<p>$50,000 / year is not a TUITION but the whole cost, which is most likely higher than this figure and can be afforded only by very, very rich or very poor who get financial aid. Some BS/MD candidates will make it to Ivy, most will not, while if they make it into BS/MD program they will be part of a very elite group in Honors Programs with tiny classes (sometime, less then 10 people) and exclusive attention of faculty and special guidenance that you cannot possibly get at any big name school. In addition, from day 1 in undergrad. school they will be making invaluable connections into very exclusive network of their future medical school. Not to mention, that if they choose to apply in-state, they ususally end up with almost 100% tuition scholarships or even full rides and medical school portion is also much cheaper than out-of-state. There are people who would give it all up for big name that they will mention for the rest of their life, but we are in free country, everybody is entitled to pursue their goal. From this perspective nothing is better / worse, it just should be a comfortable match.</p>