July/August 2012 Issue • Volume 40 • Issue 6

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New MCAT Emphasizes Social Foundations of Health and Disease

Shannon N. Davis, Department of Sociology and Anthropology, George Mason University (Member of MCAT BSS Subcommittee) and Jason M. Satterfield, Department of Medicine, University of California, San Francisco (Member of MCAT BSS Subcommittee)

A new Medical College Admission Test (MCAT) will be released in 2015. The new test reflects a growing appreciation for the complexities of modern medical practice and the requisite knowledge students must acquire in order to effectively function in an evolving and imperfect health care system. The MCAT advisory committee recommended that the new exam cover foundational knowledge of behavioral and social science (BSS) concepts there by signaling the expectation that entering medical students should be better prepared to learn about social and behavioral determinants of health and to promote a more nuanced examination of how personal and group identities influence professional development and behavior.

In their 2012 Perspective in the New England Journal of Medicine, Kaplan et al. provided several compelling examples of the role of behavioral and socio-cultural factors in life expectancy, managing illness, and disparities in health outcomes among racial and ethnic groups. They argued that, as with the natural sciences, students are not likely to develop a deep understanding of these important social phenomena without prior foundational knowledge. Teaching medical students how to counsel patients about nutrition without any background in understanding variations in the access to nutritious food or the socio-cultural meanings of food is like teaching gene therapy without a background in basic genetic principles.

Description of the Psychological, Social, and Biological Foundations of Behavior Section

The new section will test examinees’ knowledge of the psychological, social, and biological factors that influence: (1) our perceptions and reactions to the world; (2) behavior and behavior change; (3) how we think about ourselves and others; (4) how social and cultural differences influence well-being; and (5) how social stratification affects access to resources and well-being (MR5 Advisory Committee 2012). It will emphasize established theory and concepts as well as experimental and observational science. Sixty percent of the items will draw on concepts typically taught in introductory psychology courses, 30 percent from introductory sociology courses, and 10 percent from introductory biology courses. As members of the MCAT BSS Subcommittee, we worked with the larger MCAT advisory committee to ensure that a breadth of sociological concepts, theoretical foundations, and methodological approaches were included in the new test.

Implications for Medical Schools, Students, and Sociology Departments

Currently, entering medical students have widely variable levels of BSS preparation. This heterogeneity limits the depth of initial BSS instruction and consumes limited curricular hours that could be used for more advanced BSS training in medical school. The addition of the Foundations of Behavior section should encourage students to arrive with superior BSS knowledge and permit medical schools to begin instruction at a higher level. Ultimately, this should result in future physicians who are better prepared to serve a more diverse population and to understand the impact of behavior on health and wellness.

Students may prepare for this new section of the test in a variety of ways. For example, they may choose introductory psychology and sociology courses, more advanced courses, or study independently. The MCAT exam is course neutral; students do not have to take any specific courses before sitting for the exam. Despite the variability in how students will prepare, we know these changes may have implications for sociology departments. Currently, about one-third of MCAT examinees take an introductory sociology course. It is possible that the enrollment in introductory sociology courses may increase as soon as fall 2012.

You can learn more about the MCAT2015 by visiting the website: https://www.aamc.org/students/applying/mcat/mcat2015/. In addition to learning more about the new MCAT, you also can download a copy of The Preview Guide for the MCAT2015, which describes the new exam’s content and format and includes detailed topic lists and sample test questions. In addition, you can also download three webinars that describe the content of the new exam.

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