Medicine From The Trenches

Experiences from medical school, residency and beyond.

Preparing for the Medical College Admissions Test (MCAT): Aim High!

A significant step in towards your goal of becoming a physician is taking the Medical College Admissions Test. This test, now offered on computer 22 times per year, is one of most significant hurdles for any prospective applicant. Your score on this exam in conjunction with your UNDERGRADUATE grade point average, will be the most significant factors in determining whether or not you will be accepted into medical school.

Now why did I put the word “undergraduate” is all capital letters? For significance and emphasis. Your undergraduate GPA is the grade point average that is most significant. Obtaining and pursuing a graduate degree in order to attempt to “shore up” an uncompetitive GPA is not going to be helpful.

Post bacc programs may allow graduates with no science or weak science backgrounds to obtain these courses and are quite useful for doing undergraduate “damage control”, but a graduate degree will not perform the same role. A special master’s program will enhance your application but often the pre-reqs for these programs are a competitive undergraduate GPA and thus if your undergraduate grades are weak, you may still need significant post bacc work to get yourself competitive for a Special Masters.
Now, back to the MCAT. This test will examine your ability to use the knowledge presented in the pre-med subjects (General Biology, General Chemistry, Organic Chemistry and General Physics) to solve problems. These “problems” as presented on the MCAT do not test your regurgitation of facts (in the manner that many undergraduate courses test) but require that you are able to do secondary thinking. You must apply your knowledge base to a problem.
Often students make a very grave mistake in thinking that obtaining an “A” in all of the pre-med courses ensures a competitive MCAT score. Because the testing manner of the MCAT is far different from the testing manner of most colleges, practice and preparation with the types of questions and the manner of questioning of the MCAT is required. Quite simply, the MCAT tests both your knowledge base and your test-taking skills base. The MCAT tests how you “think” and “evaluate” information as much as it tests your basic knowledge and fund of information. It is no surprise that the MCAT tests how you will evaluate information for the rest of your career in medicine.
Your preparation should include making sure that your knowledge base is adequate. This may be done with any means of good MCAT review books and commercial courses (expensive). The commercial MCAT-prep courses will provide their students with outlines of the subject matter that is tested on the MCAT. These courses also provide plenty of practice exams for making sure that their students are thoroughly with the MCAT testing procedures and manner of questioning.

In addition to the commercial preparation courses, the MCAT website offers full-length MCAT practice tests for $35 each. There are currently five practice tests available for purchase. They are actual “retired” items from the paper-version of the MCAT. Purchasing one or more of these practice tests and taking these tests under actual exam conditions, can give you a very good idea of where you have weaknesses and where you should place your preparation emphasis. Again, a knowledge deficit can be strengthened with review of topics that you need. A test-taking skills weakness can be strengthened by taking test-taking skills courses (offered free at most universities).

A common mistake is for students to feel that they must “memorize” every test question presented in a book or course. By taking this approach, students wind up with major “burnout” by the actual test day. You simply cannot memorize every potential question that the MCAT can produce or offer.

Another common mistake is believing that there will be grammatically incorrect answers to questions that will be easy to spot. The MCAT is not constructed in this manner. Looking for patterns of answers will not be helpful in taking this exam. While you do need to be extremely skillful in your reading comprehension and observations, you still need a significant knowledge-base in order to to well.

Many students make the mistake of not actually reading the full question and all of the answer choices. They read the question, come to an answer choice that they think is correct and move on to the next question. There may be an answer further down the choices that is MORE correct and thus you need to read all of the possible solutions.

