I think he should go to the school he wants to be at, and major in whatever he loves best. If he finds the premed curriculum too cut throat competitive, he should finish his premeds after college at a state college near home. What is going to matter, in applying to medical school, is his MCAT and his GPA, not whether he did his premeds at said hypercompetitive Ivy.
It really bothers me that young people are choosing the place where they’re going to spend four years, and have the best opportunity in their lives to become broadly educated people, based upon which one is supposedly going to allow the easiest path to medical school.
It doesn’t matter! He can major in art history, and med schools will love him. As long as he has a credible back story, something like “I always loved medicine, but I also loved Art History, and thought that I would become a museum curator - but something changed and I decided to return to my interest in medicine”, he will get into medical school just fine with premeds done afterwards, cheaply, at your local state college.
Assuming one has taken the premed sciences, one does best on the MCATs by prepping intensively for them, over a couple of months before taking them. It’s not as if having taken a fantastic general chemistry class at an Ivy 3-4 years before one takes the MCAT is going to be better prep than taking general chem at state college the year before taking the MCAT. Either way, one is going to have to spend a lot of time studying for the MCAT.
So just have him choose the school he wants to go to, to get an education, to become a broadly well-educated person, without considering med school. If he can do well in the pre-meds at that school, too, wonderful. If he finds them ridiculously cut throat, he can stop doing premeds altogether, get an education in whatever he loves, take the premeds cheaply and easily at your local state college after he’s graduated, and still get into med school.