Medicine has become more and more molecular ever since the author of this article graduated. Today, a resident or fellow can't find a journal article suitable for presentation in a journal club, which is devoid of molecular data. So, obviously, today's doctors need knowledge about research and interpretation of the data. In about 10 years, doctors need knowledge of AI to survive. So, saying that MCAT scores and GPA are sufficient to make good doctors is like asking to get rid of smartphones and bring back landline rotary phones. It makes no sense to me. I spent all my career in academic medicine memtoring premeds and interviewed candidates for medical school admissions. These days a physician has to be all rounder, including a leader and administrator. This calls for a holistic approach in preparation and selection process. Thanks - BK Kishore, MD, PhD, MBA
I offer my thoughts, now at age 83, of a young man who wanted to become an art history teacher, but whose individual circumstances led to his entry to med school. Let me say first, that this topic is needing far more than an editorial and a commentary. We are speaking of those who we entrust our lives to- both quantity and quality of human life, and to all those others touched by how well or not well we have done. To limit the assessment of an undergraduate as to his or her worthiness to become a physician (or a teacher, or a police or fireman) or any foundational part of a society deserves a far greater focus on "vetting."
It is absurd to think that an essay or some extracurricular activity plus grades somehow fits into the pattern recognition of a good or better candidate for becoming a physician. In my specialty of oncology, I sat in on urology meetings focused on prostate cancer (PC) and noted how ignorantly almost all attendees decides on their idea of the best treatment for men newly diagnosed with PC. "He's young, his PSA is < 10, and therefore a good candidate for RP (radical prostatectomy)." "Or, he is older, his Gleason score is 8, I would advise RT (radiation therapy)." I was the only MedOnc in the meeting. The moderator asked me what I thought. I said, I use the tables from Hopkins per the publication by Partin (The Partin Tables) that uses the experience of hundreds of men who were found to have three major determinants regarding how well they would do with a RP. The Gleason score (read by expert pathologist Jon Epstein at Hopkins), the T-stage determined by the digital rectal examination (DRE) and the PSA. This use of an algorithm, based on pattern recognition, has stood me in good stead by virtue of the excellent results that men under my care have had.
In other words, the candidates for RP were "vetted" properly. We don't vet key people in the lives of our fellows, be they MDs, educators, fire and police officers, Senators, Reps, or even the POTUS. Basically, what you end up with is garbage in = garbage out.
I ended up at the U of Chicago after three years at the U of Rochester because I received a scholarship and because I had a lousy guidance counselor, and I was young and naive about the path I had chosen. Maybe the rest of you were far beyond me in your understanding of who you were and what life you wanted to lead. I, for sure, was not.
During my first year in Chicago, I hated it. Rote memorization; the 26-steps in cholesterol synthesis; identify what this nerve is as seen surrounded by a surgical drape. WTF. It was not until my first patient that I realized the instant intimacy that the physician has access to. It was not until my preceptor, Elizabeth Kübler-Ross showed me her humanity, as did Mila Pierce in Hematology and Douglas Buchanan in pediatric neurology, did I fall in love with medicine.
I was basically forced to do research, and my first exposure was long distance communicating with a wonderful physician, Alan Eisenberg, at Harvard. I went from lymphocyte transformation and its artistic beauty to delayed type hypersensitivity (DTH) in humans with HD (Hodgkin’s disease). I ended up bringing a $100,000 grant to the University, of which not a penny went to me. Despite my scholarship, I hauled laundry, worked as a Diener, donate blood for money, and worked evenings doing lab tests. I ended up writing more papers for peer-reviewed journals than any other classmate. I found the artistic world that intrigued me through the lens of a microscope. But the human element, that instant intimacy with a "stranger" was so incredible that the world of medicine became a love affair.
So what is the answer about how we pick individuals for the job most fitting/meaningful for them? It goes way beyond an essay or some task done to be a good candidate. It's just not that simple. But such due diligence is badly needed. One real physician is worth 100 "docs" who want the ego or the money or whatever other motive they may have. Seeing so much schlock medicine, being subjected to such medicine myself, is a tragedy and a travesty.
