Page last updated: May 27, 2019


Every time. Every time I tried to look for a BS/MD advice article, I was hit with the same few articles written by college counseling websites. I never found something that was real, a piece of high-quality, free advice which was able to help me get through some of the toughest parts of high school that I had faced—the college admissions process.

I’m not particularly pissed off about this, because it allowed me to test and ideate some of the advice that is generally held behind a paywall of college counselors, and through my experience and those of my classmates, put it out to the public. On Reddit and other websites which have advice for college admissions, they don’t necessarily focus on BS/MD programs, because they are a very niche type of programs and not everyone will be interested in a guaranteed admissions into medical school.

This is my attempt to pay it forward. Here’s the high-quality information that I wish I had known about as I was applying to the program that I am currently in.

Sounds good? Let’s begin.

What the heck is a BS/MD program? Why would I be interested?

I have already covered what BS/MD programs are and the pros and cons of these programs in another post, but they essentially boil down to getting an undergraduate degree and having a reduced requirement load or guaranteed admission to a medical school. They often also have the added benefit of decreasing the time spent in school if they are seven years. As you can imagine, these programs are competitive. On average, there are only 20-30 spots in a program, and the acceptance rate for these programs is less than 10%.

Speaking from experience, I didn’t know that I was interested in a BS/MD program until late in my junior year when I learned that I really liked medicine. Since I didn’t even know that these programs existed, it was hard to comprehend my chances for a prestigious program with a medical school as I felt that I needed to play catch up with all of the people who were.

This definitely made me feel scared. I was just a normal kid, I didn’t have an insane talent or passion, and coming up to application time I was driven to succeed but so were the hundreds of other students who were applying as well. As I was doing my research, and a feeling of dread rose over me as I procrastinated on my Common Application, a natural question arose in my mind when I was trying to gain admission into some of these programs: how do I get the attention of these schools enough for them to say, “WE WANT YOU!”? I felt like I was one of the girls on The Bachelor and the BS/MD program was the single suitor, but I was the one who was probably going to get kicked off first, right after the introductions.

I Just Want It To Be Over Vanessa GIF by The Bachelor

How I felt all through the process. I feel you, Vanessa.

Okay, cool. I know I want to do this program now. And I’m interested. How do I get in?

Hold up there, partner. As I said before, There are a lot of students who are interested in BS/MD programs. Slow and steady wins the race.

Because I don’t know whether you’re a precocious freshman or a procrastinating junior, I’m going to try and split up my advice based on the timeline of how I would plan if I was a freshman or sophomore just hearing about these programs. This advice will position you in the best place to gain the “WOW!” factor that is so elusive in the heightened admission process. However, if you’re a procrastinating junior (like I was), I’ll be trying to make a blog post about it as well—contact me through Twitter, Instagram, or the comments below this post if you would like to learn about that as well.

I like to think of the preparation process as a pyramid. It starts of with having the right fundamentals which we’ll call the Requirements. These are your bread and butter stats which everyone rattles off when they’re trying to prove why they got into a certain school: their SAT or ACT score, their GPA, and AP and SAT Subject Test Scores. In order to apply to BS/MD programs, you need to have a certain cutoff for each of these components. They’re not the same for each program, as we’ll talk about more in depth later in the article, but they are important to keep in mind if you have a specific program in mind.

The next step of the pyramid is your Extracurriculars, and talks about activities out of school you’ve done. I also lump letters of recommendation (LOR) into this category, because a lot of strong letters of recommendation come from teachers who know you in a capacity outside of school. This will allow them to use better anecdotes to speak to your character and your drive as you’re trying to stand out from the crowd.

Finally, the pyramid culminates with the peak of Application Curation. This includes writing a compelling essay and preparing for the interview processes. This step can (literally) make or break your chances because a well-crafted story with mediocre extracurricular involvement is better than a horribly crafted story with superb extracurricular involvement. Results may speak for themselves in other fields, but college admissions is a very subjective field and a well-placed anecdote can sway the admissions officer one way or the other based on how it is framed.

The Pyramid Of Success (or the Illuminati One, whichever you prefer)

Requirements: Making Sure that You Can Apply

As a freshman, I had no idea what standardized tests I had to take to get into college. It all seemed so far away. 4 years is a long time when it’s a quarter of your life up to that point. As I went through my classes and the applications, and now in my position in working with applicants, I’ve realized that there are three places where you really need to nail in school to have a baseline to successfully apply for BS/MD programs: your GPA (Grade Point Average), showing that you have advanced coursework, and your standardized tests.

