Medical School Admission Test

What is the MCAT?

The Medical School Admissions Test (MCAT) serves as the entry screening assessment for most U.S. medical schools. Developed by the Association of American Medical Colleges (AAMC) and administered to over 55,000 students annually, the 6-hour exam consists of 221 multiple-choice items and two essays. Divided among four sections, scores on Biological Sciences, Physical Sciences, and Verbal Reasoning are each reported on a scale from 1 (lowest) to 15 (highest). The Writing Sample receives a score of 1 to 6, converted to an alphabetical scale ranging from J (lowest) to T (highest).

The MCAT does a poor job of predicting success in medical

According to the AAMC, the MCAT is designed to “assess mastery of basic concepts in biology, chemistry, and physics; facility with scientific problem solving and critical thinking; and writing skills.” According to several independent researchers however, the skills the MCAT tests relate most closely to the first two years of medical school classroom work but have little relevance in predicting success during clinical training or actual practice as a physician. William McGaghie writes in the journal Academic Medicine: “No physician answers pages of multiple-choice questions when he or she practices clinical medicine… Grades predict grades, test scores predict test score, ratings predict ratings, but attempts to demonstrate scientific convergence among such indicators of professional competence have not been successful.”1

While the MCAT’s developer claims the exam should play a central part in forecasting success in medical school interviews, the predictive value of the test is in fact quite small. Several studies confirm that the predictive ability of the MCAT is confined to the basic science portion of the medical school curriculum, explaining only 9-16% of the variance, or difference, in grades during the first two years. MCAT scores prove to be an even weaker indicator of performance during clinical training (the third and fourth years of medical school).

One research study showed that as a student progresses through medical school the power of the pre-admission interview ratings to predict medical school grade point average (GPA) generally increases over time while the power of MCAT scores decreases.2 Another study considered the effects of MCAT scores and “non-cognitive” measures on basic science grades and clinical competence in medical school. While only 4% of the variation in the ratings of clinical competence was related to MCAT scores, 14% could be explained by psycho-social measures.3 While no one factor contributes greatly to predicting success, test scores are clearly only weak predictors whose value decreases as students progress through training.

The Texas A & M University System offers another admissions route that doesn’t require MCAT scores. Applicants coming from areas of Texas with a shortage of medical services can become part of the Partnership for Primary Care Program. Participation in the program allows for the waiver of all MCAT requirements, provided the individual pledges to work in underserved areas upon graduation.

In a 1991 report, the Southern Regional Education Board highlighted the admissions practices of medical schools with high enrollments of people of color. Among their most significant findings were that these schools used MCAT scores to compare students of color among themselves and to diagnose special needs a student may have, and not as an absolute admissions hurdle.