We, my colleagues, have not been good stewards of the Earth nor with our fellow men. The profession we profess to have is far from the precepts of Hippocrates. The wisdom of "seek with the soul, see from the heart" has dwindled away, to be replaced with "what's in it for me."
I don't know specifically why you are asking this question at this time, but when this question is asked, generally a point is being made that an applicant got an unfair leg-up by being a legacy. I would say this: An applicant who grew up in a household with a physician or a surgeon probably understands better than anyone of the sacrifices that a doctor makes to take care of people -- being called out in the middle of the night, missing holidays and birthdays, going to courses and meetings to get CMEs, and so on. Not to mention "pajama time" finishing charts, and not to mention the grief of constantly relicensing and recredentialing, the stress of having someones life in your hands, having to deal with hospital politics and the concern in the back of ones mind that any patient is a potential litigant, even if everything is done perfectly. A doctor - parent who suffers through all that, and still devotes himself unselfishly and happily to the care of strangers, gives an applicant the best data both of the downsides and joys of being a doctor. The child of a doctor, particularly in this day-and-age of not getting rich in medicine, SHOULD get a leg-up because he knows all this and STILL wants to go to medical school. Whereas an applicant who is naive regarding all of that, or thinks medicine is just a sure way to prestige and a rich life, should be looked at more critically.
Hmmmm... As someone whose parents and all my brothers left school at 15, father died when I was 15 and we were better off cos my mother got a widow's pension, who's been homeless with a child with a severe disability... etc etc etc... I would be peeved if one of the sons of a Prof of Medicine got given preference to me, solely because he had a better idea of what we were in for...
Interesting comment. Especially since I really tried to dissuade my children from medicine. I’ve had a 75% success rate. I did make my daughter promise she wouldn’t follow my footsteps in Emergency Medicine.
Bravo! Surgery has been our "family business" for generations. That said, I did not make ANY recommendations to my kids about ANY career path. My child - surgeon yield rate was 50%.
I tend to agree, but diverse life experience, same as great MCAT scores, doesn't guarantee you will became a good physician either! There is no good answer.
Applying for medical school back in 1980, I was in my masters to PhD program in nuclear engineering with a concentration in radiation health physics and nuclear waste management. I was asked by the physician interviewer of the prestigious Ivy League medical school I applied to, who had noted the unique educational background, what I was going to do when I was not accepted to any medical school. My response must have shocked him as I replied that my professional life would not end simply because I did not achieve admission to this or any other school of medicine since I would go on to finish my PhD in nuclear engineering and still be productive to society. I said that I would be sad that I had not made the admission process because I felt that my engineering education prepared me well for not only the academic rigor of medical school but also with the critical analytic skills necessary to be a good physician. The interview ended upon that and I simply accepted I would not be admitted. Four weeks later I was admitted to and attended that same prestigious school.
I tell that anecdote because I joined a class of traditional track students, but also students who were professional musicians, banking executives, engineers, a former NYC taxi driver, and a few other diverse experiences. Each have gone on to be fine physicians. Fortunately, this Ivy League school was wise enough to know that a diversity of life experiences made excellent physicians.
Doctors come from the general population pool of shared life experience and the concept that a very proscriptive selection process based on a measured set of test scores and typical educational exercises can select the best candidates is folly. Yes, it is hard hard work to look at the medical school applicants and select the best candidates, but the reward of sustaining the medical profession which in the end serves us all is immeasurable.
Get a BS in Engineering from a top tier university (while simultaneously fulfilling all pre-med requirements -- i.e., take 18-22 credit hours per semester). Graduate suma cum laude. Ace your MCATs and be a normal, engaged human being at your interview. That should get you admitted most anywhere. P.S. You don't need family money or prestige to get the job done. Just work your butt off. No "game playing" here.
