Warning! Companies that offer MCAT preparation programs are responsible, in part, for much misinformation about the MCAT. This will be especially true as the MCAT moves from a paper-based test to a computer-based test. If you find information from different sources that are in conflict, it is to the student's advantage to seek out the truth.

A Brief History of the MCAT

The Medical College Admissions Test (MCAT) was developed by the Association of American Medical Colleges (AAMC) in 1928 as one of several efforts to improve student attrition rates in medical schools at that time. The primary goal of the evolving MCAT over the decades has been to assess the student's readiness for medical education. Most agree that the MCAT does a good job in predicting success in the first two years of medical school and as a good predictor in passing Step 1 of the USMLE. There remains considerable disagreement on how well the MCAT selects for non-cognitive qualities of a successful physician. Taking into consideration all aspects and measurements of the admission process is important in supplementing the type and attributes of individuals who are entering the medical profession. Concerns about how MCAT scores are used and the weight given to MCAT scores in the medical school admission process are shared by medical educators, the public, medical school admissions officers, and premedical advisors. Does the MCAT help predict the kind of physician who will emerge after medical school?

The Current MCAT (through August 2006). See discussion of the the "computer-based test MCAT" or "CBT MCAT" near the end of this document. Any student who will take the MCAT after January 2007 needs to be aware of the changes in the MCAT that will take place.

The current "paper version" (through Aug 2006) of the MCAT is an all-day (about 6 actual hours) standardized test that assesses the applicant's academic achievement (knowledge) and certain cognate skills after having had the course work required for medical school admission. A 5 (hour) computer version of the MCAT will be administered at Prometric Testing Centers and will replace the paper-based test in January 2007 with one-third fewer questions. Scores on the MCAT are used to select applicants with the knowledge and skills considered necessary for success both in medical school and in medical practice. The MCAT couples knowledge assessment with various skill assessments. The subject area sections measure the breadth and understanding of basic information in the physical sciences or "PS" area and biological sciences or "BS" area. These subject area sections also assess various cognate skills such as the student's reading comprehension, problem-solving ability, analytical skills, and critical thinking skills. Often students having less experience in the biological and physical sciences do better on the MCAT than students who major in these subjects because they have developed these skills more effectively. Too often, the typical science major has concentrated on memorizing facts. Even though the MCAT format resembles a multiple-choice test, for the most part, the MCAT questions are not the typical "choose-the-correct-answer" type. In the MCAT, reading and understanding the information correctly, processing that information accurately and appropriately, and answering the question that is being asked are all required in determining the correct answers. These are the "skills" being tested.

The verbal reasoning section or "VR" section tests the student's ability to read and comprehend information and then answer questions about a written passage. All of the answers to the questions are based on the passage presented. The student's task is to interpret the information properly within the context of the passage itself. The best way to prepare for the VR section is to READ, READ, READ and have a long history of doing so. It doesn't matter what the subject matter is, reading comprehension develops with practice. It does not have to be science, it can be for pleasure and relaxation. Read on your own without having an assignment to do so, and if needed, take literature courses.

Normally, the habit of reading, whether for information or pleasure, should develop early in life, certainly by high school, and continue through the college years. For the college premedical student, the choice of reading materials can supplement the student's knowledge of the profession by reading books about physician experiences and current issues in medicine by the habit of subscribing to and/or regular reading of a national newspaper such as The New York Times or USA Today in addition to at least one weekly magazine such as Time, Newsweek, or U.S. News and World Report. Premedical applicants should also become aware of medical policy articles appearing regularly in the New England Journal of Medicine and The Journal of the American Medical Association known commonly as JAMA. Also, more and more of these reading items are available on line without a subscription. If needed, students should consider taking additional college literature courses where these skills can develop.

The essay section will continue to require the writing of two essays and will be evaluated with a "letter score" of "J" through "T".

Scores on the VR, PS, and BS sections of the MCAT from "1", the lowest, to "15", the highest. When reported separately, the report is in the order above with the essay letter between the PS and BS scores (e.g. 12,13,R,10. The total score is determined by adding up the three subscores (VR,PS,BS) and following that total with the letter score for the writing section. For example, with a top writing score of T, and MCAT subscores of VR=10;PS=8;BS=9 (10,8,T,9) would be reported as 27T. Subscore means for these subsections range at about "8.0". Although these are the means for those taking the MCAT, the means for those students who matriculated into medical schools are higher. Note that the mean scores do vary slightly from year to year: VR = 9.5, PS = 9.7, BS = 9.8 and the present average of applicants is 8.96 and matriculants is 9.96. Also note that an individual's reported subscores and total score are reported only as rounded means.

