I read this English-language thriller novel in 2017 or 2018 (publish date unknown) at a local library in the Western United States. It's been bugging me for a while. I remember a lot of details but I'm terrible at searching... long question incoming!
The main character (MC from now on) lives in a rural area, and their family doesn't have much money. MC wants to go to a prestigious medical school run/funded (I can't remember which) by a large drug-making company. The school has free tuition and its own entrance test.
MC studies very hard and then goes to take the entrance test, along with a friend who isn't very serious about medicine. The school requires prospective test-takers to stay for a night, ostensibly to equalize the environment under which the test is taken. While most of the questions are normal and MC can answer them, there are 2 or 3 that are strange. MC can't figure out the answers and inwardly remarks that this is odd - they studied so hard! MC cheats off a nearby test for one of the strange questions and leaves the rest blank.
Later on it is revealed that the strange questions are a test to see if the school's brainwashing equipment works. Some devices in the rooms where the test-takes slept send information into their heads while they sleep. During the night before the test, these devices give the answers to the strange questions. The devices don't work on all people, so the strange questions allow school administrators to see if the knowledge was properly received.
MC goes home to wait for results. They check the mailbox every day. Eventually, a notice comes that MC was put on the waitlist. MC is devastated, and is forced to seriously consider other options. (I don't remember the specifics of the other options, it may have been community college or a job or something else). MC's friend, however, gets in.
MC's friend realizes that they don't really want to go to the medical school. MC and friend devise a plan to get MC into school. MC strikes up a correspondence with the "front-desk" people. On the orientation day, or some other day where students must present themselves, MC's friend does not show up and MC hangs out in the office with the front-desk people. When it becomes clear that the friend won't show up, and therefore a spot is open, the front-desk people push hard for MC to get in. The leaders of the school debate over whether this is safe, as MC left 1 or 2 of the strange questions blank, (they only want brainwash-able students) but eventually allow MC in.
From here on I don't remember the order in which the plot progressed, so information will be scattered around. There are two classes that I remember with great detail.
In one, about bioethics, MC is disturbed when the teacher speaks of humans as disposable. The teacher talks about how sometimes you have to let people die, and that some people should be used for gruesome experiments in the name of the greater good. While the MC is horrified, and some of the other students initially agree, eventually (due to the brainwashing devices) the others start parroting the teacher's talking points.
In the other, the students learn about anatomy by dissecting a cadaver. The students are told to not try to learn about their cadavers, but eventually MC finds a tag of sorts with their cadaver's name. Later MC does research into the cadaver and discovers something shady relating to the insurance company. I think this may have been about unethical experiments, as argued for by the bioethics teacher.
(A more fuzzy detail) There may have been a tradition among the students of holding a 24/7 medicine/ethics discussion. People join or leave as they have time. This is where the brainwashing becomes most obvious.
MC also makes a new friend (NF from now on), who is affected by the devices. I think NF has a photographic memory and was disturbed that they couldn't remember where they learned the information from the devices. NF could normally recall the specific page. MC and NF investigate and find the devices, though they have no idea what they mean initially.
MC and NF at some point, during a break or weekend, go to a Trump casino and gamble. NF tries to teach MC some rudimentary card-counting, but MC is confused. NF instead sets up a hand signal that will tell MC when to switch from playing as normal to playing in a different way. I think the hand signal may have been connected to surfers. MC and NF win lots of money at the casino, which NF says isn't stealing because Trump/the "house" has a lot of money.
MC gets an internship/research assistant position with a kindly scientist (KS from now on) developing an anesthetic. The anesthetic is medically interesting because it has no known LD50 - that is, no known 50% lethal dose. I don't remember how MC helps KS.
The building that KS works in has a special room that people are told to stay away from. According to the company, they are helping some severe burn victims there, and any sort of interference would be damaging. The treatment involves skin grafts onto the burned areas. I think that KS's anesthetic was being used, but I am not sure.
Approaching the end, I am more sure of the order of events.
MC and NF do some more research. NF discovers something big (maybe with MC, maybe not) so the school whisks NF away. The official story being that they died from a car accident. (Believable to most students, as NF was quite reckless)
Now NF is taken to the special room. When they wake up, they discovered that they have been purposefully burned. They are also paralyzed with medicines that drain their energy and make it impossible to move. Someone tells NF that they will be more severely burned once the treatment's effectiveness can be evaluated for the current one. NF's large amount of healthy skin is noted as useful for the experiments.
MC is devastated at losing their friend. When going to KS's lab/office, they pass the special room and see a new patient (NF, though MC does not know) all wrapped up in gauze. The first time MC looks they are hurried away, but eventually MC is in front of the window long enough for NF to signal. NF makes the hand gesture set up for gambling, and this allows MC to realize that the new patient is NF.
From NF's perspective, they saw MC in front of the window but couldn't do anything. NF grows depressed trapped in their head. Another one of the "patients" in the special room is another former student who supposedly had died. The other student has very little skin left and has gone insane from being, frankly, tortured for years. NF realizes that they don't want to go like that. They start keeping sane by moving/exercising the little that they can, waiting until the latest dose of paralyzing-medication is wearing off. NF is able to signal because there was some mix-up or delay that led to their paralyzing-medication dose being late.
MC may have tried to contact their other friend (the one who gave up going to the school) at this point, but I am not sure.
The school/company at some point realizes that MC knows as well. MC frees NF (I'm pretty sure, though MC may have just tried.) There is sneaking around and KS gets alerted somehow. In the lobby of KS's building, there is the Big Confrontation. This confrontation at least involves MC and some company representatives, and I believe that the police may come in and save the day. MC's other friend is perhaps involved, though I can not remember very well if so.
I am unsure if the unethical experiments were revealed to the public, or what became of the company. I also can't remember what happened to MC or NF. The only part of the conclusion that I remember involves KS. KS is found dead by suicide, with a note along the lines of "If this works out, then that will prove the anesthetic has an LD50 after all". KS couldn't bear the knowledge of what the company they worked for had done.
A key part of the unethical experiments was unethical gathering of patients. I don't remember how exactly this was unethical, nor when/how the characters learn of it.
The book was fairly thick. (Which should be evident, given that I've forgotten some of the plot and still managed to fill 8k characters) I think the cover was fairly simple but I am bad at remembering covers. I do not remember any names, genders, etc. for the characters. Hopefully the above is enough to identify this book - it was a wonderful thriller and I'd love to read it again.