What goes into the rankings?

[KnightDoc]

Meh. I'm fine with how schools use the MCAT as it is and standardized tests in general (except Casper, if that even counts). Regardless of household income it takes some combination of intelligence and work ethic to get a high score and I think that should be rewarded. There's a lot of things the application process that are unnecessary to being a "good" doctor, like hundreds of hours of cleaning glassware research or cleaning beds clinical volunteering. These extracurriculars which are often unpaid also favors rich applicants because they are less concerned for money, but no one complains about these like they do the MCAT because doing bad on the MCAT hurts the ego much more than not having enough time to volunteer.

I agree with everything you said but, to be fair, people who need to work and therefore have less ability to volunteer receive way more consideration in the application process (because they receive recognition for their hours worked in the W/A Section, and they have an ability to explain) than people who, for whatever reason, don't do well on the MCAT. So, it really does involve more than just ego, even though that probably plays a role. I especially love your cross-outs!!!

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[doomer_md]

I agree with everything you said but, to be fair, people who need to work and therefore have less ability to volunteer receive way more consideration in the application process (because they receive recognition for their hours worked in the W/A Section, and they have an ability to explain) than people who, for whatever reason, don't do well on the MCAT. So, it really does involve more than just ego, even though that probably plays a role. I especially love your cross-outs!!!

The same probably applies to a poor GPA, but there are a lot more potential excuses for doing bad like "the professor doesn't like me," "he's a bad teacher," "the tests are subjective," etc. which probably explains why there is no "abolish GPA" campaign for admissions that I'm aware of. With the MCAT you decide pretty much everything - how you study, how much you prepare, when you take it - so there's no one else to blame.

Being rich permeates through pretty much every aspect of your life, not just test scores. People like you more, you probably are more confident and socially competent, you are probably able to spend more time managing your appearance, which translates to more opportunities. The MCAT is probably the only thing on your app that can't be gamed or cheated so the idea that the test is "unfair" is hilarious to me.

 

[deleted1025488]

Being rich permeates through pretty much every aspect of your life, not just test scores. People like you more, you probably are more confident and socially competent, you are probably able to spend more time managing your appearance, which translates to more opportunities. The MCAT is probably the only thing on your app that can't be gamed or cheated so the idea that the test is "unfair" is hilarious to me.

It's probably more about how the test is used. When schools selectively pick the top .5% and have a 522 median while also preaching diversity and holistic admission on top of "free tuition" (more like free tuition to the already rich who will become orth/derm/etc. lmao), I can't help but laugh...

 

[thetenthletter]

The same probably applies to a poor GPA, but there are a lot more potential excuses for doing bad like "the professor doesn't like me," "he's a bad teacher," "the tests are subjective," etc. which probably explains why there is no "abolish GPA" campaign for admissions that I'm aware of. With the MCAT you decide pretty much everything - how you study, how much you prepare, when you take it - so there's no one else to blame.

Being rich permeates through pretty much every aspect of your life, not just test scores. People like you more, you probably are more confident and socially competent, you are probably able to spend more time managing your appearance, which translates to more opportunities. The MCAT is probably the only thing on your app that can't be gamed or cheated so the idea that the test is "unfair" is hilarious to me.

+1
The MCAT is pretty fair and should be kept graded because it is standardized. It is probably the fairest thing we have.

Prep classes and tutoring, from what I've seen, are not very helpful for MCAT prep. Most of the 99-100th percentile scorers that I know utilized <$600 worth of materials (excluding the exam fee), whereas those who used prep courses typically struggled to achieve the 50th percentile.

Here is how I've seen high SES folks game the system:
- Getting handed pubs/stellar research LORs from connections their parents have to PI's (this results in them getting research awards)
- Faking clinical/volunteering hours (It is more common than you think, some communities have "a guy they know" that can check off for hours and hand out rec letters. This happens at well-known organizations
- Shadowing (again, physician friends will sign off on an exaggerated number of hours)
- GPA (students have a MUCH easier time cheating in undergrad - I know a biochem major who cheated his way through with a 3.9+ and has a solid career but no understanding of fundamental biology)

All of the above is literally why the MCAT should stay graded. It weeds out the cheaters and the liars more than anything else.
edit: spelling

 

[voodoomagic]

Indeed, a proxy for wealth:




I can't post the imgur link with the median household income by undergrad school unfortunately because SDN is messing it up. The point is though that any undergrad ranking advantage for med schools is just classism.

In the 50s/60s I think Physicians didn’t make much. It was almost a “hobby” profession is which obviously was for the very rich. I think it will be that way again.. and certainly it’ll be a two tier system more than it already is. Rich, educated patients may luck out and get Physicians whereas others will get mid-level providers who granted can do what we do, but it’ll just be another element of inequality.

