What if the MCAT was pass/fail?

[dbeast]

In response to the quote below (tl;dr GPA and MCAT are too heavily weighted, so says the president of the AAMC)

What do you guys think would happen if there was a minimum cut off on the MCAT (like 75th percentile or equivalent of a 32 or whatever you want to make up), and beyond that, you applied based on other qualities and experiences? Assuming premeds didn't start a mutiny, anybody care to speculate on what would make a top applicant? Anybody think it's a good idea?

I was considering an inflammatory argument in favor of it just to troll everybody, but I'm not that motivated at the moment. Still, I'd be curious to see what SDN has to say.

Ahhhh med2006, unsubstantiated blanket statements.... Where would we be without them?

Jorden Cohen, the president of AAMC is with you on accepting more non-traditional students. Give this excerpt a read...

November 4, 2001

Jordan J. Cohen, M.D., President of the Association of American Medical Colleges (AAMC), issued the following statement, today, at the Association's 112th Annual Meeting in Washington, D.C.:

The Admissions Process

"What about the way we pick students for admission? My concern here is the imbalance that currently exists in how we convey to applicants the selection criteria we use. I'm referring, of course, to our tendency to under-emphasize, because they are harder to measure, the personal characteristics we are seeking in our applicants, and to over-emphasize the more easily measured indices of academic achievement.

"I know how tough this issue is. And please don't misunderstand me; in no way am I suggesting that native intelligence and academic prowess are anything less than essential for success in medical school, or for becoming an effective physician or scientist. What I am suggesting, however, is that our admission processes do not project to prospective applicants the degree to which we value, in addition to GPAs and MCAT scores, those other essential attributes we prize: altruism, fervor for social justice, leadership, commitment to self sacrifice, empathy for those in pain.

"That many idealistic students do make it through the process, despite the distorted signals we send them about what we are looking for, is no guarantee that sufficient numbers will continue to do so going forward. If more such intelligent and dedicated idealists were to perceive that we would give as much weight to what's in their hearts as to what's in their heads, a career in medicine would no doubt attract them strongly. As it is, I'm persuaded that many don't perceive this balance in our selection criteria, and turn away convinced that medicine is for grade-grubbing Philistines but not for them.

"To balance the strong message we send about the importance of grades and test scores with more visible evidence of our co-equal interest in humanistic attributes, let me offer six ideas for you to consider:

"1. Use MCAT scores and GPAs only as threshold measures. Rather than giving more weight to higher scores, why doesn't each school decide for itself, from data available from its previous students, what level of GPA and MCAT performance is sufficient for predicting success in clearing the high academic hurdles of medical school -- and leave it at that. We would send a powerful signal to those intelligent idealists who are currently eschewing medicine if they knew that, once having met the academic achievement threshold, they would be evaluated solely on the basis of their humanistic qualities, their penchant for serving others, their leadership abilities, and so on.

"2. Even more daring, how about beginning the screening with an assessment of personal characteristics and leave the GPAs and MCAT scores 'til later. Rather than looking first for reasons to reject an applicant -- like evidence of a lackluster start in college, or a bad semester, or a C in an organic chemistry, or a "7" on an MCAT subtest -- why not look first for reasons to accept an applicant - like evidence of deep-seated social awareness, of having triumphed over adversity, of personal sacrifice for the benefit others - and only then consider the statistical predictors of mastering our challenging curriculum. Approaching their task in this way, admission committees might well find many instances in which truly compelling personal characteristics would trump one or two isolated blemishes in the academic record.

"3. Look even more favorably than you do now on the more mature applicants, those who chose some other field at the end of college, but who awakened several years later to medicine as their true calling. Such students often manifest a depth of motivation that not only predicts success as future physicians, but also provides inspiration to their fellow students.

"4. Stop using the average MCAT scores and GPAs of our matriculants as if they were valid measures of the relative quality of our schools. Take a look at the devastating critique of the U.S. News & World Report's rankings of the "best" medical schools in this month's Academic Medicine and see if you don't agree with what the authors have to say. In accepting without objection the use of such misleading measures as average MCATs and GPAs, let alone in ballyhooing them in our own promotional materials, we reinforce the public perception that they are, indeed, our principal criteria for admission.

