BS/MD rejections? How Early Assurance Programs Can Save Your Premed Timeline

We've covered BS/MD programs extensively in this newsletter. What they are, how to get in, how to decide between them, and why they should be Plan A if you're a high-achieving premed. (Learn more about the Plan A-E system here).

But let's be real. A 1–4% acceptance rate means the overwhelming majority of applicants — even strong ones — don't get in. Geography, finances, a blemish on an otherwise strong application, or just an unlucky interview day: any of these can close that door.

So what do you do if Plan A doesn't pan out?

Let’s talk about it!

If you've gone through the Fast Track Intensive course, you already know the answer. The A-E methodology is built as a layered system with safety nets for acceleration. And Plan B in that system is Early Assurance Programs, or EAPs.

Early Assurance Programs (EAPs) allow college students to secure a guaranteed medical school seat from their freshman or sophomore undergraduate year — no traditional application cycle, no MCAT in many cases, and no gap year roulette. These programs are designed for high achieving premed students, like you.

I love these programs because I think of them as a “second chance” at BS/MD. My own 7-year BA/MD pathway was essentially an accelerated EAP. I secured my medical school seat in sophomore year of undergrad.

And I am still amazed at how many students have never even heard of them.

What is an Early Assurance Program?

At its core, an EAP is a guaranteed (or near-guaranteed) entry point into medical school that you secure from college. Most students apply at the end of sophomore year, but some open applications to freshmen. (Which is why I always emphasize about learning how to Fast Track early so you don’t miss deadlines you didn’t know about!)

If accepted, your seat is reserved. No MCAT in many cases. No gap year risk.

There are two main types:

Accelerated EAPs compress the total timeline to under 8 years. You apply from college and finish medical school faster than the traditional path — similar to a BS/MD, but entered from undergrad rather than high school.

Standard EAPs (4+4) keep the full timeline but eliminate the competition. You still do four years of undergrad and four years of medical school — but your seat is secured before traditional applicants even open AMCAS.

The 4+4 EAP often gets underestimated. Even though the timeline doesn't change, the level of certainty does. Even if you have to take the MCAT or keep up a minimum GPA, you’re still trading years of weed-out courses, research and extracurricular pressure, secondary applications, and the very real possibility of a gap year. So even non-accelerated EAPs are a huge win.

What you need to know before you apply

1. Most EAPs are school-specific.

The majority are only open to students at that specific undergraduate institution. This is exactly why I talk about choosing an undergraduate carefully, focusing on substance over prestige. A less recognizable school with an EAP attached to a medical school gives you a structured, lower-risk route to medicine. A prestigious name with no EAP gives you a name but no opportunity to enter early or accelerate. Think carefully about that trade-off.

2. A few programs are open to students from any college.

Mount Sinai FlexMed — The most open EAP in the country. College sophomores from any accredited US or Canadian institution can apply, any major. MCAT is waived after acceptance. Requires SAT/ACT (strong preference for 1400+ SAT), one year of college biology or chemistry, and meaningful clinical experience. US citizen or permanent resident only. About 800–1,000 students apply for roughly 50 seats. Competitive — but open to everyone.

University of Toledo MedStart — Open to juniors at any accredited US college or university. Apply at the start of your junior year and secure your seat at Toledo's College of Medicine and Life Sciences before senior year. No MCAT required for acceptance. Recommended 3.7+ GPA and 1350+ SAT or 30+ ACT. About 12–16 students accepted from 100–160+ applicants annually. Competitive, but the door is genuinely open regardless of where you go to school.

Zucker School of Medicine College Pipeline Program (SOM-CPP) — Open to college freshmen from any institution who are US citizens from economically disadvantaged backgrounds. Students are considered for direct matriculation to the Zucker School of Medicine at Hofstra/Northwell. No application fee and accepted students receive a $500 annual stipend. Requires 3.2 GPA and 1200+ SAT or 25+ ACT.

3. Your SAT score still matters.

This is one of the most important reasons to be running all plans simultaneously from day one. You cannot wait for Plan A to fail before preparing for Plan B. If you've been building toward a competitive BS/MD application (strong SAT, strong GPA, real clinical experience) that foundation directly feeds EAP eligibility. The work overlaps, which is the point of the Fast Track system.