I disagree. It has been proven many times that grades do not equate to being a “good” doctor, by which ever metric you use. Knowledge has little to do with wisdom or judgment. Just because you got top scores on your MCAT does not indicate you will be a compassionate or ethical physician. We must look beyond academic excellent at other qualities that will predict physicians that will always be uncompromising patient advocates and be at the top of their profession.
In 60 years as an emergency physician, dealing with every specialty, I have found the best doctors are those whom you would want to treat your own family. Those qualities have nothing to do with academic grades in pre-medical school. So why would you want to use those grades as your only criteria for selection to medical school?
I fully agree. The highest achievers in real life from my medical school class were not gold medalists. They are regular good students with strong personal skills. - BK Kishore, MD, PhD, MBA
This is true. “Average“ candidates can contribute more to general health care than a top grade applicant without other qualities in my experience over 47 years in practice. However, we also need the “stars” of applicants. Medicine is evolving. We need versatility and resilience in our workforce.
I don't want to use grades only; I don't think grades are great predictors. I just don't think the other predictors are any better, and I think they hurt the applicants. I want to know that an applicant can learn what they need to, and then probably just randomly select students. Too nihilistic? Thoughts?
The other non-academic criteria help us to get a clear picture of the "Avatar" of the candidates, which MCAT or GPA do not reveal. That is how we assess the true nature of the personality of the candidates. BTW, we do not know the GPA or MCAT scores of the candidates we interview to avoid any bias. Trust me, by this approach few candidates with high MCAT or GPA score do not make, but many with strong record of non-academic records but not so high MCAT or GPA scores make it. Many of the latter group also prove to be good physicians later in life, as they proved their service and leadership.minds even before entering the medical school. Two of my premed students who belong to the latter category proved to be excellent physicians in real life. I am speaking with more than 30 years of experience in mentoring premeds and about two decades of interviewing candidates for medical school. Thanks - BK Kishore, MD. PhD, MBA
In over 40 years as a missionary and volunteer doctor, I have had over 200 pre-med students work with me. I can definitely assess, from their interaction with patients and with me, which ones will make great doctors. Many of them have gone on to be tops in their profession. I had no idea what their grades were, nor did I care. Grades are not related at all to compassion, positivity, integrity, judgment, wisdom, enthusiasm, persistence, confidence, altruism, empathy, application of knowledge to the big picture etc.
Application to medical school, PA school etc has taken on a life of it's own. It's true when they say "the hardest part is getting in." We are selecting for people who can write the best applications, i.e., play the game, who can do more mock interviews, take more MCAT prep tests and check the correct extracurricular boxes, not those who might be the best doctors. It's like running for political office. Complete BS! We all know that the very people who wind up in political office are the very ones who should never be allowed to do so in the first place, with only a few exceptions.
A long time ago I read an editorial in a major medical journal written by an elder physician who had served for decades on admission committees. He argued that the most reliable quality that led to an excellent physician was curiosity. I considered this as I taught medical students and residents in the following years and believe he was right. One can explore this fairly well in a well-done interview.
There is a desperate need for primary care physicians in this country, especially so in rural areas. I have a proposal; medical schools should seek to identify applicants who pledge to fill that need and offer them low or no tuition. If upon completion of residency those students fail to fulfill their pledge then back tuition should be charged plus a hefty interest rate. Look for students who want to help communities not themselves. Remove the financial burden of medical school.
Primary Care and Family Medicine will be soon transformed by AI inducting Nurse Practiotioners and Physician Assistants into the front roles. In some states NPs and PAs are getting parital or full licenses. In our university hospital, they are sitting in OPD and seeing patients. This transformation will reduce the number of MDs needed in primary care and family medicine and this eliminate the need for foreign medical graduates. Trust me, this is going to happen. Thanks
Having a diverse medical school class may have no impact on serving the needs of a diverse community. Diversity in a medical school class point to the wrong metrics. Medical students will apportion themselves to the various specialties and locations for issues like salary and lifestyle. Sometimes new doctors will serve communities when they don't even have a priori membership. The cost of tuition remains an unreasonable barrier, perhaps most of all.