"5. Use past experience to improve our ability to spot the truly outstanding prospects. As a general rule, it doesn't take long for a consensus to emerge among faculty and staff about who among each entering class of students are destined to be the best, most caring, most compassionate physicians. They are the ones who win the humanism awards, who tutor their classmates, who are elected class representatives, who are the pacesetters for student-initiated community service activities, and so on. Why don't we look back at those students' credentials at the time of admission and see if we can find some common characteristics that might be helpful in sharpening our ability to identify such stars among future applicants. And let's use even more of those star students as recruiters and as full-fledged members of our admission committees.

"6. Help us devise better tools for evaluating students' personal characteristics. It's too easy to assume that the so-called soft qualities we're looking for are beyond our ability to assess any more accurately than we do with our present crude measures. I just don't believe that. But we'll never know for sure unless we try. For starters, I have directed the AAMC staff to see what we can do to develop better tools, and I urge all of you to give thought to this tough problem. Not only because we may actually succeed in improving our selection process, but also because there are surely many more dedicated and intelligent idealists out there who would recognize our efforts to seek better measures of character traits as a strong signal that we want them as colleagues."

Doesn't include any youngin bashing does it? Just acknowledges the various attributes a variety of people bring to medicine. Maturity is certainly a desirable quality for those entering medicine. I applaud you and Dr. Cohen for recognizing it as such.

What you didn't need to do was say that those who have chosen medicine at a younger age than you are less desirable canidates. Maturity is not just a function of age. It is also not the only desirable characteristic of a good physician. Whitewashing the field by saying that "most" people at 22 are "not that mature" and unworthy of admission as compared to their older counterparts is simplistic and, dare I say it, immature.

Inb4 mbuto pass me the baby

---

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[mcloaf]

I imagine the exploitation of ECs would get much more extreme.

 

[circulus vitios]

If MCAT/GPA weren't used as points of elimination, pointless ECs would be used as points of elimination.

 

[plumhill]

Libraries would be emptier, and there'd be more young people out in the community doing meaningful things. And maybe that's a good thing, or maybe that'll create a pre-med community full of checklist-obsessed people.

 

[The Buff OP]

 

[dbeast]

Libraries would be emptier, and there'd be more young people out in the community doing meaningful things. And maybe that's a good thing, or maybe that'll create a pre-med community full of checklist-obsessed people.

I think we're already there, bruv.

 

[Iso4ane]

Libraries would be emptier, and there'd be more young people out in the community doing meaningful things. And maybe that's a good thing, or maybe that'll create a pre-med community full of checklist-obsessed people.

Like we are not already checklist obsessed.

Maybe not pass fail but a simple 5 point scale. 3- Is Average and within one std dev; 2/4 between 1-2 std deviations, and 1/2 greater that two std deviations from the mean. So the top 5% (35+) get fives, 4 (31-34) 3,(20-30) 2 (14-19), 1 (3-13).

And if you closely this works out nicely as even though the average mcat score hover around 26-28, the average score for matriculants is higher in the 30+ range.

And as well always say on here 30+ you are reasonable competitive, well thats why you are part of the top 15%.

 

[TheShaker]

Probably a shift from academic gunning to EC gunning. Medical schools won't be able to handle it since they will be forced to actually contact the references of ECs to preserve any kind of integrity in the selection process.

 

[RogueUnicorn]

I
I was considering an inflammatory argument in favor of it just to troll everybody, but I'm not that motivated at the moment.

 

[DrEnderW]

If MCAT/GPA weren't used as points of elimination, pointless ECs would be used as points of elimination.

I think that the idea is that the MCAT is relatively pointless when predicting success in medical school and Step 1 score.

I don't have the data on hand, but I recall that the correlation value for the bio section is the highest with an R of 0.5 something. In my lab I repeat experiments that fit 0.99 and not 1.0. The point is, ECs and other interests may be more important when selecting a compassionate future clinical physician and not a biomedical researcher.

 

[RogueUnicorn]

I think that the idea is that the MCAT is relatively pointless when predicting success in medical school and Step 1 score.

I don't have the data on hand, but I recall that the correlation value for the bio section is the highest with an R of 0.5 something. In my lab I repeat experiments that fit 0.99 and not 1.0. The point is, ECs and other interests may be more important when selecting a compassionate future clinical physician and not a biomedical researcher.

a proper scientist should know different fields have different thresholds for a high R

 

[mcloaf]

I think that the idea is that the MCAT is relatively pointless when predicting success in medical school and Step 1 score.

I don't have the data on hand, but I recall that the correlation value for the bio section is the highest with an R of 0.5 something. In my lab I repeat experiments that fit 0.99 and not 1.0. The point is, ECs and other interests may be more important when selecting a compassionate future clinical physician and not a biomedical researcher.