In your freshman year, the most important thing in terms of academics would be to make sure that you start off on the right foot. I cannot stress this enough. Make sure that the transition from middle school to high school is seamless. If you tank your GPA, it’s hard to get it back up. This is simple advice to give, but I understand it’s hard to execute. Between uncooperative teachers who grade harshly, stress from outside of school, and social obligations, you may find yourself struggling to get a 4.0.

But, in order to apply to a BS/MD program successfully, I would suggest that you are in the top 5% of your graduating class, or at least the top 10%. Without this type of academic prowess, it’s hard to justify admission into medical school based solely on high school performance. My advice, based on my high school experience, is to make sure that you’re studying with some sort of purpose. The competition may be a little fierce but working for an internal purpose is better inspiration and a better goal. Focused studying is like a muscle: you become more efficient the more you use it.

The next part of the formula to apply to BS/MD programs is to have advanced coursework. This varies from school to school, but I’ll be using Advanced Placement Tests (AP Tests) as a national benchmark for the level of rigor that programs expect. I would suggest taking AP Biology, AP Physics (1, 2, or both C tests), and AP Chemistry at least to show that you are interested in taking high level courses. I would suggest a rule of thumb to taking five to eight AP exams if possible in your high school career before application time, spread out between the humanities and sciences. For example, an idealized schedule would look like this (bolded are highly recommended):

Freshman Year: AP Biology

Sophomore Year: AP Chemistry, AP US History

Junior Year: AP Physics (1, 2, or C), AP Psychology, AP Spanish, AP Calc BC

Senior Year: Exams that you’re personally interested in, or will help in the future in medicine—shows continued academic rigor (AP Stats)

This is where my advice goes a little off of the beaten path: if you are a freshman or sophomore, even if you are not enrolled in the class, you can try self-studying for AP exams. I can already see you frowning and saying, no, this is not how it’s supposed to be. Why should I take a test when I didn’t even take the class? This frees up valuable time later in your high school career to take other AP classes, while showing that you are able to manage studying by yourself for some of these exams.

Note: I understand that various school districts have different policies regarding AP exams and courses. Depending on what your school allows you to take, I would advise you to take as many as possible if you can’t get to the recommendation of 5-7 exams on your own. In my experience, however, all you have to do is really ask and lobby the administration to allow you to take an AP exam. A lot of people discount the power of a simple, polite “ask and you shall receive” policy when it comes to school administrators. I’ll be trying to make a blog post about my experiences lobbying my own school to take these exams if anyone’s interested in that (let me know in the comments below). If you can’t take AP exams early, don’t freak out. You can definitely still get into a BS/MD program. I only had 3 exams when applying so it is definitely possible, this is just me speaking retrospectively and hoping I had taken more.

Finally, we come to standardized exams: in order to apply for BS/MD programs, you need to have a minimum score on the ACT or the SAT. As far as planning to take the exam, there are plenty of free resources that I could list, and since it is a work in progress, I want to limit the length of this article and save that discussion of preparation for another time. In terms of SAT Subject Tests, I definitely strongly recommend you to take at least Biology, Chemistry, and Math II. I would also recommend taking a humanities subject, whether that is a foreign language or history.

The standardized testing criteria differ from program to program (some are vague). From what I can surmise, though, try to get a 1500 or above on the SAT and a 32 or above on the ACT. From what I could find, here are some GPA and SAT/ACT requirements for the most selective of the BS/MD programs that I could gather from this complete list:

Name GPA Requirement SAT Requirement ACT Requirement SAT Subject Tests Required? See Link For More Requirements
The College of New Jersey/ Rutgers New Jersey Medical School 7 Year BS/MD Program Applicants must be in the top 5% of their class, and/or have an unweighted GPA of 4.5 or 95% depending on how the school evaluates achievement 1500 34 No; SAT II and AP tests are optional. Many of our accepted students have taken many of these examinations
Penn State BS/MD program A rank in the highest tenth of their high school class A total score of 1470 or higher on the new SAT (Math plus Evidence Based Reading and Writing), 1420 or higher on the old SAT (prior to March 2016 – Critical Reading and Math sections) 32 No
Boston University 7 Year BS/MD Program No No No Yes; Chemistry and Math II; recommended foreign language
University of Rochester BS/MD program 3.95 Perform exceptionally well on standardized tests (SAT, ACT, and SAT Subject Tests). Perform exceptionally well on standardized tests (SAT, ACT, and SAT Subject Tests). Perform exceptionally well on standardized tests (SAT, ACT, and SAT Subject Tests).
Brown University PLME None None None Yes; Two subject tests of choice (strongly recommend one test in Biology, Chemistry, or Physics)
Case Western Reserve University 7 Yr BS/MD None Admission to the Pre-Professional Scholars Program is highly competitive Admission to the Pre-Professional Scholars Program is highly competitive None
University of Pittsburgh 7 Year BS/MD program Highest grade point average available in their high school in the context of a curriculum showing the greatest academic rigor possible 1490 34 None
Rice/Baylor Program None None None No; Recommended but not required
Northwestern HPME No requirement; Due to the variation in GPA calculation among high schools, HPME does not have a minimum required GPA for applicants. It should be noted, however, that students admitted into the program are generally at or near the top of their class. Average admitted score is 1554 (based on admitted profile) , Required to take SAT (ACT is optional) Average admitted score is 35 composite SAT Subject Exams in Math Level 2 and Chemistry
Washington University in St. Louis Washington University’s medical program is selective, so students who become finalists for the University Scholars Program are highly accomplished in their academic and extracurricular undertakings.

