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Choosing Tomorrow’s Doctors

In recent decades, the qualities that medical schools have looked for in their applicants have changed significantly – and for the better. While in the past being a straight-A science student was the ticket in, recently medical schools have placed an increasing emphasis on the personal qualities of applicants and their demonstrated interest and experience in the human aspects of medicine.

As a recent college graduate beginning the process of applying to medical school, I have been heartened by this shift in emphasis. I take it as an encouraging indication that medical educators recognize that good doctoring requires not just scientific knowledge and technical skills but also the ability to relate to patients and to understand their ailments in their social context. It’s a shift that makes me excited to begin medical school.

However, the American Association of Medical Colleges (AAMC) has laid out a set of recommendations that aims to further increase the emphasis on human and societal issues in the application process in a way I find at best unnecessary and at worst misguided: it is proposing to add testing in the social and behavioral sciences to the Medical College Admissions Test, known as the MCAT.

The AAMC states that its new recommendations are intended to “communicate the need for students who are prepared to deal with the human and social issues of medicine” and they stress the necessity of reading broadly to prepare for medical school. While I wholeheartedly support this intention, I don’t agree that more standardized testing is the most productive way to achieve this end.

The proposed update to the MCAT, which would be initiated in 2015, would require knowledge of introductory sociology and psychology. New science topics – biochemistry and cellular and molecular biology – would be added as well. The AAMC is recommending to medical schools that they “review current premedical requirements and modify them so they align with tested concepts.” To my ears, this statement indicates that the AAMC is pushing for four new courses to be added to premedical curriculum, which for most students already consists of 10 or 11 courses.

While a 90-minute-longer MCAT (it’s already almost five hours) and four more premedical courses might be aggravating to premedical students, it’s not the additional burden of studying and preparation that concern me per se. There are lots of hoops to jump through to enter any profession, and if these become the hoops for medicine, applicants will jump through them as well.

But gaining knowledge in the social and human aspects of medicine shouldn’t be just another hoop to jump through. Premedical students should pursue meaningful volunteer work and research along with coursework in the humanities and social sciences because they find these experiences interesting, valuable, and beneficial to how they think about medicine. They also need the flexibility to pursue these experiences in a way that melds with their other interests and goals.

Though my own undergraduate education would certainly not have been sabotaged by a few more course requirements, I am thankful that I had time and space to think creatively about my interests. I have been able to explore the human and social dimensions of medicine by majoring in women’s and gender studies and working at The Hastings Center. I didn’t take introductory psychology or sociology, and I’m not sure those courses would have better prepared me for these humanistic and societal aspects than the path I took.

Premedical students are different from medical students: not all premedical students will or should become doctors, but almost all medical students will. That makes the goals of educating these two groups distinctive. Medical school admissions committees could reasonably decide not to require premedical courses in sociology or psychology in order to see which premedical students pursue the humanities and social sciences on their own. For full-fledged medical students, requiring courses in the social sciences makes more sense.

If the proposed MCAT changes are instituted, some of the flexibility that allows premedical students to explore other interests will likely be sacrificed. From witnessing my peers navigate the premedical path, I can say with confidence that those who are genuinely interested in the social and human dimensions of medicine seek out these interests with dedication, creativity, and initiative. They do so in myriad ways, from conducting anthropology research on Caesarean sections to spending a year studying first responders on three different continents.

These future doctors don’t need requirements to tell them to pursue these interests. Their commitments to the broader goals of medicine arguably say more about their ability to be effective doctors than their GPAs and MCAT scores, even if those scores included test subjects like sociology. While there are many qualities we as a society want in our future doctors, not every quality can, or should, be measured on a standardized test.

Colleen Farrell is a research assistant at The Hastings Center.

Published on: May 12, 2011
Published in: Medical Education

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