Medical College Admission Test

The Medical College Admission Test, commonly known as the MCAT, is a computer-based standardized examination for prospective medical students in the United States and Canada. It is designed to assess problem solving, critical thinking, written analysis, and writing skills in addition to knowledge of scientific concepts and principles. Prior to August 19, 2006, the exam was a paper-and-pencil test; since January 27, 2007, however, all administrations of the exam have been computer-based.

==Evolution of the MCAT ==

The Moss Test: 1928–1946
In the 1920s, dropout rates in US medical schools soared from 5% to 50%, leading to the development of a test that would measure readiness for medical school. Physician F.A. Moss and his colleagues developed the "Scholastic Aptitude Test for Medical Students" consisting of true-false and multiple choice questions divided into 6-8 subtests. Topics tested included visual memory, memory for content, scientific vocabulary, scientific definitions, understanding of printed material, premedical information, and logical reasoning. The score scale varied from different test forms. Though it had been criticized at the time for testing only memorization ability and thus only readiness for the first two years of medical school, later scholars denied this. In addition to stricter medical school admission procedures and higher educational standards, the national dropout rate among freshman medical students decreased from 20% in 1925 to 1930 to 7% in 1946.

A simpler test: 1946–1962
Advancements in test measurement technology, including machine scoring of tests, and changed views regarding test scores and medical school readiness reflected the evolution of the test in this period. The test underwent three major changes. It now had only four subtests, including verbal ability, quantitative ability, science achievement, and understanding modern society. Questions were all in multiple-choice format. Each subtest was given a single score, and the total score was derived from the sum of the scores from the subtests. The total score ranged from 200-800. The individual scores helped medical school admission committees to differentiate the individual abilities among their candidates. Admission committees, however, did not consider the "understanding modern society" section to be of great importance, even though it was created to reward those with broad liberal arts skills, which included knowledge of history, government, economics, and sociology. Committees placed greater emphasis on scores on the scientific achievement section as it was a better prediction of performance in medical school.

From 1946–1948, the test was called the "Professional School Aptitude Test" before finally changing its name to the "Medical College Admission Test" when the developer of the test, the Graduate Record Office (under contract with the AAMC) merged with the newly-formed Educational Testing Service (ETS). In 1960, the AAMC transferred its contract over to The Psychological Corporation, which was then in charge of maintaining and developing the test.

Status quo: 1962–1977
From 1962–1977, the MCAT retained much of its previous format, though the "understanding modern society" section was renamed as "general information" due to its expanded content. Handbooks at the time criticized the test as only a measure of intellectual achievement and not of personal characteristics expected of physicians. Responding to this criticism, admission committees took different approaches in measuring personal characteristics among their applicants.

Phase Four: 1977–1991
During phase four, the MCAT underwent several changes. The "general information" section was eliminated and a broader range of knowledge was tested. At this point, topics tested included scientific knowledge, science problems, reading skills analysis, and quantitative skills analysis. Individual scores were reported for biology, chemistry, and physics rather than a composite science score, thus six different scores for the whole test were reported. The score scale changed to 1-15 as opposed to 200-800 from previous versions of the test. Cultural and social bias was minimized. Though the AAMC claimed the new version intended to evaluate "information gathering and analysis, discerning and formulating relationships, and other problem-solving skills," no research supported this claim.

New changes: 1991–present
The test again underwent final changes. Though still divided into four subtests, they were renamed to the verbal reasoning, biological sciences, physical sciences, and writing sample sections. Questions retained the multiple-choice format, though the majority of the questions are divided into passage sets. Passage-based questions were implemented to evaluate "text comprehension, data analysis, ability to evaluate an argument, or apply knowledge from the passage to other contexts." A new scoring scale also came about. The total composite score, which ranges from 3-45, is based on the individual scores of the verbal reasoning, biological sciences, and physical sciences, which each have a score range of 1-15. The writing sample, which consists of two essays to be written within 30 minutes for each, is graded on a letter scale from J-T. This question structure and scoring scale still exist today.

On July 18, 2005, the AAMC announced that it would offer the paper-and-pencil version of the MCAT only through August 2006. A computer-based version of the test was implemented in January 2007. Select testing sites, however, offered the computer-based version for trial purposes throughout 2005 and 2006. The computer-based version is shorter in length, offered numerous times annually, and scores take less time to receive.

The MCAT today
The exam is offered 22 times per year on 19 different testing dates at Thomson Prometric centers. Ever since the exam's duration was shortened to 4.5-5 hours, the test may be offered either in the morning or in the afternoon. Some test dates have both morning and afternoon administrations.

