Medical College Admission Test Research Articles

Characteristics of MD Matriculation in American Universities

Characteristics of MD matriculation in American universities lie in cooperation between Association of American Medical Colleges and Medical Schools on campus. AAMC highlights its role in three aspects, arranging Medical College Admission Test, providing American Medical College Application Service, entrusting to conduct Criminal Background Check. Medical School takes its part by proclaiming premedical courses and identifying applicants with attributes essential for medical education. The outcome of cooperation is having satisfying matriculants. The essence underlying is the professionalism permeated in medicine profession.

Beyond Grade Point Averages and Medical College Admission Test Scores: A Thematic Analysis of Exceptional Performing Medical Student Applications.

This article was migrated. The article was marked as recommended. Introduction: Medical school admissions committees are tasked with selecting the best students for their institution and historically rely on grade point averages and Medical College Admission Test scores as measures for academic success. Yet research and expertise theory suggest that personal characteristics play a critical role in exceptional performance. Understanding the characteristics of exceptional performing medical students upon application to medical school could contribute to the holistic review process and selection decisions of medical universities. Methods: The purpose of this study was to identify themes in the American Medical College Application Service (AMCAS) application that reflect the characteristics of exceptional performing medical students when they applied to medical school. The authors completed an inductive thematic analysis of the primary AMCAS application of exceptional performing medical students. Selection to both Alpha Omega Alpha Honor Medical Society and the Gold Humanism Honor Society defined exceptional performance. Results/Analysis: 22 (4.5%) of 485 medical school graduates between 2017 and 2019 met criteria for exceptional performance. The authors identified seven themes from the AMCAS applications: success in a practiced activity, altruism, entrepreneurship, passion, perseverance, teamwork, and wisdom. Discussion: The seven identified themes were consistent with the personal characteristics associated with both expertise theory and the AAMC's core personal competencies for medical student success. By constructing an understanding of the personal characteristics exceptional student performers display in their applications to medical school, these themes offer an additional lens for medical school admission committees to assess a student's potential to be successful in medical school.

What Influences the Decision to Interview a Candidate for Medical School?

Holistic review, in which medical schools seek to balance applicant attributes and experiences alongside traditional academic metrics in making admissions decisions, has been in place for over a decade. Medical school applicants and the admissions' community are still trying to understand the impact of holistic review on the composition of those medical schools choose to interview and accept. The study cohort included all candidates who applied to Uniformed Services University of the Health Sciences (USU) in 2014, 2015, and 2016 (N = 8,920). We conducted logistic regression analysis to examine the associations between the sociodemographic, academic, and military service variables of applicants applying to the School of Medicine and offers for interview. Medical College Admission Test scores and undergraduate grade point averages were important in predicting who would receive an interview. Having military experience, being a woman, and being self-reported African American race also predicted a higher likelihood of receiving an interview invitation. For example, controlling for all other variables in the model, if an applicant had previous military experience, the odds of being invited for interview was about 4 times that of an applicant who had no previous military experience. Leave this for the text and discussion. The resulting pool of interviewed and accepted students more increasingly represented the Military Health Service population served. The use of holistic review generated a class with a composition different from that which would be predicted by Medical College Admission Test and grade point average alone. Further, holistic review produced an interview pool and class more representative of the wider Military Health Service beneficiary population. In the case of USU, holistic review allowed the school to better meet its mission to create a representative class able to "care for those in harm's way."

Achieving a Diverse, Equitable, and Inclusive Environment for the Black Orthopaedic Surgeon: Part 1: Barriers to Successful Recruitment of Black Applicants.

Achieving a Diverse, Equitable, and Inclusive Environment for the Black Orthopaedic Surgeon: Part 1: Barriers to Successful Recruitment of Black Applicants.

Flipped Classroom in Podiatric Medical Education.

