Industry Voices—Could less emphasis on the MCAT bring more diversity to medicine?

We’re experiencing challenges in 2020 that continue to disrupt our lives, our businesses and how we think about our institutions, practices and beliefs, from the devastating impacts of COVID-19 to engaging conversations about racial equity across our nation.

In healthcare, the COVID-19 pandemic has magnified the inefficiencies, healthcare workforce shortages and access issues that have long taxed our system. Even before COVID-19 pushed our hospitals to their limits, the World Health Organization estimated we were facing a global shortage of 7.2 million healthcare workers. 

Yet, many nurses, doctors and other medical specialists have been furloughed or lost their jobs in recent months. It’s a paradox that speaks to the healthcare industry’s need to innovate how it educates and prepares people to enter its workforce.

The current system simply isn’t set up to address the areas of greatest need or provide the access required to create more diversity across the healthcare industry.

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A report issued in June by the Association of American Medical Colleges (AAMC) paints a dire picture of the state of diversity in medicine. According to AAMC, only 5% of active physicians identify as Black or African American and just 5.8% identify as Hispanic. We must do more to open opportunities for diverse talent in medical professions.

Reliance on MCAT test puts diverse students at a disadvantage

The fact is traditional medical education has long relied on measures that are inherently weighted against diverse candidates to gauge future admissions success. An over-reliance on test scores and grades puts many students who have had to work through college, care for family members or take other nontraditional paths to medical school at an extreme disadvantage. These requirements disproportionately affect Black, Hispanic and other Americans from diverse backgrounds and become barriers to entry.

 As COVID-19 puts logistical pressure on medical school admissions testing, some schools are extending deadlines and accepting partial applications until students can complete these tests. At the same time, the University of California recently announced it’s ending SAT and ACT requirements to help ensure a more equitable admissions process.

Many other schools are making the standardized tests optional for admission into undergraduate programs. Pre-COVID-19 research published by the National Association for College Admissions Counseling has shown that such test-optional policies can increase both the number of undergraduate applications and the number of underrepresented minority students in freshman classes.

This same level of flexibility has not been applied to medical schools, many of which still require prospective students take the Medical College Admission Test, or MCAT, despite numerous cancellations and rescheduling in the wake of the global pandemic.  

As a medical educator and physician, I challenge all medical schools to embrace this moment as an opportunity to reevaluate our dependence on the MCAT as a defining value indicator in the admissions process.

Since 1928, medical schools have relied on the MCAT to gauge an applicant’s potential. Today, applying for medical school, which includes test fees and charges for preparation courses, can cost up to $10,000. And there’s no guarantee the investment will lead to school acceptance.

This risk automatically prices out many prospective candidates at a time when healthcare faces a projected shortage of up to 139,000 physicians by 2033 in the U.S. Paired with the medical school applications costs, school fees, tuition and living expenses, the traditional medical system has created a career path that limits the type of students it admits and attracts and, ultimately, the type of doctors it produces.  

More than a test score

There’s so much more to a student than their MCAT score. I see this every day in my work.

Many students who may not have performed well on the MCAT have the drive and academic strengths to succeed in medical school.

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With the right support and mentoring, I have seen these students thrive and know they can achieve their dream to become physicians.  

Bottom line: A single test cannot be the only measure of one's potential to succeed in medicine

Assessment tools like the MCAT may have made sense in the past, but putting too much emphasis on them is limiting opportunity for too many deserving students today.

The time is right for the medical industry to rethink how it evaluates, educates and advances the healthcare professionals of tomorrow. As the impacts of COVID-19 give rise to new technologies in the classroom, and MCAT exams, clinicals and internships are placed on hold, we have an unprecedented opportunity to transform our antiquated approach to medical education that, for far too long, has denied access to many promising students.

Now is the time for meaningful change.

David Lenihan, Ph.D., is president of Ponce Health Sciences University and co-founder and CEO of Tiber Health, an education technology company offering health-science curricula.