Medical College Admission Test

Medical College Admission Test

Acronym	MCAT
Type	Computer-based standardized test
Developer / administrator	American Association of Medical Colleges
Knowledge / skills tested	Physical sciences, biological sciences, verbal reasoning.
Purpose	Admissions to medical colleges (principally in the United States and Canada; 15 other countries).
Year started	1928 (1928)
Score / grade range	118 to 132 (in 1-point increments) for each of the 4 sections (Chemistry and Physics, Biology/Biochemistry, Critical Analysis and Reasoning Skills, and Psychology and Social Sciences). So total score on scale of 472 to 528.[1]
Score / grade validity	Usually 2 to 3 years (depends on medical college being applied to).[2]
Offered	33 times in January 2014 through January 2015.[3]
Restrictions on attempts	Can be taken maximum 3 times in January 2014 through January 2015.[4]
Countries / regions	United States, Canada and 19 other countries.[5]
Languages	English
Prerequisites / eligibility criteria	Candidate must be preparing to apply to a health professional school (otherwise, "special permission" is required).[6] Fluency in English assumed.
Fee	Gold zone (registration about 1 month or more prior to test date): US$ 275 Silver zone (registration about 3 to 4 weeks prior to test date): US$ 275 Bronze zone (registration about 1 to 2 weeks prior to test date): US$ 325 International testing: US$ 90 in addition to above.[7] ("Fee Assistance Program" available to U.S. citizens, permanent residents or refugees, demonstrating financial need.[8])
Scores / grades used by	Medical colleges (mostly in United States and Canada).
Website	students-residents.aamc.org/applying-medical-school/taking-mcat-exam/

The Medical College Admission Test (MCAT) is a computer-based standardized examination for prospective medical students in the United States, Australia,^[9] Canada, and Caribbean Islands. It is designed to assess problem solving, critical thinking, written analysis and knowledge of scientific concepts and principles. Prior to August 19, 2006, the exam was a paper-and-pencil test. Since January 27, 2007, however, all administrations of the exam have been computer-based.

History

The Moss Test: 1928–46

In the 1920s, dropout rates in US medical schools soared from 5% to 50%,^[10] leading to the development of a test that would measure readiness for medical school. Physician F.A. Moss and his colleagues developed the "Scholastic Aptitude Test for Medical Students" consisting of true-false and multiple choice questions divided into six to eight subtests. Topics tested included visual memory, memory for content, scientific vocabulary, scientific definitions, understanding of printed material, premedical information, and logical reasoning. The score scale varied from different test forms. Though it had been criticized at the time for testing only memorization ability and thus only readiness for the first two years of medical school, later scholars denied this. In addition to stricter medical school admission procedures and higher educational standards, the national dropout rate among freshman medical students decreased from 20% in 1925-1930 to 7% in 1946.

A simpler test: 1946–62

Advancements in test measurement technology, including machine scoring of tests, and changed views regarding test scores and medical school readiness reflected the evolution of the test in this period. The test underwent three major changes. It now had only four sub tests, including verbal ability, quantitative ability, science achievement, and understanding modern society. Questions were all in multiple-choice format. Each subtest was given a single score, and the total score was derived from the sum of the scores from the subtests. The total score ranged from 200–800. The individual scores helped medical school admission committees to differentiate the individual abilities among their candidates. Admission committees, however, did not consider the "understanding modern society" section to be of great importance, even though it was created to reward those with broad liberal arts skills, which included knowledge of history, government, economics, and sociology. Committees placed greater emphasis on scores on the scientific achievement section as it was a better predictor of performance in medical school.

From 1946 to 1948, the test was called the "Professional School Aptitude Test" before finally changing its name to the "Medical College Admission Test" when the developer of the test, the Graduate Record Office (under contract with the AAMC) merged with the newly formed Educational Testing Service (ETS). In 1960, the AAMC transferred its contract over to The Psychological Corporation, which was then in charge of maintaining and developing the test.

Status quo: 1962–77

From 1962 to 1977, the MCAT retained much of its previous format, though the "understanding modern society" section was renamed as "general information" due to its expanded content. Handbooks at the time criticized the test as only a measure of intellectual achievement and not of personal characteristics expected of physicians. Responding to this criticism, admission committees took different approaches in measuring personal characteristics among their applicants.