The purpose of this study was to evaluate student learning outcomes in a flipped classroom versus a traditional classroom in a podiatric medical school. To date no published reports in podiatric medical schools have used the flipped classroom for the entirety of a medical school course. Students from the class of 2017 completed the Emergency Medicine and Trauma course using traditional classroom lectures, and the class of 2018 used a flipped classroom approach. Each class took two assessments that contained 99 identical questions and completed a postcourse evaluation that contained student comments. A multivariate analysis of covariance was conducted to determine whether student performances were significantly affected by the differences in the teaching method. Student evaluation comments were analyzed using textual data analysis to determine the sentiments that students expressed regarding their exposure to the teaching method. The multivariate analysis of covariance results revealed that students scored slightly lower on assessments during the flipped classroom delivery compared with the traditional classroom delivery, when adjusted for Medical College Admission Test scores and grade point average, but not significantly (P = .4340). Similarly, the sentiment analysis of student comments indicated that the average positive sentiment score for the flipped classroom delivery was higher but was not significant (P = .08914). The analysis showed there was not a statistically significant change in examination scores based on teaching method. Sentiment analysis revealed that student sentiments were more positive with the flipped classroom group compared with the traditional lecture group, although not statistically significantly.

Changes in Health Care Following COVID-19

Changes in Health Care Following COVID-19

Addressing Kentucky's Physician Shortage While Securing a Network for a Research-Intensive, Referral Academic Medical Center: Where Public Policy Meets Effective Clinical Strategic Planning.

A critical shortage of physicians is looming in the United States. The situation in Kentucky is especially dire, especially in rural areas. Class size constraints have resulted in the University of Kentucky College of Medicine (UK COM) unable to admit over 100 qualified Kentuckians each year. This article describes how leadership at University of Kentucky committed to addressing the state physician shortage while simultaneously strengthening relationships with critical partners through the establishment of two 4-year UK COM regional medical campuses. Based on criteria (such as a commitment to educating physicians, ample patients, sufficient willing physician preceptors, etc.), partners selected were Med Center Health, the leading health care system in southwestern Kentucky, and St. Elizabeth Healthcare, the predominant health care system in northern Kentucky. These regional campuses allow UK COM to expand its class size to 201 and total enrollment to 804, increasing from historically 70 to currently 120 graduates per year expected to practice in Kentucky. Critical to the success of this expansion is the buy-in of leadership and the Admissions Committee to consider students with a wider range of Medical College Admission Test scores. The regional clinical partners have substantially increased their teaching opportunities, with a greater ability to attract physicians. Both partners have made substantial financial contributions in support of the regional campuses. These relationships have energized UK COM engagement with its area alumni and have resulted in fewer Kentuckians referred out of state for advanced specialty care. Partnerships are also occurring with UK COM to increase graduate medical education offerings at the regional sites, fulfilling the vision of "training Kentuckians in Kentucky to practice in Kentucky."

Does conventional early life academic excellence predict later life scientific discovery? An assessment of the lives of great medical innovators.

SummaryBackgroundPerhaps, as never before, we need innovators. With our growing population numbers, and with increasing pressures on our education systems, are we in danger of becoming more rigid and formulaic and increasingly inhibiting innovation? When young can we predict who will become the great innovators? For example, in medicine, who will change clinical practice?AimsWe therefore determined to assess whether the current academic excellence approach to medical school entrance would have captured previous great innovators in medicine, assuming that they should all have well fulfilled current entrance requirements.MethodsThe authors assembled a list of 100 great medical innovators which was then approved, rejected or added to by a jury of 12 MD fellows of the Royal Society of Canada. Two reviewers, who had taken both the past and present Medical College Admission Test as part of North American medical school entrance requirements, independently assessed each innovator’s early life educational history in order to predict the innovator’s likely success at medical school entry, assuming excellence in all entrance requirements.ResultsThirty-one percent of the great medical innovators possessed no medical degree and 24% would likely be denied entry to medical school by today’s standards (e.g. had a history of poor performance, failure, dropout or expulsion) with only 24% being guaranteed entry. Even if excellence in only one topic was required, the figure would only rise to 41% certain of medical school entry.ConclusionThese data show that today’s medical school entry standards would have barred many great innovators and raise questions about whether we are losing medical innovators as a consequence. Our findings have important implications for promoting flexibility and innovation for medical education, and for promoting an environment for innovation in general.

Beyond High-Stakes Testing: Learner Trust, Educational Commodification, and the Loss of Medical School Professionalism.

