Do the MCAT's and USMLE predict how good a physician one will be?

[DrBowtie]

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What I'm saying is the exact problem you mention. With this form of testing you have established a base line of competence that the profession requires which most people in any medical school have already because most pass these exams. I totally agree that we need more spots in medical schools and that is currently happening yearly, but not quick enough. There is a physician shortage in this country and that is well known.

You seemed to make implications based upon my post that I wasn't trying to make.

There needs to be stratification at this level and standardized testing is the best way to separate the competant from the more competant.

 

[Kappy1]

simply put it's supply and demand. Currently, physician's are in demand and while dealing with people's lives they better be competent. I know I'm sounding idealistic but, it is something to strive for.

 

[Kappy1]

You seemed to make implications based upon my post that I wasn't trying to make.

There needs to be stratification at this level and standardized testing is the best way to separate the competant from the more competant.

If that is the case then why aren't the physician's with the highest boards scores considered the best physicians? Studies have shown (when I find the link I will post it and I have seen the data on it.) that the best physicians do not have the highest board scores or highest GPA in Med school!!! If anyone else knows a source feel free to post it.

 

[DrBowtie]

If that is the case then why aren't the physician's with the highest boards scores considered the best physicians? Studies have shown (when I find the link I will post it and I have seen the data on it.) that the best physicians do not have the highest board scores or highest GPA in Med school!!! If anyone else knows a source feel free to post it.

A) Everyone has a different definition of a good physician.

B) Standardized testing right now is the best metric to determine knowledge of pertinent subjects. There isn't a way to test how good of a doctor someone will be 8 years down the line.

 

[Kappy1]

A) Everyone has a different definition of a good physician.

B) Standardized testing right now is the best metric to determine knowledge of pertinent subjects. There isn't a way to test how good of a doctor someone will be 8 years down the line.

I agree with A. But after 4 years of schooling in a medical school approved by LCME, AOA, or WHO have most of thier students passing the boards regardless of the medical program they attend. Therefore it is not giving you any measure of anything that was not known before. If these organizations are approving these schools is because it meets a certain level of teaching required to be a competent physician. These exams are a pain and are only an obsticle to residancy programs. For example ( not sure if true but you'll get the point) if you get a 190 on your boards you passed the boards and you can't take them over and you could not get into a Surgery program. Then you are making four years of school come down to three test days of the boards.

 

[DrBowtie]

I agree with A. But after 4 years of schooling in a medical school approved by LCME, AOA, or WHO have most of thier students passing the boards regardless of the medical program they attend. Therefore it is not giving you any measure of anything that was not known before. If these organizations are approving these schools is because it meets a certain level of teaching required to be a competent physician. These exams are a pain and are only an obsticle to residancy programs.

Honestly, deciphering between qualified candidates is hard enough with objective data and eliminating that would make things even more of a pain and an obstacle to residency programs.

Fact of life, people succeed on different levels and people need benchmarks to compare competition. Your philosophy just doesn't work when there is competition.

 

[Kappy1]

Honestly, deciphering between qualified candidates is hard enough with objective data and eliminating that would make things even more of a pain and an obstacle to residency programs.

Fact of life, people succeed on different levels and people need benchmarks to compare competition. Your philosophy just doesn't work when there is competition.

With the way it is now your future is decided by three test days. To me after busting your butt in med school it should not just come down to the boards which is what it essentially comes down to because most applicants have good LOR's and dean's letter. I also did not suggest anything to use at a mesureing stick at this point because I haven't found a solution. But I am alerting you of the problem.

 

[DrBowtie]

With the way it is now your future is decided by three test days.

We're lucky here. In foreign countries, 1 test determines your career path.

It's not ideal but there isn't anything plausible that can replace it.

 

[Kappy1]

That is what I'm looking for with this thread. I am speaking to very "intellegent people" (again using the term loosely) to come up with a solution.

 

[DrBowtie]

With the way it is now your future is decided by three test days. To me after busting your butt in med school it should not just come down to the boards which is what it essentially comes down to because most applicants have good LOR's and dean's letter. I also did not suggest anything to use at a mesureing stick at this point because I haven't found a solution. But I am alerting you of the problem.

Your problem is that everyone busts their butt in med school (some schools have gone to P/F so no grades to decide on) has good LORs and dean's letter. Thus no way to distinguish them.

There has to be a way to stratify the best students from the not so great.

You can't interview 17k med students for 80 derm spots.

 

[DrBowtie]

That is what I'm looking for with this thread. I am speaking to very "intellegent people" (again using the term loosely) to come up with a solution.