The test consists of four sections, listed in the order in which they are administered on the day of the exam:
 * Physical Sciences (PS)
 * Verbal Reasoning (VR)
 * Writing Sample (WS)
 * Biological Sciences (BS)

The Verbal Reasoning, Physical Sciences, and Biological Sciences sections are in multiple-choice format. The Writing sample consists of two short essays that are typed onto the computer. The passages and questions are predetermined, and thus do not change in difficulty depending on the performance of the test taker (unlike, for example, the Graduate Record Examination).

The science sections (PS and BS) test analytical and logical cognitive abilities. The Verbal Reasoning section was implemented to test understanding of various subtleties involved in human communication and understanding. The Biological Sciences section most directly correlates to success on the USMLE Step 1 exam, with a correlation coefficient of .553 vs .491 for Physical Sciences and .397 for Verbal Reasoning. Predictably, MCAT composite scores also correlate with USMLE Step 1 success.

Administration
The Physical Sciences section is administered first (prior to the April 2003 MCAT, Verbal Reasoning was the first section of the exam). It is composed of 52 multiple-choice questions related to general chemistry and physics. Exam takers are allotted 70 minutes to complete this section of the exam.

The Verbal Reasoning section follows the Physical Sciences section and an optional 10 minute break. Exam takers have 60 minutes to answer 40 multiple-choice questions evaluating their comprehension, evaluation, and application of information gathered from written passages. Unlike the Physical and Biological Sciences sections, the Verbal Reasoning section is not supposed to require specific content knowledge in order to perform well.

Prior to the computerization of the MCAT there was a 60 minute lunch break after the Verbal Reasoning section followed by the Writing Sample. With the new Computer-Based Testing format the 60 minute lunch break has been substituted by an optional 10 minute break. The Writing Sample gives examinees 60 minutes to compose responses to two prompts (30 minutes for each prompt, separately timed). Each essay is graded on a scale of 1 to 6 points twice. The scores from individual essays are added together and then converted to a letter scale of J, the lowest, through T, the highest.

After the Writing Samples, there is an optional 10 minute break followed by the Biological Sciences section. Examinees have 70 minutes to answer 52 multiple-choice questions related to organic chemistry and biology.

Scoring
Scores for the three multiple-choice sections range from 1 to 15. Scores for the writing section range alphabetically from J (lowest) to T (highest). The writing section is graded by three different readers. The first reader is Intellimetric, a proprietary computer program developed by Vantage Learning, which analyzes creative writing and syntax. The second and third readers are humans, who generally look at the overall impact rather than spelling and grammar.

The numerical scores from each section are added together to give a composite score. The score from the writing sample may also be appended to the composite score (e.g. 35S). The maximum composite score is 45T but any score over 30P is considered fairly competitive, as this is the average for matriculants to medical school. There is no penalty for wrong multiple choice answers, and thus even random guessing is preferable to leaving an answer choice blank (unlike many other standardized tests). Students preparing for the exam are encouraged to try to balance their subscores; physical, verbal, and biological scores of 12, 13, and 11 respectively may be looked upon more favorably than 14, 13, and 9. (even though both tests amount to the same composite score).

The standard deviation is 2.0-2.3 depending on the year and form of the exam. For example, if a student received a 10, the mean being an 8 and the standard deviation being 2, then that student tested better than 84% of the students on that section.

Policies
Like some other professional exams (e.g. the Law School Admission Test (LSAT), Graduate Management Admission Test (GMAT)), the MCAT may be voided on the day of the exam if the exam taker is not satisfied with his or her performance. The decision to void must be made before leaving the test center and before seeing the exam results.

The AAMC prohibits the use of calculators, timers, or other electronic devices during the exam. Wristwatches are prohibited in the MCAT Essentials document provided by the AAMC, but allowed on their FAQ page Cellular phones are also strictly prohibited from testing rooms and individuals found to possess them are noted by name in a security report submitted to the AAMC. The only item you may bring into the testing room with you is your photo ID. If you wear a jacket or sweater, it may not be removed in the testing room

It is no longer a rule that students must receive permission from the AAMC if they wish to take the MCAT more than three times total. The limit with the computerized MCAT is three times per year, with no lifetime limit. An examinee can register for only one test date at a time, and must wait two days before registering for a new test date.

MCAT exam results are made available to examinees approximately thirty days after the test via the AAMC's MCAT Testing History (THx) Web application. Examinees do not receive a copy of their scores in the mail. MCAT THx is also used to transmit scores to medical schools, application services and other organizations (at no cost).

Preparation
Like most standardized tests, there are a variety of preparatory materials available. The AAMC itself offers both paper and computerized practice tests (composed of administered test questions and diagnostics) available for purchase at its website. Many test preparation companies offer classroom based courses. Approximately half of the students taking the MCAT use a test prep company. Various books are available from test preparation companies to prepare for the test.