With ever-growing emphasis on high-stakes testing in medical education, such as the Medical College Admission Test and the United States Medical Licensing Examination Step 1, there has been a recent surge of concerns on the rise of a "Step 1 climate" within U.S. medical schools. The authors propose an alternative source of the "climate problem" in current institutions of medical education. Drawing on the intertwined concepts of trust and professionalism as organizational constructs, the authors propose that the core problem is not hijacking-by-exam but rather a hijackable learning environment weakened by a pernicious and under-recognized tide of commodification within the U.S. medical education system. The authors discuss several factors contributing to this weakening of medicine's control over its learning environments, including erosion of trust in medical school curricula as adequate preparation for entry into the profession, increasing reliance on external profit-driven sources of medical education, and the emergence of an internal medical education marketplace. They call attention to breaches in the core tenets of a profession-namely a logic that differentiates its work from market and managerial forces, along with related slippages in discretionary decision making. The authors suggest reducing reliance on external performance metrics (high-stakes exams and corporate rankings), identifying and investing in alternative metrics that matter, abandoning the marketization of medical education "products," and attending to the language of educational praxis and its potential corruption by market and managerial lexicons. These steps might salvage some self-governing independence implied in the term "profession" and make possible (if not probable) a recovery of a public trust becoming of the term and its training institutions.

Correlation of Medical College Admission Test Scores and Self-assessment Materials with the United States Medical Licensing Examination Step 1 Performance.

PurposeCandidates' performance on the United States Medical Licensing Examination (USMLE) Step 1 examination had been correlated with the Medical College Admission Test (MCAT). However, in 2015, a new MCAT format was released and its correlation with Step 1 remains to be fully analyzed. Preparation for Step 1 typically involves purchasing and perusing practice tests from the National Board of Medical Examiners (NBME) and UWorld; however, their predictive value to performance on Step 1 remains to be ascertained, especially with the release of five new NBME practice tests. Additionally, there is a need for accurately predicting Step 1 scores to self-evaluate study progress and reduce student anxiety.RationaleProgram directors rank USMLE Step 1 scores as the number one criterion in selecting interviewees for residency. Step 1 scores are more important than Step 2 scores, Dean’s letter, or other letters of recommendation in determining the overall ranking of a candidate after interviews.HypothesesThe authors hypothesized that the new MCAT scores correlated positively with Step 1 scores and that the new NBME practice tests were more predictive of performance on Step 1 as compared to old NBME tests. MethodsLinear regression analysis followed by either analysis of variance (ANOVA) or Student's t-tests were used to analyze 399 responses. Data obtained was used to update an existing Step 1 score predictor, which was then validated.ResultsA positive correlation between the MCAT (average score: 510.1 ± 6.3) and Step 1 scores (average score: 246.1 ± 14.2) was observed. While new NBME practice tests were more predictive of Step 1 scores than old NBME tests, UWorld test scores were the most predictive. Students who practiced with the new NBME practice tests scored significantly higher than students who did not use them. However, students using any of the UWorld practice tests did significantly better than students who practiced using only NBME practice tests but not UWorld practice tests. Ironically, NBME16,the second-most correlativetest to Step 1 performance, is no longer available for purchase. Overall, taking six or more practice tests significantly enhanced Step 1 scores; the optimal number of tests was found to be between six and nine. The predicted score by an updated Step 1 score predictor was within 3.8 points or 1.6% of the actual Step 1 score.ConclusionsWe believe this study will aid in the selection and purchase of appropriate self-assessment tests as preparatory material for the USMLE Step 1 examination. It will also introduce them to an existing Step 1 score predictor that will help determine their readiness for Step 1.

Correlation of MCAT scores and preparative study material to USMLE Step I performance

The Medical College Admission Test (MCAT) is a well‐utilized metric for stratifying students for medical school admissions. The United States Medical Licensing Examination (USMLE) is a three‐step examination that assesses student knowledge of gross anatomy, biochemistry, biostatistics, genetics, and other basic science disciplines required for practicing medicine in the United States. The MCAT has been shown to correlate positively with student success on Step 1. However, in 2015, a new MCAT format was released and its correlation with Step 1 remains to be analyzed. Additionally, preparation for Step 1 typically involves purchasing and perusing practice tests from the National Board of Medical Examiners (NBME®) and UWorld®; however, their predictive value to performance on Step 1 remains to be ascertained, especially with the release of five new NBME® practice tests. We hypothesized that the new MCAT scores correlated positively with Step 1 scores and that the new NBME® practice tests were more predictive of performance on Step 1 as compared to old NBME® tests. An anonymous survey was posted on www.reddit.com requesting users to submit their scores on Step 1, practice tests and MCAT along with examination dates. Regression analysis indicated positive correlation of MCAT with Step 1 scores (P= 1.236E‐15; R2=0.2047; n=282). While new NBME® practice tests were more predictive of Step 1 scores than old NBME® tests, UWorld® SA2 scores were most predictive (P=3.752E‐93; R2=0.6803; n=370). Taking more than six practice tests significantly enhanced Step 1 scores (P=0.040). Data from this study can be used to create a mathematical framework using MCAT and practice test scores for accurate prediction of Step 1 scores.

