Cecilia asks about
>gifted students with almost perfect grades, who score very low in the
>Verbal Comprehension section of the MCAT.
The specific students she has in mind appear to be science majors. They have
been given rigorous exposure to the liberal arts, but I'm guessing that the
extent of this exposure has been that which is required by her institution's
general education core.
I have worked with similar students who excel in math and the sciences but
struggle with reading and writing and the humanities. I have two theories.
1. I suspect that some of them regard science / math as their strengths and
verbal / humanities as their weakness. They work harder at their strengths
to compensate for the weakness. They are probably drawn to medicine
as a career because they see it as applied science par excellence.
One clue that many of my students think this way is the reluctance with
which they approach classes in writing, literature, art or music, and
(horror of horrors) public speaking. They would procrastinate them all
until the senior year if they could. They ask if they can test out of these
subjects via CLEP or other mechanism, even though SAT / ACT scores
suggest that they are not stellar in those subjects. We require all of
these classes for graduation, but these very students speak of applying
early to health professions schools and (if accepted) entering them
without finishing college. Public speaking and humanities are frequently
the classes that would be left undone in this scenario.
One way that advisors should address this type of student is to point
out the fallacy that medicine is just applied science and that medical
schools are looking for outstanding scientists. A doctor needs to be
that, among other things, but (s)he needs to be more than that.
If the coverage of MCAT is any indication, medical schools are looking
for well rounded individuals.
2. I suspect that many of these same students have made a value decision
that math and science are worth their time and effort, while music, art
and literature are not. They betray this thinking when they seek to use
CLEP, AP, correspondence, or summer school to "get it out of the way"
so that they can get down to what they perceive as "the real business"
of biology, chemistry, and physics.
I have noticed over and over that my students who do the best on the biological
and physical science MCAT sections seem to do the worst on the verbal and, above
all, writing sections. And these have been A students, as were Cecilia's;
students who consistently did well in their prescribed humanities courses, as
they also did in their majors, which were usually bio or chem.
How to address this? None of my pleas to colleagues in the humanities have
resulted in a crash course or a miracle cure. I suspect there isn't one. I am
beginning to realize that continued, slow growth in all areas is the answer.
One cannot expect freshman composition to produce S writing scores on the MCAT,
nor can one expect introductory literature class to result in stellar verbal
scores. We must ensure that students keep on growing in those areas after they
leave their freshman-level classes. Certainly one way to do that is to require
meaningful writing in "major" (read: science) classes, but more than that, one
could require READING of the literature, and TEACHING (e.g. expect students to
make comprehensible public presentations). It could get even more creative than
that.
I recently attended an hour-long presentation by a senior capstone class that we
call Senior Colloquium. At our institution this is a universal graduation
requirement, and its purpose is to integrate writing and speaking skills while
exploring topics with ethical implications. This particular section of the class
had devoted itself to understanding the implications of stem cell research.
They presented an hour-long theatrical extravaganza complete with songs, dance,
costumes, props, mock television personalities (you can well imagine their zest
in simulating a lover's quarrel on the Springer show!). I suspect that the more
skills and interests one integrates into a learning experience, the more one
learns and, the more one grows in skill areas that could be quantitated by MCAT.
Then again, if a student learns to use artistic, musical, reading and speaking
skills creatively to get across a point (even a scientific one), I suspect that
(s)he is becoming what the MCAT is really trying to measure anyway -
a liberally educated, well rounded person.
Joseph H. Lechner, Ph.D.
Professor of Chemistry
Mount Vernon Nazarene College
800 Martinsburg Road
Mount Vernon, OH 43050-9500
[740] 397-9000 extension 3211
To add to Joseph Lechner's excellent comments:
I have had numerous science students tell me that they know how to get the
"right answer" in a science course, but that in order to get a good mark in
a humanities/literature course, they would certainly have to be able to
"read the professor's mind." "How am I supposed to know what the right
answer is in a humanities course?" they wail. These students are what I
call the "right answer gang." Their course selection is guided by (a)
prerequisites and (b) avoidance of any courses in which marks might end up
less than perfect.
I always point out that this practice has implications for the way in which
they will practice medicine: will they only accept patients whom they know
they can cure? And, surely, some subtlety of thought is required in the
art of medicine. Humans do not present themselves to doctors as
multiple-choice problems to be solved; people are often more like poems,
elliptical and unresolved.
Reading short stories, especially character studies, may be a way to gain
some insight into other people's lives and thoughts. (At the risk of some
stereotyping, in my experience many science students typically dislike short
stories and hate poetry, often preferring plot-driven novels, if they read
at all - apart from the textbooks!)
