Journal Club: May 2013

by Cynthia A. Searcy, Ph.D., director MCAT research, and Dana M. Dunleavy, Ph.D., manager, Admissions Research, Association of American Medical Colleges, Washington, DC

Overview of all changes to the MCAT

The Medical College Admission Test (MCAT) was introduced in 1928 as a way of assessing applicants’ readiness for medical school. The MCAT exam has undergone a major substantive review five times since 1928. Over the years, the exam has had a steady emphasis on natural sciences concepts and skills and verbal reasoning. However, the inclusion of other areas, such as quantitative reasoning, social sciences, and humanities, has varied.

Each version of the MCAT exam reflected the prevailing beliefs and evidence about the knowledge and skills important for success in medical school at that time. For example, the 1928 version responded to the Flexner Report’s call for foundational knowledge of chemistry, biology, and physics as a prerequisite to medical school; the 1962 version responded to the recognition that problem solving skills are required throughout medical school by emphasizing problem solving rather than memorization questions; and the 1991 version responded to calls for medical students to have strong communication skills with the addition of the Writing Sample.

Overview of recent changes to the newest MCAT

The sixth version of the MCAT will be introduced in 2015.  As described in the Commentary and Last Page, changes to the new exam preserved what worked, eliminated what didn’t, and enriched the exam by giving attention to concepts that future physicians are likely to need. The 2015 version of the MCAT exam will:

  • Continue to measure important concepts from the natural sciences and enrich those sections adding concepts in biochemistry;
  • Provide information about examinees’ knowledge of important concepts from the behavioral and social sciences;
  • Increase emphasis on scientific reasoning, reasoning about data, and the design and execution of research in all three science sections;
  • Shift to measuring knowledge and problem-solving related to natural, behavioral, and social sciences presented in an interdisciplinary way; and
  • Enrich testing of critical analysis and reasoning skills in ways that reflect current thinking in cognitive sciences and focuses on topics from the fields of ethics, philosophy, cultural studies, and population health;

As described in the Commentary, the changes in the 2015 version of the MCAT exam “reflect changes in medical education, medical science, healthcare delivery, and the needs of populations served by graduates of U.S. and Canadian medical schools.”  The inclusion of biochemistry in the natural sciences sections and the addition of the a new section on the behavioral and social sciences responded to calls from the medical education community about the growing need for entering medical students and to have foundational knowledge of biochemistry and the need for future physicians to possess competencies in the behavioral and social sciences so that they are able to learn about the socio-cultural determinants of health during medical school. The shifts toward an interdisciplinary approach and the measurement of scientific inquiry, research, and statistics concepts and skills are in response to calls for medical students and physicians to be able to integrate knowledge across disciplines and stay current with rapid changes in science, scientific research, and technology. Decisions about what to maintain, update, and replace required balancing trade-offs between content coverage and test length, as well as the number of undergraduate courses that could reasonably be taken (and be made available) to medical school aspirants.

Questions:

  1. What are the implications of the new MCAT with respect to medical school curriculum?
  2. How often should a new version of the MCAT exam be introduced?
  3. What tradeoffs are important to consider when deciding what to test on the MCAT exam?
  4. Thinking about where medicine is headed in the next 15 years, what new concepts and skills will be important for the seventh version of the MCAT exam?

Further reading:

Albanese MAS, Mikel H, Skochelak SE, Huggett, KN, Farrell, PM. Assessing personal qualities in medical school admissions. Acad Med. 2003;78(3):313-321.

Carey SJ, ed. Essential Learning Outcomees, the New MCAT, and Curricular Change. Peer Review 2013; 14(4, theme issue):3-31.

Cooke, M Irby, DM Sullivan, W Ludmerer, KM. American Medical Education 100 Years after the Flexner Report. N Engl J Med. 2006; 355:1339-1344.

Julian E. Validity of the Medical College Admission Test for predicting medical school performance. Acad Med. 2005;80(10);910-917.

Kaplan, RM Satterfield, JM Kington, RS. Building a Better Physician—The Case for the New MCAT. N Engl J Med. 2012l 366:1265-1268.

McGaghie, WC. Assessing readiness for medical education: Evolution of the Medical College Admission Test. JAMA. 2002; 288: 1085-1090.

Ed. Note: See our MCAT collection for the complete list of Academic Medicine‘s May 2013 articles on the MCAT exam,.

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