MCAT difficulty

[Mansamusa]

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Is there actually evidence that MGH residents have better outcomes than crap-tier residents outcomes?

I already outlined an example above.

Having more extensive prior experience in complex surgeries leads to better outcomes with those procedures. MGH does way more complex procedures than a rural community hospital would, so residents there would have more exposure. This concept extends to other specialties. Community hospitals (not all, but many), when they don't know what's going on with a patient, send them to places like MGH. Therefore a resident from MGH will have more knowledge of unique pathologies and clinical presentations. The more you know, the more you can manage as an attending.

Experience is important

 

[efle]

I'm curious what people think about parallels to the undergraduate level - would having a student body with median ACT 33 vs 25 (similar percentiles to 38 vs 30) predict different quality of researchers, writers, teachers, etc after college, out in the jobs themselves? Probably not. Yet elite colleges clearly care about numbers well beyond the threshold for handling collegiate academics, and I do think you'd notice a difference if your peers at an Ivy type college were swapped back to feeling more like an honors class at a decent high school. I really don't think whether admissions tools actually correlate to meaningful post-education performance tells you how admissions will use the tools.

 

[ace_inhibitor111]

I think we should all thank the MCAT for being the single easiest way to prove your academic capability if you are willing to work hard. Have you ever heard of a heroic story of someone get in with a 2.7 GPA? Not even a 4.0 in SMP can undo that, even if that person is completely different than he was in undergrad. On the other hand, you hear people go from 32->39, 27->33, etc. all the time, and at least 30% of retakers improve by 3+ points in the old scale.

Moral of the story: not good at test-taking? Get good. It's not like you can be in the middle of surgical residency and say "sheeeiit, Guess I'm just not good at this surgery thing, think I'm going to switch to radiology after all."

 

[efle]

On the other hand, you hear people go from 32->39, 27->33, etc. all the time, and at least 30% of retakers improve by 3+ points in the old scale.

Moral of the story: not good at test-taking? Get good.

I don't think this quite describes what is happening though. Someone that jumps 7 points was plenty capable, and just didn't put in effort to reach their capabilities the first time around. It's not that they went from not capable to capable through "getting good". Someone that studies fully and hits a 32 should not think ah well, I just need to practice even more and I'll move my capability up to a 39 next time around. Being willing to work hard will take you much further towards a near-perfect GPA than a near-perfect MCAT (hence the many people with awesome A- and A grade records that fall short on the MCAT)

 

[MaxPlancker]

1) This is entirely hypothetical and so the answer to your question would be completely opinion-based and indefensible. Even your answer would be completely opinions-based.

2) Yes, but not for the reasons you think. The Harvard graduate would likely have access to better residency programs and thus receive better training. Thus, he or she would be in a better position to enact better patient outcomes, probabilistically speaking.

Is there actually evidence that MGH residents have better outcomes than crap-tier residents outcomes? At face value most people would say of course that has to be true but i would probably surprised if top program doctors killed less people significantly than community hospital doctors.

I'm not too familiar with the quality of training across programs, but I'd imagine there's really not a noticeable difference across most programs. Top programs such as MGH are very academic and so there's likely more exposure to rarer cases. Perhaps graduating from top programs will provide more experience with rare conditions but I'd argue that the residents who train at high volume primary care centers probably have better clinical skills for the majority of common cases, if a difference were to be noticeable.

 

[aldol16]

I'm not too familiar with the quality of training across programs, but I'd imagine there's really not a noticeable difference across most programs. Top programs such as MGH are very academic and so there's likely more exposure to rarer cases. Perhaps graduating from top programs will provide more experience with rare conditions but I'd argue that the residents who train at high volume primary care centers probably have better clinical skills for the majority of common cases, if a difference were to be noticeable.

See http://jama.jamanetwork.com/article.aspx?articleid=184623

 

[pithy84]

I often hear people saying "just crush the MCAT and you'll be in a good position to apply". Is it as simple as everyone makes the process out to be?

