No --nobody said this. There is a ton of gray area between the two illogical extremes you are providing. The schools need multiple hurdles to separate the wheat from the chaff, to try and pick out the best and the brightest, and those who will make it through the basic science years. The prereqs and MCAT are a crude attempt to do this, (with essays, ECs, LORs and interviews selecting for other desired attributes) and at a minimum these have some value in creating a hurdle above which you need to vault to get into med school. It is a form of quality control -- you impose a variety of obstacles and see who gets through. What I am saying is that after that, all bets are off. You have culled the herd to those who objectively you believe can compete at the medical school level. From there it is anyone's bet. Those that work hard in med school will probably do well on the Step exams. Beyond that, all else is speculative. (Note that the best ranked schools frequently take a pretty nice spread of scores from amongst solid credentialed people rather than the absolute highest scoring types -- they are doing this for a reason. If higher MCAT directly translated into something of value, such as better doctors, or even better Step scores, they wouldn't supplant their own wisdom for that of the numbers and would just blindly fill the class numerically from top on down. They don't do this, even though it would be easier and cost a lot less. Guess why? They think they can do a better job of selecting than a standardized test).