Lol at needing R=1

 

[Spinach Dip]

I think that the idea is that the MCAT is relatively pointless when predicting success in medical school and Step 1 score.

But it has been stated before (numerous times) that the MCAT, while not perfect, is the SINGLE BEST indication of future success in med school.

 

[scene]

then medical schools would be flooded with C average kids. the entire foundation of the medical education system would collapse.

 

[Narmerguy]

But it has been stated before (numerous times) that the MCAT, while not perfect, is the SINGLE BEST indication of future success in med school.

First of all, let's not forget that this requires us to interpret "success" in a very narrow, specific way. Is our goal to churn out good test scores, or good physicians? If the best justification of using the MCAT the way we do is that it weakly predicts success on another test, we should really rethink what we're measuring. Do doctors with marginally higher USMLE scores translate into better doctors? Who are we missing out on and turning away in pursuit of these better test scores?

I would support a P/F version of the MCAT. I think the threshold needs to be sufficiently high to ensure that it has some practical meaning that a medical school can trust, but not so high that it encourages the kinds of wasteful studying and stressing that our current system is guilty of. I don't think the MCAT should be eliminated, but its importance has become a distraction at this point.

 

[Mako555]

this thread is ******ed. last time i saw a thread this dumb i took a months-long break from SDN. I think I'll do the same this time.

 

[mehc012]

then medical schools would be flooded with C average kids. the entire foundation of the medical education system would collapse.

No, the opposite...it would take away the single greatest equalizer for those with shadowy academic histories.

Nontrad with a crappy GPA? No MCAT to showcase your potential despite your 2.1 in Engl 5yrs ago.

Engineering major? Kid from a school with grade deflation? Non-premed who just realized what they should have been gunning for all along?

The MCAT gives the comeback kid a chance to show that their history doesn't reflect the full of their academic capabilities. For those with a decent history, it's a hurdle that shows their dedication, but doesn't require stellar performance for success For those with poor test-taking capabilities, it's a warning of what's to come. For those with a crappy past, it's a bit of hope.

Not everyone is good at tests, but that doesn't mean that it's an unfair metric. Leave well enough alone.

 

[circulus vitios]

But it has been stated before (numerous times) that the MCAT, while not perfect, is the SINGLE BEST indication of future success in med school.

That's like saying 'this is the best tasting turd' in a buffet of turds.

 

[Spinach Dip]

That's like saying 'this is the best tasting turd' in a buffet of turds.

Your comparison made me laugh. Congratulations!

 

[Geebeejay]

If MCAT/GPA weren't used as points of elimination, pointless ECs would be used as points of elimination.

On the bright side, there would be an influx of tens of thousands of 18-20 yr olds suddenly very excited and passionate about things like highway cleanup, soup kitchens, international missions, teach for america/americorps, etc. because it will be a blood bath trying to find volunteer hours at the hospital

 

[Narmerguy]

On the bright side, there would be an influx of tens of thousands of 18-20 yr olds suddenly very excited and passionate about things like highway cleanup, soup kitchens, international missions, teach for america/americorps, etc. because it will be a blood bath trying to find volunteer hours at the hospital

Who knows, they may also learn something in the process. Certainly more than they'd learn memorizing math shortcuts so they can estimate pH values on a multiple choice test.

 

[Guero]

Who knows, they may also learn something in the process. Certainly more than they'd learn memorizing math shortcuts so they can estimate pH values on a multiple choice test.

Whatever the best solution may be, it's clear that our admissions process/qualifiers and medical school curricula must change and remain fluid with the ensuing changes to our medical system. My biggest complaint will likely lie in the superfluous material we're required to learn and regurgitate during M1 and M2. I'm in line with the schools that are focusing on reducing the time spent on didactic basic sciences and instead focusing on increasing clinical education while revisiting relevant basic science topics as they're encountered in the clinic, hospital, and OR. I favor the 1+3 rather than the 2+2 model. But who knows, it's so early on. Hopefully the results of these changes will be made available somewhat soon.

 

[circulus vitios]

But who knows, it's so early on. Hopefully the results of these changes will be made available somewhat soon.

15 years from now, pre-meds and medical students will be complaining about the same issues.

