Representing the first major modification to the exam in a quarter century, the new 2015 Medical College Admissions Test (MCAT) has created a ripple effect in sociology departments across the country. Responding, in part, to a need to train future physicians for a patient population that is becoming more diverse and rapidly aging, the Association of American Medical Colleges (AAMC) redesigned the test to add an emphasis on behavioral and social sciences (www.aamc.org/newsroom/newsreleases/273712/120216.html).
The emphasis on the social sciences will draw a broader population of premedical students to sociology classes, and will require faculty to balance their current course objectives with the need to help prepare the future health care workforce. Amid other pressures currently facing faculty in institutions of higher education, such changes represent a mixed blessing. A steady stream of undergraduate students preparing for medical schools provide a boost to enrollments in sociology courses, but finding faculty/instructors to restructure and teach courses to meet these demands is no easy task. Even so, the fact that such a large proportion of undergraduate premedical students will set foot in sociology classes provides a unique opportunity to engage in public sociology by helping to shape the field of medicine for decades to come.
Why Modify the MCAT?
The AAMC approved changes to the MCAT in response to a variety of reports about broader trends in the patient population, changes in health care delivery, and concerns about providing quality care. From a practical perspective, the AAMC cited the evolving structure of health care reimbursement as one reason to train tomorrow’s doctors differently, observing that future physicians will be reimbursed for their patients’ outcomes and the quality of care they provide. But the AAMC’s motivation was rooted in the fundamental desire to train better doctors because “being a good physician is about more than scientific knowledge;” physicians need to understand people, “how they think, interact, and make decisions.”
Teaching Premedical Students
Understanding people, and patients, is precisely where sociologists excel. When introducing students to sociology, so often we invoke C. Wright Mill’s “sociological imagination,” a classic perspective that is perfectly suited to teach students how to view the social phenomena that shape the clinical encounter and patient behavior. Beyond this sociological lens, I provide five specific recommendations for teaching premedical students:
- Advertising. Although premed students are well aware of the modifications to the MCAT, they may not know which classes include topics covered on the new MCAT exam. One approach that faculty at Indiana University have taken is to mention the MCAT examination in the course description. For example, I include the following text at the end of my course description, “[t]his course is designed, in part, to help students prepare for social portions of the Psychological, Social, and Biological Foundations of Behavior section of the new MCAT Exam.” Connecting the course description with the MCAT exam underscores the importance of the sociological imagination for their premedical careers.
- Courses. In responding to the new influx of premed students, faculty and instructors are faced with the dilemma of whether and how to restructure their course material. In many cases, intro sociology courses cover the majority of topics included on the exam, such as functionalism, conflict theory, and socialization. However, the exam also asks about topics not generally covered in an Introduction to Sociology course, such as demographic shifts, social epidemiology, and health/healthcare disparities.
- Recognizing that institutions will vary in the resources and time they are able to dedicate to preparing premed students for the MCAT, departments may decide to develop a spectrum of approaches. First, departments may solely offer an Introduction to Sociology course. Second, they may pair this with a health course, such as Medical Sociology or Social Epidemiology. An additional option involves designing an upper-level course that addresses the social and behavioral topics included on the MCAT in more detail. At the Indiana University Department of Sociology, we currently offer 100-level Introduction to Sociology and Medical Sociology courses. In order to accommodate premed students’ busy schedules, we are also designing an advanced online course on social and behavioral topics related to the MCAT.
- Course Content. With regard to course content, I recommend that faculty and instructors purchase a copy of The Official Guide to the MCAT Exam through the AAMC, which outlines foundational concepts derived from sociological approaches. For each foundational concept, the guide outlines a number of specific topics that are useful for including or highlighting during course lectures. Additionally, having taught both introduction to sociology and Medical Sociology courses, I have found it helpful to dedicate one lecture to review concepts specific to the MCAT. During this MCAT lecture, I also discuss the diversity of career options available to premed students in public health and sociology. Students have responded favorably, and often the lecture serves the double purpose of recruiting them into additional sociology courses.
- A Multidisciplinary Approach. The AAMC has also challenged baccalaureate faculty to “develop multidisciplinary curricula” in order to integrate premed students’ studies and emphasize the overarching principles used by physicians and scientists. Although sociology introductory courses are less conducive to a multidisciplinary approach, courses with a health focus are often perfectly suited to use interdisciplinary perspectives. For example, my Medical Sociology course includes lectures on social epidemiology, health demography, health services research, and social biology. Students from a variety of majors enroll in premedical courses, also affording the opportunity to further explore their own interdisciplinary perspectives during class discussion or in-class active learning exercises.
- Informal Mentoring. Perhaps one of the most rewarding aspects of teaching, a significant amount of teaching occurs informally while answering questions after class or during office hours. Premed students tend to be very engaged in their coursework, and frequently remark that their sociology courses offer a perspective they were yearning for in their studies. Faculty and instructors may use these interactions to ask about premedical students’ MCAT preparations. A variety of MCAT preparatory courses and books are available, and it is often useful to offer clarification on specific topics.
Finally, faculty are frequently asked to write letters of recommendation for students when they apply for medical school. While undergraduate grade point averages and MCAT scores are rated as the most important data that admissions committees use to determine which students to interview, letters of recommendation and interview recommendations are also especially important in determining which students are accepted into medical school.
Although we must remain true to our disciplinary standards, responding to these changes in the MCAT require some modifications among faculty and instructors in sociology departments. Rather than serving as an obstacle, though, we can view these changes as an opportunity to engage a population of undergraduate students poised to use our teachings during their clinical experiences. Serving as ambassadors to the field of sociology empowers us to engage in public sociology by exposing future physicians to the sociological imagination.
- Borland 2015; Jansen 2015; Davis 2012; Kain 2012 - Footnotes
- Brint, Steven, Kristopher Proctor, Kerry Mulligan, Matthew B. Rotondi, and Robert A. Hanneman. 2012. “Declining Academic Fields in U.S. Four-Year Colleges and Universities, 1970-2006.” The Journal of Higher Education 83:582-613.
- Institute of Medicine. Crossing the Quality Chasm. A New Health System for the 21st Century. Washington, DC: National Academy Press, 2001.
- Institute of Medicine. Health Professions Education. A Bridge to Quality. Washington, DC: National Academy Press, 2003.
- Association of American Medical Colleges. MCAT and Medical School Admissions.Washington, DC: Association of American Medical College, 2013.www.aamc.org/download/410078/data/mcatacademicmedicinearticles.pdf
- Monroe, Alicia, Erin Quinn, Wayne Samuelson, Dana M. Dunleavy, and Keith W. Dowd. 2013. “An Overview of the Medical School Admission Process and use of Applicant Data in Decision Making: What Has Changed Since the 1980s?” Academic Medicine. 88:672-81.