Through written expression, the writing samples section (WS) assesses the abilities of the applicant: (1) to analyze the meaning, explain, or interpret a presented statement, often from a quotation, in the first several sentences, (2) to describe a specific example that qualifies the statement, being sure to explain how the basis of exception or qualification, and (3) to resolve the conflict between the presented statement and the contradiction(s) the student has described. The student's ability to effectively organize and communicate a theme-generated written discourse is being assessed. An essay for each of two topics is presented and the student has 30 minutes for each theme. The scores on the writing samples section range from "J", the lowest, to "T", the highest. The 50th percentile for those taking the MCAT is about "N". The 50th percentile for those students accepted into medical school is about "O". Medical schools report that they use the WS scores to varying degrees. Advisors often find it ironic that students do not recognize the importance of their writing and reading skills in presenting themselves as competitive applicants. Red flags appear in an advisor's mind when a student disparages their writing and speech courses that are required in general education.

Contrary to student perceptions after receiving their scores from the MCAT, studies show that the MCAT does a rather good job in discriminating among students with different levels of the knowledge and skills achievement in those areas that the MCAT measures. Each medical school must be concerned with admitting students who can handle the rigors of their educational program. Over the years, the MCAT has proven to be a good predictor of probable student success and failure, especially on being able to pass Steps I and II of the United States Medical Licensing Examination (USMLE) or the COMLEX. Each medical school has established a strong "success correlation" for students who score above a particular level of performance and student "difficulty or failure correlation" for those who score below that level. Notice the comparison grouping here: "those above a particular level" and "those below that level". This implies that those who may have lower MCAT scores that are still above the cutoff are just as successful in medical school as those who have higher MCAT scores. Admissions committees have used their own experiences with past matriculants to establish particular MCAT cutoff scores. Borderline students who score just above the cutoff receive more scrutiny in other areas of their credentials. However, medical schools have not found a strong correlation among the levels of performance above their cutoff scores and overall successes in producing good physicians. This is true because, beyond the minimum cutoff scores, factors other than those measured by the MCAT become more important in successfully producing good physicians.

Each student who approaches the MCAT can be expected to have some degree of apprehension. Unfortunately, premedical advisors note that often the amount of apprehension tends to be inversely proportional to the preparedness of the student. After the test, advisees may tend to confuse the relationship between "test performance" and "test anxiety" by evoking the claim that test anxiety was the cause of poor test performance. Generally, poor performance can indicate the lack of abilities or a lack of preparation. "I don't test well" is a lame excuse for any student who will be tested in every phase of their professional experience. Very often students who prepared for the MCAT by taking MCAT practice tests score lower on the actual MCAT than the scores on the practice tests. Taking tests and being required to perform above a particular cutoff is an "expected characteristic" of the medical profession.

Medical schools tend to place substantial emphasis on MCAT scores because the MCAT creates one of the few "level playing fields" they have in evaluating applicants. The MCAT compares students from different educational backgrounds using the same yardstick. Differences in grade point averages due to grade inflation, different undergraduate program quality, institutional differences, and the emphasis that a school has in providing MCAT preparation programs tend to be equalized. Students are expected to perform on the MCAT at a level consistent with their grade point averages. When students do not consistently perform at levels consistent with GPA, it tends to reflect on the undergraduate institution itself. When an individual MCAT score is low, but the GPA is high, a variety of questions can be posed. In most cases, such discrepancy indicates a lack of preparation by the student.

Generally, a student must perform above the MCAT cutoff scores for a particular medical school to be a viable applicant to that school. Students who are close to the cutoff levels must have strong credentials in other areas to compensate. High MCAT scores do not provide an explanation or compensation for a low GPA, but a strong MCAT score can verify the promise of a student with a borderline GPA who has shown a consistent improvement over time. Medical schools realize that premedical students may underperform during their freshman year. Students who start off strong in their freshman year, but slowly slack off by the time they are juniors are not looked on favorably. Students who have high GPAs, but who submit transcripts showing consistently "easy" schedules, do not fair well in the eyes of most admission committees. Some schools place more weight on certain sections of the MCAT, such as the "VR" section, particularly if the applicant is not a science major. Science majors tend to score lower on the "VR" section.