Phase four: 1977–91

During phase four, the MCAT underwent several changes. The "general information" section was eliminated and a broader range of knowledge was tested. At this point, topics tested included scientific knowledge, science problems, reading skills analysis, and quantitative skills analysis. Individual scores were reported for biology, chemistry, and physics rather than a composite science score, thus six different scores for the whole test were reported. The score scale changed to 1–15 as opposed to 200–800 from previous versions of the test. Cultural and social bias was minimized. Though the AAMC claimed the new version intended to evaluate "information gathering and analysis, discerning and formulating relationships, and other problem-solving skills," no research supported this claim.

New changes: 1992–2012

In 1992 the test changed again. Though the test was still divided into four subtests, they were renamed as the verbal reasoning, biological sciences, physical sciences, and writing sample sections. Questions retained the multiple-choice format, though the majority of the questions are divided into passage sets. Passage-based questions were implemented to evaluate "text comprehension, data analysis, ability to evaluate an argument, or apply knowledge from the passage to other contexts." A new scoring scale was also implemented. The total composite score, which ranges from 3–45, is based on the individual scores of the verbal reasoning, biological sciences, and physical sciences, which each have a score range of 1–15. The writing sample, which consists of two essays to be written within 30 minutes for each, is graded on a letter scale from J-T with T being the highest attainable score. 2013-2014

On July 18, 2005, the AAMC announced that it would offer the paper-and-pencil version of the MCAT only through August 2006. A subset of testing sites offered a computer-based version of the full-length exam throughout 2005 and 2006. A shorter, computer-based version of the test debuted in January 2007. The exam was at that point offered numerous times annually, and scored more quickly.^[11][12]

MR5 and the 2015 test

The MR5 advisory committee was appointed by AAMC in fall 2008.^[13] Highlights of the MR5 process were surveys of what undergraduate institutions teach and surveys of medical school faculty in which they ranked undergraduate subjects for importance in medical school curricula of the future. Late in 2011, the MR5 recommendations were formalized as core competencies that will be tested in 2015.^[14] MR5 recommendations were enacted by the AAMC in 2012. The largest changes consist of testing in biochemistry, multicultural/behavioral concepts, and critical analysis/reasoning from the humanities. Because college freshmen, entering in fall 2012, took a new MCAT, undergraduate premedical advisers studied the MR5 documents to translate tested core competencies into premedical course recommendations at their campuses. The MR5 MCAT revision has the potential to lead to changes in mathematics, physics, psychology, sociology, and general education recommendations in addition to changes in biology, chemistry and biochemistry. One scientific society to comment on the new MCAT and its implications for the undergraduate curriculum is the American Society for Biochemistry and Molecular Biology. Though ASBMB noted that the premedical curriculum in mathematics, physics, social sciences and the humanities is likely to change, the society confined its recommendations to coursework in biology, chemistry and biochemistry.^[15]

Administration

The exam is offered 25 or more times per year at Prometric centers.^[16] The number of administrations may vary each year. Most people who take the MCAT are undergraduates in their junior or senior year of college before they apply to medical school. Ever since the exam's duration was lengthened to 7.5 hours, the test is only offered in the morning.

The test, updated in 2015, consists of four sections, listed in the order in which they are administered on the day of the exam:

• Chemical and Physical Foundations of Biological Systems
• Critical Analysis and Reasoning Skills (CARS)
• Biological and Biochemical Foundations of Living Systems
• Psychological, Social and Biological Foundations of Behavior

The four sections are in multiple-choice format. The passages and questions are predetermined, and thus do not change in difficulty depending on the performance of the test taker (unlike, for example, the general Graduate Record Examination).

The first section assesses problem-solving ability in general chemistry and physics while the third section evaluates these abilities in the areas of biology and organic chemistry. The Critical Analysis and Reasoning Skills section evaluates the ability to understand, evaluate, and apply information and arguments presented in prose style. The Biological Sciences section most directly correlates to success on the USMLE Step 1 exam, with a correlation coefficient of .553 vs .491 for Physical Sciences and .397 for Verbal Reasoning.^[17] Predictably, MCAT composite scores also correlate with USMLE Step 1 success.^[18]

Test contents

The Physical Sciences section is administered first (prior to the April 2003 MCAT, Verbal Reasoning was the first section of the exam). It is composed of 59 multiple-choice questions related to general chemistry and physics. The majority of the multiple-choice questions are divided into passage sets. Passage-based questions are implemented to evaluate "text comprehension, data analysis, ability to evaluate an argument, or apply knowledge from the passage to other contexts." Examinees are allotted 95 minutes to complete this section of the exam.

