Realistically, in modern medicine it would be more reasonable to require students to take classes in inorganic chemistry, biology, molecular and microbiology, genetics, histology, statistics, nutrition, anatomy and physiology, business, statistics, computer science, and/or behavioral sciences. These would be more related to actual medical knowledge and practice but would require a complete change in the way admissions committees view applications and how the MCAT is structured. Some people say the important thing is find critical thinkers and not just students who have a great deal of medically related knowledge. However, if the point is just have difficult classes that require critical thought regardless of whether or not they are related to medicine, why not require dance, calculus, a course in quantum mechanics of language courses (yes I know some schools already require calculus.) These courses are difficult and require critical and creative thought. The issue is that we need relevant critical thinking. The prerequisite courses ought to be changed because they make little sense and the MCAT should change to follow suit.

The current MCAT does a good job of testing logic and critical thinking. In this increasingly litigious society, sensitive doctors seem to be favored over more blunt doctors, possibly reducing malpractice lawsuits. In addition, with decreasing reimbursements it would probably be a good idea to select for people who would not mind taking a drastic pay cut. The only way I can think of to test an applicant’s interpersonal skills would be to have a test similar to the clinical skills test in medical school, where actors play the roles of patients. But premed students clearly have not yet learned how to assess patients.

It seems like the current system of secondary essays expanding on personal qualities, recommendation letters, and the interview are good ways to select for humanistic qualities. I am curious as to how a computer-administered test could be designed to do this, as those same qualities are inherently based on feeling rather than thinking. Tests can measure lots of things but humans are the best gauge of other humans.

The goal is not to prevent anybody from becoming physicians. But, the reality is that there are only limited medical schools with limited seats, in the face of a vastly growing number of students applying to medical school. The goal is to identify who would best deserve those seats, by predicting how much they are likely to contribute to medicine itself or to society if they are trained to be physicians, and in what forms those contributions are likely to be. The MCAT is only one metric used in this pseudo-scientific complex ranking (GPA, interviews, research, community involvement, etc are some other metrics useful for gauging different things). There is no precise definition of a “successful” physician, because it is subjective, changes with time, and is only meaningful when compared with other physicians. But, on a subjective level, there are many ways to be a “successful” physician: an accurate diagnostician, or a respected mentor, or a visionary team organizer, or a disease-curing researcher, or a skillful surgeon, or a bringer of healthcare to the poor – these are all some ways “success” is measured by society. Many of these factors are orthogonal to each other, so perhaps one successful physician is strong all-around while another successful physician is especially focused in one strength. The problem all comes back to giving the limited number of prized seats to the most deserving students – it’s not a question of who has deficits and is unsuitable for the job, it’s a question of who is better for the job and in what ways. I’m sure you could think of quite a few people who, when comparing apples to apples, are worse at their job than others. The goal is simply to narrow that gap as much as possible. At least this is just my view.