Special Feature

Different MCAT, different physician? New med school admissions test to debut in 2015

For successful medical practice in today's—and tomorrow's—rapidly changing health care environment, it's more critical than ever for our new generation of physicians to have the right knowledge and skills. As the nation ages and becomes more diverse, the need for good communication skills and cultural competence is growing. Similarly, the medical home model will require a new level of teamwork and interdisciplinary care, and the information explosion makes the ability to analyze data and isolate the essential clinical nugget a valuable tool in the physician's arsenal.

These needs are part of the rationale for the newly approved Medical College Admission Test® (MCAT®), as described in an open letter to pre-med students from Darrell G. Kirch, MD, president and CEO of the Association of American Medical Colleges (AAMC). The first revision to the MCAT since 1991, MCAT2015 features a new section, Psychological, Social, and Biological Foundations of Behavior, which is designed to measure students' understanding of "behavior, perception, culture, poverty, and other concepts from psychology and sociology." A second new section, Critical Analysis and Reasoning Skills, will ask students to "analyze passages from a wide range of disciplines, including ethics, philosophy, cultural studies, and even population health." At the same time, MCAT2015 will still include two sections focused on the natural sciences.

Taken together, this new direction in the MCAT is intended to lead to selecting more well-rounded individuals with both the bedside manner and analytical skills to thrive in medicine. “These additions to the MCAT are very timely in light of the importance of understanding health and illness in the context of the social and community setting, along with the need to help patients change their health behaviors to control chronic disease,” said Susan Skochelak, MD, MPH, vice president of medical education at the AMA.

Not surprisingly, MCAT2015 has sparked much discussion among pre-med and medical educators, advisors and students. Members of the National Association of Advisors for the Health Professions, for example, have vigorously debated the new MCAT and its implications for undergraduate coursework. One wrote, "I think it's interesting/unfortunate that . . . people are conflating the idea of having knowledge of psychological/sociological principles and have the skills to be empathic listeners and responders. . . . I just think it's a little troubling to be thinking that one necessarily leads to the other -- that's a little simplistic."

Meanwhile, a MedPage Today blogger named "Dr. Wes" opines, "Developing selection criteria for medical school based on social and humanitarian coursework without addressing the reality of today's increasingly computer-screen-focused medical practice is whistling in the dark." And a first-year medical student who writes a blog for Scientific American suggests, "Not every desirable trait is exposed through filling in bubbles. To me, the new test means more mandates. More hoops to jump through. More rigidity. More contrived benchmarks of success. More ways to fall behind." Her concern is echoed in a New York Times article on MCAT2015: "The big question, of course, is how well a multiple-choice test can help screen for the ethereal mix of scientist and humanist and spiritualist that makes a good doctor. That is uncharted territory."

In the end, perhaps the best quality for a physician to have is curiosity—especially when it is expressed as interest in other people.