Pre-Med’s New Priorities: Heart and Soul and Social Science

In addition to the hard-science and math questions that have for decades defined this rite of passage into the medical profession, nearly half of the new MCAT will focus on squishier topics in two new sections: one covering social and behavioral sciences and another on critical analysis and reading that will require students to analyze passages covering areas like ethics and cross-cultural studies.

“Enrollment doubled and I had to turn 20 away,” said Professor Hale, a professor of the history of modern science. “But what’s really exciting is not that taking this class will get these kids into medical school, but that it will help them become better physicians.”

The Medical College Admission Test is, of course, much more than a test. A good score is crucial for entry into a profession that is perennially oversubscribed. Last year, nearly 44,000 people applied for about 19,000 places at medical schools in the United States. So the overhaul of the test, which was announced last year and approved in February, could fundamentally change the kind of student who will succeed in that process. It alters the raw material that medical schools receive to mold into the nation’s future doctors.

Which is exactly what the A.A.M.C. has in mind. In surveys, “the public had great confidence in doctors’ knowledge but much less in their bedside manner,” said Darrell G. Kirch, president of the association, in announcing the change. “The goal is to improve the medical admissions process to find the people who you and I would want as our doctors. Being a good doctor isn’t just about understanding science, it’s about understanding people.”

The adoption of the new test, which will be first administered in 2015, is part of a decade-long effort by medical educators to restore a bit of good old-fashioned healing and bedside patient skills into a profession that has come to be dominated by technology and laboratory testing. More medical schools are requiring students to take classes on interviewing and communication techniques. To help create a more holistic admissions process, one that goes beyond scientific knowledge, admissions committees are presenting candidates with ethical dilemmas to see if their people skills match their A+ in organic chemistry.

The big question, of course, is how well a multiple-choice test can help screen for the ethereal mix of scientist and humanist and spiritualist that makes a good doctor. That is uncharted territory.

“Yes, we’ve fallen in love with technology, and patients are crying out, saying, ‘Sit down and listen to me,’ ” said Dr. Charles Hatem, a professor at Harvard Medical School and an expert in medical education. “So what the MCAT is doing has a laudable goal. But will recalibrating this instrument work? Do more courses in the humanities make you more humane? I think the best we can say is a qualified maybe.”

And then there are the more immediate concerns of pre-med students and their colleges, which are preparing for the seismic changes.

Where will students find time to take in the extra material? How to prepare pre-med students long primed to answer questions like “Where are the serotonin receptors 5-HT2A and 5-HT2B mostly likely to be located in hepatocytes” to tackle more ambiguous challenges, like: “Which of the following explanations describes why the Identity vs. Role Confusion stage likely affects views about voting and being a voter?”

The first class to experience the new test, which is traditionally taken junior year, will enter college this fall. Some current students could face it, too, as it has become increasingly popular to take a gap year or two before applying to medical school.

“I can definitely see students panicking about this,” said Dr. W. Alexander Escobar, director of the pre-medical mentoring office at Emory University, who is preparing new recommendations for coursework.