The Verbal Reasoning section follows the Physical Sciences section and an optional 10-minute break. Exam takers have 90 minutes to answer 53 multiple-choice questions evaluating their comprehension, evaluation, and application of information gathered from written passages. Unlike the Physical and Biological Sciences sections, the Verbal Reasoning section is not supposed to require specific content knowledge in order to perform well.

After Verbal Reasoning, there is an optional 10-minute break followed by the Biological Sciences section. Examinees have 70 minutes to answer 52 multiple-choice questions related to organic chemistry and biology.

Beginning in 2013, the Writing Sample was removed in order to make room for a new Trial Section that will test examinees in either: biochemistry, biology, chemistry, and physics or in psychology, sociology, and biology. The new Trial Section is optional and will be in effect from 2013 to 2014 only. The Trial Section is not scored and is not to be a part of the exam taker's composite score.^[19] Exam takers have a total of 45 minutes to answer 32 multiple-choice questions. The Trial Section is merely an option to examinees who choose not to void their exam after the Biological Sciences section.

Scoring

Scores for the three multiple-choice sections range from 1 to 15. The numerical scores from each multiple-choice section are added together to give a composite score. The maximum composite score is 45. According to the AAMC, the average 2008 MCAT score for U.S. medical school applicants was 28.1P, while for matriculants it was 30.9P.^[20] There is no penalty for incorrect multiple choice answers (which is not the case in many other standardized tests). Thus, guessing is preferable to leaving an answer choice blank. Students preparing for the exam are encouraged to try to balance their subscores; physical, verbal, and biological scores of 12, 13, and 11 respectively may be looked upon more favorably than 14, 13, and 9, even though both combinations yield the same composite score.

The standard deviation is 2.0-3 per section depending on the year and form of the exam.^[21]

2016 percentiles

The following are the scores along with their percentiles from test takers from April through September 2015. MCAT percentiles are updated every year on May1st. The average scaled score was 499.6 with a standard deviation of 10.4.^[22]

Policies

Like some other professional exams (e.g. the Graduate Management Admission Test (GMAT) or the Law School Admissions Test (LSAT)), the MCAT may be voided on the day of the exam if the exam taker is not satisfied with his or her performance. It can be voided at any time during the exam, or during a five-minute window that begins immediately after the end of the last section. The decision to void can only be based on the test taker's self-assessment, as no scoring information is available at the time—it takes 30–35 days for scores to be returned.

The AAMC prohibits the use of calculators, timers, or other electronic devices during the exam.^[23] Cellular phones are also strictly prohibited from testing rooms and individuals found to possess them are noted by name in a security report submitted to the AAMC. The only item that may be brought into the testing room is the candidate's photo ID. If a jacket or sweater is worn, it may not be removed in the testing room.^[24]

It is no longer a rule that students must receive permission from the AAMC if they wish to take the MCAT more than three times in total. The limit with the computerized MCAT is three times per year, with no lifetime limit. An examinee can register for only one test date at a time, and must wait two days after testing before registering for a new test date.

Scaled MCAT exam results are made available to examinees approximately thirty days after the test via the AAMC's MCAT Testing History (THx) Web application. Examinees do not receive a copy of their scores in the mail. Nor are examinees given their raw scores. MCAT THx is also used to transmit scores to medical schools, application services and other organizations (at no cost).

Preparation

Like most standardized tests, there are a variety of preparatory materials and courses available. The AAMC itself also offers a select few tests on their website.

Some students taking the MCAT use a test preparation company. Students who do not use these courses often rely on material from university text books, MCAT preparation books, sample tests, free web resources, and educational mobile applications (free/paid).

See also

• List of MCAT topics
• List of admissions tests
• CASPer

References

Further reading

• Julian, E (2005). "Validity of the Medical College Admission Test for predicting medical school performance". Academic Medicine. 80 (10): 910–7. doi:10.1097/00001888-200510000-00010. PMID 16186610. 
• Simonton, W. Kyle (2006). "Accommodations for the Disabled During Administration of the MCAT, Individual State Interests Versus National Uniformity". Journal of Legal Medicine. 27 (3): 305–322. doi:10.1080/01947640600870890. PMID 16959654. 

External links

• Official website
• Association of American Medical Colleges
• AAMC: MCAT Student Manual