Goodhart's Law may also be applied to a good deal of conventional medical practice. Three measures that come to mind are cholesterol levels, blood glucose (or A1C) level, and blood pressure. Those targets have been moved lower and lower without any scientifically credible justification. But they sure have generated a lot of business for the medical and pharmaceutical industries.
Great post. I would be interested to see this thought extended to the Casper test, which is a requirement for over half of Canadian medical schools and many American allopathic programs as well.
Casper claims to "provide insights about" skills including, "collaboration, communication, empathy, fairness, ethics, motivation, problem solving, resilience and self-awareness."
It seems unlikely that programs would insist on a certain Casper score. However, when applications need to be sorted into different piles it is doubtless used to downgrade priority on students who did not score well. Additionally, test takers are never themselves informed of anything beyond the quartile they scored within.
There is a decent post on the website Science Based Medicine ('Ad-Conned: A Critical Look at CASPer') discussing the test. This post is over four years old now--which is quite some length of time in the lifespan of a test that is itself not yet old enough to enroll in medical school.
It has also made the medical students uber-competitive with each other. A family friend's daughter was sharing that her classmates compare their grades on every test and all are trying to get the highest grade possible. Of course you should want to excel, but not because you want to beat everyone else - because you want to learn the material and be prepared for your boards, etc.
When I was in med school in the 80's, none of us cared what anyone else got on a test, and we studied together and helped each other so that we would all do well. In a profession where compassion and collaboration are critical, I find it incredibly disappointing that we are instead breeding competitive, performance-driven young people. It is high time for something to change!
That is what happens when we consider MCAT or GPA scores as the sole or main criteria for admissions. This type of competition will destroy the profession.
Medicine has become more and more molecular ever since the author of this article graduated. Today, a resident or fellow can't find a journal article suitable for presentation in a journal club, which is devoid of molecular data. So, obviously, today's doctors need knowledge about research and interpretation of the data. In about 10 years, doctors need knowledge of AI to survive. So, saying that MCAT scores and GPA are sufficient to make good doctors is like asking to get rid of smartphones and bring back landline rotary phones. It makes no sense to me. I spent all my career in academic medicine memtoring premeds and interviewed candidates for medical school admissions. These days a physician has to be all rounder, including a leader and administrator. This calls for a holistic approach in preparation and selection process. Thanks - BK Kishore, MD, PhD, MBA
I offer my thoughts, now at age 83, of a young man who wanted to become an art history teacher, but whose individual circumstances led to his entry to med school. Let me say first, that this topic is needing far more than an editorial and a commentary. We are speaking of those who we entrust our lives to- both quantity and quality of human life, and to all those others touched by how well or not well we have done. To limit the assessment of an undergraduate as to his or her worthiness to become a physician (or a teacher, or a police or fireman) or any foundational part of a society deserves a far greater focus on "vetting."
It is absurd to think that an essay or some extracurricular activity plus grades somehow fits into the pattern recognition of a good or better candidate for becoming a physician. In my specialty of oncology, I sat in on urology meetings focused on prostate cancer (PC) and noted how ignorantly almost all attendees decides on their idea of the best treatment for men newly diagnosed with PC. "He's young, his PSA is < 10, and therefore a good candidate for RP (radical prostatectomy)." "Or, he is older, his Gleason score is 8, I would advise RT (radiation therapy)." I was the only MedOnc in the meeting. The moderator asked me what I thought. I said, I use the tables from Hopkins per the publication by Partin (The Partin Tables) that uses the experience of hundreds of men who were found to have three major determinants regarding how well they would do with a RP. The Gleason score (read by expert pathologist Jon Epstein at Hopkins), the T-stage determined by the digital rectal examination (DRE) and the PSA. This use of an algorithm, based on pattern recognition, has stood me in good stead by virtue of the excellent results that men under my care have had.
