A few days ago, Eduardo called to tell me that his father had died of COVID-19. I had met the first-generation college student in the emergency room a few months back while taking care of his father and had kept in touch to answer any questions on the medical school admissions process. Eduardo works as a harm-reduction counselor at a needle-exchange program on Manhattans Lower East Side and aspires to be an addiction psychiatrist. He completed his premedical course requirements by attending a community college in the evenings and was scheduled to take the Medical College Admissions Test in March 2020.
Then COVID-19 struck -- leaving Eduardo and his family devastated on multiple fronts. His five-person family of service-industry workers -- deemed essential in this pandemic -- lives in a one-bedroom apartment, making it nearly impossible to isolate and minimize the risk of exposure to the virus. With the exam officially postponed by test administrators and the unimaginable burden of personal tragedy, Eduardo feels depressed and deeply anxious. Among other things, he is worried that his personal circumstances and emotional state will impact his MCAT performance and chances of getting into medical school, and he does not have the luxury of deferring applications for another year.
While many have deemed the pandemic the great equalizer, capable of sickening anyone, data show that it hasnt affected all communities equally. The latest statistics from the New York City Department of Health show that the risk of COVID-19 mortality for African Americans and Latinos is nearly double that of Asians and whites. From a socioeconomic perspective, Hispanic and African American communities are experiencing greater poverty and unemployment and bearing a disproportionate burden of disease due to the greater likelihood of having lower-paying jobs in essential sectors such as food service and delivery, transportation, and health care. Multifamily households are also common among these communities, making it difficult to self-isolate or quarantine. Aspiring medical students coming from these backgrounds might find it difficult, if not impossible, to separate the impact of these unfortunate circumstances from their day-to-day lives for months, if not years, to come.
Medical school applicants from underrepresented groups have long been challenged by the MCAT. Stratification of the latest scores by race/ethnicity reveals stark disparities: mean percentiles for Asians and whites were 74th and 71st respectively, yet 47th and 37th for Hispanics and African Americans. While this divide may lead one to assume that the MCATs design, use or predictive value are inherently biased against African Americans and Latinos, the research suggests otherwise. Rather, systemic factors such as generations of low parental income, unequal educational opportunities, food insecurity and racism are more likely contributors.
The COVID-19 pandemic has only exacerbated these inequities. It is possible that the psychosocial and economic challenges that minority communities are facing during this pandemic, compounded with already existing structural barriers, may inadvertently lower MCAT scores for many applicants like Eduardo. Lower scores may even discourage them from applying to medical school altogether. Consequently, it may dissolve years of effort to diversify the physician workforce, which is critical to serving vulnerable communities.
But unprecedented circumstances also provide opportunities for bold measures, and one such measure may be to reimagine short-term changes to the applied use of MCAT scores in medical school admissions. Some near-term changes are already underway. The Association of American Medical Colleges is shortening the MCAT to exclude experimental questions. Additionally, California medical schools will offer secondary decisions even if MCAT scores are unavailable, with hopefully more schools following suit.
I would argue that in order to make the admissions process fair and equitable to all applicants, the MCAT should be optional in the upcoming enrollment cycle.
Importantly, there is already precedence for optional test score reporting in graduate and medical school admissions. As of last year, more than 70 institutions of higher learning, including Harvard, Stanford, Cornell and Princeton Universities, made the Graduate Record Examination optional for several biomedical master's and Ph.D. programs. Princeton reported that doing so has entirely changed the demographic landscape of its graduate school, with nearly 43percent identifying as minorities and 28percent identifying as low-income and/or first-generation students. Additionally, there are existing Early Assurance medical school programs at institutions such as Icahn School of Medicine at Mount Sinai and Zucker School of Medicine at Hofstra/Northwell that dont require the MCAT at all, and others where it is optional.
Obviously, there are many factors to consider: schools often use the MCAT as a practical screening modality to select for applicants they believe can achieve academic success. Medical school is academically rigorous, and schools need to be assured that students can do the work. However, the exam does not assess other factors that are equally critical to the quality and caliber of physician one might become, including professionalism, integrity and interpersonal skills. Additionally, the weight attributed to the MCAT as a performance indicator of academic success will likely evolve once the United States Medical Licensing Examination Step 1 is offered pass/fail. Making the MCAT optional can encourage committees to weigh other attributes and metrics not only in final admissions decisions but also initial interview considerations. This can promote greater equity throughout the process, especially opportunity access for underrepresented minorities and those negatively impacted by COVID-19.
Some might argue that MCAT scores are critical to national rankings of medical schools -- which often impact student enrollment decisions. If medical schools are truly committed to equity in admissions, though, they should be able to deprioritize rankings-related concerns in the short term and instead emphasize the equitable measures they are implementing to attract the best and most deserving students. Additionally, medical scientist training programs often have MCAT reporting requirements to the National Institute of General Medical Sciences (NIGMS). Perhaps the NIGMS can waive the requirement to account for near-term equitable accommodations.