Another useful skill is being able to solve quantitative problems by using order of magnitude. Let’s say, you are presented with a physical science question that requires knowledge of a formula. If you are familiar with units and the order of magnitude of the numbers that go into a formula, you won’t need to do a complete calculation in order to choose the correct answer. In the case of more than half of the questions that I encounted on the physical sciences portion of my MCAT exam, I didn’t need to do the complete calculation once I looked at the answer choices.
In terms of the Verbal Reasoning and Writing Sample portions of the test, you want to have plenty of practice with reading and writing. It never fails that good readers are also good writers. Practice with the editorial pages of your local newspaper. See if you can pick out the arguement and propose a counter arguement. What is the hypothesis and what evidence does the writer show in support of that hypothesis. What is the writer’s conclusions and how does the writer tie all of his/her evidence that leads to a conclusion?
When you write your answers to the questions in the Writing Sample, the outline is Introduction where you present your thesis, evidence (next paragraph), evidence (next paragraph), counter thesis for arguement against and conclusion. You should write about 1 and 1/2 pages total on each of the subjects. You want your subjects and verbs to agree and you want your ideas as crisp and logical as possible. Again, spend some time in the Writing lab of your school where you can get critiques of your writing style.
Remember that you study for your coursework and review for the MCAT. If you have not completed your coursework, do not spend time away from your studies attempting to review material that you have not learned in the first place. Put your emphasis on thorough mastery of your Pre-Med courses while you are taking the class. When your class is complete, you can start your review if you wish. Allow plenty of time for review. This step cannot be rushed.
If you find that your review is not going according to schedule, cancel your test. It is far better to lose the testing fee than post a low grade. Again, allow yourself plenty of time to prepare, make a schedule and stick with it. If you cannot make a reasonable schedule and get your prep done, don’t register for the test.

Your planning for taking the MCAT should be one take and that’s it. DO NOT take the MCAT for “practice” and repeat for “actual grade”. The MCAT is not a practice test. One test take when you are thoroughly prepared and you are done. An application killer is several mediocre MCAT test attempts (whether released or not) and a mediocre score in the end. This is a huge “red flag” on your application.

You also cannot talk yourself out of a good performance. “I hate standardized tests and I am no good at them” can be self-fulfilling. If you thoroughly prepare and are thoroughly familiar with the MCAT testing manner, you can do well on this test no matter what you have done in the past. Talk yourself “into” a good performance rather than talk yourself “out” of a good performance. Also, don’t let the fact that the test is computerized unnerve you. The computerized test has the same knowledge requirements as the old paper exam and thus you still need the same knowledge base. If you have found this website, you have all of the computer skills that you need to take the computerized MCAT.

Resist the urge to believe that if you do not spend $1,500 in an MCAT preparation course, you are doomed to a low score on this exam. If you prepare thoroughly and analyze your performance on the practice exams ($35 each), you can do quite well on this test. If you NEED to have the experience of sitting in a prep classroom and taking their tests, then that $1,500 expenditure will be worth the money. Make no mistake, you DO NOT need a prep course but you do NEED solid preparation.
Finally, “Aim High”. The average MCAT score of medical school matriculants for 2005 was 29. That’s an average score. You don’t want to be “average” you want to be “above average”. Shoot for that 45. If you wind up with a 35, you are still well above “average”. Bottom line: “Aim High”.

10 February, 2007 - Posted by | difficulty in medical school, MCAT, MCAT preparation


  1. Awesome post! I am a Medical Student – eagerly waiting on USMLE prep tips!

    Comment by Anonymous | 20 March, 2007 | Reply

  2. The “optimal” time for taking the test is when you are “optimally” ready for the test. Certainly the test dates in April and May will continue to be the more popular dates because they allow your AMCAS/ACOMAS application to be in the earlier completion dates.

    The later dates, just like the August exam, will place put your application with the later applications which, may not be good if you need the small advantage that an early application gives.

    In general, earlier is better than later as long as you are under the deadlines for the schools that you are applying to. If you are a competitive applicant (well above the averages for matriculants) then early or late, you are not at a significant disadvantage because medical schools will begin waitlisting marginal applicants until their deadlines in hopes that they can snag competitive but late applicants.

    Comment by Drnjbmd | 10 February, 2007 | Reply

  3. Since there are now 22 times the test is available, which is the ‘optimal’ time to take the exam for apps.? Also, is there a better time to send in apps?

    Comment by Jacqueline | 10 February, 2007 | Reply

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