"Just" do well on the MCAT is not good advice, it will not get you all the way there. Scoring 510 or better is good, of course, but you need a good GPA, you need extracurriculars, you need letters of recommendation, you need physician shadowing, and ideally clinical volunteering with patient contact.

A good score on the MCAT will not allow you to coast into med school, just look at the acceptance statistics. A bad score on the MCAT will not keep you out of med school. A very bad score means you should take the MCAT again.

 

[MaxPlancker]

I'm curious what people think about parallels to the undergraduate level - would having a student body with median ACT 33 vs 25 (similar percentiles to 38 vs 30) predict different quality of researchers, writers, teachers, etc after college, out in the jobs themselves? Probably not. Yet elite colleges clearly care about numbers well beyond the threshold for handling collegiate academics, and I do think you'd notice a difference if your peers at an Ivy type college were swapped back to feeling more like an honors class at a decent high school. I really don't think whether admissions tools actually correlate to meaningful post-education performance tells you how admissions will use the tools.

I personally think that yes, there would be a significant difference between ACT 33 vs 25 in terms of research (where I'm most familiar with). Also, I think 38 vs 30 is a significant difference. Intellectually perhaps the difference wouldn't be huge (yet still noticeable I'd think) but I think the students who score a 33 are more likely to have the work ethic required in research and give up less.

 

[MaxPlancker]

See http://jama.jamanetwork.com/article.aspx?articleid=184623

Hmm quite interesting at a brief glance. I think the one caveat would be that the comparison is between top and bottom programs. Of course, there's many variables but I think one thing may be that people at top programs are probably more "conscientious" (yes docs are also human) which leads to moderately better outcomes. I've seen a few er...less careful/conscientious? docs when working as a scribe.

 

[aldol16]

Hmm quite interesting at a brief glance. I think the one caveat would be that the comparison is between top and bottom programs. Of course, there's many variables but I think one thing may be that people at top programs are probably more "conscientious" (yes docs are also human) which leads to moderately better outcomes. I've seen a few er...less careful/conscientious? docs when working as a scribe.

It's not comparing top and bottom programs but rather doing a correlation with quintile rank of the program. So you basically get five bins for comparison.

Before anyone else jumps on the article, I would like to note that there are obviously shortcomings as with any data-driven study and there are inherent biases. The point is, though, that a study has been done - the only one of its kind that I know of - and it's limited to obstetrics, but it found that there are significant differences between patient outcomes depending on the residency program. More work is needed to understand if this is a general effect or isolated to obstetrics in NY and FL practitioners.

 

[Astra]

I think this is safe to say

Better MCAT score ---> better Step 1 score ---> better residency --> better training ---> better doctor

 

[Integral]

Unless you have proof to that statement, i am gonna say that is false.

That would make the MCAT an useless exam.

Also, what would you consider to be a big enough difference to show how well a person can be a doctor?

Well, the Medical College Admissions Test is more geared at admitting students than predicting the caliber of future physicians.




However, as this entire thread has discussed, there is some correlation to STEP performance and the latter.

 

[7331poas]

I think this is safe to say

Better MCAT score ---> better Step 1 score ---> better residency --> better training ---> better doctor

Well I think the whole discussion is whether that statement is true or not.

 

[Integral]

I think this is safe to say

Better MCAT score ---> better Step 1 score ---> better residency --> better training ---> better doctor

Not exactly.

Consider Texas Tech El Paso PLF, a school that has an average matriculating MCAT of about 28-30, but their STEP 1 average is ~235. There are much more prestigious programs that do not have a similar correlation and in fact many are reversed.

 

[aldol16]

Not exactly.