Extracurriculars: What do you do outside of high school?

Imagine the bell just rang for the end of the school day. Where are you going to go? What are you going to do? How do you like to spend your time after school?

During the college application season, I was always confused how students achieved such an elite level of performance in the activities that they pursued, but also had time for other pursuits: they were able to do research in college labs, give TED talks, and intern with the UN and work on their passions. They were, as author Cal Newport writes, a “zen valedictorian.

A better question would be: why should you focus on anything outside of school? And more importantly for this article, how does that help me prepare for BS/MD program admissions?

As far as the first question goes, I’ve realized high school is an interesting laboratory to experiment with your passions and have more fun, learn more, and create something that they are proud of outside of the mundanity of school grades. In order to gain admission into a BS/MD program, extracurriculars have to be deep, meaningful, and innovative.

As I was going through high school, I made the very easy mistake of trying to do it all—I tried being a “well-rounded” student which meant that I was constantly being pulled in many different ways. Instead, try focusing on extracurriculars that are deep. For example, imagine a student named Charles. He knew that he wants to apply to a BS/MD program, and he had just entered his freshman year of high school. There are so many activities to explore! In order to get the deep involvement in an extracurricular, Charles needed to find something that he is passionate about, and pursue it to no end in high school, often to the exclusion of other activities.

This deep involvement in extracurriculars leads to impressive achievements given enough time and effort. How do you find these activities? Through focused exploration: it is all about finding interesting ideas (through joining communities, cultivating a reading habit, and reaching out to other successful students) and acting on them to become better at the chosen activities. Returning to Charles, in his freshman year, he was able to join a club which focuses on health professions (HOSA) and from this club, he got very interested in public health. In the first semester, he was trying all kinds of extracurricular activities with the express intent to see which ones actually interested him—but by February of his freshman year, he knew what he liked and didn’t.

Charles had only a few activities—he was on the soccer team and he was interested in public health and medicine. This meant that he had free time to figure out his interests. But now, after figuring out his interests, he had to create deep and meaningful social value.

For a BS/MD program, they look for volunteering experience, gaining experience through shadowing, finding research opportunities in his area of interest, and demonstrating leadership in those areas. As Charles’ freshman summer approached, he was interested in public health research so he started emailing local universities if any public health research opportunities were available. He sent an email to hundreds of public health professors, and a lab was able to take him in.

Based on these opportunities, he was able to volunteer at an undocumented immigrants clinic that his lab advisor ran. As he was doing this, he realized that the stories of these immigrants were inspiring, and due to his free time, he started writing these stories down and joined a community of immigrant writers. Being an immigrant himself, he was able to take his public health research interest and continue with it every summer, culminating in a service trip to other undocumented clinics to write and publish their stories in a book, to widespread acclaim.

He was able to use his one activity—public health research—to satisfy all the requirements that BS/MD programs look for in an extracurricular. He was able to gain volunteer and shadowing experience by helping out and shadowing his advisor in the clinic, contributing to original public health research in his summers, and demonstrating leadership by writing a book. This would not have been possible if he had been saddled with other, more extraneous activities that cut down on his decision fatigue.

Charles’s efforts also point to the last part of how extracurriculars impact admissions—they have to look innovative. Consider Peter’s story: he’s the same age as Charles, and participated in soccer and was interested in public health research. As a member of HOSA, he was also involved in the same club as Charles.

Except Peter took the trap of trying to “do it all.” He joined Model UN, debate, band, and other activities which kept him very busy. When Peter and Charles were applying to college, Peter’s summary would have looked something like this: “Peter was an excellent student—he was a varsity soccer starter, played in the marching band, and was involved in debate and Model UN where he won a smattering of awards. He is very interested in public health, and he is the president of his HOSA chapter.”