In other words, the candidates for RP were "vetted" properly. We don't vet key people in the lives of our fellows, be they MDs, educators, fire and police officers, Senators, Reps, or even the POTUS. Basically, what you end up with is garbage in = garbage out.
I ended up at the U of Chicago after three years at the U of Rochester because I received a scholarship and because I had a lousy guidance counselor, and I was young and naive about the path I had chosen. Maybe the rest of you were far beyond me in your understanding of who you were and what life you wanted to lead. I, for sure, was not.
During my first year in Chicago, I hated it. Rote memorization; the 26-steps in cholesterol synthesis; identify what this nerve is as seen surrounded by a surgical drape. WTF. It was not until my first patient that I realized the instant intimacy that the physician has access to. It was not until my preceptor, Elizabeth Kübler-Ross showed me her humanity, as did Mila Pierce in Hematology and Douglas Buchanan in pediatric neurology, did I fall in love with medicine.
I was basically forced to do research, and my first exposure was long distance communicating with a wonderful physician, Alan Eisenberg, at Harvard. I went from lymphocyte transformation and its artistic beauty to delayed type hypersensitivity (DTH) in humans with HD (Hodgkin’s disease). I ended up bringing a $100,000 grant to the University, of which not a penny went to me. Despite my scholarship, I hauled laundry, worked as a Diener, donate blood for money, and worked evenings doing lab tests. I ended up writing more papers for peer-reviewed journals than any other classmate. I found the artistic world that intrigued me through the lens of a microscope. But the human element, that instant intimacy with a "stranger" was so incredible that the world of medicine became a love affair.
So what is the answer about how we pick individuals for the job most fitting/meaningful for them? It goes way beyond an essay or some task done to be a good candidate. It's just not that simple. But such due diligence is badly needed. One real physician is worth 100 "docs" who want the ego or the money or whatever other motive they may have. Seeing so much schlock medicine, being subjected to such medicine myself, is a tragedy and a travesty.
We, my colleagues, have not been good stewards of the Earth nor with our fellow men. The profession we profess to have is far from the precepts of Hippocrates. The wisdom of "seek with the soul, see from the heart" has dwindled away, to be replaced with "what's in it for me."
Excellent points. Fully agree.
I don't know specifically why you are asking this question at this time, but when this question is asked, generally a point is being made that an applicant got an unfair leg-up by being a legacy. I would say this: An applicant who grew up in a household with a physician or a surgeon probably understands better than anyone of the sacrifices that a doctor makes to take care of people -- being called out in the middle of the night, missing holidays and birthdays, going to courses and meetings to get CMEs, and so on. Not to mention "pajama time" finishing charts, and not to mention the grief of constantly relicensing and recredentialing, the stress of having someones life in your hands, having to deal with hospital politics and the concern in the back of ones mind that any patient is a potential litigant, even if everything is done perfectly. A doctor - parent who suffers through all that, and still devotes himself unselfishly and happily to the care of strangers, gives an applicant the best data both of the downsides and joys of being a doctor. The child of a doctor, particularly in this day-and-age of not getting rich in medicine, SHOULD get a leg-up because he knows all this and STILL wants to go to medical school. Whereas an applicant who is naive regarding all of that, or thinks medicine is just a sure way to prestige and a rich life, should be looked at more critically.
Hmmmm... As someone whose parents and all my brothers left school at 15, father died when I was 15 and we were better off cos my mother got a widow's pension, who's been homeless with a child with a severe disability... etc etc etc... I would be peeved if one of the sons of a Prof of Medicine got given preference to me, solely because he had a better idea of what we were in for...
Interesting comment. Especially since I really tried to dissuade my children from medicine. I’ve had a 75% success rate. I did make my daughter promise she wouldn’t follow my footsteps in Emergency Medicine.