 

[Lucca]

tl;dr a tournament style competition for artificially scarce careers drive a general culture of perfectionism which is harmful to everyone going through the training pipeline, especially at selection stages and it doesn't have to be this way but for it to change we would have to contend with the fundamental structures of our healthcare system and the way we supply and pay physicians which most are wary to do because they want to protect extremely high incomes. And as long as that protectionism is our modus operandi, PAs/NPs and such will continue to increase in numbers and practice scope especially in states where its harder to recruit physicians to practice.

I think the root of inequality in the gateway from undergrad --> medical school is the expectation (and general culture of medicine) that applicants should be perfect the first time. I've said this before but medical schools and certainly not elite medical schools are not interested in the business of training people from the ground up. They want people to come in as already excellent and highly motivated students, admittedly this is helpful as the expectations of medical school and training in general are very high. This is why everyone in medical school complains about preclinical education being useless -- yes, the way preclin is taught is highly variable, often inefficient, or even just plain counterproductive to learning, but what is also true is that medical students have more or less already figured out how to hurdle academic obstacles and can figure out how to teach themselves almost anything with enough time and space.

If you don't come from money or a privileged background, you are far more likely to face obstacles and traumas on the way to medical school be they financial, legal, academic, or even existential. On top of that you're unfamiliar with the cultural mores and expectations of the ivory tower and risk coming off as not only unprepared but even immature just because you don't fully grasp what "kind" of person academia wants you to be. Medical schools try to take this into account, to an extent, and maybe even increasingly so. But there are limits. Everyone wants the student who is both A Come From the Bottom, Self-made Underdog but ALSO an Academic Superstar with impeccable credentials, pedigree. I think a lot of first-gen and low income students might fall into the former category but because of structural barriers fail to register as the latter.

This same expectation comes into play at residency selection. Failed step 1 the first time but passed the second? That will set you back. Nobody cares if that first failure is actually indicative of anything or meaningful or useful as a selection barrier, but the reality of tournament systems is that it doesn't matter what is meaningful, it just matters what everyone else looks like on paper at the stage you are competing.

In general, I think we should move completely away from things like GPA and scored MCAT (or scored boards) which allow this to persist. But that's impossible in the current state of supply, demand, and structure of physician work and compensation as the outsized lifestyles and incomes of a few specialties and their tight control of their specialty's supply will continue to mean that they get to dictate precisely what the "medical school metagame" looks like and everyone else has to follow suit regardless of whether or not it is a worthwhile thing to do. At the undergrad --> med school transition things like US News and prestige in general also mean that whatever HMS/Stanford/Penn/UCSF etc value become the de facto standard for all medical schools, by which students will either be deemed "meritful" or lacking. An excellent example of this is valuing research vs. work experience. Having seen enough clinical medicine now, I would say that someone with ample experience as a service worker or in blue collar public facing work is far better prepared for clinical medicine than someone who spent 40 hours a week in a lab for four years, however the top-down tournament system we have means that not just the elite but all medical schools value the research experiences and productivity more than the service work, although no one will deny that both carry some value. Here again there are parallels to residency selection.

I could go on and on and on.

 

[deleted1105534]

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[doomer_md]

It's probably more about how the test is used. When schools selectively pick the top .5% and have a 522 median while also preaching diversity and holistic admission on top of "free tuition" (more like free tuition to the already rich who will become orth/derm/etc. lmao), I can't help but laugh...

Holistic doesn't mean your scores don't matter and diversity isn't mutually exclusive with high test scores which seems to be what you're implying. These private schools have every right to pick the top scorers, but it's not currently politically correct to admit doing so. Right now it's trendy to use words like "equity" and "oppression" in every other sentence, and I have my secondary essays to prove it.

+1
The MCAT is pretty fair and should be kept graded because it is standardized. It is probably the fairest thing we have.

Prep classes and tutoring, from what I've seen, are not very helpful for MCAT prep. Most of the 99-100th percentile scorers that I know utilized <$600 worth of materials (excluding the exam fee), whereas those who used prep courses typically struggled to achieve the 50th percentile.

Here is how I've seen high SES folks game the system:
- Getting handed pubs/stellar research LORs from connections their parents have to PI's (this results in them getting research awards)
- Faking clinical/volunteering hours (It is more common than you think, some communities have "a guy they know" that can check off for hours and hand out rec letters. This happens at well-known organizations
- Shadowing (again, physician friends will sign off on an exaggerated number of hours)
- GPA (students have a MUCH easier time cheating in undergrad - I know a biochem major who cheated his way through with a 3.9+ and has a solid career but no understanding of fundamental biology)

All of the above is literally why the MCAT should stay graded. It weeds out the cheaters and the liars more than anything else.
edit: spelling

Pretty much. I scored a high 51x and I only paid for UWorld and the AAMC stuff which is about $600. Premade Anki decks are free and I torrented all the prep books lol.