Compare that to Charles: “Charles is a public health researcher and an author who wrote a best-selling book about undocumented immigrant health, has published articles in peer-reviewed journals, and has presented at various conferences. In his free time, he was a varsity soccer starter, volunteered for an undocumented immigrant clinic, and was a member of his HOSA chapter.”


Which sounds more impressive to you, and which student would you admit into your BS/MD program if you were on the admissions committee?

BS/MD programs aren’t looking for well-rounded applicants, contrary to popular opinion, they’re looking for highly achieving individuals who are passionate about what they do, and remember that consistency matters. You shouldn’t do things that aren’t contributing to your personal interests and growth. Extracurriculars are made to develop your interests in a future health profession, and the notion that you should be involved in an activity that you dislike is something that is wholly antehical to that idea.

Letters of Recommendation: Why is it so weird to ask for them?

I always felt guilty about asking for LOR from teachers because it seemed like I was expressly telling them that I wanted a strong LOR to make sure that I got in, but I had to tiptoe around that fact just to get to it at the literal end of the email when I would say, “Okay, please help me get into this one school by writing glowing things about me. Thank you, see you.”

I put LOR in the extracurricular section rather than the final step of the process, Application Curation, because cultivating a relationship with your mentors is important every step of the way, and not just at the end of high school when you need them to help you with college applications. Certainly, you can do it then, but you just won’t get a good LOR and it will severely impact your chances at the program of your choice.

Stellar recommendations are easily achievable—they require the same kind of focused exploration that you use to choose your extracurricular activities. In each of the activities, you have an adult mentor—a lab advisor, a teacher who supervises the club, a coach, or a volunteer coordinator. These adults are looking for the same kind of deep and meaningful work that colleges are: are you passionate about what you do? What have you achieved as a member of the research lab? What have you done as a volunteer? These anecdotes are only built through time and experience, which is why consistency and under-scheduling (rather than the popular advice of over-scheduling) are important.

When it comes time to ask for a LOR, you should not feel guilty—in fact, asking advisors if they’re able to provide you a specifically strong LOR for a program is actually a very good idea. You can also take some time to prepare a brag sheet with some of your accomplishments and some of the things that you have done in the organization to help jog their memory as they are writing this LOR. Remember, it is in your best interest to make this as easy as it can be for them to wax poetic about the activities that you have undertaken during high school. Okay, maybe not waxing poetic but definitely writing about how you are one of the best students they’ve ever seen.

Application Curation: The Final Frontier Awaits

Finally. We come to the application. This is where you’re going to take all of the fundamental requirements, extracurriculars, and other intangibles and summarize it neatly into a few word-limited essays, send it off to colleges, and hope for the best. Right? Wrong.

I thought college application curation was a black box when I was applying as well. What is a FAFSA? You need to write the Common Application when? What is a supplemental? There are interviews? So…many…questions. So little time.

With a trusty laptop in hand and an Excel spreadsheet, I started logging in deadlines, documents that needed to be sent to different schools, and the essays of the different schools. For normal college applications, it’s usually only a few essays in the Common Application. BS/MD programs have more requirements, because you’re also technically applying to the medical school as well. Added applications means added essays, unfortunately.

I won’t bore you to death with organization, but make sure that you have an organization system handy. When I asked my friend—who’s now at the Penn State/SKMC 7-Year Medical Program—how she stayed organized, she said she used ToDoIst to keep track of which documents arrived where and when she was scheduled for different interviews as she was given them. Her ToDoIst had a calendar handy of what due dates she was missing and it emailed her a reminder saying when things were due. On the other hand, she and I both used a color-coded spreadsheet to see what programs I needed to apply to. These reminders are super important, you don’t want to miss a deadline that you worked hard for just because you forgot about it.

Doesn’t look too fancy, but it gets the job done.

Essays and Interviews: Two Halves of the Curation Process

Now that all of our logistics are covered, you should have a pretty good idea of what essays you need to complete, by when. Essays are very personal efforts, and they have been covered in so many blog posts that I’ll try to keep my advice short and sweet, based on what I’ve gleaned from successful BS/MD applicants.

Generally, no one cares about a story unless it makes them feel something. And if every applicant is trying to do the same thing, trying to be memorable, it comes off as hackneyed and painful to read. A direct medical program needs to know why you’re so interested in medicine, so the essay should be focused on experiences that you have cultivated in your extracurriculars which have pushed you in this, very specific direction. Having an English teacher or someone who has experience editing the written word are good candidates to help you polish the story and get that visceral emotional reaction from the admissions committee as well.


