Medicine From The Trenches

Experiences from undergradute, graduate school, medical school, residency and beyond.

Changes for the 2015 Medical College Admissions Test (MCAT).

In 2015, the Medical College Admissions Test (MCAT) will undergo changes to reflect current needs and changes in medical education. While this exam in its current form has been in place since 1991, the new changes that are in the pipeline for 2015 will likely stay in place for 15 years or more. This means anyone who is beginning their undergraduate career (starting college) or who is targeting their application year for 2016 (Medical School Class of 2020) should be making sure that their coursework is reflective of the 2015 MCAT rather than the current exam.

 

In terms of preparation, what has not changed is the need for a medical school applicant to be well-prepared for a rigorous medical curriculum. This means that a high ability to rote memorize is not going to be of much value in preparing for medical school. Rote memorization of facts without regard to application of those facts is not going to prepare you well for either the current or future MCAT

 

If you are currently enrolled in courses that do not provide the critical thinking, problem-solving and scientific literacy that you will need as a modern 21st century physician, you will need to make some drastic changes in your college coursework to get the preparation that you need. These changes might involve taking additional coursework that will challenge your ability to critically analyze and read resource from a variety of disciplines (philosophy, social sciences, literature, and history). In short, just majoring in biology and staying away from the humanities is going to be detrimental to your preparation for the MCAT.

 

Currently, you still need to take and master the premedical science courses (General Biology, General Chemistry, General Physics and College Math/Statistics) but additionally you will need to be well-versed in analytical skills. Medical school is the application of scientific principles to patient problem-solving. If you do not prepare yourself for critical reading of the scientific literature and the practice of evidence-based medicine, you are not going to be able to have much of a medical practice in today’s world.

 

There is currently so much information at the fingertips of today’s physician, that one must make a concentrated effort to analyze and incorporate the best knowledge for patient care. If you are not able to do this and do not have a strong foundation in critical reading and analysis, you will be left behind very quickly.

 

Medical schools today rely less on rote memorization of PowerPoint lectures and more on challenging the student to integrate and build a solid knowledge base for application in patient care. This knowledge base is not obtained by memorizing a review book but by solid reading and integration of scientific concepts coupled with the incorporation of new research (clinical and basic science). The foundation for this integration and incorporation comes from an excellent undergraduate preparation for medical school which will be more tested on the 2015 MCAT.

 

As an undergraduate student, you will need to demand that your premedical coursework be of sufficient rigor to prepare you for medical school and future medical practice. By the time you are sitting in your pre-clinical coursework, you have to already have the foundations to understand medical literature. Medical school courses today and in the future will rely on you coming in with more academic/scholarship skills rather than attempting to teach you these skills. With the vast amount of knowledge that has to be assimilated and integrated with clinical skills coupled with less time in the classroom, you as an prospective medical student will spend more time preparing yourself for practice (life-long learning) than expecting a course to do the preparation for you.

 

The premedical coursework in many colleges and universities lacks the rigor that will be required for success in medical school or on the current (or 2015) MCAT. Too many courses place emphasis on rote memorization of facts rather than building a broad knowledge base and application of that knowledge base. Today’s physician needs to be able to understand how scientific principles are obtained (research) and applied along with scientific reasoning and critical thinking at every juncture of practice. Modern physicians do not just follow checkboxes or memorize an algorithm but have to be able to synthesize information across various technologies, disciplines and practices.

 

The changes in the pipeline are very exciting for those of us who are involved in medical education. We have looked at everything in our various curricula and have examined how materials are presented to our students. With this examination of curricula has come an intense examination of how students are prepared for medical education and how students are not prepared for the changes that modern medical practice will demand.

 

The most alarming trends have come in looking at how undergraduate coursework in some areas has lost rigor and the observation of how many undergraduates do not know how to propose research and query scientific databases. Pre-medical and medical students today have to be well-versed in the use of scientific and medical informatics as research in this country is relentless.

 

In addition to being able to utilize scientific and medical informatics, today’s physician needs to be able to evaluate new medical education and research for incorporation in to practice on a daily basis. There are many information systems at the fingertips of today’s physician but that physician needs to be able to understand the strengths and weaknesses of information systems and databases  in order to make the best use of their data.