 

[Geebeejay]

Whatever the best solution may be, it's clear that our admissions process/qualifiers and medical school curricula must change and remain fluid with the ensuing changes to our medical system. My biggest complaint will likely lie in the superfluous material we're required to learn and regurgitate during M1 and M2. I'm in line with the schools that are focusing on reducing the time spent on didactic basic sciences and instead focusing on increasing clinical education while revisiting relevant basic science topics as they're encountered in the clinic, hospital, and OR. I favor the 1+3 rather than the 2+2 model. But who knows, it's so early on. Hopefully the results of these changes will be made available somewhat soon.

3 years of rotations? I'm all for taking as many rotations as possible before applying for residencies, but 3 full years of rotations? Before a residency? Seems unnecessary and brutal. And what exactly do you propose cutting from the preclinical education? At least in the current system third year med students can fall back on their M2-knowledge to make some sort of sense in what is going on pathologically with a patient while they are learning clinical skills. Take that away and many of them will become barely distinguishable from traditional shadows when they start on the floor. Med students get enough **** already from residents and staff, taking away a year of preclinicals will make them even more clinically useless....

 

[Guero]

3 years of rotations? I'm all for taking as many rotations as possible before applying for residencies, but 3 full years of rotations? Before a residency? Seems unnecessary and brutal. And what exactly do you propose cutting from the preclinical education? At least in the current system third year med students can fall back on their M2-knowledge to make some sort of sense in what is going on pathologically with a patient while they are learning clinical skills. Take that away and many of them will become barely distinguishable from traditional shadows when they start on the floor. Med students get enough **** already from residents and staff, taking away a year of preclinicals will make them even more clinically useless....

I didn't necessarily mean 3 years of rotations, but perhaps a more gradual transition into the clinical curriculum while revisiting basic science concepts as they emerge. [Edit, now the mimelim chimed in, I don't feel nearly as bad.] Either way, I'm neither a clinician educator nor a med student yet; so it's more of a food for thought post. I believe the schools I alluded to are on more of a 1.5+2.5 model, anyway. The only schools that come to mind that are doing this are Duke and Vandy, FWIW. But I'm sure other schools are doing it, too. Like I said, hopefully we'll soon have some finite measures as to how students performed and perceived these changes.

 

[mimelim]

3 years of rotations? I'm all for taking as many rotations as possible before applying for residencies, but 3 full years of rotations? Before a residency? Seems unnecessary and brutal. And what exactly do you propose cutting from the preclinical education? At least in the current system third year med students can fall back on their M2-knowledge to make some sort of sense in what is going on pathologically with a patient while they are learning clinical skills. Take that away and many of them will become barely distinguishable from traditional shadows when they start on the floor. Med students get enough **** already from residents and staff, taking away a year of preclinicals will make them even more clinically useless....

Sorry, but no. You learn far more from time on clinicals than in pre-clinical. It isn't even close. Yes, it requires more drive and different study habits to get the most out of it, but it would be far better to have more clinical time prior to residency. You learn next to nothing in MS1 that is applicable in how to take care of patients or even how to practice good medicine. You spend as much if not more time learning about the zebras because it is easier to test that knowledge, which is just plain silly.

Medical students are more clinically useless because they are less clinically involved than they used to. They have less responsibility and more 'protected' time away from services. It is very obvious who has had a poor clinical education in medical school the first week you show up in residency, no matter whose fault it is (medical school or student's).

 

[Guero]

15 years from now, pre-meds and medical students will be complaining about the same issues.

Indeed. I thought the cyclic nature of these complaints was tacit. You disappoint me, CV.

 

[mimelim]

I didn't necessarily mean 3 years of rotations, but perhaps a more gradual transition into the clinical curriculum while revisiting basic science concepts as they emerge. I'm neither a clinician educator nor a med student yet; so it's more of a food for thought post. I believe the schools I alluded to are on more of a 1.5+2.5 model, anyway. The only schools that come to mind that are doing this are Duke and Vandy, FWIW. But I'm sure other schools are doing it, too. Like I said, hopefully we'll soon have some finite measures as to how students performed and perceived these changes.

I have spent 4 years in medical education. When the medical school that I went to asked the student body if they would recommend switching to a 1.5+2.5 model, they voted 97% in favor of it. Do you know how hard it is to come up with something that 97% of medical students agree with?

 

[Guero]

I have spent 4 years in medical education. When the medical school that I went to asked the student body if they would recommend switching to a 1.5+2.5 model, they voted 97% in favor of it. Do you know how hard it is to come up with something that 97% of medical students agree with?

