Well, medical education in Europe is generally 5½-6 years, based on the fact that applicants come straight from high school. The 4 yr program is not found anywhere in Europe or other parts of the world, it's only in the US meant for American students who have already done their "pre-med" at some college/uni somewhere. Now, if an American high schooler wants to apply for the 6 yr program then hey go for it. But that's the fundamental difference in a nutshell. But hey I'm sure some American college graduates choose the 6 yr program for various reasons, like lack of knowledge, like whoops already pointed out. It may also be a good choice for
non-traditional students who have already majored in something like economics or what ever. Right?