My solution is keep it how it is. Sink or Swim my friend.

 

[Static Line]

I think the responsibility should sit with the individual schools to remove those students who are detrimental to society.

Very few people who graduate medical school are bad physicians...and even at that, the quality of a physician is often based on perspective.

Society has a way of handling these types of docs...malpractice, lawsuits, lack of hospital privelages, etc

No standardized test is going to accurately predict what someone will become.

You cant test compassion, empathy and desire on a standardized test. You can only evaluate subjective things.

Any objective test is open to interpretation. And I dont trust any governing body interpreting an objective exam.

If they want to see that I know my antibiotics and chromosomes, fine. But no exam is going to guage my compassion for a dying patient or my desire to read journal articles to keep up with current medical therapy.

If the MCAT ever comes to that you are going to end up with a bunch of handholding bookworms going to medical school, while those of us who function in different ways will be excluded because we dont have the righ objective characteristics...according to a panel of doctors. Give me a break.

I understand what you are saying. I don't entirely disagree with it either. However, I am not so sure that if it were left up to the schools that they would do the right thing. I think if it were left up to the school to dismiss unfit students more than likely they would find a way to remediate students through the process. Dismissing too many students would hurt the schools bottom line and left up to them, their not gonna do that. I know students who have remediated many classes here and I know of others who have cheated. They may get by here but I think a nationally standardized board exam would weed them out if they haven't learned something.

Perhaps the board exam could be P/F and that is it. You are right that there are some people better fit to care for really sick and dying patients and they may not test well at all, thus eliminating certain possibilities for them. Perhaps that is where doing audition rotations during your 3rd and 4th years would play a much bigger role in determining if you are fit for a certain program or not.

I don't think what we have is the ideal situation but we have to have something. Most every professional school I can think of has some sort of governing body for exams--eg... law, nursing, police, CPA.

Speaking of exams I take step 1 in 80 days so I gotta go. Can't get surg with a poor score. You'll still be in philly though won't you friend🙂

 

[Dr JPH]

kappy

You are all over the place with your argument...its hard to keep it straight.

One minute you say that MCATs and boards need to change so that they weed out people who arent going to be "good physicians" and the next minute you say these exams are counted too heavily.

 

[It'sElectric]

Your spelling is atrocious, kappy. I'm a prick, I know.....but I had to say something. It actually prevented me from following this thread.

 

[Dr JPH]

Your spelling is atrocious, kappy. I'm a prick, I know.....but I had to say something. It actually prevented me from following this thread.

Good thing spelling isnt one of his criteria for becoming a good physician.

 

[Kappy1]

My bassic arggument iss thatt if there iss a test thatt iss beingg usedd itt shouldd encompasss alll thee partss too beingg a physiciann andd iff noo testt doess thatt theirr shouldn'tt bee a testt. (this was for the the spell prick)

 

[It'sElectric]

My bassic arggument iss thatt if there iss a test thatt iss beingg usedd itt shouldd encompasss alll thee partss too beingg a physiciann andd iff noo testt doess thatt theirr shouldn'tt bee a testt. (this was for the the spell prick)

Awesome. A fool actually promoting and even emphasizing his/her own inadequacies.

 

[Kappy1]

Awesome. A fool actually promoting and even emphasizing his/her own inadequacies.

If you made a half A$$ attempt to follow you could of. If you have nothing to add then we don't need you here.

 

[spicedmanna]

My bassic arggument iss thatt if there iss a test thatt iss beingg usedd itt shouldd encompasss alll thee partss too beingg a physiciann andd iff noo testt doess thatt theirr shouldn'tt bee a testt. (this was for the the spell prick)

I felt like I was seeing double, reading the above. 😛

First of all, at this point in time, there is no realistic way for a standardized test to "encompass" all the aspects of being a physician. Second of all, there should absolutely be tests. These tests, as I mentioned before, are a convenient way by which to screen applicants at various levels and to provide an objective way to ensure some very basic level of competence (one of many...there are also clinical evaluations in rotations and in residency). You can't really use these test for anything else.

 

[Kappy1]

I felt like I was seeing double, reading the above. 😛

First of all, at this point in time, there is no realistic way for a standardized test to "encompass" all the aspects of being a physician. Second of all, there should absolutely be tests. These tests, as I mentioned before, are a convenient way by which to screen applicants at various levels and to provide an objective way to ensure some very basic level of competence (one of many...there are also clinical evaluations in rotations and in residency). You can't really use these test for anything else.

we agree to disagree. I believe it is there anyway most of the time because most Medical Students pass these exams. I'm glad to see someone found it funny.

