1. Admissions to Medical School The new MCAT and the Holistic Review
David M. Quillen, MD
Associate Professor
Community Health and Family Medicine
And now, Dr. Quillen.

2. Holistic Review in Medical School Admissions
AAMC definition
A flexible, individualized way of assessing an applicant’s capabilities, by which balanced consideration is given to the experiences, attributes and academic metrics, and when considered in combination how the individual might contribute value as a medical student and future physician.
Based on the “Roadmap to Diversity”
2 key US Supreme court cases involving “diversity”
Regents of the University of California vs Bakke 1978
Grutter vs Bollinger 2003

3. Holistic Review as a means of enhancing student body diversity to…
Support the medical school’s mission and goals
Help achieve educational excellence
Address the healthcare needs of the local and global communities
Diversity is described in the context of the institutional mission and goals
“Diversity enhances the educational mission”

4. Stages of Admissions

5. Beware of the Waterline…
Traditional Focus
The other things
Holistic review

6. AAMC Experiences Attributes Metrics (EAM) model

7. What does it entail? Experience, Attributes and Metrics
Experiences: This category encompasses the path the applicant has taken to get where he or she is. Examples of experiences could include being the primary care giver for an ill family member, distance traveled, educational background, employment history, research experience, or experience in a health care setting.
Attributes: This category includes the applicant's skills and abilities at time of entry to medical school personal and professional characteristics, and demo-graphic factors.
Examples of skills and abilities include active listening, problem solving, written and oral communication, critical thinking, and being multilingual.
Examples of personal and professional characteristics include resilience. integrity, adaptability, persistence, motivation, intellectual curiosity, and empathy.
Examples of demographic factors include socioeconomic status, parental education levels, geography, being a first generation college student, race, ethnicity, and gender.
Metrics: This category includes the academic quantitative components of the applicant's portfolio, most notably GPA and MCAT scores.

8. What does it entail?

9. Goals
Enrollment management initiatives - outreach, recruitment, admissions, financial aid, retention efforts, and other related student support services - should work in concert to assure the success of accepted applicants both academically and in terms of the school’s broader priorities.
Alignment of criteria across the discrete stages of the admission process - screening, interviewing, and selection

10. Does it work? UF story 5 years ago we embraced this process
Class is more diverse
Race
Religion
Background
Undergraduate schools
Much more
Higher metrics

11. The New MCAT Starting in 2015 a new exam First major update since 1991
Why?
Better reflect changes in medical education
Better reflect changes in the medical profession

12. Changes
Subject
MCAT January 2015
MCAT2015
Biology 39 45
Biochemistry
0** 30
Physics 26 15
General Chemistry 20
Organic Chemistry 13 11
Psychology 38
Sociology 18
Verbal Reasoning/CARS* 40 53
Total Number of Questions
144
230
Total Time (not including breaks)
3 h, 20 m
6 h, 15 m
* "CARS" is the acronym for the new MCAT verbal section (Critical Analysis and Reasoning Skills). CARS is the same as the ‘old’ MCAT Verbal Reasoning except that it is longer and it does NOT contain natural sciences-themed passages.

13. 4 sections Chemical and Physical Foundations of Biological Systems
Critical Analysis and Reasoning Skills
Biological and Biochemical Foundations of Living Systems
Psychological, Social, and Biological Foundations of Behavior

14. Score Normalized for an average score of 500
Range from 427 to 532
Individual sections scored from 118 to 132
Normalized to 125
Unlike the old MCAT that focused on the top 1/3
New MCAT focus is on the center
Historically predicts success in medical school
Consistent with the holistic review

15. Sections 2 sections test competency in natural sciences
Chemical and Physical Foundations of Biologic Systems
Biologic and Biochemical Foundations of Living Systems
knowledge about biology, general and organic chemistry, physics, and biochemistry to solve problems about biological and other living systems.
These sections will test the extent to which applicants think like scientists by reasoning about research designs and results, interpreting data and drawing conclusions, and considering ethical issues in research

16. Sections Psychological, Social, and Biological Foundations of Behavior
Will be formatted like the two natural sciences sections
test the ways that psychological, sociocultural, and biological factors influence people’s perceptions and reactions to the world, behavior and behavior change, individuals’ opinions of themselves and others, cultural and social differences that influence overall health, and the relationships between social stratification, access to resources, and well-being.

17. Sections Critical Analysis and Reasoning Skills
Testing reasoning and analysis skills using:
passages from population health,
studies of diverse cultures, ethics and philosophy, and other humanities and social sciences disciplines.
The most current science on cognitive processing will be used to test applicants
ability to comprehend and analyze what they read
draw inferences from text
apply arguments and ideas to new situations.
Reading broadly in preparation for medical school will help test takers familiarize themselves with the issues and arguments these disciplines raise

18. It’s a curve Here is why percentile ranks are helpful:
• Percentile ranks show the percentage of test takers who received the same or lower score. They show how individual test takers compare to the population of test takers who prepare for and take the new exam. Scores with higher percentile ranks represent higher levels of competency on the exam.
• In the hypothetical percentile rank table on the following page, a total score of 500 on the new MCAT exam is associated with a percentile rank of 50. This means that applicants who report a score of 500 performed better than or equal to 50 percent of other test takers.

20. What next? Situational Judgement Testing (SJT) What is SJT?
An SJT is a standardized test that presents a series of hypothetical scenarios and asks examinees how they would respond or behave in that situation.
Who uses SJT in medical school admissions?
United Kingdom (Medical School and General Practitioner Selection)
Belgium (Medical School Selection)
Canada (Medical School Selection)
Israel (Medical School Selection)
Singapore (Medical School Selection)
Australia (General Practitioner Selection)
Data indicates that SJTs predict medical students’ grades in clinical courses and physician performance several years after admission (Belgium) and residency job performance (UK). While the US medical school context differs from our international colleagues, we believe the SJT holds promise as a potential tool for identifying aspirants who have strong inter- and intrapersonal skills

21. What’s Next? Early in the process We started interviewing in September
Comparison table and percentiles make sense
Only time will tell
For more….

22. This year so far Interviewed 155 Accepted 118 (76%) Wait list 38
M 55, F 63
URM 36
Wait list 38