Holy crap, that's insane!

 

[Geebeejay]

Sorry, but no. You learn far more from time on clinicals than in pre-clinical. It isn't even close. Yes, it requires more drive and different study habits to get the most out of it, but it would be far better to have more clinical time prior to residency. You learn next to nothing in MS1 that is applicable in how to take care of patients or even how to practice good medicine. You spend as much if not more time learning about the zebras because it is easier to test that knowledge, which is just plain silly.

Medical students are more clinically useless because they are less clinically involved than they used to. They have less responsibility and more 'protected' time away from services. It is very obvious who has had a poor clinical education in medical school the first week you show up in residency, no matter whose fault it is (medical school or student's).

I never said otherwise, and I absolutely agree with you...my top program does the sorta 1.5/2.5 model that Guero mentioned (they don't call it that, but m3 year starts pretty early) But cutting out an entire year? Isn't that year a big part of what separates midlevels from physicians. (that and long post-graduate residencies)

Don't get me wrong, the most important factor when I looked for schools was quality and reputation of the clinical years. One of the big reasons I did not want to attend school at the affiliate of my hospital is because I thought the clinical program was lacking and didn't afford medical students with many opportunities for hands-on learning on the floor, and definitely seemed last priority after all the throngs of residents and fellows. But I think you need a decent foundation of knowledge at least at the beginning of your first rotation to stand a chance out there of walking away not completely lost or humiliated.

 

[mimelim]

I never said otherwise, and I absolutely agree with you...my top program does the sorta 1.5/2.5 model that Guero mentioned (they call it early beginning of clinical rotations). But cutting out an entire year? Isn't that year a big part of what separates midlevels from physicians.

Don't get me wrong, the most important factor when I looked for schools was quality and reputation of the clinical years. One of the big reasons I did not want to attend school at the affiliate of my hospital is because I thought the clinical program was lacking and didn't afford medical students with many opportunities for hands-on learning on the floor, and definitely seemed last priority after all the throngs of residents and fellows. But I think you need a decent foundation of knowledge at least at the beginning of your first rotation to stand a chance out there of walking away not completely lost or humiliated.

I think you could argue to change the information that is taught in MS1/2 to be more clinically relevant, but then it would be less relevant for Step 1. Then, yes it would make sense to have a full 2 years of pre-clinical time. But, as the average medical school curriculums stands right now, you lose little to nothing by cutting it out. Minimum 6 months, if not longer. It just isn't high yield information. While on your clinicals, you should be learning all of the relevant "pre-clinical" information as a background. I won't compare to a midlevel, but your functional understanding and background that you learn in MS1/2 will not impact being a residency and beyond.

 

[Geebeejay]

I think you could argue to change the information that is taught in MS1/2 to be more clinically relevant, but then it would be less relevant for Step 1. Then, yes it would make sense to have a full 2 years of pre-clinical time. But, as the average medical school curriculums stands right now, you lose little to nothing by cutting it out. Minimum 6 months, if not longer. It just isn't high yield information. While on your clinicals, you should be learning all of the relevant "pre-clinical" information as a background. I won't compare to a midlevel, but your functional understanding and background that you learn in MS1/2 will not impact being a residency and beyond.

Gotcha....so if you had to make ANY proposition, what would it be? Would it be to trim down MS1 year? I think I know which school you are talking about when you say that 97% voted for the 1.5/2.5 model, and I believe that is what they did, am I correct?

Obviously step1 is the big reason why most of the preclinical curriculums are similar and last 1.5-2yrs, but I've heard from a few sources that m1 is mostly not covered in step1.

 

[Guero]

Gotcha....so if you had to make ANY proposition, what would it be? Would it be to trim down MS1 year? I think I know which school you are talking about when you say that 97% voted for the 1.5/2.5 model, and I believe that is what they did, am I correct?

Obviously step1 is the big reason why most of the preclinical curriculums are similar and last 1.5-2yrs, but I've heard from a few sources that m1 is mostly not covered in step1.

I second these questions... Thanks for taking the time to answer our questions from a clinician educator's/resident's perspective...

 

[mimelim]

Gotcha....so if you had to make ANY proposition, what would it be? Would it be to trim down MS1 year? I think I know which school you are talking about when you say that 97% voted for the 1.5/2.5 model, and I believe that is what they did, am I correct?

Obviously step1 is the big reason why most of the preclinical curriculums are similar and last 1.5-2yrs, but I've heard from a few sources that m1 is mostly not covered in step1.