4. Your freshman year performance matters a lot.

Most EAP applications are submitted at the end of sophomore year, which means admissions committees are largely evaluating your freshman record. The mentality mirrors BS/MD applications in one critical way: you're asking to secure a seat in medical school before you've finished undergrad. They want to see that your early academic performance gives them reason to trust you'll follow through. Clinical experience counts here too, just as it does for BS/MD.

5. Some programs have very specific eligibility angles worth knowing.

University of Maryland BS/MD (Engineering, CS, and Math) — UMD College Park students majoring in engineering, computer science, or mathematics apply after completing their first year. Upon successful completion, students proceed directly to the University of Maryland School of Medicine. Application deadline is June 1 following freshman year of undergrad.

Texas A&M E2EnMed Early Assurance — For Texas A&M sophomore engineering students. A genuinely distinctive track that trains physician-engineers. No MCAT required, Texas residents preferred. If this is your profile, there is no comparable program in the country.

Joint Admission Medical Program (JAMP) — This one deserves its own category. JAMP guarantees admission to one of 14 participating Texas medical schools for economically disadvantaged Texas residents who meet all program requirements. Students apply in their freshman year at one of 68 participating Texas undergraduate institutions, must qualify as a economically disadvantaged. MCAT is required but prep is provided. Students receive undergraduate and medical school scholarships, two paid summer internships at Texas medical schools, and monthly mentorship.

6. Not all EAPs are accelerated, but they’re still a win.

A 4+4 EAP doesn't compress your timeline, but it removes anxiety, risk, and the marathon of traditional applications. It also removes one of the biggest threats to the medical timeline: the gap year. For many students, the value is in the certainty which is worth a lot when the alternative is two or three years of high-stakes uncertainty.

As I always say: You cannot leverage pathways you don't know exist.

This is why the Fast Track Intensive covers EAPs as one of the core pillars of the acceleration system. If you know about these programs early enough, you can select an undergraduate institution that gives you access to one, build the freshman year profile that makes you competitive, and enter sophomore year with a real plan in place.

Most students find out about EAPs too late to act on them.

Fast Trackers to MD Timeline (May):

9th-10th Grade: Summer planning starts now. You need to know what your Fast Track plan is. If you don’t have one yet, start here.

11th Grade: You're entering the primary application window for BS/MD/DO. Start researching and building your program list now and know which programs offer guaranteed seats vs. guaranteed interviews. Also look at which programs near you offer second-chance early assurance programs, because remember: BS/MD acceptance rates are 1-4%. That's harder than any Ivy. Make sure you have a backup plan, like I teach here.

12th Grade: You are likely committed by now. Congratulations! Even if BS/MD didn’t pan out for you, you’re still on the Fast Track if you want to be. Key tips for you are to check the course catalog at your institution to ensure the courses you AP out of still qualify to replace key premed courses. APing out is a strategy you have to do with care. If you AP out of a science course, you have to take an upper level course in that same department. You also might still have to take a corresponding lab course. (You should also be researching if your institution has an EAP). If you need more help: find my course.

College freshmen: EAPs and accelerated options are still available to you. So is the option for early graduation and 3 year med schools. If your school has an EAP, this is your application window. If it doesn't, FlexMed and Toledo MedStart are your best open-access options. If you're trying to compress your timeline through a 3-year undergrad curriculum, make sure you're on track to finish organic chemistry and biochemistry before the spring of sophomore year so you can take the MCAT sophomore spring.

College sophomores and juniors: If your school has an EAP, this is your application window. If it doesn't, FlexMed and Toledo MedStart are your best open-access options. It’s not over! You can still accelerate. Look into 3 year medical schools.

PS. If you are currently applying to medical school, AMCAS is OPEN and the personal statement is likely staring you down right now. I have opened a limited number of personal statement review spots. If you want a perspective from a surgeon and medical educator with committee experience, reply directly to this email for more information.

-Dr. Samarrai

Fast Track to MD

If this resonated, don’t let it be a one time insight.

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BS/MD programs are one way to accelerate your premed journey, but they are not the only way. I got my MD at 23 and now I teach students how to leverage systems and pathways to help them accelerate.

Find my full course here where we discuss strategies to implement accelerated medical pathways including BS/MD, EAPs, 3-year undergrad curriculums, international acceleration, and 3-year medical schools.

Let’s get you on the Fast Track to MD!