Tolerance for ambiguity is an important element of critical thinking. For
many students, however, the marking system does not reward or even encourage
such tolerance. In these ethically fraught times, how much more important
these things become!
Cheers,
Judy
================================
Judy Libman
Ambitions Educational Consulting
44 Strathearn Road
Toronto, ON M6C 1R6
416-780-0288 fax 416-781-3549
email: jlibman@ambitions.ca
http://www.ambitions.ca
>Their course selection is guided by (a) prerequisites and (b) avoidance
>of any courses in which marks might end up less than perfect.
>I always point out that this practice has implications for the way in
>which they will practice medicine: will they only accept patients whom
>they know they can cure?
Increasingly, the answer to that question would be "yes".
Joseph H. Lechner, Ph.D.
Professor of Chemistry
Mount Vernon Nazarene College
800 Martinsburg Road
Mount Vernon, OH 43050-9500
[740] 397-9000 extension 3211
In response to everyone's comments about a low verbal score, I believe it is
important to look at several other things besides avoidance of humanities
courses. Although it should be said that I'm in much agreement with other's
comments about the lack of a liberal arts education. Things I would ask are, "Is
English a second language?" and "Has this student been thoroughly evaluated for
learning disabilities?" In the UCSF Post baccalaureate program, many of our
students come to us with good science scores and low verbal scores (I'm talking
about a 4-5 range). We have found that in many cases, although not all, students
are either ESL or have some type of learning disability. Those are the first
questions I would ask. Then those not being the problem, I would address the
issue of avoiding liberal arts courses. My advice to our students is Read a lot
and a variety, and not just science texts. Hy Doyle at UCLA Drew is an expert in
taking the MCAT. He travels the country !
gi!
ving workshops. He might be a good resource.
Valerie Margol
Senior Analyst, External Programs
UCSF School of Medicine
margolv@medsch.ucsf.edu
This discussion does remind my of the concept of deferred gratification.
Medical students certainly need a sense of what it takes. Scores can only
go so far to identify those with the array of basic skills and attitudes.
Candidates such as this one, an obvious plodder instead of a leaper, do not
get full consideration.
My concept of medical school is changing. It seems that students can hold
up so far, before they cave in and go for more limited areas of medicine,
such as a subspecialty. As medical education continues to face challenges
from changes in care of the indigent and liability problems, there is less
access to patients and students do not get to make decisions. This passive
education keeps students from maturing and advancing in medicine. More
mature and advanced students will see the importance of physician
relationships with patients and populations and the powers that be. Less
mature students carve out a smaller niche with a defined subset of
knowledge and relationships.
Primary care is more challenging. Cures are usually not possible, or rare.
Long term care is common. Successes are often unseen and unrewarded.
Students who choose primary care are usually older, married, etc. Primary
care has a very small part of the medical curricula. So small as to
actually overwhelm students. It takes 6 months of primary care rotations to
become comfortable with it in studies in students spending 9 months in
their M-3 year in rural Minnesota. At 3 months these students were
overwhelmed with the complexity of primary care. Most medical schools allot
closer to 3 months and almost none come close to the minimal 6 months noted
in the study (Verby, RPAP, Minnesota).
Overall cancer mortality dropped for the first time in studies by the
National Cancer Institute and reported in Primary Care and Cancer Jan 1997.
These studies noted a 2.6% drop in mortality in a 5 year period. The report
attributes much of the success in reducing cancer to declines in smoking
beginning in 1965. All of these wonderful advances and yet the reason for
improvements are not cures, but changes in lifestyle. The front lines for
cancer (and heart disease, adolescent health problems, mental health, etc.)
are not cures and specialists and research. The front lines are primary
care people who deal with deferred gratification, care for the elderly, do
mental health, etc.
COGME studies continue to note that these are the specialties in most need
in medicine. Considering that we do not select for these in medical
students, this is not a surprise.
Things like emotional IQ are more difficult to measure, short of trained
interviews and more detailed gathering of info from direct observers of the
students qualities.
In many ways, I really like college advisors as an objective resource for
helping to determine these qualities and I wish that more medical schools
worked in collaboration with college advisors to help them choose better
forks, those with service-orientation, emotional IQ, and have passed the
tests of deferred gratification.
I continue to pass this on to family practice sources and in my advice to
medical schools that I contact.
Robert C. Bowman, M.D, Co-Chairman
Rural Medical Educators Group of the National Rural Health Association
UNMC Department of Family Medicine Director of Rural Health Education and
Research
983075 Nebraska Medical Center
Omaha, NE 68198-3075
(402) 559-8873 or fax at -8118
Email: rbowman@unmc.edu
http://www.unmc.edu/Community/ruralmeded/
Education - the entire pipeline