Predictors of success on the MCAT among post-baccalaureate pre-medicine students

Post-baccalaureate pre-medicine programs (PBPMP) provide prerequisite coursework for non-life science majors who aspire to become physicians. Students entering these programs generally do not have previous college-level exposure to the natural sciences. This pilot study was conducted to determine characteristics of scientifically naive, career changer, pre-medical students that may be used by PBPMP admissions committees. Statistical analyses were performed between Medical College Admission Test (MCAT) scores and student gender, Scholastic Aptitude Test (SAT) scores, undergraduate field of study, and undergraduate Grade Point Average (GPA). While relationships between certain subscores on the SAT and MCAT were found, data suggest that other non-quantitative metrics be considered as predictors of performance among PBPMP students.

Academic Predictors of MCAT performance for Post‐baccalaureate Pre‐medical program students

Career changers, i.e. students who did not major in the traditional pre‐medicine fields like chemistry and biology, presently constitute a large percentage of medical school applicants. Post‐baccalaureate pre‐medical programs (PBPMP) provide prerequisite coursework for non‐life science majors who aspire to become physicians. Curriculum includes physics, general and organic chemistry, biology and biochemistry. Students entering these programs generally do not have significant exposure to natural sciences, and are considered “scientifically naïve”. Therefore, post‐baccalaureate programs are searching for criteria for admission process to help identify applicants with potential to succeed in PBPMP and matriculate into medical schools.This study analyzed academic metrics of career changer pre‐medical students to predict their success on mandatory Medical College Admission Test (MCAT). Data analysis correlated MCAT scores with gender, high school Scholastic Aptitude Test (SAT) scores, undergraduate major or field of study, and undergraduate Grade Point Average (GPA). Undergraduate GPA is not correlated with performance on MCAT. Analysis yielded positive correlations between MCAT scores and SAT scores, and between MCAT and undergraduate non‐science major/field of study. The results provide insight into academic metrics that could predict future success on MCAT and matriculation into medical school. While positive correlations between certain sub‐scores on the SAT and MCAT were found, other holistic non‐quantitative characteristics should be considered for medical school admission.

Associations Between Medical Education Assessments and American Board of Family Medicine Certification Examination Score and Failure to Obtain Certification.

Family medicine residency programs can be cited for low pass or take rates on the American Board of Family Medicine (ABFM) certification examination, and the relationships among standardized medical education assessments and performance on board certification examinations and eventual board certification have not been comprehensively studied. The objective of this study was to evaluate the associations of all required standardized examinations in medical education with ABFM certification examination scores and eventual ABFM certification. All graduates of U.S. MD-granting family medicine residency programs from 2008 to 2012 were included. Data on ABFM certification examination score, ABFM certification status (as of December 31, 2014), Medical College Admission Test (MCAT) section scores, undergraduate grade point average, all United States Medical Licensing Examination (USMLE) Step scores, and all ABFM in-training examination scores were linked. Nested logistic and linear regression models, controlling for clustering by residency program, determined associations between assessments and both certification examination scores and board certification status. As many international medical graduates (IMGs) do not take the MCAT, separate models for U.S. medical graduates (USMG) and IMGs were run. The study sample was 15,902 family medicine graduates, of whom 92.1% (14,648/15,902) obtained board certification. In models for both IMGs and USMGs, the addition of more recent assessments weakened the associations of earlier assessments. USMLE Step 2 Clinical Knowledge was predictive of certification examination scores and certification status in all models in which it was included. For family medicine residents, more recent assessments generally have stronger associations with board certification score and status than earlier assessments. Solely using medical school admissions (grade point average and MCAT) and licensure (USMLE) scores for resident selection may not adequately predict ultimate board certification.