 

Medical education is far more uniform than divergent in today’s world which means that emphasis on strong scholarship, personal challenge and self-reflection in terms your preparation for medical school. Additionally, you have to be sure that your premedical coursework is worth every penny of tuition money that you have paid for it. This means that you have to challenge yourself at every class, every course, every semester and exam, to make sure that you have thoroughly mastered what you need in preparation for the rigors of medical school. These needs can be met and honed by a very broad but very rigorous education at the undergraduate level as anything less is not going to work on the 2015 MCAT.

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7 August, 2012 - Posted by | academics, MCAT, MCAT preparation, medical school preparation

5 Comments »

  1. I wanted to thank you, whether you acknowledge it or not; you are helping a lot of people, and myself included. Your knowledge and warming personality, as well as your kindness for other, really does emerge fully from your writing.

    I have spent so much time reading, enjoying your blog, and yet only manage to put a small dent in the huge amount of volume of information you have left behind.

    Oppose to some of the “younger” medical student writing. Your blog is much more pleasant to read; having never a negative comment or rant for anything “too” difficulty.

    I’ll keep on reading your ever post, and apply it toward my own experience through the route of medicine. You have been my role model, and kept me sane for the past two years of residency. I hope to be a great surgeon like you one day!

    Comment by Sarah28 | 19 August, 2012 | Reply

  2. lol i think its a no, to “fleshing out”, more importantly she’s too busy saving people lives and family matter to argue.

    Comment by linda | 18 August, 2012 | Reply

  3. “This means that a high ability to rote memorize is not going to be of much value in preparing for medical school.”

    Oy. I entirely disagree with that statement – and think the truth of medical school is much more nuanced than that.

    Medical school is a strange three headed beast – a vehicle for obtaining knowledge, a vehicle for socialization and the beginning of a (lifelong) apprenticeship.

    The ability to rote memorize is absolutely VITAL for the preclinical years of medical school. The tipping point of this balance is step 1 – the transition between the pre-clinical and clinical years. The last time you have to regurgitate knowledge in such a pure and unbridled setting.

    In the clinical years rote memorization and having a solid fund of knowledge begin to take a back seat to practical problem solving and teamwork. If you can’t manage your time to see all of your patients, do what the residents tell you to do, and learn independently, it doesn’t matter if you know the nucleotide sequence of every enzyme in krebs cycle – you won’t thrive in the socialization phase of the clinical years.

    As far as residency and beyond, i’ll tell you when I get there. But for now, premeds of the world, please don’t stop memorizing and don’t stop learning how to add knowledge to your knowledge banks. You won’t get in to med school without that ability. Once you’re in the door and on your way, its a whole different ball game.

    In summary, I agree with some of the conclusions in the above post – but the case has been stretched too far. Rote memorization is the cornerstone of medical school, upon which all problem solving and critical thinking skills stand. For better or for worse, it’s here to stay.

    Comment by ThirstyScholar | 10 August, 2012 | Reply

    • To ThirstyScholar:
      The changes to the MCAT and to curriculi would prove otherwise. If you are memorizing you are going to be “dead in the water”. Rote memorization is very far from being the “cornerstone” of medical school in the US.

      Comment by drnjbmd | 10 August, 2012 | Reply

      • To be honest, I don’t think I understand your distinction between “rote memorization of PowerPoint lectures” and “integrat[ing] and build[ing] a solid knowledge base for application in patient care.” I would argue that memorization is HOW you build your knowledge base and is a prerequisite to application.

        As a current (fourth year, american) medical student, I can only report to you that rote memorization is a necessary but not sufficient skill for success in medical school.

        In my opinion there is NOTHING wrong with that. I am tremendously grateful for my rote memorization during anatomy as a first year because it provides me with the scaffolding to understand and broaden my knowledge during a carotid endarterectomy or cerebral angiography.

        Furthermore the “application” required by standardized tests (e.g. USMLE Step 1 and 2, NBME shelf exams) is usually only thinly veiled memorization (short female with webbed neck -> 45 XO).

        I’m sure the changes to the MCAT will require a whole new set of memorizations – patient scripts, ethical dilemmas, etc.

        And what’s more, the use of checklists and “best practices” is becoming increasingly important in medicine. Although those things are only a starting point, practicing medicine in a standardized fashion is definitely an improvement …

        I would be interested to understand how “rote memorization” differs from “building a knowledge base”? Would you be willing to flesh this out a bit more?

        Comment by ThirstyScholar | 11 August, 2012


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