Students routinely ask their premedical advisor how much the MCAT counts in the admission decision process. This is a difficult question since a high or low MCAT score can have an extraordinary impact on an admission decision. Generally, most schools give the MCAT scores a value of 25-30% of the overall decision. Students need to remember this when self assessing their own qualifications that may be high in areas other than the MCAT scores.

How do admissions officers handle multiple MCAT scores? Each school differs and any one school may differ over time. During the last survey in 2003, 38% use the most recent score, 15% use the average of all scores, 21% use the highest score, and 27% consider all scores.

A List of MCAT Preparation Tips:

The detailed makeup of each of the MCAT sections is described in numerous sources available to students and will not be covered here. Here, we will concentrate on providing guidelines and advice for what it is worth:

• Student performance on the MCAT depends on innate abilities and two successful routes of preparation.

  The first route of preparation begins early (in your freshman year) and involves a "study plan" for the subject areas of the MCAT itself.

  The second route of preparation involves gaining a knowledge of the skills that are being assessed in the MCAT and being sure to refine and practice those skills. This is done formally in classes and informally by individual study. By identifying the cognate skills tested for in the MCAT early in college, the student can focus on improving these skills as they proceed through the undergraduate program.

• Students in science majors seem to forget that the MCAT tests for knowledge at the basic levels of the disciplines, not at the advanced levels found in upper-level classes in the major. Therefore, as far as the MCAT is concerned it does not matter what your academic major is. Being a science major may be a valuable asset for the first two years once you get into medical school, but being a science major may not help in applying to medical school. A general rule of thumb is: if the topic is covered in the introductory texts of the discipline, it is fair game for it to be addressed on the MCAT. This means that you should know the information in your general chemistry textbooks, your organic chemistry textbook, your introductory biology textbooks, and your general physics textbooks. Students report that going over several different introductory textbooks was valuable in identifying the "basic information" of the discipline. The selected textbooks ought to be at the level of a major's course for that discipline, not a survey textbook for non-majors. This concentration on preparing at the basic level of the discipline does not exclude the benefits that upper level classes will have in reinforcing your introductory knowledge, but it will not replace it. If the science major practices the cognate skills tested for in the MCAT during their undergraduate studies and re-surveys the breadth of basic scientific knowledge in the MCAT disciplines, they can be prepared.
• Keep the textbooks for all discipline subjects covered on the MCAT. Even though a course has been completed, pick up the text and reread and review a chapter or two each month. Re-organize your class notes for these courses so that reviews of specific topics and areas can occur easily. Enter additional notes to your class notes if you find new information that you might want to review later. Because introductory courses rarely cover all of the material in the textbook, it is important that you cover all of the chapters in the book as a part of your MCAT preparation.
  
• Do not waste time memorizing specific formulas or the periodic table, but be sure that you can use them to work out solutions to problems if called for. Every practice calculation solidifies your problem-solving procedures. When learning to solve problems with standard formulas, make sure you recognize the different presentation forms in which the formula may be expressed and be able to solve problems using each of the forms of the equations.
  
• Regardless of your academic major, the biological knowledge covered in introductory biology courses and textbooks may not be adequate for all coverage areas. Introductory biology courses show much more variations than chemistry or physics textbooks in the topics that may be covered. Pay particular attention to the coverage of biochemical and physiological concepts in introductory biology textbooks. Take a course in cell biology (here BMS 320 or 321 or BIO 320) and/or biochemistry (CHM 350) and review the textbook and course notes before taking the MCAT. Reviewing your notes from a genetics course (BMS 230, 2231, or BIO 235) is also recommended.
  
• Be sure you have as much experience as possible in interpreting graphs, diagrams, figures, tables of data, etc. Take every opportunity to practice these skills in your regular classes and in your medical reading materials.
  
• Do not avoid priming your skills in writing and do consider taking additional writing courses. The best experiences gained from your science courses is when you are required to write essay answers to questions, rather than choosing one answer from a selection as in multiple choice tests. Courses known for requiring a developed written answers include BMS 521 and BMS 525. Maintaining a laboratory notebook for each course is a good writing exercise. Don�t avoid opportunities for practicing and improving writing skills in preparation for the MCAT. Pick out writing theme-type statements, outline your approach, and practice writing responses within a thirty minute time period. When you have finished, have others evaluate your writing.
  
