Here are correlations with the average MCAT score of 110 US medical schools (not osteopathic, not black schools, not Puerto Rican Schools, not Duluth or University of MN impacted by Duluth, not Mercer, not MCP/Hahneman/Drexel, not DC schools. You can certainly see where the nation is going by where the MCAT and education and medical school debt is driving us. Again MCAT is only a reflection of socioeconomic status and past experiences. It is not a bad tool in that it does predict USMLE 1 well for about 75% of students, it is just a tool that is used incorrectly, especially on the 25% of students who we most need admitted, the ones who go where most needed. You can also see what students of the most urban origin and the highest socioeconomic status prefer in these correlations. For each medical school I calculated a % of the graduates of that school going into research, FM, rural practice, etc. For education variables I used Education Weekly sources. Ethnicity sources were % of White and Asian ethnicity by school for 1994, 1997, and 2000 graduates from AAMC Minorities in Medicine

Correlations of MCAT, Medical School Characteristics, Physician Distribution, and Career Choice

The MCAT average is the average of all three scores (verbal, biosciences, physical sciences) for 5 different internet sources compiled from medical school web sites from 2000-2003. Research was self designation as a medical researcher in the Masterfile. The family medicine percentage is all FP and GP graduates of a school graduating 1987-2000. The internal medicine column is the proportion of office-based IM compared to all IM graduates for a medical school. All rural docs include all choosing rural practice by zip code RUCA determination. The High School to College Graduate ratio for 1986 is a measure of state investment in breadth of education (High School Graduation) compared to depth (bachelors or more).

MCAT and researcher variables are in significant agreement across all of the comparisons. If medical school admissions committees used the GPA to a higher degree than the MCAT, there was much less potential for impact on the distributional specialties. Schools that lean more heavily on GPA than MCAT will likely have better graduation of the physicians most needed.

The same factors impacting choice of family medicine also relate the same way to graduation of all rural doctors and to the proportion of medical school graduates who end up in office based general internal medicine compared to all who specify internal medicine. This was calculated with office based general IM compared to general IM totals (shown above) and office based general IM compared to all who initially took internal medicine graduate training and there was no difference in these relationships. Office-based primary care physicians in poverty areas have the same level of agreement with the exception of high school graduation rates. This has to do with the poorer states have the lowest high school graduation levels. The breadth vs depth HS to College ratio measurement moves completely to 0.229 on the positive side for office-based primary care poverty.

Basically the variables above all relate strongly to socioeconomics and densities of population, education, and income.  Depth measurements complement one another, such as MCAT, % researcher, % subspecialty, % bachelor's degree graduates, % urban, and higher income levels.  The correlations of family medicine and office-based IM relate with the same significance, but in the opposite direction. FP and rural physician choice connects with breadth in education and admissions. High school graduation, % older students, % instate students, % low income students or people,

FP match or % choice of family medicine is available by state, medical school, ethnicity, country of origin, county, gender, and various divisions of birth origin and all relate to the above and each other in a consistent socioeconomic level with crosstabs, tables, correlations, and multiple linear regression.

It is much more than large city, or perceived medical school quality

It is about socioeconomic status

Medical Schools By Choice of Family Medicine for 1987 – 2000 Graduating Classes

* FP Likely groups were born in urban influence codes 2 and 3, rural areas, and military bases.

All we are measuring is relationships to socioeconomic status.

can do studies by RUCA, by urban influence code 1993 1 - 9 level by county, or by metro-non metro

can do rural per cent, or older, or instate admissions or MCAT scores

since it is socioeconomic status that we are really measuring, it does not matter

The Jefferson studies clearly link SES and choice of FP, with 13% in highest and 22% in lowest. My birth origin studies provide a further link and move it from individual schools, to nationwide. I calculated a birth origin ratio per 100000 population and here are the comparisons with income of origin and percent of students who chose FP from each birth origin group from urban influence codes 1 to 9, which also mark income levels as well

This says more about the origins of the student getting in as compared to geography or quality or other measures

The MCAT is a standardized test and may actually be even more biased for different and diverse students because of its "speeded" nature.

The MCAT as compared to basic science performance does vary by different types of students http://www.aamc.org/students/mcat/research/bibliography/velos001.htm

Here is the 2002 data on ACT tests nationwide by income level and ethnicity.

Over 51.5% of allopathic medical students in the US were from parents with incomes of over $100,000 a year for the class admitted in 2004. This increased from 23.5% of the class in 1997. AAMC Minorities in Medicine Studies

2000 MCAT scores by race/ethnicity and sex compared to ACT 2002 also

Approximately 54,000 test-takers, 52.3% female from the American Association of Medical Colleges, Summary Data on the Combined April/August 2000 MCAT

from November 4, 2001

Jordan J. Cohen, M.D., President of the Association of American Medical Colleges (AAMC), issued the following statement, today, at the Association's 112th Annual Meeting in Washington, D.C.:

Our Compact with Tomorrow's Doctors    http://www.aamc.org/newsroom/pressrel/2001/011104a.htm

Cohen on The Admissions Process

"What about the way we pick students for admission? My concern here is the imbalance that currently exists in how we convey to applicants the selection criteria we use. I'm referring, of course, to our tendency to under-emphasize, because they are harder to measure, the personal characteristics we are seeking in our applicants, and to over-emphasize the more easily measured indices of academic achievement.

"I know how tough this issue is. And please don't misunderstand me; in no way am I suggesting that native intelligence and academic prowess are anything less than essential for success in medical school, or for becoming an effective physician or scientist. What I am suggesting, however, is that our admission processes do not project to prospective applicants the degree to which we value, in addition to GPAs and MCAT scores, those other essential attributes we prize: altruism, fervor for social justice, leadership, commitment to self sacrifice, empathy for those in pain.

"That many idealistic students do make it through the process, despite the distorted signals we send them about what we are looking for, is no guarantee that sufficient numbers will continue to do so going forward. If more such intelligent and dedicated idealists were to perceive that we would give as much weight to what's in their hearts as to what's in their heads, a career in medicine would no doubt attract them strongly. As it is, I'm persuaded that many don't perceive this balance in our selection criteria, and turn away convinced that medicine is for grade-grubbing Philistines but not for them.

"To balance the strong message we send about the importance of grades and test scores with more visible evidence of our co-equal interest in humanistic attributes, let me offer six ideas for you to consider:

"1. Use MCAT scores and GPAs only as threshold measures. Rather than giving more weight to higher scores, why doesn't each school decide for itself, from data available from its previous students, what level of GPA and MCAT performance is sufficient for predicting success in clearing the high academic hurdles of medical school -- and leave it at that. We would send a powerful signal to those intelligent idealists who are currently eschewing medicine if they knew that, once having met the academic achievement threshold, they would be evaluated solely on the basis of their humanistic qualities, their penchant for serving others, their leadership abilities, and so on.

"3. Look even more favorably than you do now on the more mature applicants, those who chose some other field at the end of college, but who awakened several years later to medicine as their true calling. Such students often manifest a depth of motivation that not only predicts success as future physicians, but also provides inspiration to their fellow students.

"6. Help us devise better tools for evaluating students' personal characteristics. It's too easy to assume that the so-called soft qualities we're looking for are beyond our ability to assess any more accurately than we do with our present crude measures. I just don't believe that. But we'll never know for sure unless we try. For starters, I have directed the AAMC staff to see what we can do to develop better tools, and I urge all of you to give thought to this tough problem. Not only because we may actually succeed in improving our selection process, but also because there are surely many more dedicated and intelligent idealists out there who would recognize our efforts to seek better measures of character traits as a strong signal that we want them as colleagues.

Older Premeds