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Delian Asparouhov arrived in the United States at age 3, emigrating with his parents not long after the fall of Bulgaria's communist government.

"Everyone who was ambitious basically wanted to go to the States to do a Ph.D.," said his father, Tihomir Asparouhov, who earned a doctorate in mathematics from the California Institute of Technology. The family later moved to Salt Lake City, where Delian's mother, Elena Asparouhova, became an associate professor of finance at the University of Utah.

Their son racked up honors in math, science and robotics at West High School and, at age 14, wrote software that "revolutionized" statistical modeling at the company where his father works.

"Since he was a young kid, we've kind of groomed him to pursue as much [education] as he can," his father said.

But this summer, at 19, Delian Asparouhov dropped out of the Massachusetts Institute of Technology to launch an innovative health care app called Nightingale.

It's an American dream story with a twist — one that raises questions about the state of higher education.

Delian Asparouhov is one of a handful of young entrepreneurs chosen for a fellowship funded by Peter Thiel, a billionaire PayPal co-founder and early Facebook investor. Now in its third round, the program gives $100,000 to about 20 students under age 20 a year to drop out of college and develop an idea.

Three entry-level computer science courses short of a degree, Delian Asparouhov felt he wouldn't be "learning anything new" at MIT. "I want to be learning where I am. It didn't make tons of sense for me."

Going to college is "not like it used to be," said Danielle Strachman, program director of the Thiel Fellowship. "Now young people coming out have an average of $35,000 of debt, if not a lot more."

That pressure means fewer 20-somethings can take risks, start businesses and try out new ideas, she said, even as the promise of a college diploma leading to a secure job can seem ever-further out of reach.

The new Nightingale • Delian Asparouhov's concept took a vast issue — "changing how people think about health and medicine and the health care industry," as Strachman put it — and created a manageable solution.

"One of the biggest things we look for is someone who can hold a big mission but can really bring that big mission down to the ground," she said.

Delian Asparouhov's app uses accelerometer and other data from a patient's mobile phone to create personalized medication reminders around his or her daily routines rather than simply times of day.

It adjusts as routines change, like if a patient eats lunch a little late. "You can't create a one-size-fits-all solution and expect that to work for every single patient," Delian Asparouhov said.

The patient taps a button to confirm taking medication.

The app also allows caregivers to check whether patients are keeping up, such as a daughter who wants to remind her father to take his heart pills.

Delian Asparouhov and fellow MIT student Eric Bakan released the app last week. It's free for patients but they will eventually sell the caregiver version. He's hoping that with the help of fellowship advisors, the company will be off the ground when the fellowship ends after two years.

He doesn't rule out completing his degree (after finishing an email security pamphlet as punishment for sending a prank campus-wide email that appeared to be from MIT's president), but he's not planning on it — a decision was that not universally popular.

"I didn't take it well at all," said his mother, Elena Asparouhova. When her son announced he wasn't going back to MIT even before he got the fellowship, she wrote him a long letter, "calling, calling on the responsibilities," and arguing a diploma is an essential fallback for a first-generation immigrant.

When he didn't change his mind, though, she backed her son's choice.

The lack of a college degree, after all, didn't exactly hold back Steve Jobs or Mark Zuckerberg, and one Thiel alum, Dylan Field, has already raised nearly $4 million for his browser-based photo-editing program.

"In my generation, everyone says you should go back," she said. But now, "it is sexy to be a dropout."

Playing the 'student card' • Still, the road to tech riches is paved with the corpses of failed startups. Dropping out to pursue a dream is like "buying a lottery ticket — that's how good your odds are," Vivek Wadhwa, who teaches and advises startup companies at Stanford Law School, recently told the Associated Press.

"More likely than not, you will become unemployed. For every success, there are 100,000 failures."

And a traditional higher education has plenty to offer young entrepreneurs, said 22-year-old Andrew Pagels, a University of Utah student who has started a business, 3PDx, with his brother. They're creating a chip and an accompanying app that can run diagnostic tests, including those for HIV and the staph infection MRSA, from a smartphone.

They hope to begin selling the device in Europe next year. The brothers paid for college with scholarships, and have been able to secure about $40,000 in seed money though student business competitions.

While going to school and starting a company over the last year was a grind, Pagels said there's an advantage to what he calls "having a 'student card.'"

"Being a student is maybe one of most powerful positions to start a company from," he said. Business owners "have been incredibly willing to help us, and I think it's because we're students."

Most entrepreneurs start companies after working for 10 or 15 years, said Troy D'Ambrosio, director of the Pierre Lassonde Entrepreneur Center at the U.

"The [formal education] process you go through helps build critical thinking," he said.

Delian Asparouhov, now living in a "hacker house" in Mountain View, Calif., agrees his path isn't for everyone.

"I would not say people should be dropping out of school to work on whatever whim goes their way," he said. Not every student, after all, kicks out software as a teenager or develops startups in a dorm room.

But even students who haven't decided on a major or have no interest in writing a business plan could take something away from the underlying philosophy, Strachman said. She'd like to see college turned upside down, with a student's first two years spent trying out careers in a real-world environment. A gap year spent traveling, volunteering or working could also be useful, she said.

"We just want people to really think about those things," she said. "People just making conscious decisions is really important to us."

Twitter: @lwhitehurst