The 1.5/2.5 model was my proposition, primarily because it was validated at other schools already. I think that you do a disservice to your medical students to not go over the preclinical knowledge covered by Step 1. I think that it is a waste of time, but it is reality. I hate the concept of teaching for a test. I pushed my high school to get rid of APs for that reason. Took them 2-3 years after I graduated, but they eventually did.

I think different parts of MS1 need to be cut to varying degrees depending on the school. Anatomy is important, but typically poorly taught and a lot of time is lost. The amount of info you need to know for Step 1 is miniscule, but teaching to that level would also be a waste of time. The same can be argued for a lot of micro/immuno, genetics etc.

 

[Geebeejay]

The 1.5/2.5 model was my proposition, primarily because it was validated at other schools already. I think that you do a disservice to your medical students to not go over the preclinical knowledge covered by Step 1. I think that it is a waste of time, but it is reality. I hate the concept of teaching for a test. I pushed my high school to get rid of APs for that reason. Took them 2-3 years after I graduated, but they eventually did.

I think different parts of MS1 need to be cut to varying degrees depending on the school. Anatomy is important, but typically poorly taught and a lot of time is lost. The amount of info you need to know for Step 1 is miniscule, but teaching to that level would also be a waste of time. The same can be argued for a lot of micro/immuno, genetics etc.

Impressive, I regret every AP course I ever used for college credit because of how weak the course was compared to actual college level. Shame that this is the system.

 

[Pons Asinorum]

In response to the quote below (tl;dr GPA and MCAT are too heavily weighted, so says the president of the AAMC)

Inb4 mbuto pass me the baby

Why is you do this to us when you know we're supposed to be hitting World right now?! Stop listening to the guy with the Beat by Dr. Dre sitting next to you at the library and get back to FA and leave this until the second week of June! Amateur...

 

[mehc012]

I can't believe I'm the only one defending the MCAT as the counterbalance to gpa...I don't believe for a second that it's more important, or that a crappy MCAT can/should counteract a poor gpa, but it offers everyone a chance to showcase two different aspects of their academic side: the cumulative and the present. I think that has some value.

 

[dbeast]

Why is you do this to us when you know we're supposed to be hitting World right now?! Stop listening to the guy with the Beat by Dr. Dre sitting next to you at the library and get back to FA and leave this until the second week of June! Amateur...

SDN arguments have become my primary entertainment during my regularly scheduled 7.5 minute breaks.

 

[Pons Asinorum]

SDN arguments have become my primary entertainment during my regularly scheduled 7.5 minute breaks.

Mine too. Obviously.

 

[chrissx]

Alone, the MCAT, your GPA, your ECs, they don't really show much about you.

I'm sure there are tons of people with good MCAT scores but bad GPAs, good ECs but can't take a test to save their life.

All together...the physician you want is someone that can perform under pressure, but still has a human side.

Yes, to get through studying for the MCAT is tough, but to show your commitment to others through keeping with ECs, all the while performing well in school and excelling on standardized tests...well, together, maybe those people might be the ones you want.

If you throw out one piece of the puzzle, the pressure to excel in the others will go up. If we only look at ECs, you're going to be seeing a lot more sociopaths in medicine.

But it is more difficult, IMO, for someone to game GPA, MCAT, and ECs. The point is you're figuring out who wants it the most, who has the determination and the skills to make it. Straight up ECs = sociopath ass kissing fest, Straight up academics = Dr. Asperger.

The force requires balance.

 

[plumazul]

The 1.5/2.5 model was my proposition, primarily because it was validated at other schools already. I think that you do a disservice to your medical students to not go over the preclinical knowledge covered by Step 1. I think that it is a waste of time, but it is reality. I hate the concept of teaching for a test. I pushed my high school to get rid of APs for that reason. Took them 2-3 years after I graduated, but they eventually did.

What replaced it? To just "get rid" of such a program without a viable successor is IMO a giant step backwards.

I think different parts of MS1 need to be cut to varying degrees depending on the school. Anatomy is important, but typically poorly taught and a lot of time is lost. The amount of info you need to know for Step 1 is miniscule, but teaching to that level would also be a waste of time. The same can be argued for a lot of micro/immuno, genetics etc.

I'd suggest considering cutting most of it. Why not have a standardized "premedical" university degree? Students would then enter medical schools that only teach the practice of medicine not basic science. The MCAT could be replaced by Step 1 for entry qualification.

