Medical College Admission Test
The Medical College Admission Test is a computer-based standardized examination for prospective medical students in the United States, Canada, Australia, and the Caribbean Islands. It is designed to assess problem solving, critical thinking, written analysis and knowledge of scientific concepts and principles. Before 2007, the exam was a paper-and-pencil test; since 2007, all administrations of the exam have been computer-based.
The most recent version of the exam was introduced in April 2015 and takes approximately hours to complete, including breaks. The test is scored in a range from 472 to 528. The MCAT is administered by the Association of American Medical Colleges.
History
Moss Test: 1928–1946
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 Fred August 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: 1946–1962
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 to 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 merged with the newly formed Educational Testing Service. 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: 1962–1977
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. Admission committees responded to this criticism by measuring personal characteristics among their applicants with various approaches.Phase four: 1977–1991
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.Changes: 1991–2014
In 1991, 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 were 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 had a range of 3–45, was based on the individual scores of the verbal reasoning, biological sciences, and physical sciences, which each had a score range of 1–15. The writing sample, which consisted of two essays to be written within 30 minutes for each, was graded on a letter scale of J–T with T being the highest attainable score.The exam in this format was available twice a year, lasted 8-9 hours with a lunch break, and consisted of 214 questions in addition to the essays. It took 60 days for students to receive their score.
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.
MR5 and the 2015 test
The MR5 advisory committee was appointed by AAMC in fall 2008 to conduct the fifth comprehensive review of the MCAT exam and to recommend changes for the new exam set to be released in 2015. The advisory committee had 21 members including medical school deans and administrators, basic and clinical science faculty, pre-health advisors, one medical student and a medical resident. The recommendations determined were also based on responses from 2,700 surveys, over 75 meetings and conferences, and 90 outreach events to solicit input. The recommendations considered the content and format of the MCAT, the resources that should be provided relating to the exam, and the changes that should be made to medical school admissions in general.To determine the content that should be tested for the exam, the MR5 committee surveyed medical school faculty, residents, and medical students, and asked what concepts entering students need to know to be successful in medical school curricula. Three separate surveys were sent asking about concepts in the natural sciences, research methods, and behavioral sciences. The MR5 committee also consulted various expert committees from within and beyond the AAMC.
The largest changes in the exam consist of testing in biochemistry, psychology and sociology concepts. The addition of biochemistry material follows survey results placing biochemistry concepts as highest importance for success in future medical school curricula. The addition of behavioral and cultural material was recommended to provide a solid foundation for learning of these concepts in medical school. According to the committee, psychological science should be understood by medical students as an essential aspect of healthcare. The writing sample section was also removed, since data showed that these scores were not used by most admission committees. These changes were revealed in 2012 so that undergraduate premedical advisers studied the MR5 documents to translate tested core competencies into premedical course recommendations at their campuses.
This version of the MCAT has been administered since March 2015 and is expected to be in place until 2030.
Administration
The exam is offered 25 or more times per year at Pearson VUE centers. The number of administrations may vary each year. As of the 2023 MCAT testing period, 41.8% of students take the MCAT within one year of graduation, 32% sit the exam within 1-2 years post-graduation, 13.5% take the exam between three and four years after graduation and 12.7% sit for the exam five or more years after graduation.The test, updated in 2015, consists of four sections, listed in the order that they are administered
- Chemical and Physical Foundations of Biological Systems
- Critical Analysis and Reasoning Skills
- Biological and Biochemical Foundations of Living Systems
- Psychological, Social and Biological Foundations of Behavior
Test structure
The MCAT consists of four distinct sections that are individually scored. Each section is allotted either 90 or 95 minutes and tests between 53 and 59 questions. Including breaks, the full examination lasts approximately hours. The information for each of the science sections is organized into 10 foundational concepts and four Scientific Inquiry & Reasoning Skills. The science passages are guided by Scientific Reasoning and Inquiry Skills identified by the MR5 for medical school success. The Critical Analysis and Reasoning Skills section focuses on three skills, since this section does not require outside knowledge to answer questions.| Section | Questions | Minutes |
| Chemical and Physical Foundations of Biological Systems | 59 | 95 |
| Critical Analysis and Reasoning Skills | 53 | 90 |
| Biological and Biochemical Foundations of Living Systems | 59 | 95 |
| Psychological, Social and Biological Foundations of Behavior | 59 | 95 |