiative. Proximity to a medical school like Austin’s Dell Medical School or UT Southwestern in Dallas may allow more convenient shadowing or internship opportunities during the school year. Those opportunities may not be as available in rural or regional universities or small liberal arts colleges.

So, the college you choose and its resources/opportunities will have indirect consequences for your potential medical studies, but the university’s reputation rankings in and of themselves won’t help your chances. Medical school chances matter almost exclusively what you do after arriving on campus and how you utilize the STEM resources in your environment rather than where you go.

Consequently, pre-med should play little or zero role in your college search or enrollment decision.

Minimize Your Undergraduate Debt

Since any student from any major receiving their bachelor’s from any accredited undergraduate program can compete for any medical school spots, it’s essential to minimize your debt load. Popular private universities like USC, NYU, Stanford, and others cost upwards of $320,000 for four years. Consider the total cost of attendance at The University of California - Berkeley. The total annual cost for non-California residents is $70,000 - 75,000 or around $300,000 for a four-year degree. Michigan Ann Arbor and other public flagships have similar price tags, although some prominent public universities like Georgia Tech or Indiana Bloomington have lower out-of-state fees (albeit still not worth it in many instances).

Contrast this with the four-year cost of UT at $120,000, Texas A&M or UT-Dallas at $125,000, or, if you’re a high achieving student receiving merit scholarships to the University of Houston, Texas Tech, or similar mid-tier public universities, you may pay $75,000 or less for four years. Many mid-tier schools, irrespective of residency, offer full rides for National Merit Finalist. Nevertheless, I’m a big fan of Texas families remaining in-state because we have high-quality public options at less than half the price of private or out-of-state public equivalents. I share my full thoughts on building a reasonable college list here.

UT Southwestern is one of the more affordable and high-quality medical schools in the country, yet the four-year total price is around $240,000. Their financial aid page has a helpful breakdown of average debt at UTSW, public equivalents, and private universities. Unsurprisingly, private medical schools tend to be substantially more expensive, although you may be able to justify the added value for residency and specialist placements by attending a prestigious medical school.

Harvard Medical School and other private medical schools may cost upwards of $400,000 for your MD. MDs regularly finish their degree with $250,000 in student loan debt, including debt accrued during their undergraduate studies. If you’re going to spend half a million dollars on your education, save money in your bachelor’s and allocate it for medical school if you receive admission to Harvard or equivalent.

Minimizing debt for your undergraduate degree will free up finances for future medical school or other health professions graduate studies. A UT-Austin or Texas A&M bachelor’s plus a public university medical school costs similarly to a four-year degree at Berkeley, USC, Stanford, etc. Attending private universities for your bachelor’s and medical school may cost $700,000-800,000, a mind-boggling sum even for physicians with future high earning potential.

Unless your family has literally millions of dollars, and/or you’re the only child, attending a Texas public university provides the most financially prudent pathway. Medical school also has an opportunity cost since you lose high-earning potential during your four years of medical school, two or more residency years, and any specialties you pursue. You may not begin earning adequate salaries until your early- or mid-30s. All things equal, computer scientists and engineers have eight or ten more years of earning potential relative to many physicians.

When cost-conscious prospective pre-med families email me, and when they have pricey out-of-state public universities that do not offer merit aid or discounts for non-residents, I strongly caution them against even applying for these schools. Gaining admission to schools you cannot afford or that are imprudent to enroll fuels “fear of missing out” and sometimes nudges families toward irrational decisions. There are real downsides to applying “just to see if I can get in.”

How many prospective pre-med students actually become doctors?

Physicians, professors, and medical professionals, please chime in with your thoughts about the vast funnel of potential pre-med students who actually earn their bachelor’s, complete medical school, finish their residency, and become full-fledged practicing physicians. It’s hard to find reliable empirical data about college freshmen who begin with pre-med and jump through the hoops to enroll in medical school.

It seems like 10% or maybe one in every eight or twelve pre-med freshmen attend medical school. Approximately 80-85% of medical school enrollees eventually finish their degree. Not all medical school graduates will receive a residency placement, with 10% not receiving a position on Match Day. Not all residents will finish their programs to earn their physician or specialty qualifications. Some physicians choose to leave the medical profession entirely. There are many junctions to misstep or opt out of pre-med and medicine.

Back-of-the-napkin calculations suggest that only 1 in 15 or 20 premed freshmen advance through each filter to become a practicing physician. That means almost every prospective pre-med applicant in high school who messages me will not become a doctor.

Some receive a reality check when they bomb biology with lab freshmen year or organic chemistry sophomore year. Others lose interest in the sciences or realize their high school experiences and expectations don’t align with their college experience. They acknowledge family or societal pressures to become a doctor don’t match their aptitudes and interests. “Doing medicine for the money” or “to make a difference” usually aren’t sufficient motivators to clear all of the medical career hurdles. Having a sub -3.5 university GPA is almost an automatic disqualifier, as is underperforming on the MCAT.

One of my three college roommates, all initially pre-med, couldn’t earn a high enough MCAT score. He pivoted to physical therapy school and now practices as a PT. Another gained admission to MD/PhD programs after his second application attempt and is a practicing surgeon, and the third never took the MCAT and has spent his career outside of science.

Consequently, statistically speaking, almost every prospective pre-med will need to earn a degree that matches their interests and professional aspirations, knowing that becoming a doctor probably won’t happen. Almost nobody begins their undergraduate studies as pre-dental, pre-PT, pre-PA, and others, yet we have plenty of these professionals.