A short logistical note as well: as far as timing goes, don’t procrastinate. It’s important, so I’ll say it again: do not, do not, do not leave things until the last minute. Do what I say, not what I do. Procrastinating on your college essay is only worse off for you, as you’re going to have to deal with all of the repercussions that come with not having recommendations in hand early, having to scramble on crafting your story, and having editors only have one pass as opposed to a few drafts. If you want a horror story, I’ll give you one: I wasn’t able to apply to a program because I realized I hadn’t factored in the time for me to finish some of the essays, so I had to give up an application that I had worked hard for due to one essay not being complete at the deadline. Keeping that in mind, let’s talk about the other half of application curation which requires a healthy dose of preparation: interviews.

Each program does this a little differently, but generally you’re going to have an interview day with the medical school to make sure that you show maturity and poise as you are talking about why you want to become a physician. Through your killer extracurriculars, you’ve no doubt had tons of stories that you can regale your interviewer with. However, let’s talk specifics. There are certain questions that come up often in an interview that you should always be prepared for. The most important one is: why medicine? Other important ones include:

  • Why do you want to go to a direct medical program?
  • Why do you want to go to our program?
  • Tell me a little bit about yourself.
  • What was your most meaningful extracurricular experience in high school?
  • What was an interesting thing that you read recently?
  • What do you do for fun?
  • What are your 3 biggest strengths and weaknesses?
  • What could you contribute to our school?

Usually, they will have an interview day where all the candidates come in or a group of candidates comes in to interview with various members of the admissions committees. They may also have a student meet-and-greet, presentations about financial aid, and other interesting tid-bits for the parents while the students are interviewing. The format of the interview is a conversation or a discussion (if it is a group interview) about ideas in healthcare and how you fit into the school’s environment. It is also a candid observation of your goals in life and how you think they will be enhanced by attending a BS/MD program. My advice for this part is very cliche: try not to be nervous and just do your best. Get your pump-up playlist going, put in your headphones, and go in there and dazzle them. Cliches got that way because they have a certain truth to them, and a lot of people have resonated with their advice. My pump up song was “Lose Yourself,” so I’ll quote Slim Shady here: “You only get one shot, do not miss your chance to blow.”

Side note: Current Events in Health

It’s important to learn a little bit about what is going on in healthcare through books and print media. For example, before I went for my interviews, I had a reading list from which I gleaned some knowledge of the healthcare system. It’s important not to “flex” this information like you’re a know-it-all, because you’re probably going to embarrass yourself. I learned this (quite painfully) at my PSU/SKMC 7 Year Interview when I started debating my interviewer about the legality of the individual mandate of the ACA, not realizing that I was coming off as a pretty big douche. Lesson learned, very quickly, that I should not debate politics in college interviews. Ever. Especially when the person on the other side has an MD and a PhD in health policy and you’re a high school student.

Interview prep doesn’t have to be hard, and I’m actually thinking of writing an Interview Cheat Sheet which would help people go from zero to hero when it comes to talking about themselves, and learning about how to present themselves in the best light when it comes to these very regimented, often arcane formats for assessing a person’s worth to a school. Interviews can be a very fun conversation (an experience I had plenty of times), but they can also collapse into a dumpster fire of massive proportions (as I learned at Penn State).

Waiting for Decisions: Purgatory, on Earth

Pretty soon, you’ll be done with interviews and on your way to the final step of the process: getting the decision back. It’s agonizing to wait for acceptances or denials, especially as the process for BS/MD applicants stretches into February, when most people are done with their applications and are enjoying their second semester of senior year with a healthy dose of “senioritis.”

It feels like an endless purgatory to wait for college decisions, but if there is one thing that I have learned during this process is that I’ve been able to focus more on the journey that got me there (I’ve written a whole post about the journey, so I would say I’m pretty committed to the process). I think that during this time, the decisions slowly started to trickle in at the end of March and April, and soon I was going to senior prom and graduation. It comes faster than you would expect, so I would say hold tight and enjoy the journey.

Soon, you’ll be well on your way to becoming a physician!

Thanks for reading! If you’re interested in any part of what I had just mentioned, or feel like anything wasn’t explained as clearly, please do not hesitate to contact me through Instagram, Twitter, or by leaving a comment below.

Also, as a subtle (read: shameless) plug, check out the About page and other pages on this blog for a summary of the podcast that I run called Common Sense Medicine. I try to interview health professionals about their experiences and we talk about new advances and perspectives in medicine. I think it would be really helpful for high schoolers who are trying to cultivate the focused exploration that I was talking about in the article.

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