Consider Texas Tech El Paso PLF, a school that has an average matriculating MCAT of about 28-30, but their STEP 1 average is ~235. There are much more prestigious programs that do not have a similar correlation and in fact many are reversed.

http://journals.lww.com/academicmed...he_Medical_College_Admission_Test_for.10.aspx
http://ovidsp.tx.ovid.com/sp-3.20.0...0434bf7be232e55e11099887d0d006c339eaec8272d98
http://www.ncbi.nlm.nih.gov/pubmed/25850120

Since we do not presume to know where everybody is applying, we should talk about overarching trends and not specific cases.

 

[Integral]

http://journals.lww.com/academicmed...he_Medical_College_Admission_Test_for.10.aspx
http://ovidsp.tx.ovid.com/sp-3.20.0...0434bf7be232e55e11099887d0d006c339eaec8272d98
http://www.ncbi.nlm.nih.gov/pubmed/25850120

Since we do not presume to know where everybody is applying, we should talk about overarching trends and not specific cases.

Deflection? 🙂

"DISCUSSION: MCAT scores were weakly to moderately associated with assessments that rely on multiple choice testing. The association is somewhat stronger for assessments occurring earlier in medical school, such as USMLE Step 1. The MCAT was not able to predict assessments relying on direct clinical observation, nor was it able to predict PD assessment of PGY-1 performance."

There is 'some' correlation.

 

[efle]

I'd guess it's high MCAT -> high step (.65ish correlation iirc?) and that's all that admissions reads into it.

 

[MaxPlancker]

I read a while back that the verbal score correlated with clerkship performance. Kinda makes sense...will look up the article tomorrow...too sleeeeepy.

 

[efle]

I read a while back that the verbal score correlated with clerkship performance. Kinda makes sense...will look up the article tomorrow...too sleeeeepy.

It's still weak though - interview assessments, particularly MMI, correlate best with clinical grades by a long shot

 

[aldol16]

"DISCUSSION: MCAT scores were weakly to moderately associated with assessments that rely on multiple choice testing. The association is somewhat stronger for assessments occurring earlier in medical school, such as USMLE Step 1. The MCAT was not able to predict assessments relying on direct clinical observation, nor was it able to predict PD assessment of PGY-1 performance."

I was never the target of your questions so idk how I would deflect. Anyway, the correlation is moderate. Did you read the paper or did you just look at the abstract?

 

[NimbleNavigator]

Not exactly.

Consider Texas Tech El Paso PLF, a school that has an average matriculating MCAT of about 28-30, but their STEP 1 average is ~235. There are much more prestigious programs that do not have a similar correlation and in fact many are reversed.

Isn't the average step score 230 anyway?

 

[Integral]

I was never the target of your questions so idk how I would deflect. Anyway, the correlation is moderate. Did you read the paper or did you just look at the abstract?

Abstract.

Isn't the average step score 230 anyway?

Yes, but does a lower/higher MCAT -> lower/higher STEP 1?

 

[aldol16]

Abstract.

Then read the paper before accusing anybody of anything. There's a moderate correlation between MCAT and Step 1. Which corroborates the above poster's claim that better MCAT ---> better Step 1. The correlation may not be strong but that's to be expected because there are many factors that determine a Step 1 score. Since a simple regression doesn't take into account those factors (and some factors cannot be accounted for numerically), one should not expect a strong correlation anyway. So the point is, there is a correlation above noise and that's what's important. My post above also suggestions better residency ---> better clinical outcomes. Any other correlations implied by other posts may or may not be supported by the data but these are.

 

[Lucca]

It's still weak though - interview assessments, particularly MMI, correlate best with clinical grades by a long shot

This makes plenty of sense too. Having a short period of time to come up with an effective response to an emergent situation is exactly what anyone is doing in any job ever that requires decision making. Given that, it's not strange that the AAMC is working on ways to standardize that element of the MMI for everyone in the form of the SJT.

https://www.aamc.org/initiatives/admissionsinitiative/sjt/

 

[eteshoe]

Yes, but does a lower/higher MCAT -> lower/higher STEP 1?

Not necessarily