Medical College Admission Test (MCAT)
The Medical College Admission Test (MCAT) is a standardized examination designed to assess the readiness of prospective medical school applicants in the United States and Canada. Administered by the Association of American Medical Colleges (AAMC), the MCAT evaluates the knowledge and skills that are essential for success in medical education and practice. The test consists of four primary sections: biological and biochemical foundations, chemical and physical foundations, psychological, social, and biological foundations of behavior, and critical analysis and reasoning skills, totaling 230 questions over approximately seven and a half hours.
Scoring ranges from 118 to 132 for each section, culminating in a maximum total score of 528, with a median total score around 500. Since its inception in 1948, the MCAT has undergone several revisions to reflect advancements in medical education and the evolving skills required for healthcare professionals. Notably, the exam introduced new content areas, including biochemistry and behavioral sciences, in response to the complexities of modern medicine. In addition to medical schools, the MCAT is also accepted by certain osteopathic, podiatric, and veterinary schools, making it a versatile component of the admissions process for various health-related programs.
Medical College Admission Test (MCAT)
Definition: A computer-based standardized exam used by medical and other health professions schools for assessment of student readiness in a medical curriculum
Purpose and Use
The MCAT is administered by the Association of American Medical Colleges (AAMC), the body that represents the allopathic medical schools (those granting Doctor of Medicine or MD degrees) in the United States and in Canada. The purpose of the MCAT is to assess prospective medical school applicants on the knowledge that they have attained during their undergraduate education. The test has been devised by looking at what is required for success in medical school and in the practice of medicine, as determined by medical educators and practicing physicians. In addition to AAMC schools, the MCAT is used by the American Association of Colleges of Osteopathic Medicine (AACOM), comprising forty schools granting osteopathic medical (DO) degrees, and the American Association of Colleges of Podiatric Medicine (AACPM), comprising eleven schools granting podiatric medical (DPM) degrees. The MCAT is also used by many veterinary medical schools and other allied health programs in lieu of other standardized testing.
Content, Coverage, and Scoring
The MCAT consists of four sections: biological and biochemical foundations of living systems; chemical and physical foundations of biological systems; psychological, social, and biological foundations of behavior; and critical analysis and reasoning skills. Each of the multiple-choice sections is scored on a scale of 118–132, giving a maximum total score of 528. The median score per section is estimated at 125, for an average total of 500. There are a total of 230 questions to be answered in six hours and fifteen minutes. Optional breaks extend the seated time for the test to just over seven and a half hours.
The three "foundations" sections are meant to test knowledge in ten central scientific areas within biology, biochemistry, general chemistry, organic chemistry, physics, sociology, and psychology. This broad approach is designed to stimulate cross-discipline thinking. Each section includes fifty-nine questions that include fifteen individual questions and ten sets of four to six questions, each based on provided passages.
The critical analysis and reasoning skills section is designed to assess one’s ability to understand, evaluate, and apply information and arguments presented in prose style. This section consists of passages taken from the humanities, social sciences, and natural sciences and is included partly to encourage undergraduates with broad educational backgrounds to consider careers in the health professions. Each passage is followed by questions assessing the ability to extrapolate and use information. No specific content knowledge is required to do well on this section. It is composed of fifty-three questions arranged in sets of five to seven questions corresponding to nine passages.
The multiple-choice sections of the MCAT are not adaptive (unlike the Graduate Record Exam, or GRE); therefore, students who finish early may go back through any of the questions in that particular section since they are set and do not change according to how well the test taker has done. Penalties are not applied for guesses.
Perspective and Prospects
The MCAT has been part of the medical school admissions process since 1948. All medical schools in the United States and most in Canada require applicants to submit recent MCAT scores. Many other health professions and graduate programs also accept MCAT scores in lieu of other standardized tests.
The forerunner of the MCAT was developed by F. A. Moss in 1928. Responding to unacceptably high dropout rates of up to 50 percent in US medical schools, he and his colleagues prepared the Scholastic Aptitude Test for Medical Students. This test assessed visual memory, content knowledge, scientific vocabulary and definitions, logical reasoning, and knowledge of required premedical courses. Following the introduction of this test, the national dropout rate decreased by more than two-thirds.
Following advancements in test-measurement technology and testing psychology, the Medical College Admission Test was rolled out in 1948. Four subtests were used, measuring verbal ability, quantitative ability, scientific understanding, and knowledge of modern society (broad liberal arts skills and knowledge). Most medical schools at the time deemed scientific and quantitative knowledge to be much more important than verbal ability or societal knowledge and often used only those two scores to determine admissions. In 1977, the societal knowledge section (renamed general knowledge in the 1960s) was eliminated, and subscores began being reported for biology, chemistry, and physics. In 1991, the MCAT was changed to include biological sciences, physical sciences, and verbal reasoning multiple choice sections and a writing sample section. It updated the scoring system to a range of 1–15 for each section and 3–45 for the composite score. In 2007, the MCAT became a computer-based assessment.
Although the MCAT has remained relatively stable in its content and format (multiple-choice questions) over a long period of time, periodic changes in the content and style of questions have kept the exam fresh and taken advantage of research on how students learn and demonstrate that learning. In 2007, the AAMC convened a task force to revamp the content of the exam, taking into consideration new skills and knowledge needed for twenty-first-century medicine. The revised exam, introduced in 2015, included considerably more content that tests students' introductory knowledge of biochemistry, psychology, sociology, and behavioral and sociocultural factors that shape human health. The updated exam asks students to analyze and evaluate passages from a greater variety of humanities disciplines and social sciences compared to the 1991 version of the test. It also introduced a longer testing period and a new scoring format.
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