• Study all the old MCAT examinations (called "practice tests" or "PTs") you can get your hands on and all of the MCAT preparation and study aids that you can locate. A worthwhile investment is AAMC's unlimited single user online e-access to practice tests III-R, IV-R, V-R, and VI-R (full member status) available for $80 at www.e-mcat.com. PT 3r is available for free online. (Note: Use of the Roman numeral to describe these tests is being replaced by Arabic numbers so the practice tests (PTs) are also identified as 3r, 4r, 5r, and 6r). Most premedical students report that concentrating on practice tests and other preparatory materials benefited them the most when taking the MCAT. Other MCAT product descriptions are available at www.aamc.org/mcat. Non-science students may well benefit more from formal MCAT preparation courses. Formal preparation courses (Kaplan, etc.) are expensive. Most students who have participated in the less expensive local MCAT reviews have found them helpful, but report that they usually concentrate on subject matter and overall test taking strategies rather than the intellectual and analytical skills that characterize the MCAT. In all cases, MCAT review courses may help, but they do not replace the student's individual preparation for the MCAT.
  
• Don't take your first MCAT "for practice". Do it for real. In the past with the paper test, too many students took the April MCAT with a plan to take it again in August if they did not do well the first time. The August MCAT was the last opportunity for those applying for medical school entry the following year that usually starts in August. A possible August retake provides an "escape option" for the student, but the best strategy is to take the MCAT once and be as prepared as possible for it at that time. MCAT scores that are sent to medical schools will include all scores from all administrations of the MCAT. Even though a school may use only the last score, the admissions committee will see the others and this may initiate questions at the interview about the previous MCAT scores. Be aware that some admission committees average all administrations of the MCAT taken by the applicant. You should be prepared to take the MCAT again if the medical school suggests that a better score will improve your credentials. If no suggestions concerning the MCAT are made and if you are above the school's cutoff, it might be wiser to concentrate on improving your other credentials rather than trying for a higher score. Taking the MCAT more than three times shows desperation "without results".
  
• There are guidelines, recommendations, and available statistics for determining whether an applicant should retake the MCAT "to improve their scores". The guidelines are different for those who have low scores (1 to 9 on the BS, PS, and VR sections and below "N" on the writing sample) than for those who have higher scores. Discuss any plans to retake the MCAT with your advisor. If you do plan a retake, and again, do not prepare and do not do well, you may be in danger of closing the door to future opportunities in medicine as a physician.
  
• Although GPA and MCAT scores are what most premedical students worry about, these hurdles once met, become secondary in the considerations of medical school admission officers who are evaluating all of your credentials. Having a high GPA and a high MCAT score do not insure admission. Regardless of how high these scores are, your other credentials become deciding. There are many instances of students with GPAs of 4.0 and MCAT scores above 30 who were rejected by every medical school to which they applied. Currently, the average overall GPA of medical school applicants is 3.47 and the average GPA of medical school matriculants is about 3.63. Because the average values for applicant and matriculant GPA and MCAT scores are rather close to one another, the applicant must understand the importance of other aspects in medical school admission other than being "knowledgeable" and "smart". Do not underestimate the importance of these "other credentials" in your preparation for admission.
  
• When showing up for the MCAT, follow the advice that is provided in your instructions and bring the materials required. Scout out the site a day or two in advance, if possible. Arrive early (15-25 minutes), but not too early. Leave your cell phone at home or in your car. Dress comfortably. Do your best and if you have prepared well, there should not be any reason to panic. Remember that your memory after the MCAT will emphasize questions and areas where you had difficulty, not those parts that went smoothly. Don't try to guess your score -- just wait until the results come in. Focus on completing your academic semester as strongly as possible and only then begin your wait for the results in the mail. The turn around time for the CBT MCAT will be much shorter(30 days) that the paper-based MCAT was (about 60 days).

  Current Structure of the written MCAT

  • The physical sciences section (PS) is the first section, followed by the verbal reasoning (VR), writing sample (WS), and the biological sciences (BS) section.
  • The verbal resaoning (VR) section has 60 questions.
  • Questions on DNA and genetics have replaced several of the organic chemistry questions.

  Information on the Upcoming Computer-Based MCAT

  In August 2006 they will be Beta testing the Computer Based Test (CBT) of the MCAT at 10% of the sites and 90% of the seats will be for the paper test. As of 2007 the paper test will be completely replaced with the CBT MCAT.