Implementing an MCAT-optional admissions cycle would undoubtedly require a very nuanced approach. Medical schools would need to make those decisions independently. But they would also need to be explicit in their messaging to applicants that there are no ulterior disadvantages to forgoing the test, as applicants often view such policies with suspicion and caution -- convincing themselves that the policy is in name only. What about applicants who have already taken and/or retaken the MCAT prior to COVID-19-related cancellations? AMCAS, the application service, could introduce a feature whereby applicants can decide if they want to send their scores to medical schools or not. If they choose not to, the feature should require them to explain why. Medical schools could also update their secondary application templates to allow applicants to explain if and how they were impacted by the pandemic.
Every day, we deem our own professionals heroes for fighting COVID-19. Now, we must also take similar heroic steps and make sure that every aspiring physician, including disadvantaged minority applicants like Eduardo, gets a fair chance in the admissions process. The time is here, and the time is now to reimagine the richness of a diverse physician workforce. And a critical first step is through reimagining the applied use of the MCAT and making it optional.
Read more from the original source:
- A bill would spend $1 billion on diversifying medical schools to close the racial health gap - NBC News - August 10th, 2020
- Pandemic acts as dress rehearsal for new medical school curriculum - Washington University School of Medicine in St. Louis - August 10th, 2020
- The Unnamed Hero - Pager Publications, Inc. - August 10th, 2020
- Testing is the key to a successful fall reopening on campuses (opinion) - Inside Higher Ed - August 10th, 2020
- TUNE IN: Alexandria Addressing Back-to-School Worries in Virtual Town Hall - The Zebra - August 10th, 2020
- Community Healthcare honored during National Health Center Week - Times Record News - August 10th, 2020
- When Things Arent OK With a Childs Mental Health - The New York Times - August 10th, 2020
- Making sure patients, physicians know about the advances in treating female cancers - Norton Healthcare - August 10th, 2020
- 'We Are Here to Help Them' | Harvard Medical School - Harvard Medical School - August 10th, 2020
- In the face of challenges posed by a pandemic and racism, the White Coat Ceremony underscores the importance of our shared humanity - AAMC - August 10th, 2020
- Physician Group Wants Medical Schools To Waive The MCAT This Year - Physicians News Digest - August 10th, 2020
- Born with 1 hand, she's an inspiration in virus fight - ABC News - August 10th, 2020
- What to Expect in Medical School - AAMC for Students ... - August 8th, 2020
- International med students ease the path for others with new mentor group - STAT - August 8th, 2020
- Texas schools reopening mandate sets off another local control debate - The Texas Tribune - August 8th, 2020
- Amid COVID-19 Pandemic, Morehouse School of Medicine Welcomes Its... - Diverse: Issues in Higher Education - August 8th, 2020
- Guntersville native joins Andrews Sports med team | Free Share - Sand Mountain Reporter - August 8th, 2020
- COVID-19 changing study of medicine on Long Island - Newsday - August 8th, 2020
- Health Care Workers Of Color Nearly Twice As Likely As Whites To Get COVID-19 - WUSF News - August 8th, 2020
- Dancing Wildcats Enjoy Smoother Transition to the Field of Medicine - UKNow - August 8th, 2020
- Kindness is the best medicine - Argus Leader - August 8th, 2020
- Kindness is the best medicine | Coronavirus | rocketminer.com - Daily Rocket Miner - August 8th, 2020
- With academic health center, the imagined can be reality - Las Vegas Sun - August 8th, 2020
- Need to Take the MCAT? You'll Still Have to Do It in Person - The New York Times - August 8th, 2020
- Why isn't ventilation part of the conversation on reopening schools? - STAT - August 8th, 2020
- A UT undergrad helped build the app that will assist students coming back to school this fall. Here's what it can do. - UT News | The University of... - August 8th, 2020
- Med School Professor Removed from Fellowship Director Post, Apparently for Publishing Anti-Affirmative-Action Journal Article - Reason - August 7th, 2020
- Good Shepherd celebrates one of it's first graduates on track to realize dream of becoming doctor - WDSU New Orleans - August 7th, 2020
- Change the course of the pandemic: UMass Medical School, Boston tech company at center of national push to - MassLive.com - August 7th, 2020
- Duality Health Begins Rapid Blockchain Innovation Cycle with Health Product Innovation Team at Dell Medical School - Tyler Morning Telegraph - August 7th, 2020
- Deciding whether to send your child back to school? Heres what the experts say to consider - nj.com - August 7th, 2020
- Kaine introduces bill that would support medical schools in underserved areas - WDVM 25 - August 4th, 2020
- Medical school affiliates on lack of diversity, burden of the 'minority tax' - The Stanford Daily - August 4th, 2020
- International medical school graduates need an easier path to practice in the US | TheHill - The Hill - August 4th, 2020