Bravo! Surgery has been our "family business" for generations. That said, I did not make ANY recommendations to my kids about ANY career path. My child - surgeon yield rate was 50%.
I tend to agree, but diverse life experience, same as great MCAT scores, doesn't guarantee you will became a good physician either! There is no good answer.
Applying for medical school back in 1980, I was in my masters to PhD program in nuclear engineering with a concentration in radiation health physics and nuclear waste management. I was asked by the physician interviewer of the prestigious Ivy League medical school I applied to, who had noted the unique educational background, what I was going to do when I was not accepted to any medical school. My response must have shocked him as I replied that my professional life would not end simply because I did not achieve admission to this or any other school of medicine since I would go on to finish my PhD in nuclear engineering and still be productive to society. I said that I would be sad that I had not made the admission process because I felt that my engineering education prepared me well for not only the academic rigor of medical school but also with the critical analytic skills necessary to be a good physician. The interview ended upon that and I simply accepted I would not be admitted. Four weeks later I was admitted to and attended that same prestigious school.
I tell that anecdote because I joined a class of traditional track students, but also students who were professional musicians, banking executives, engineers, a former NYC taxi driver, and a few other diverse experiences. Each have gone on to be fine physicians. Fortunately, this Ivy League school was wise enough to know that a diversity of life experiences made excellent physicians.
Doctors come from the general population pool of shared life experience and the concept that a very proscriptive selection process based on a measured set of test scores and typical educational exercises can select the best candidates is folly. Yes, it is hard hard work to look at the medical school applicants and select the best candidates, but the reward of sustaining the medical profession which in the end serves us all is immeasurable.
Get a BS in Engineering from a top tier university (while simultaneously fulfilling all pre-med requirements -- i.e., take 18-22 credit hours per semester). Graduate suma cum laude. Ace your MCATs and be a normal, engaged human being at your interview. That should get you admitted most anywhere. P.S. You don't need family money or prestige to get the job done. Just work your butt off. No "game playing" here.
I disagree. It has been proven many times that grades do not equate to being a “good” doctor, by which ever metric you use. Knowledge has little to do with wisdom or judgment. Just because you got top scores on your MCAT does not indicate you will be a compassionate or ethical physician. We must look beyond academic excellent at other qualities that will predict physicians that will always be uncompromising patient advocates and be at the top of their profession.
In 60 years as an emergency physician, dealing with every specialty, I have found the best doctors are those whom you would want to treat your own family. Those qualities have nothing to do with academic grades in pre-medical school. So why would you want to use those grades as your only criteria for selection to medical school?
I fully agree. The highest achievers in real life from my medical school class were not gold medalists. They are regular good students with strong personal skills. - BK Kishore, MD, PhD, MBA
This is true. “Average“ candidates can contribute more to general health care than a top grade applicant without other qualities in my experience over 47 years in practice. However, we also need the “stars” of applicants. Medicine is evolving. We need versatility and resilience in our workforce.
I don't want to use grades only; I don't think grades are great predictors. I just don't think the other predictors are any better, and I think they hurt the applicants. I want to know that an applicant can learn what they need to, and then probably just randomly select students. Too nihilistic? Thoughts?
The other non-academic criteria help us to get a clear picture of the "Avatar" of the candidates, which MCAT or GPA do not reveal. That is how we assess the true nature of the personality of the candidates. BTW, we do not know the GPA or MCAT scores of the candidates we interview to avoid any bias. Trust me, by this approach few candidates with high MCAT or GPA score do not make, but many with strong record of non-academic records but not so high MCAT or GPA scores make it. Many of the latter group also prove to be good physicians later in life, as they proved their service and leadership.minds even before entering the medical school. Two of my premed students who belong to the latter category proved to be excellent physicians in real life. I am speaking with more than 30 years of experience in mentoring premeds and about two decades of interviewing candidates for medical school. Thanks - BK Kishore, MD. PhD, MBA
In over 40 years as a missionary and volunteer doctor, I have had over 200 pre-med students work with me. I can definitely assess, from their interaction with patients and with me, which ones will make great doctors. Many of them have gone on to be tops in their profession. I had no idea what their grades were, nor did I care. Grades are not related at all to compassion, positivity, integrity, judgment, wisdom, enthusiasm, persistence, confidence, altruism, empathy, application of knowledge to the big picture etc.