 

[Dr JPH]

These tests, as I mentioned before, are a convenient way by which to screen applicants at various levels and to provide an objective way to ensure some very basic level of competence (one of many...there are also clinical evaluations in rotations and in residency). You can't really use these test for anything else.

Exactly. 👍

 

[DrBowtie]

we agree to disagree. I believe it is there anyway most of the time because most Medical Students pass these exams. I'm glad to see someone found it funny.

But most med students can't score 99%ile on the COMLEX or USMLE thus it gives a way to distinguish between students.

 

[Kappy1]

I would agree with you that a student scoring in 99% on the USMLE or COMLEX knows his material cold and someone scoring 1% on USMLE or COMLEX doesn't know anything. But who is to say that distinguishing someone who scored a 220 on this one time test is more or less competent than someone scoring a 230 (just an example, not sure if true). The student scoring a 230 may have had more questions in an area he or she knew while the other student didn't. Therefore the student with a 230 could get into a surgery and the other student can't (only an example not sure if is true). I just feel their is too much emphasis put on these exams and not enough put on the other parts to being a physician. As stated a bad physician is weeded out socially. Patients say he or she is terrible, he or she is sued for malpractice, or the practice becomes limited to certain areas in medicine.

 

[Dr JPH]

I would agree with you that a student scoring a 99% on the USMLE or COMPLEX knows his material cold and someone scoring 1% on USMLE or COMPLEX doesn't know anything. But who is to say that distinguishing someone who scored a 220 on this one time test is more or less competent than someone scoring a 230 (just an example, not sure if true). The student scoring a 230 may have had more questions in an area he or she knew while the other student didn't. Therefore the student with a 230 could get into a surgery and the other student can't (only an example not sure if is true). I just feel their is too much emphasis put on these exams and not enough put on the other parts to being a physician. As stated a bad physician is weeded out socially. Patients say he or she is terrible, he or she is sued for malpractice, or the practice becomes limited to certain areas in medicine.

You went get very far with a 99th percentile COMPLEX score.

 

[Kappy1]

You went get very far with a 99th percentile COMPLEX score.

I'm not trying to imply that someone who scored lower doesn't know his or her stuff.

 

[Static Line]

I'm not trying implying that someone who scored lower doesn't know his or her stuff.

clue 😱 less

 

[Dr JPH]

I'm not trying to imply that someone who scored lower doesn't know his or her stuff.

You dont even want to know my COMPLEX score. It was terrible. 👍

 

[HarveyCushing]

You dont even want to know my COMPLEX score. It was terrible. 👍

I am sure that you did well in your classes and had great LORs. Great to know that scores aren't everything and that you can still match into a great surgery program if you want it. 👍

 

[Kappy1]

I am sure that you did well in your classes and had great LORs. Great to know that scores aren't everything and that you can still match into a great surgery program if you want it. 👍

Agreed and I think you all understand my point.

 

[Static Line]

I am sure that you did well in your classes and had great LORs. Great to know that scores aren't everything and that you can still match into a great surgery program if you want it. 👍

Another 😱 one

 

[Dr JPH]

Here is the thing with the COMPLEX. Its a very difficult test. It has questions that are 3 and 4 steps long. Its cryptic, obscure and perplexing. Why cant it be a happier test like the USMILE?

 

[Static Line]

Here is the thing with the COMPLEX. Its a very difficult test. It has questions that are 3 and 4 steps long. Its cryptic, obscure and perplexing. Why cant it be a happier test like the USMILE?

The only COMPLEX I have is the one after having just taken some practice questions. I don't have a smile but I still have time.

 

[Kappy1]

I finally found the link to show that the MCAT's are not the best predictor of how someone will perform in medical school. http://www.jaoa.org/cgi/content/full/107/4/157

 

[Animus]

I finally found the link to show that the MCAT's are not the best predictor of how someone will perform in medical school. http://www.jaoa.org/cgi/content/full/107/4/157

That study also mentions a bunch of other studies that say MCATs are the best predictor's...sorry.

For those of you who are still falling for what JP is saying I am going to give in and help you all, Kappy said "COMPLEX" and it is COMLEX so JP was leading everyone on and no one but Static picked up on it .

 

[Kappy1]

That study also mentions a bunch of other studies that say MCATs are the best predictor's...sorry.

For those of you who are still falling for what JP is saying I am going to give in and help you all, Kappy said "COMPLEX" and it is COMLEX so JP was leading everyone on and no one but Static picked up on it .

