Premed students’ biggest fear is taking the MCAT. After 25 years, the MCAT is being revised, becoming longer (by three hours) and covering a broader range of topics than simply chemistry, physics and biology.
o One quarter of the new test covers psychology, sociology and the biological foundations of behavior
o More specifically, students will be tested on social inequality, class consciousness, racial and ethnic identity, institutionalized racism and discrimination, and power, privilege and prestige
Addition of new topics are due to significant integration of topics in modern day society.
First two years of medical school are spent predominantly in the classroom or laboratory.
o Core subjects include anatomy, physiology, pharmacology, pathology
o Much of what is learned is forgotten or irrelevant
What is important is the ability to continue learning, apply critical thought and analysis. A shift is underway with cultural myths replacing hard science and group identity politics replacing individualized care.
How might the new MCAT testing facilitate such a transition in the next generation of physicians?
o Will social inequality and class trump being brutally honest with a patient?
o Will public health policy be determined by disease modeling and the scientific method, or by the latest politically popular, but unproven, fads including global warming or gluten-free diets?
o Will claims of sexual assault or police violence be immediately accepted as true if the victims and perpetrators fall into certain power or privilege classes regardless of evidence?
o Will physicians blame disparate disease prevalence due to ethnicity and genetics on social injustice, or will they push for customized care and gene therapy to raise the health of all groups?
U.S. medical school acceptance rate at about 40 percent
Will schools choose and train the best and brightest as the next generation of physicians? Or will the students look more like a discussion panel on MSNBC? Make no mistake: Compassion, empathy and listening are important skills for physicians. Some are better at this than others. Those lacking in the human skills will lose patients and referrals and may migrate into non-patient care activities. Declining reimbursement and increasing regulations are forcing physicians to see more patients each day, spending less time with each one.
Mandated electronic medical records require a physician to hold a computer mouse rather than his patient's hand. Add to that an aging population and a growing prevalence of chronic diseases. Will this demand be better met by physicians who are smart and efficient or those pondering social inequality, meritocracy, environmental justice and class-consciousness?
Why the new MCAT is better
Patients want doctors who treat the whole person, not just the illness. The new exam preserves what works about the previous exam, eliminates what isn’t working, and further enriches the exam by giving attention to the concepts that tomorrow’s doctors will need. The natural sciences sections reflect recent changes in science and medical education. The addition of the social and behavioral sciences section recognizes the importance of socio-cultural and behavioral determinants of health and health outcomes
The Critical Analysis and Reasoning Skills section reflects the value that medical schools place on analysis, evaluation, and reasoning skills and on broad preparation for medical school
The revision sends an important message: the current premedical curriculum only adds to the prevailing attitude that success in the “hard sciences” (biology, chemistry, organic chemistry, and physics) is all that determines success in medicine, and that the social determinants of health are “soft” in comparison.
But if you’ve ever had a doctor who can choose an affordable treatment based on your insurance status, or who understands that there’s more to your life than your disease, you may agree that those skills aren’t soft — they’re critical.
Most of all, spending time outside medicine — in business, service, and other fields — has shown doctors the world beyond science, the world that most of our patients inhabit.
The goal of the new MCAT is to have more medical students who’ve explored more of the world beyond the classroom; it will only make them better able to connect and care for patients.