The non-clinical volunteering is probably the easiest to fudge hours even if you don't have any connections. I've seen some places that use GPS sign-in so volunteers can use their phone to check-in when they arrive at the site. If you ever find one of these you could just drive there and sign-in and leave or you could fake your GPS location and sign-from anywhere and get all the hours you ever need. It's a joke, really.

 

[deleted1108964]

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[doomer_md]

You can easily game the MCAT as a rich person. I go to a UG where 90% of premeds are rich gunners and voiding a MCAT where you have 'uncomfortable' topics, and retaking until you get a 'good' exam is common enough to a point where it's actually just plain sad. I know a person who voided 3x exams because "of physics and orgo" and ended up with a 523 with 132 on CP after finally getting "an easy" section (at WashU now, btw).

The nature of the MCAT is that they test 10 topics out of probably hundreds on each section...of course, this strategy of voiding until you get a comfortable exam is viable. If they wanted to make it more accurate, they could just have it be a 2-3 day exam with longer sections (like literally every other graduate exam/standardized college exam in every other country). Obviously, they just want the retake process to be easier (shorter exam, less annoying to take, etc.) --> more money for AAMC.

Of course this is probably like .1% of the testing population, so its not like it really matters, but don't pretend like you can't game it. Everything can be cheated with $$$.

Also there is no reason schools shouldn't see your voided attempts. If you show up for the exam, TAKE IT, and know you F'd up enough to void it, then it's ridiculous that you can just get a free pass. If you no-show, then that should not go on your record. Voiding is just stupid. Most people's justification is that they crumbled due to nerves...well too bad that's part of testing. If you feel sick or have a legitimate excuse, don't show up. Anything else is just part of the standardized testing process. It's ridiculous to me that a 523 scorer could have gotten a 510-15 3 times over and no one would have known about it.

And his punishment is having to live in St. Louis for 4 years. I say he got what he deserved.

In all seriousness, I do agree on some points. I spent the time a lot of topics that were hardly tested if at all. I don't know about making the test be taken over multiple days but I'd personally like it more if the test was all discrete questions and not passage-based which would allow for more topics to be tested.

For your gamer specifically, if he only had a problem with the CP section, he still had to do exceptionally well on the other three parts to get a 523, so saying he would get a 515-510 (an 8-13 point difference because of one section) is a bit of an exaggeration. I'm also pretty sure the soonest you can retake an MCAT is a month after your last attempt, so this guy could've just studied for 4 months and gotten a similar result. Good for him I guess? There's still no way to cheat the MCAT like you can a typical undergrad exam and especially those online "honor policy" exams that were common during remote learning last year. It's still the most valid and fair thing in the entire process and I think we both agree that it shouldn't just be eliminated.

 

[LizzyM]

What annoys me is the attitude that anyone with less than a 518 is unworthy of admission to medical school or would be a bad choice. Such a high threshold is certainly being driven by USnooze and not by the data and it is shutting out good candidates.

 

[EdgeTrimmer]

What annoys me is the attitude that anyone with less than a 518 is unworthy of admission to medical school or would be a bad choice. Such a high threshold is certainly being driven by USnooze and not by the data and it is shutting out good candidates.

Does your school have no thresholds?

 

[deleted1108964]

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[deleted1080380]

People also seem to ignore the impact of private schooling or competitive HS schooling imparted by parents. Most of these schools in the NY, SF, etc. area, especially most privates, require excellence in standardized examinations starting at age like, 8. Then if you want to break into the high schools you have to take another standardized exam, not to mention the college SAT/ACT. Parents shell out $$$$$ for tutoring and the like so their students will be eligible for these schools, and this isn't only limited to rich parents (I know many poor immigrant parents who paid for things like this so their kid could have a better future). Stuff like this compounds on the MCAT and easily results in stuff like 510+ benchmark deflated third party exams. Not that it's a bad thing, but just one of the many factors that make standardized exams not so...standardized.

I mean, hell, you can literally see this in the AAMC data too. States like CA/NY nearly breaching 515 average MCATs while some in the south are barely hovering over 505. No, these kids are not just magically smarter.

Considering the material on the MCAT is not hard, critical thinking and testing 'ability' that is ingrained since you're 12 gives a massive advantage. Not to mention CARS, which essentially seems to exist as a blockade for the 'normal' premeds and a high starting-CARS score or innate ability (from previous stuff like it, or going to rigorous primary schooling) will immediately put you up 3-4 points above everyone else.

Also to echo a previous sentiment, it's not the fact that the MCAT exists. It's that a rather significant number of schools are actively screening <95th percentile MCATs, especially for ORMs. That's not something that should happen, ever, especially in an already thinned premed cohort. So much for 'destressing by removing STEP 1.' Imagine being a freshman premed ORM and seeing the MCAT pattern that is emerging. Soon even mid-tiers will have 515 screens for us.