Admissions Is Not Enough: The Racial Achievement Gap in Medical Education.

The achievement gap is a disparity in academic and standardized test performance that exists between White and underrepresented minority (URM) students that begins as early as preschool and worsens as students progress through the educational system. Medical education is not immune to this inequality. URM medical students are more likely to experience delayed graduation and course failure, even after accounting for science grade point average and Medical College Admission Test performance. Moreover, URM students are more likely to earn lower scores on licensing examinations, which can have a significant impact on their career trajectory, including specialty choice and residency competitiveness. After the release of preliminary recommendations from the Invitational Conference on USMLE Scoring (InCUS) and public commentary on these recommendations, the National Board of Medical Examiners and Federation of State Medical Boards announced that the United States Medical Licensing Examination (USMLE) Step 1 would transition from a 3-digit numeric score to pass/fail scoring. Given that another of InCUS's recommendations was to "minimize racial demographic differences that exist in USMLE performance," it is paramount to consider the impact of this scoring change on URM medical students specifically. Holistic admissions are a step in the right direction of acknowledging that URM students often travel a further distance to reach medical school. However, when residency programs emphasize USMLE performance (or any standardized test score) despite persistent test score gaps, medical education contributes to the disproportionate harm URM students face and bolsters segregation across medical specialties. This Perspective provides a brief explanation of the achievement gap, its psychological consequences, and its consequences in medical education; discusses the potential effect of the Step 1 scoring change on URM medical students; and provides a review of strategies to redress this disparity.

The Validity of Scores From the New MCAT Exam in Predicting Student Performance: Results From a Multisite Study.

The new Medical College Admission Test (MCAT) was introduced in April 2015. This report presents findings from the first study of the validity of scores from the new MCAT exam in predicting student performance in the first year of medical school (M1). The authors analyzed data from the national population of 2016 matriculants with scores from the new MCAT exam (N = 7,970) and the sample of 2016 matriculants (N = 955) from 16 medical schools who volunteered to participate in the validity research. They examined correlations of students' MCAT total scores and total undergraduate grade point averages (UGPAs), alone and together, with their summative performance in M1, and the success rate of students with different MCAT scores in their on-time progression to the second year of medical school (M2). They assessed whether MCAT scores provided comparable prediction of performance in M1 by students' race/ethnicity, socioeconomic background, and gender. Correlations of MCAT scores with summative performance in M1 ranged from medium to large. Although MCAT scores and UGPAs provided similar prediction of performance in M1, using both metrics provided better prediction than either alone. Additionally, students with a wide range of MCAT scores progressed to M2 on time. Finally, MCAT scores provided comparable prediction of performance in M1 for students from different sociodemographic backgrounds. This study provides early evidence that scores from the new MCAT exam predict student performance in M1. Future research will examine the validity of MCAT scores in predicting performance in later years.

A Study of the Validity of the New MCAT Exam.

To conduct a study of the validity of the new Medical College Admission Test (MCAT). Deidentified data for first- and second-year medical students (185 women, 54.3%; 156 men, 45.7%) who matriculated in 2016 and 2017 to the University of Minnesota Medical School-Twin Cities were included. Of those students, 220 (64.5%) had taken the new MCAT exam and 182 (53.4%) had taken the old MCAT exam (61 [17.9%] had taken both). The authors calculated descriptive statistics and Pearson product moment correlations (r) between new and old MCAT section scores. They conducteda regression analysis of MCAT section scores with Step 1 scores and with preclerkship course performance. They also conducted an exploratory factor analysis (principal component analysis with varimax rotation) of MCAT scores, undergraduate grade point average, Step 1 scores, and course performance. The new MCAT exam section mean score percentiles ranged from 72 to 78 (mean composite score percentile of 80). The old MCAT exam section mean score percentiles ranged from 84 to 88 (mean composite score percentile of 83). The pattern of correlations among and between new and old MCAT exam section scores (range of r: 0.03-0.67; P < .01) provided evidence of both divergent and convergent validities. Backward multiple regression of new MCAT exam section scores and Step 1 scores resulted in a multiple R of .440; the same analysis with Human Behavior course performance as the dependent variable provided a similar solution with the expected sections of the new MCAT exam (multiple R = .502). The factor analysis resulted in 4 cohesive, theoretically meaningful factors: biomedical knowledge, basic science concepts, cognitive reasoning, and general achievement. This study provided empirical evidence of multiple types of validity for the new MCAT exam.

