April 4, 2013 | Posted By John Kaplan, PhD

It is now just about a year since the American Association of Medical Colleges (AAMC) announced major changes to the Medical College Admission Test (MCAT). These changes will go into effect in about two years from now. This is a very big deal. These are the first changes since 1991. During 2011 86,181 people took the MCAT. This event was extremely important to all of these people. These are the people who wish to go to medical school. The results of the MCAT will be an extremely important determinant of who is admitted to medical school. The number of people who took the exam is approximately five times the number of people who will actually be admitted to and enter an American allopathic medical school for studies leading to the coveted Doctor of Medicine (M.D.). Those on this path have been planning and preparing for the MCAT for years. A change in the test will lead to corresponding changes in the path.

According to AAMC President and CEO Darrell G. Kirch, M.D. “We all know America is becoming much more diverse, and we have an aging population unlike anything we’ve seen in this country. These changes to the exam have been done with a very clear eye toward the changes that are occurring in health care and the kinds of physicians we will need.”

The changes that are being implemented are increased assessment of critical analysis and reasoning as well as greater emphasis on testing knowledge of the behavioral and social sciences.  These are extremely important. I fully support the value of these skills and knowledge for both physicians and aspiring physicians. This support is based both on decades of experience with medical school admissions and similarly long experience teaching medical students the subjects at the cusp of natural and social sciences and the humanities. And yet I am not sure how I feel about these changes.

The reason I question these revisions is two-fold. These qualities have long been viewed as important components of the admissions process. However different methods have been utilized to determine student’s aptitude and development in these areas. These have been assessed by a more subjective evaluation of applicant’s selection of and success in certain courses, their participation in nonacademic activities including human service and by engaging the applicant in personal interviews. I do not have full confidence in the capacity for multiple-choice questions to replace these. And they will likely replace them. Medical admissions processes are time consuming and expensive and such scores will be used to make those processes “more efficient”. Moreover the more areas that are included in the MCATs the more every student will choose (be driven) to take the same preparatory courses during college and there will be less correspondingly less time for students to pursue their own interests and personal development. The diversity of education and experiences of aspiring medical students is an asset and this will be placed at risk by this broadening of the MCAT. Just my opinion.

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1 comments | Topics: Medical Education


sheila otto

sheila otto wrote on 04/04/13 3:04 PM

Critical analysis and reasoning and behavioral and social science....it would seem the former would lend itself to testing while the latter would be challenging. The problem with the interview process is, in my opinion, the interviewer. An astute applicant can "size up" what the interviewer is looking for and answer accordingly, regardless of that being a reflection of the prospective student's perspective. Although I am a long standing critic of the interview process, unfortunately, I have not been able to come up with a better alternative. It would be interesting to see some of the MCAT questions.

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