  In 2007 the CBT MCAT will be offered on 19 different dates, beginning with two dates in January, and the remaining times in April through the beginning of September, with each month having mulitple test dates except June. There will only be one test date in June due to the number of contracted dates for other groups in that month. The most test dates will be available in May and August. Three of the test dates will have two test time sessions, one in the morning and one in the afternoon. The remaining test dates will have the exam offered half in the morning, half in the afternoon. There will be weekday test dates in addition to weekends. The test dates in September (7th and 8th) will be the final ones until the following January. Medical school admissions may elect to use the January test scores for the current year applicants or the following year at their discretion.

  Currently the paper test takes 60 days to score. The CBT MCAT will be scored in 30 days or less. Eventually, they hope to be able to score it in two weeks, but do not know how soon that will be possible. The CBT MCAT will NEVER have immediate test resulting. This will allow students to contest questions that they did not believe had proper answer choices available. Also, they do not want the emotional impact of the test scores to occur at the testing center where the proctors will have to handle upset students, nor do they want returned scores to impact students who are still taking the exam. There will be no paper score reports for the test scores. Students will have to log onto the website to obtain test scores.

  The test length will be five hours, which is what allows them to offer it twice a day on some days. They are reducing the length of the test by 1/3 by having fewer questions. The Writing Sample portion of the exam requiring two essays will remain the same for now.

  There will be no spell check function on the written essay component of the exam. Students will only be able to register for one exam at a time, with a maximum of three times. The "documentation rule", a letter of exception will be required for any student who wishes to take the MCAT a fourth time. If students would like a particular test exam date and location they recommend that students register at least 60 days in advance. If students register with less than 60 days they cannot guarantee the exam site location will be the students choice. While students can still register up to one week before the exam time, students who want to take the exam at a particular location should register 60 days prior to the exam. Remember, unlike the paper test, the CBT MCAT will have a limited number of seats based on the number of computer terminals available. There will be 4000 seats available for 22 different sessions, so hopefully everyone will be accommodated. They will try to find students a test location that is within 100 miles of where they requested to take the exam. As mentioned before, students will not be able to take the exam more than three times in one year. Currently, with the paper test, students are not allowed to take the MCAT more than three times without a written request from their Pre-Health Advisor. As the MCAT becomes computer based, this will shift to four times. A student will be able to take the exam three times in one year, and once the following year. After that if a student needs to take the exam a fifth time it will require a written request from the Pre-Health Advisor to the AAMC. A written request does not guarantee the student will be permitted to take the MCAT again.

  Before the MCAT begins, biometric information (photographs and digital fingerprints) will be taken for each student. The students will have a tutorial on how the CBT MCAT works before the exam begins. The CBT MCAT is designed so nothing is automatic. The program will not move on to the next computer screen until the test taker instructs it to do so. The AAMC has a free practice exam in the new CBT format available on its website for you to use as a learning tool. It can be found at CBT MCAT practice exam For more information about the CBT MCAT, what dates and locations it will be offered, please visit the AAMC website at CBT MCAT.

  In addition to the shorter reporting time of 30 days (eventually two weeks), the new CBT will have several advantages over the old paper-based examination. The new test will eliminate timing errors and "bubbling" (put answers down after time has been called). With a computer, no answers will register after time is called. The new CBT will reduce the noise and shuffling. The environmental and booth-like conditions at Prometric Testing sites should be improved over that of large rooms or testing centers. Cost for the 2007 examination will remain at $210 with about the customary $10 increase the following year. With the new CBT MCAT you will need to allow 10 business days in advance of the test date in order to get a refund.

  Students must be aware of possible scheduling difficulties during transition to the CBT MCAT. About 70,000 students take the MCAT in a given year. Prometric can handle about 3,500 students during a test period. With 22 test periods this will accommodate a potential of 77,000 takers. This does not leave much leeway for students who want to take the MCAT at a particular site on a particular test date! The advice from all premed advisors is to register as early as possible, especially in areas of the country where places may fill up quickly.

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  For More Information

  Contact one of the following Premedical Advisors:
  

  Dr. Michael Hendrix* (417) 836-4509, Prof. Bldg, Room 339
  Dr. Colette Witkowski* (417) 836-6140, Prof. Bldg, Room 341
  Dr. Joanne Gordon (417) 836-7601, Prof. Bldg, Room 335
  Dr. Christopher Field (417) 836-5478, Prof. Bldg, Room 352
  Dr. Richard Garrad (417) 836-5372, Prof. Bldg, Room 345
  Dr. Albert Gordon (417) 836-5730, Prof. Bldg, Room 333