Impressive, I regret every AP course I ever used for college credit because of how weak the course was compared to actual college level. Shame that this is the system.

I'm sorry your school let you down but you cannot indict "the system" because of your schools poor implementation. I believe the AP exams should be made much more difficult in order to identify the underachieving schools. My high school used board certified teachers (many with PhDs) for the AP classes and the quality was as good or better then most universities. My AP classes resulted in 55 credits which allowed me to start college taking college level courses instead of glorified high school level classes and to deepen my knowledge in my major by taking grad courses for ug credit and broaden by knowledge by taking upper level classes in associated sciences. Intro chem, calc, physics, bio, and whatever intro classes are being added for 2015 are high school classes. Eventually everyone should have the opportunity to take them in high school. There could be real cost advantages to doing all of these changes. (something many debt laden students will appreciate)

 

[giantswing]

There is also a huge difference between a 20 and a 30 on the MCAT and lumping them together would be pointless.

 

[JESSFALLING]

I think medical school should last 3 years (1.5, 1.5 model) & then everyone should complete a modified rotating internship (2 years of GP residency). Then, students could choose to specialize, or remain a GP - similar to a PA, but with substantially more clinical knowledge. This system would also reduce the debt burden all students face, as they would start working sooner, and it would also expedite the training period for those that want to enter the workforce as a general doctor. More importantly, it would ensure that every student is capable of providing adequate primary care services, superior to a newly minted mid-level, regardless of ultimate sub-specialization. Additionally, the mandatory 2 years of GP residency would increase the supply of practicing GP residents in many communities, which could help with accessibility of care issues stemming from the ACA. Obviously, this is an ambitious approach....but I thought I'd throw it out for feedback.

 

[mehc012]

I think medical school should last 3 years (1.5, 1.5 model) & then everyone should complete a modified rotating internship (2 years of GP residency). Then, students could choose to specialize, or remain a GP - similar to a PA, but with substantially more clinical knowledge. This system would also reduce the debt burden all students face, as they would start working sooner, and it would also expedite the training period for those that want to enter the workforce as a general doctor. More importantly, it would ensure that every student is capable of providing adequate primary care services, superior to a newly minted mid-level, regardless of ultimate sub-specialization. Additionally, the mandatory 2 years of GP residency would increase the supply of practicing GP residents in many communities, which could help with accessibility of care issues stemming from the ACA. Obviously, this is an ambitious approach....but I thought I'd throw it out for feedback.

Gods no, specializing already takes forever without adding a few years of PCP internship before beginning.

 

[JESSFALLING]

Gods no, specializing already takes forever without adding a few years of PCP internship before beginning.

You would have one less year of med school, though ...plus, this system would of course include ample electives. It would also give students a little more time to choose their specialty. Lastly, I'd like to speculate that most specialties (e.g. neuro-psychiatry, obstetrics, gas, pm&r, family medicine, peds, im, surgery, etc..) would benefit from the increased early clinical responsibility prior to diving into their particular service.

 

[Narmerguy]

I'm sorry your school let you down but you cannot indict "the system" because of your schools poor implementation. I believe the AP exams should be made much more difficult in order to identify the underachieving schools. My high school used board certified teachers (many with PhDs) for the AP classes and the quality was as good or better then most universities. My AP classes resulted in 55 credits which allowed me to start college taking college level courses instead of glorified high school level classes and to deepen my knowledge in my major by taking grad courses for ug credit and broaden by knowledge by taking upper level classes in associated sciences. Intro chem, calc, physics, bio, and whatever intro classes are being added for 2015 are high school classes. Eventually everyone should have the opportunity to take them in high school. There could be real cost advantages to doing all of these changes. (something many debt laden students will appreciate)

Understand that your situation is not the situation of most students in the country. Very few schools have PhDs teaching high school classes, and regardless, the quality of teaching can very quite widely. I think AP classes can be a nice idea, but most of my peers have expressed that it was much weaker than their actual college classes. A good friend of mine actually just took a bunch of the college classes at the local state university or community college rather than do the AP stuff and he loved it.

I agree that many of these courses can be offered in high school, but they need to be done well and not hastily thrown together to make the school look good or try to keep up with their peers. It's already hard enough to find competent math and science teachers at most public schools, with many of them not having degrees in math or science (but instead education).

