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Unlike those in public high school, students who aren't serious about medical school won't have earned the entrance grades. So at least in first year, most students will have a serious attitude. Are you suggesting that someone will bust their ass for four years, only to start slacking once in medical school? Or that medical school entrance grades don't require serious study?

I can see what you mean about the halfway point. Maybe undergrad came easily, and at the halfway point, the student realizes that medical school simply isn't a good fit, or it's more work than they thought it would be. So they drop out. This is probably a good thing, to prevent people becoming doctors who don't have the chops or the attitude for it. Unfortunately, the school does lose some money on a candidate they ought to have filtered out in the interview.

Happily it's an empirical question, and we can circle back in a few years to see if the drop out rate increased or not. Maybe the drop out rate increases at first, and then the entrance interview becomes more stringent.