That was true for the USMLE's, but not for the COMLEX. It showed for Osteopathic schools that UGPA is the greatest factor.

 

[Animus]

That was true for the USMLE's, but not for the COMLEX. It showed for Osteopathic schools that UGPA is the greatest factor.

Only because comlex ones have not been done before...

The point is there is information both ways, hence, this really does not tell you anything.

 

[Kappy1]

Only because comlex ones have not been done before...

The point is there is information both ways, hence, this really does not tell you anything.

You are right their seem to be conflicting studies. Therefore it is unclear if MCAT's are or are not a predictor of these other standarized exams or osteopathic medical school peformance. Which again comes back to my main arguement that too much emphasis is being put on these exams and not on the other parts that make a physician great. When these exams may not be accurate predictors of a medical school performance.

 

[Animus]

Bottomline is this, there are far too many factors going into what makes a good physician. Perhaps the best one is personality(for physicians that see patients regularily), but this cannot be tested because there are millions of traits that go into personality. So what they do is use knowledge base as an indicator, because it can be (relatively) understood by asking questions and getting answers.

Until a test can be created that combines knowledge along with personality and drive we will not be able to even begin to consider what really makes a good doctor. There are far too many factors to work in at this time.

 

[Taty]

Im still confused.

Could someone PLEASE tell me if my patients are going to die...my MCAT was <30

Please help

Even if your MCAT was < 30...I will trust you to remove my gall bladder if I'll have problems with it again 🙂 who cares🙂

 

[scdocusc]

this whole thread is a huge loaded question

 

[Kappy1]

this whole thread is a huge loaded question

I would like to state the obvious as well. The sky is blue, the moon comes out at night, and clouds are white.(no offence but I found what you said funny)

Feel free to speak your mind on the issue I would love to hear what you think.

 

[Dr JPH]

MCATs dont play a role in "making a great physician", which I still think is a ridiculous term anyway.

Medical schools need a standardized score that they can use to look at all of their applicants across the board. That is what the MCAT is for.

The MCAT does nothing else. Studying for it wont prepare you for medical school. Doing well on the MCAT proves nothing more than you know how to study.

Medical school admissions people, most of whom are NOT physicians, should not be in any position to judge whether or not you will be a "great physician." They will agree with this.

Their job is to accept or deny applicants based on their likely performance academically in school. They are asking "can this applicant handle the academic burden of medical school?" Then, the physician in the interview is asking "can I trust this student with one of my patients?"

There is no possible way to determine anything further.

Things are just fine the way they are. We have a standardized test that can be used by medical schools (MCAT), we have board exams which weed out people who cant demonstrate at least a baseline level of recall knowledge and we have the 4 years of school itself. On top of that, people who want to practice need to get into a residency program...and those programs have a way of keeping out the bad.

Medical school is just the first step in this process and it is not the most important, the most difficult or the most career defining.

People here say that the MCAT isnt a good predictor of how good a doctor you will be. Well, no $hit.

Youre looking at 2 separate things.

You can either look at how a person will do academically in medical school.

OR

How good a physician someone will become.

They are mutually exclusive and the latter is open to interpretation.

Regardless, I dont think the majority of people in this thread have any credit in saying that things should change. Many of you just took the MCAT a few months ago. So when a premed says "I think it should be changed" I am worried for the future of THAT person in becoming a great physician.

IME the people who bitch and complain from day one...or in this case, before they even start...are NOT the ones who become the best doctors.

So maybe the bar should be set based on how dumb your SDN comments are.

A few of you here are way ahead of the pack. Keep it up...with a few tries at the boards, the "6 year plan" and a rural FP residency you too will become doctors.

 

[scpod]

Youre looking at 2 separate things.

You can either look at how a person will do academically in medical school.

OR

How good a physician someone will become.

They are mutually exclusive and the latter is open to interpretation.

That's the best post you've had in quite a while JP. (Note- my opinion is also open to interpretation 🙂) But, you are soooooooo right on this one. I know several people who I think would make great physicians in my class, but they aren't cutting it academically right now. It's sad sometimes, but you have to have more than personality, compassion and desire to become a physician-- you have to excel academically as well. OTOH, I know even more people who are doing well academically that I wouldn't send my worst enemy to for treatment.