 

[mehc012]

You would have one less year of med school, though ...plus, this system would of course include ample electives. It would also give students a little more time to choose their specialty. Lastly, I'd like to speculate that most specialties (e.g. neuro-psychiatry, obstetrics, gas, pm&r, family medicine, peds, im, surgery, etc..) would benefit from the increased early clinical responsibility.

It's not really increasing early clinical responsibility anymore than a normal internship is...it's just making you spend extra time focusing on an area which isn't necessarily the one you want to end up in. In this plan you:

Spend an extra year on an area that's not necessarily your primary interest
Create the impression that GP docs are all n00bs
Flood the PCP market with a lot of GPs who don't want to be there
Gain an extra year of clinical responsibility (I'm sure the experience in a completely unrelated field will really impress the residents when you start your surgical internship afterwards)
Pay for one less year of med school, but rack up interest for an extra year before earning anything
Cost the gov't the salary of the additional PGY.

 

[circulus vitios]

I'm sorry your school let you down but you cannot indict "the system" because of your schools poor implementation. I believe the AP exams should be made much more difficult in order to identify the underachieving schools. My high school used board certified teachers (many with PhDs) for the AP classes and the quality was as good or better then most universities. My AP classes resulted in 55 credits which allowed me to start college taking college level courses instead of glorified high school level classes and to deepen my knowledge in my major by taking grad courses for ug credit and broaden by knowledge by taking upper level classes in associated sciences. Intro chem, calc, physics, bio, and whatever intro classes are being added for 2015 are high school classes. Eventually everyone should have the opportunity to take them in high school. There could be real cost advantages to doing all of these changes. (something many debt laden students will appreciate)

Hi, why don't you join us public school commoners back on planet Earth.

 

[mehc012]

Understand that your situation is not the situation of most students in the country. Very few schools have PhDs teaching high school classes, and regardless, the quality of teaching can very quite widely. I think AP classes can be a nice idea, but most of my peers have expressed that it was much weaker than their actual college classes. A good friend of mine actually just took a bunch of the college classes at the local state university or community college rather than do the AP stuff and he loved it.

I agree that many of these courses can be offered in high school, but they need to be done well and not hastily thrown together to make the school look good or try to keep up with their peers. It's already hard enough to find competent math and science teachers at most public schools, with many of them not having degrees in math or science (but instead education).

I'm torn on this...on one hand, my (public) high school had a lot of AP courses and was very successful at teaching them. I don't think it's a ridiculous goal; I certainly think it's possible to set up a good AP program without Ph.d teachers or anything of the sort. Even now, 6yrs later, I am rocking MCAT chem questions solely due to AP chem from high school. I'm not really sure what I would have learned in HS if it hadn't been for AP courses; by the time I graduated, the only non-AP I was taking was music. So, no, I don't really want to get rid of them.


On the other hand, when does it stop? APs used to be the extra mile...now they're expected at top schools, and there are people advocating for them to be the normal highschool requirement. What happens in 5yrs? 10? At what point do we stop cramming more and more low-detail, high-volume information into highschool? At what point does it stop being beneficial? I don't regret any of the classes I took, but I worry that at some point there is a ceiling on what can be designated "highschool level". I also worry that if we dictate that ceiling based on the most overachieving students, we'll end up alienating or discrediting the average student.

 

[alpinism]

The 1.5/2.5 model was my proposition, primarily because it was validated at other schools already. I think that you do a disservice to your medical students to not go over the preclinical knowledge covered by Step 1. I think that it is a waste of time, but it is reality. I hate the concept of teaching for a test. I pushed my high school to get rid of APs for that reason. Took them 2-3 years after I graduated, but they eventually did.

I think different parts of MS1 need to be cut to varying degrees depending on the school. Anatomy is important, but typically poorly taught and a lot of time is lost. The amount of info you need to know for Step 1 is miniscule, but teaching to that level would also be a waste of time. The same can be argued for a lot of micro/immuno, genetics etc.

Agreed. The 1.5 / 2.5 setup seems to be the way to go.

Anatomy, Biochem, Genetics, and Immuno seem to be the worst offenders.

Memorizing bony landmarks, all the axial movements of each joint and muscle, and the location of every miniscule artery and nerve helps no one. Neither does learning about the specific mutation or gene sequence involved with some extremely rare genetic disorder that affects only 1 in 2 million infants. Not to mention you end up forgetting 90% of it all bc you never end up using it on a regular basis.

Pathology (M2) and having a wide range of clincial rotations (M3 and M4) is what separates us from the midlevels.