Application to medical school, PA school etc has taken on a life of it's own. It's true when they say "the hardest part is getting in." We are selecting for people who can write the best applications, i.e., play the game, who can do more mock interviews, take more MCAT prep tests and check the correct extracurricular boxes, not those who might be the best doctors. It's like running for political office. Complete BS! We all know that the very people who wind up in political office are the very ones who should never be allowed to do so in the first place, with only a few exceptions.
A long time ago I read an editorial in a major medical journal written by an elder physician who had served for decades on admission committees. He argued that the most reliable quality that led to an excellent physician was curiosity. I considered this as I taught medical students and residents in the following years and believe he was right. One can explore this fairly well in a well-done interview.
There is a desperate need for primary care physicians in this country, especially so in rural areas. I have a proposal; medical schools should seek to identify applicants who pledge to fill that need and offer them low or no tuition. If upon completion of residency those students fail to fulfill their pledge then back tuition should be charged plus a hefty interest rate. Look for students who want to help communities not themselves. Remove the financial burden of medical school.
Primary Care and Family Medicine will be soon transformed by AI inducting Nurse Practiotioners and Physician Assistants into the front roles. In some states NPs and PAs are getting parital or full licenses. In our university hospital, they are sitting in OPD and seeing patients. This transformation will reduce the number of MDs needed in primary care and family medicine and this eliminate the need for foreign medical graduates. Trust me, this is going to happen. Thanks
Having a diverse medical school class may have no impact on serving the needs of a diverse community. Diversity in a medical school class point to the wrong metrics. Medical students will apportion themselves to the various specialties and locations for issues like salary and lifestyle. Sometimes new doctors will serve communities when they don't even have a priori membership. The cost of tuition remains an unreasonable barrier, perhaps most of all.
And what percent of MD students are legacies?
Goodhart's Law may also be applied to a good deal of conventional medical practice. Three measures that come to mind are cholesterol levels, blood glucose (or A1C) level, and blood pressure. Those targets have been moved lower and lower without any scientifically credible justification. But they sure have generated a lot of business for the medical and pharmaceutical industries.
Great post. I would be interested to see this thought extended to the Casper test, which is a requirement for over half of Canadian medical schools and many American allopathic programs as well.
Casper claims to "provide insights about" skills including, "collaboration, communication, empathy, fairness, ethics, motivation, problem solving, resilience and self-awareness."
It seems unlikely that programs would insist on a certain Casper score. However, when applications need to be sorted into different piles it is doubtless used to downgrade priority on students who did not score well. Additionally, test takers are never themselves informed of anything beyond the quartile they scored within.
There is a decent post on the website Science Based Medicine ('Ad-Conned: A Critical Look at CASPer') discussing the test. This post is over four years old now--which is quite some length of time in the lifespan of a test that is itself not yet old enough to enroll in medical school.
Great parallel. (And you get extra credit for being able to read both Sensible Medicine and Science Based Medicine. 😉)
It has also made the medical students uber-competitive with each other. A family friend's daughter was sharing that her classmates compare their grades on every test and all are trying to get the highest grade possible. Of course you should want to excel, but not because you want to beat everyone else - because you want to learn the material and be prepared for your boards, etc.
When I was in med school in the 80's, none of us cared what anyone else got on a test, and we studied together and helped each other so that we would all do well. In a profession where compassion and collaboration are critical, I find it incredibly disappointing that we are instead breeding competitive, performance-driven young people. It is high time for something to change!
That is what happens when we consider MCAT or GPA scores as the sole or main criteria for admissions. This type of competition will destroy the profession.