- The 'dura mater' handles medical training and motherhood with aplomb - DePauw University - August 4th, 2020
- Emory University doctor and former teacher suggests staggered starts, plexiglass lunch barriers to avoid COVID-19 spread in schools - 11Alive.com WXIA - August 4th, 2020
- President Houshmand and CMSRU Dean Reboli named to South Jersey BIZ Power 50 list - Rowan Today - August 4th, 2020
- 'Its a good mix of medicine and social justice': Medical student gets experience at NATIVE Project during pandemic - The Spokesman-Review - August 4th, 2020
- Addressing inequalities in women's health research | Contemporary OB/GYN - Contemporary Obgyn - August 4th, 2020
- New medical residents experience a different kind of welcome into URMC - University of Rochester - August 4th, 2020
- 'Not surprising': International graduate students respond to short-lived ICE directive - The Stanford Daily - August 4th, 2020
- MASKED-COVID Study to Assess Renal-Related Complications of COVID-19 - DocWire News - August 4th, 2020
- Addressing inequalities in women's health research - Contemporary Obgyn - August 4th, 2020
- Seeing the Health Care Profession Through the Eyes of a Medical Scribe - Hamilton College News - August 4th, 2020
- University of Medicine and Health Sciences Launches State-of-the-Art Virtual Tour - PR Web - August 4th, 2020
- Researchers With Game - Ohio Wesleyan University - August 4th, 2020
- List of medical schools in the United States - Wikipedia - August 3rd, 2020
- Disc Medicine Expands Leadership Team with Industry Veterans to Advance Hepcidin Modulating Therapies Toward the Clinic - PRNewswire - August 3rd, 2020
- Solomon Rajput '14 takes on Michigan incumbent for seat in Congress - The Dartmouth - August 3rd, 2020
- Fighting the Coronavirus, from New York to Utah - The New Yorker - August 3rd, 2020
- Boston doctor named hospital hero relied on human connection to get through COVID peak - Boston Herald - August 3rd, 2020
- Starkman: Beaumont Executive Paid $932000 by Hospital Vendor Whose Implants Were Pushed on Surgeons - Deadline Detroit - August 3rd, 2020
- Students need to be tested every 2-3 days for colleges to safely reopen - Yale News - August 3rd, 2020
- Taking Medicine and Tech to the Next Level: Ranney on New Brown-Lifespan Center for Digital Health - GoLocalProv - August 3rd, 2020
- Medical Schools Have Historically Been Wrong on Race - The New York Times - August 3rd, 2020
- After the Match: The Match in the Age of COVID-19 : Emergency Medicine News - LWW Journals - July 31st, 2020
- North Philly coronavirus risk: Temple University's return to campus is irresponsible - On top of Philly news - Billy Penn - July 31st, 2020
- Researchers Discover Stem Cells in Optic Nerve that Preserve Vision - Newswise - July 31st, 2020
- Pre-med students spend the summer studying COVID-19 - DePauw University - July 31st, 2020
- The Author of Blacks in Medicine on Race, Racism, and Health Outcomes - KCET - July 31st, 2020
- Five Questions With: Dr. Ben Abo on Snakes and Television - EMSWorld - July 31st, 2020
- We asked 20 medical experts whether they're sending their own kids back to school. Here's what they had to say - CNBC - July 31st, 2020
- NYU Long Island School of Medicine Is First School on Long Island to Start 202021 Term, May Be Microcosm of 'Hybrid' Class Model - NYU Langone Health - July 31st, 2020
- Medical education in the time of COVID-19 - Science Advances - July 31st, 2020
- Rutgers New Jersey Medical School - July 31st, 2020
- Discrimination in the medical curriculum: are medical schools providing students with equal access to the medical profession? - The European Sting - July 31st, 2020
- Marshall School of Medicine 1 of 9 schools to offer Mission Act scholarships to veterans - Huntington Herald Dispatch - July 30th, 2020
- Irish medical school students learning about Sarnia area - Sarnia and Lambton County This Week - July 30th, 2020
- Michigan Medicine named one of best 20 hospitals in U.S. News rankings - MLive.com - July 30th, 2020
- What Cuba Can Teach the U.S. About Confronting the COVID-19 Pandemic - southseattleemerald.com - July 30th, 2020
- Stem Cell Therapy Injuries More Widespread Than We Knew - UConn Today - July 30th, 2020
- Want to be a doctor? A lawyer? COVID-19 cases are rising, but these high-stakes exams are in-person only - USA TODAY - July 29th, 2020
- Payne named associate dean for health information and data science Washington University School of Medicine in St. Louis - Washington University... - July 29th, 2020
- Mind the Gap: A 20-Year-Old Black Medical Student Is Writing a Guide Illustrating How Common Medical Symptom - The Root - July 29th, 2020
- Elizabeth Williams Talks Healthcare With Her Series "E Talks With Docs" - Jul 28, 2020 - Sports Are From Venus - July 29th, 2020
- School of Medicine one of nine schools to offer Mission Act scholarships to veterans - HNN Huntingtonnews.net - July 29th, 2020
- News | From ESL to Medical School, RIC Grad Overcomes Obstacles in Pursuit of Her Dreams - Rhode Island College News - July 29th, 2020
- Med students make history in Clovis - The Business Journal - July 29th, 2020
- The Doctor Behind the Disputed Covid Data - The New York Times - July 29th, 2020
- Dr. Stella Immanuel: 5 Fast Facts You Need to Know - Heavy.com - July 29th, 2020