Pre-med students often pivot to other health professions that match their skills, interests, lifestyle, and degree time commitment preferences. Practicing medicine requires long hours, byzantine bureaucracies, and challenging work environments, with burnout a common and significant concern, especially during and post-COVID.

That’s why my advice to “pursue the major or program where you can realistically see yourself enjoying over the next 4-5 years” is substantially more relevant than whether you will become a doctor or some other health professional. If you want to attend medical school, those opportunities will shake themselves out following your sophomore and junior year of university. It’s not particularly relevant as a high school senior or in your college search, except to minimize your debt!!!

What pre-med courses will I need to take?

The biggest upside of pursuing a Bachelor of Science is that many pre-med courses like biology, chemistry, and calculus are built into the degree plans. Pursuing a science major may make undergraduate lab research or hospital shadowing opportunities more accessible. Bachelor of Arts students often have to take pre-med prerequisite courses in addition to their degree plan.

Nevertheless, anyone who completes these courses and earns a bachelor’s degree can apply for medical school, depending on slightly varying requirements between med schools.

• Biology 1 and 2 with lab for science majors. BIO 311C + BIO 311D + BIO 206L (lab)

• BIO 325 Genetics + 3-hour BIO Elective

• Chemistry 1 and 2 with lab CH 301 + CH 302 + CH 204

• Organic Chemistry 1 and 2 with lab CH 328M + CH 328N + CH 220C

• Biochemistry BCH 339F

• Physics 1 with lab (recommended)

• Other suggested courses include calculus, psychology/sociology, or electives relevant to your future career

This flowchart helps visualize the course pathways. As you can see, any student from any major can pursue the pre-med prerequisites.

These are all things you figure out after arriving on your college campus and not as a high school senior applying to college.

About BS/MD and other combined or accelerated medical programs

A note about seven and eight-year combined medical programs. I disclose upfront that I am not a fan of either applying to or enrolling in these programs. I will share the basics first and my thoughts about them afterward.

These programs go by different names but allow students to complete their bachelor’s degree with a direct entry into their medical program, depending on the GPA and MCAT, as a high school senior applicant. Other schools like Texas A&M offer medical school assurances or provisional admissions after the freshmen year of college, but I won’t cover those here.

UT-Austin experimented with this setup for a few years in the mid-2010s before discontinuing the program for unspecified reasons. Rice had a combined program for three decades but seems to have discontinued it as of 2022. Texas Tech and Baylor still offer combined programs. This lengthy Prep Scholar post provides more insights into BS/MD programs and the complete list of ~50 programs nationwide.

These programs are EXTRAORDINARILY all-caps-bold-and-italicized competitive. Some of them, like Texas Tech and Baylor, enroll fewer than ten applicants among potentially hundreds who apply. Others like Drexel or UMKC are larger and have slightly higher admissions rates, but you should assume every BS/MD or combined medical program has an admissions rate lower than 10%, and sometimes lower than 1%. That makes them the single most competitive programs of any kind in the nation, more selective than Penn Wharton Huntsman Scholars, MIT Computer Science, UT Computer Science/Business (CSB) Honors, and so on.

Competitive applicants to BS/MD programs would also be competitive for UT’s (extraordinarily competitive) Dean’s Scholars or Health Science Honors programs. BS/MD admissions students tend to also gain admission at Top 20 universities like the Ivies, Stanford, Johns Hopkins, MIT, etc. Unless you have flawless academics, a 1550+ SAT, and stellar national/international level STEM and health accomplishments on your resume, I wouldn’t bother applying. To be honest and abrasive, if you have to ask whether you’re competitive for BS/MD, you’re probably not.

These applications are extremely time-consuming. Some require up to ten essays, so unless you have extensive relevant experience, you might struggle to complete the application. I assist one or two BS/MD students each year and only work with them at my highest price, all-inclusive package. The approach is to apply to between 8 and 15 of them and cross your fingers that you gain admission to a single program. I’ve had a few students gain admission to them over the years, and only one has actually enrolled. That enrollee was a Regular Decision admission to Harvard, for context.

The BS/MD bargain seems like a bad deal in almost all situations. Few of these programs offer funding, and the only upside is a provisional offer to med school, often contingent on your GPA and sometimes also an MCAT score. So, you sort-of-but-not-really receive a medical school admissions guarantee after a highly rigorous application process, only to lock yourself into an institution, geography, and professional pathway for seven or eight years. How can you be sure you want to live in Lubbock until your mid-20s?

These programs trade on the insecurity, uncertainty, and doubt about the medium-term future that families experience by locking you into a pathway that may seem appealing at age 17 but not match your interests or ambitions when you’re 20 or 22. Relative to their tiny number of enrollment spaces compared with the thousands of applicants who attempt to gain admission, I argue that the mere existence of these programs causes more collective anxiety and harm to students, families, and high schools than whatever healthcare benefits that may provide to society.

The universities benefit by attracting a few extremely qualified students to campus and putting a few butts in med school seats, but I’m unsure precisely what substantive benefits students and families receive. Given that few pre-med freshmen actually become doctors, you’re committing to a pathway that has a high probability of changing. Unless the program is partially or fully funded - and these are exceedingly rare - BS/MD programs seem to have little upside and very high downside. You’re better off taking the standard pathway of Bachelor’s degree completion to medical school application and subsequent enrollment.

I have no doubt that some students enroll at and thrive in these programs and become world-class physicians. I just don’t think it’s the right fit for 99% of high school applicants.

Interested in working together?