Medical College Admission Test

The Moss Test: 1928–46

In the 1920s, dropout rates in US medical schools soared from 5% to 50%, 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.

MR5 and the 2015 test

The MR5 advisory committee was appointed by AAMC in fall 2008. 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. 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.

Administration

The exam is offered 25 or more times per year at Prometric centers. 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:

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.

Test contents

The test consists of four sections, each with a maximum score of 132 points (and a minimum score of 118 points). The total MCAT score is the sum of the four section scores, and ranges from 472 to 528, with 500 being the median score.

2016 scoring 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.

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. 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.

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 a lifetime limit of seven times. 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).

Relevance

A recent study (2016), shows little to no correlation between MCAT scores and USMLE step 1 scores, as well as little to no correlation between MCAT scores and the NBME scores. The MCAT also correlated poorly with the Canadian Board exam in 2016, the (MCCQE-1). The Biological Sciences section had been the most directly correlated section to success on the USMLE Step 1 exam in 2002, with a correlation coefficient of .553 vs .491 for Physical Sciences and .397 for Verbal Reasoning. MCAT composite scores had previously been shown to correlate with USMLE Step 1 success.