Leveraging the Medical School Admissions Process to Foster a Smart, Humanistic, and Diverse Physician Workforce.

An excellent physician has a range of talents, including the knowledge and critical thinking abilities to work with the rapidly changing biomedical and social science content of the profession as well as the interpersonal and communication skills to build meaningful relationships with patients and families. The Medical College Admission Test (MCAT) was revised in 2015 to focus more on analytical reasoning skills and behavioral and social sciences knowledge to ensure that future physicians have the capabilities needed to care for patients in the 21st century and to allow admissions committees to identify applicants who have demonstrated proficiency in these areas. With these changes, scores continue to be predictive of student performance in the preclerkship curriculum.In this Invited Commentary, the author argues that, as educators struggle to define the characteristics of the "right" candidates for medical school and design processes to identify and admit those applicants, it is important to consider the message being sent by calls for the MCAT exam to play a reduced role in admissions decisions. Educators must avoid diminishing the importance of intellectual rigor and, while pursuing goals for a more diverse physician workforce, maintain standards that ensure medicine's commitment to patients. The author concludes with suggestions for how educators can work with under-resourced colleges and premedical programs to help disadvantaged students get the preparation they need to succeed in medical school and throughout their careers. Taking these steps will allow educators to support students, prepare them for practice, and fulfill their obligation to the public to produce excellent physicians.

Exploring the Socialization Experiences of Medical Students From Social Science and Humanities Backgrounds.

To explore the structural, cultural, and interpersonal issues that may contribute to the inadvertent marginalization of medical students with social science and humanities (SSH) backgrounds. Using the hidden curriculum as an analytic construct, the lead author interviewed 14 medical students with SSH backgrounds at the University of Toronto Faculty of Medicine from February to October 2015. The authors analyzed the interview transcripts for common themes around positive and negative cultural, structural, and interpersonal dimensions of the socialization process. Participants reported barriers to applying to medical school: needing to complete prerequisite courses and to do well on an exam geared toward those with a strong science background (the Medical College Admission Test) and lacking an application cohort. Some participants felt they were not ideal candidates for medical school. Participants appreciated how their SSH backgrounds and associated skill sets shaped both their perspectives on patient care and their developing professional identities. However, they perceived that others largely deemed their previous training as irrelevant, and they felt marginalized in medical school by peers, instructors, and the curriculum. These experiences led both to self-censorship, which enabled them to seem to conform to normative behaviors, and to the pursuit of reaffirming elective experiences. The existing hidden curriculum inadvertently marginalizes SSH medical students; their experiences likely reflect the socialization experiences of other students from underrepresented backgrounds. Curricular and institutional reforms are imperative to shift the hidden curriculum toward one of epistemological inclusion that better supports students from nontraditional backgrounds.

The Diversity and Success of Medical School Applicants With Scores in the Middle Third of the MCAT Score Scale.

Admissions officers assemble classes of medical students with different backgrounds and experiences who can contribute to their institutions' service, leadership, and research goals. While schools' local interests vary, they share a common goal: meeting the health needs of an increasingly diverse population. Despite the well-known benefits of diversity, the physician workforce does not yet reflect the nation's diversity by socioeconomic status, race/ethnicity, or other background characteristics.The authors reviewed the Medical College Admission Test (MCAT) scores and backgrounds of 2017 applicants, accepted applicants, and matriculants to U.S. MD-granting schools to explore avenues for increasing medical school class diversity. They found that schools that accepted more applicants with midrange MCAT scores had more diverse matriculating classes. Many schools admitting the most applicants with scores in the middle of the MCAT score scale were public, community-based, and primary care-focused institutions; those admitting the fewest of these applicants tended to be research-focused institutions and to report pressure to accept applicants with high MCAT scores to maintain or improve their national rankings.The authors argue that reexamining the use of MCAT scores in admissions provides an opportunity to diversify the physician workforce. Despite evidence that most students with midrange MCAT scores succeed in medical school, there is a tendency to overlook these applicants in favor of those with higher scores. To improve the health of all, the authors call for admitting more students with midrange MCAT scores and studying the learning environments that enable students with a wide range of MCAT scores to thrive.