MCAT scores are individual efforts, but they reflect future distributions of professionals and the status of various US populations. MCAT Correlations In addition changes in science scores can also reflect changes in student focus. The MCAT was last standardized in 1993. The average scores of admitted medical students can be compared across class years. With increasing scores as compared to increasing income, there is an advantage. There is no need to adjust for inflation. The overall performance of the group is related to the overall socioeconomic status of the group, whether this is the larger group taking a test such as the MCAT (all applicants) or the more select group that gains admission to medical school (admitted medical students).
For those admitted to medical school, the verbal reasoning subscores in the MCAT have increased from 1994 to 2005 from 9.4 to 9.7. Physical science subscores have increased from 9.4 to 10.1, and biosciences subscores have increased from 9.6 to 10.4. Verbal scores are considered the most difficult to change. The rapid increases in Asian and foreign born medical students to 30% levels, two groups with slightly lower scores, have also tended to suppress verbal scores for admitted students. Increases in science scores also result from these admission changes as well, but there is more of a science boost that may well indicate changes in who is being admitted and also the essential preparation for admission. Verbal ability is a difficult area to “teach to the test” however science skills are a different matter. MCAT Central: Changes, Impacts on Distribution and Career Choice
The most likely interpretation is that those admitted are a narrower group with regard to increasing income. Another interpretation is that medical student scores are increasing at least in part from increasing MCAT preparation or changes in top colleges to prepare more specifically for the MCAT test. The great and increasing costs of preparation and top colleges favor those of higher income origins. The potential interpretations point to a narrowing group of higher status and closer proximity to income, education, top colleges, concentrations of professionals, and medical schools.
The advantages of “connection” may also favor certain groups. Specific details about the new computerized version of the MCAT were also available within minutes after completion of the first version. What was also obvious is that those with the most connections to top colleges, top health advisors, and paid test preparation consultants had significant advantages. This emphasis does not involve learning, preparation for medicine, or efforts that will improve the physician product of medical education. The consistent focus is learning strategies for maximizing standardized test performance. A new barrier involves access to computerized testing centers which are centralized in the most population dense areas of the nation. Those less socially organized and more distant from the testing centers are more likely to be displaced and discouraged by the changes. The groups howling most vociferously about the computerized testing changes are the ones where glitches in the system have disadvantaged them. They have been forced to different centers and greater costs for travel and hotel with potential impacts upon test performance. Welcome to the usual reality of rural, lower income, and older applicants who must balance these and other issues these areas daily and often at their own expense without the resources or influence of parents or advisors to “make things right.”
Top Workforce Outcomes Rankings - when students are ranked by the probability of primary care, family medicine, rural careers, and underserved locations, admissions has a different result.
Given the above, the nation does have choices. One of the top priorities should be distributions of Education, Addressing Inequities, and a Focus on Child Development. The so-called no child left behind efforts are an opportunity. The prevaling choice to emphasize science and math in high school is a focus on the 30% remaining who are top status or who will be. This is also an effort with no proven benefit. It also involves improvements that could largely be financed without federal funding. A choice to improve preschool would be a choice to improve the lower and middle income children. However the challenge is getting the top 30% to approve and also seniors. These are the ones who vote and who would get no direct benefit from such investments, however there is little doubt of the long term improvements that would result. This in itself is a major part of the problem, since investments in children are seen 20 years later, far beyond most political careers.
Even more bad news is provided from college testing. With new changes in the SAT including changes in the format and increased costs, over 30,000 fewer lower income children took the SAT in just the first year of this change. This is a much more serious problem beyond just numbers. This is a lower income group that has managed to overcome maldistributions of education resources in the nation, including an antiquated funding system that penalizes those living in areas with lower property values, federal lands, and public properties that generate very little revenue for areas such as education. Poor distributions of education, poor distributions of quality teachers, and poor access to college are a difficult set of obstacles to overcome. College students from the top 146 colleges are already 74% from the top income quartile with only 3% from the bottom quartile. This is not likely to improve when the bottom 3% continue to face greater increases in barriers and when the greatest increases in financial support have been extended to the upper income groups . Medical school admissions are a direct reflection of access to top colleges. But the seeds of advancement and admission can be seen in child development dating back before age 8. One of the more chilling thoughts: America will not be competitive until lower and middle income children have the kind of start that will force upper income children to be more rather than cruising on a far superior child development head start. References at Education References, Distributions, Inequities, Child Development
One important aspect of physician distribution involves admissions of those most socially and geographically distant and different from the current medical students. Those most different also have superior patterns of distribution. Those most distant and different also have different scores, the scores that help determine admission to college and to medical school.
The major reasons for changing admissions are not problems with the MCAT test as to design or validity, the problems involve human errors in all the interactions and relationships involved.
Perhaps the most important limitations involve limitations of human comprehension regarding standardized testing. This limitation extends to the highest levels in the nation. The nation’s most educated peoples have developed a devotion to rankings and ratings that borders on worship, structures education to testing rather than learning, and provides its own internal narrowing process that detracts specifically from top preparation for a complex profession such as medicine
The problem involves the limitations inherent in all standardized testing. The problem is made more and more challenging because the United States is changing in ways that make it difficult if not impossible to interpret the test results. The alarm for this is not only coming from lower income peoples, or the middle income parents who find themselves with increasing levels of children in poverty, but also from those who test our children such as ETS. Education References, Distributions, Inequities, Child Development