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Revised MCAT places broader expectations on students

The Medical College Admission Test is being redesigned to ensure that medical school applicants have a broad education that enables them to communicate well with patients, understand the many social and behavioral factors that affect health and ULTIMATEly become better doctors, says the Assn. of American Medical Colleges.

The goal is to expand what is expected of prospective physicians, with the hope of attracting a wider variety of medical school applicants, said AAMC President and CEO Darrell G. Kirch, MD.

"We're recognizing in this test that being a good doctor is not just about understanding science, but it is also about understanding people," he said.

Starting in 2015, the MCAT will include two new sections:

Knowledge of psychological, social and biological foundations of behavior.

Critical analysis and reasoning skills.

The writing portion will be eliminated, and the overall exam time will increase to about 6½ hours.

The current test takes about 4½ hours and has four sections: verbal reasoning, physical sciences, biological sciences and a writing sample. The changes, which have been in the works for three years, were approved by AAMC's board of directors on Feb. 16. They are the first changes to be made to the MCAT since 1991.

The new exam will better prepare students to be doctors in today's changing health care system, said Steven G. Gabbe, MD, who chaired the 22-member AAMC advisory committee that reviewed the MCAT. The committee worked to keep the strongest parts of the exam and update portions that no longer work. "We wanted to update the scientific foundation for what students need to succeed in medical school," he said.

The new exam will give medical schools more information about prospective students beyond their knowledge of the natural sciences, said Perry Pugno, MD, MPH, vice president for education for the American Academy of Family Physicians.

"It will give medical school admissions committees a richer view of applicants," he said. Starting in 2015, the MCAT will increase to 6.5 hours, from 4.5 hours.

The changes will particularly help schools identify people who are more inclined to go into primary care. Such students are more likely to have diverse interests and a strong sense of social consciousness, Dr. Pugno said.

By signaling that medicine is about more than understanding the natural sciences, hopes are that the revisions will encourage some people to consider a career in medicine who might not have otherwise, said Dr. Gabbe, CEO of Ohio State Wexner Medical Center.

Even so, Dr. Pugno said he regrets the loss of the writing sample. It's important for physicians to have strong writing and communication skills, and the writing sample was underutilized as a way to measure that in applicants, he said.

But many admissions officers complained that the section wasn't helpful, Dr. Kirch said.

The writing sample was added in 1991 after medical school deans complained about students' poor writing skills. Admissions officials at the University of Illinois College of Medicine at Chicago tried to use the section to gauge students' communications skills but found it overwhelming, said Jorge Girotti, PhD, the college's associate dean and director of admissions.

"You end up with mounds and mounds of paper that may or may not have any significance to your process," he said.

Eliminating the section and adding the social sciences will be helpful, Girotti said. UIC College of Medicine has required three semesters of behavioral or social sciences of its applicants for about seven years, but it hasn't been any easy transition. The latest changes to the MCAT will help validate those requirements.

"No one argues that students need a strong foundation in organic chemistry, physics or biology," Girotti said. "When it comes to the realm of the social behavioral sciences, the consensus is not so solid."

Overall, the MCAT changes are positive and show a lot of promise, but exactly how well the new exam will exhibit students' broader knowledge remains to be seen, said John Schriner, PhD, assistant dean of admissions and assistant professor of social medicine at Ohio University Heritage College of Osteopathic Medicine in Athens. He said he's glad to see the AAMC take a more holistic approach to the exam.

"It has the potential to be an enhanced tool for us," Schriner said. "A lot is undecided still."

The full and original article can be found at: http://www.ama-assn.org/amednews/2012/02/27/prsa0227.htm

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