Many future, or current premeds have probably heard about the new MCAT in 2015 by now. If you haven’t, and you’re curious, here’s a link to the PDF document the American Association of Medical Colleges, or AAMC for short, released on the new MCAT. While this new MCAT is an indication that the medical community is responding to the importance of character – something I have mentioned before - it’s not going about it correctly. Before we begin though, let’s first talk about the old MCAT, what’s new on the “MCAT 2015″, and then go from there.
The current MCAT, based on the model the AAMC created in 1991, covers three major subject areas: physical sciences, biological sciences, and verbal reasoning. It is primarily a measure of knowledge mastery and analytical thinking in the sciences and verbal sections, respectively. The test assesses this mastery through the use of multiple choice questions, and, as such, there is only one right answer to any given question.
The new MCAT tests psychology, sociology, behavior, and ethics on top of the already broad subject areas of the old MCAT. These additional social sciences are meant to diagnose the students’ sensitivity to the more human side of medicine, where behavior, and the biological cause behind it, becomes open to interpretation. Test takers, however, will still answer these new questions with the same choices of A, B, C, or D as before.
This multiple choice methodology is exactly why the MCAT 2015 is the wrong step in the right direction.
The AAMC started the process of updating the MCAT due to a growing body of evidence that suggested an awareness of the cultural and socio-political factors around health care made for better physicians. By using a clear cut metric on these kinds of issues, the MCAT has applied a scientific reductionism to an altogether subjective human experience, rendering the methodology they use to find this empathetic awareness useless. The new MCAT utilizes the fields of psychology and sociology with a scientific tilt, using the disciplines to find a biochemical basis for behavior. Whether such knowledge correlates positively with personality characteristics the new MCAT is looking for seems unsubstantiated, at best. Knowledge of the bio-molecular pathway of depression makes for a better diagnostician, not a better physician in general.
Furthermore, including social sciences and humanities into the knowledge content required for the exam defeats the entire point of testing humanities. Rather, these new content areas will just become “boxes to check” instead of topics to delve into, as humanities are designed to be. Test prep companies, which are popular options with MCAT test takers, will start producing flash cards on ethics and social sciences. Inevitably, students will adopt the viewpoints that the AAMC has deemed acceptable through a textbook instead of finding their own set of values in the real world. Will this basically stymy the growth of mature individuals, who medical schools look for, and allow the proliferation of artificial values? Will we start producing physicians who all react the same way to any given dilemma? If all premedical students knew to behave a certain way because the AAMC told them to, the medical admissions interview, created to assess candidates’ characters, becomes pointless. Ethical homogeneity is the end result of the new MCAT 2015. Science is a field that prides itself on diversity, so why in the world has the AAMC made the human experience standardized? It seems to me that the AAMC missed the point.
A better way of assessing the characteristics medical schools want would be a subjective appraisal. Instead of doing away with the essay section, modify it into a mini-treatise on ethics. Present the student with an ethical dilemma or an ethically charged topic and watch their character unfurl as they write about how and why they would react. Have multiple judges review it on a subjective rubric and then assign a grade. That way a subjective topic is measured through a subjective lens and not an objective computer. Perhaps this would be a better way to find the personality medical schools are looking for.
Granted, if the AAMC feels that knowledge of the scientific and measurable basis of behavior, something that is already taught in medical school, is requisite knowledge for premedical students, then I suppose it can be included on the test. Personally, I feel that requiring premedical students to know content already taught in medical schools is redundant and unnecessary. At what point does the AAMC draw the line in terms of knowledge mastery? Will our future premedical students be required to learn half the medical school curriculum before matriculation? By including more scientific content on the exam, the AAMC has increased the curricular toll on future non-science majors by forcing them to fit yet more science courses into their four year humanities course load. With medical schools seeking to diversify their student populations with non-science majors, the new MCAT could potentially resemble a scientific literacy test for humanities majors, making medical school matriculation a disproportionately difficult feat.
Once the new MCAT comes out in 2015, we’ll know for sure how the medical community reacts. Until then, we can twiddle our thumbs and theorize all we want; no one knows the right answer just yet, whether it be A, B, C or D.