Yes, you are right in that they are two separate things, but you can still be the world's greatest ass and become a physician. Yet, you can be the world's most wonderful person, but fail to become a physician simply because you can't hack it academically. Thus, medical schools have to first focus on those most likely to cut it academically, regardless of personality or how good a doctor someone might be. Otherwise it's a total waste of everyone's time, effort and money. MCAT and GPA over time have proven to be indicators of academic success. That's why MCAT and GPA SHOULD be strongly considered for all applicants.

 

[scdocusc]

I think that if you dig too deep in the question you get lost. I dont think there are many people out there who would agree with this original statement. Test's dont prove anything but basic ability at best. No offense (not offence) taken. 😎

 

[DeLaughterDO]

MCATs dont play a role in "making a great physician"

Agreed. The MCAT has nothing to do with medical school, other than the fact that only people who are interested in going to medical school take it.

It sucks.

Medical school admissions people, most of whom are NOT physicians, should not be in any position to judge whether or not you will be a "great physician."

If only more people understood this point...

You can either look at how a person will do academically in medical school.

OR

How good a physician someone will become.

This almost sounds like you are saying to be a good physician, one has to struggle in school.

I don't think there is actually any standard to compare an applicant to, nor any means of measuring whether or not a person will become a good physician. Really, what is a good physician?

Once upon a time, I believe a good physician was a person who was knowledgeable, had the mental and physical dexterity to save and affect lives for their own betterment, and could handle the stress of the job.

Anymore, I think a good physician is almost more of a waiter/waitress at a patient's favorite restaurant - catering to their every whim and desire. Medicine, unfortunately, has become a consumer-driven machine and does not so much seem to be concerned with making patients well as with making them feel the "warm fuzzies" before they leave. Evidence? Look at the reliance on Press-Ganey scores to "rate" hospitals, rather than their compliance with standards of care, morbidity and mortality rates, or numerous other objective standards. No, instead we rely on how well a patient or their family "thinks" we treated their family member - like they went to medical school.

So maybe the bar should be set based on how dumb your SDN comments are.

Ok, I think none of us would ever get into medical school if that were the case...

 

[spicedmanna]

Anymore, I think a good physician is almost more of a waiter/waitress at a patient's favorite restaurant - catering to their every whim and desire. Medicine, unfortunately, has become a consumer-driven machine and does not so much seem to be concerned with making patients well as with making them feel the "warm fuzzies" before they leave. Evidence? Look at the reliance on Press-Ganey scores to "rate" hospitals, rather than their compliance with standards of care, morbidity and mortality rates, or numerous other objective standards. No, instead we rely on how well a patient or their family "thinks" we treated their family member - like they went to medical school.

That is a very apt way of stating it. I agree. This is exactly what my physician friends tell me all the time. I think it's important to understand this before going into medicine.

 

[DeLaughterDO]

That is a very apt way of stating it. I agree. This is exactly what my physician friends tell me all the time. I think it's important to understanding this before going into medicine.

It is a daily source of frustration. Learning medicine is, quite frankly, easy compared to learning the "game" that medicine has become.

When physicians (as a collective) are willing to stand up for themselves and their knowledge of how to help people get well, rather than lying down and just taking whatever castrating "initiative" the Joint commission on making my job a living hell (JCMMJLH, or "jak-uhm-jul-luh for the initiated) passes down from their non-medically-trained high horse, then we'll begin to see change. Until that time, the situation will only get worse.

- sorry for the hijack 🙂

But my opinion about the MCAT and USMLE/COMLEX still stand...

 

[GreenShirt]

The MCAT is not an indicator of how good a physician you will be, but an indicator of your chances for becoming a physician. Obviously med schools want to invest their time in people who have the ability to go through the process.

As for the "quality" of the physician, are you talking about personality or intelligence? Because as someone has mentioned, you need both as a physician. If my physician is the nicest, most attentive person I've met in my life but doesn't know his science, then he's pretty worthless. Essays, interviews, and LOR's are the means by which med school gauge personality. If you're a complete prick with a perfect MCAT, a few doors might shut for you.

The whole med school application process is the most involved and elaborate process of any program, because they are considering so many factors in their decisions. Heck, it would've been great if the whole thing was based on MCAT and GPA, think about how much time it would have saved all of us just to write 2 numbers down on a piece of paper and send it in.

 

[Dr JPH]

Heck, it would've been great if the whole thing was based on MCAT and GPA, think about how much time it would have saved all of us just to write 2 numbers down on a piece of paper and send it in.

You mean you had to interview?

They accepted me based on the picture I sent in. 😉

Along with the check for $10,000

 

[DeLaughterDO]

If you're a complete prick with a perfect MCAT, a few doors might shut for you.

Of course, a few might just open, as well...