The AAMC last month approved changes to the Medical College Admission Test® (MCAT®) that will require aspiring doctors to have an understanding of the social and behavioral sciences, in addition to a solid background in the natural sciences.
The changes, scheduled to go into effect in 2015, are the first to the MCAT exam since 1991, and are designed to help students prepare for medical practice in a changing health care system.
“We all know America is becoming much more diverse, and we have an aging population unlike anything we’ve seen in this country,” said AAMC President and CEO Darrell G. Kirch, M.D. “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.”
Those future physicians, Kirch said, will need to know about people and the behavioral and socio-cultural determinants of health. In addition to a shifting population and health care system, Kirch pointed to AAMC opinion research that found the public believes physicians have a strong medical background but lack bedside manner.
“In our view, bedside manner is a complex mix of understanding people, where they come from, how they think, and why they behave the way they do,” Kirch said. “We think this shift in emphasis will help us round out that dimension of a good doctor.”
The new MCAT exam, which was developed by a 21-member advisory panel known as the MR5 Advisory Committee, will balance testing in the natural sciences with testing in the behavioral and social sciences and in critical analysis and reasoning.
“Our goal was to preserve what works in the exam, eliminate what was not beneficial, and augment the exam with some new approaches that fit with what we’re looking for in physicians of the future,” said Ronald D. Franks, M.D., vice president of health sciences at the University of South Alabama College of Medicine and vice chair of the MR5 committee. “I think students will come into medical school better prepared for what the expectations will be in the future.”
The revised MCAT exam will include a new section, “Psychological, Social, and Biological Foundations of Behavior,” that will test students’ understanding of how these disciplines influence behavior and behavior change; cultural and social differences that affect well-being; and the relationship among socioeconomic status, access to resources, and well-being. This new section recognizes recent findings—highlighted in the AAMC report “Behavioral and Social Science Foundations for Future Physicians”—that integrating social and behavioral sciences into medical education can improve health care.
“We’ve proven that social and behavioral factors are strong determinants of the health of an individual,” Kirch said. “This part of the exam will test concepts from these disciplines to explore how they influence a person’s perceptions, reactions to the world, their behaviors, what they think about themselves and other people.”
A second new section, “Critical Analysis and Reasoning Skills,” will test students’ reasoning ability by asking them to analyze and evaluate passages from social science and humanities disciplines, including ethics and philosophy, cross-cultural studies, and population health. This section will not require specific subject matter knowledge, but by focusing on these disciplines, it will encourage students to read broadly in preparation for medical school.
“Students need to read widely and be socially aware,” said Steven G. Gabbe, M.D., senior vice president for health sciences at the Ohio State University Medical Center and MR5 committee chair. “If they are reading newspapers and magazines and listening to issues that are discussed about health reform and political debates that will be ongoing, they should do very well.”
Kirch noted that in creating the new exam, the MR5 committee reviewed more than 2,700 informational and opinion surveys from faculty, medical students, and residents about what content they considered most important to success in medical school. Based on that feedback, the committee revamped the two natural sciences sections, asking test takers to combine their knowledge of natural science concepts with scientific inquiry and reasoning skills to solve problems that demonstrate their preparation for medical school. These new sections build on the 2009 AAMC-HHMI report “Scientific Foundations for Future Physicians” and will cover concepts that are taught in introductory courses in biology, chemistry, biochemistry, and physics.
In addition, the new MCAT exam will eliminate the current writing section. With all the revisions, testing time for the new exam will be about six and a half hours, compared to four and a half hours for the current exam.
The revised MCAT is part of a broader effort by the AAMC and medical schools to rethink the medical school admissions process by considering not only students’ MCAT exam scores and academic records, but also interviews with admissions committees, letters of recommendation, community service, and personal experiences.
“We saw this as a very important responsibility, far beyond creating a new exam, but really creating an exam that was part of a process that led to a holistic approach to admissions,” Gabbe said. “While the MCAT is certainly an important part of the assessment of applicants, it’s not the only way to assess an applicant.”
The MR5 committee that developed the new exam was appointed by the AAMC in 2008 to review the current version of the MCAT exam. The committee consists of medical school deans, admissions officers, academic and student affairs professionals, pre-health advisers, undergraduate faculty, and a medical student and resident. This is the fifth revision of the MCAT exam in its 84-year history. After the scheduled 2015 launch, the new MCAT exam likely will be in place until 2030.