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(Medical School Admissions)

The Medical College Admission Test or MCAT has been in existence for over 50 years, and has played an important role in the medical school admissions process. As a standardized exam, it is considered a relatively objective tool to evaluate an applicant's readiness for medical school. In this section, we review reasons why medical schools place significant emphasis on the MCAT in the admissions process, and how it is used to make admissions decisions. We end with some important tips for applicants concerned about their MCAT score. 


Up until 2015, the test consisted of several subtests (verbal reasoning, biological sciences, and physical sciences) scored on a scale of 1 to 15 (top score) with a maximum score of 45. In 2015, the MCAT underwent significant changes. Material from courses such as biochemistry, psychology, and sociology was incorporated, and much more emphasis was placed on the integration of topics. 

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The arrival of the new MCAT in 2015 also brought a change in the scoring system. Each of the four sections is scored on a scale between 118 and 132. The mean score for each section is 125, yielding a total mean score of 500. 

For decades, the MCAT has been the focus of intense research. Researchers have sought to determine whether the MCAT is predictive of medical school success. Numerous studies have shown that the MCAT is a better predictive measure of medical school success than other factors, including GPA


To practice medicine in the U.S., medical students must pass a series of licensing examinations (USMLE). There is tremendous evidence that shows that the MCAT is a strong predictor of performance on the USMLE Step 1 and 2 exams (Note that much of this research was performed on the MCAT version released in 1991).  

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Since every applicant to medical school must take the MCAT, it provides medical school admissions committee with a useful tool to compare applicants from different undergraduate institutions. 

Acad Med. 2013 May;88(5):666-71. doi: 10.1097/ACM.0b013e3182864299.

The predictive validity of the MCAT exam in relation to academic performance through medical school: a national cohort study of 2001-2004 matriculants.

Dunleavy DM1, Kroopnick MH, Dowd KW, Searcy CA, Zhao X.


Most research examining the predictive validity of the Medical College Admission Test (MCAT) has focused on the relationship between MCAT scores and scores on the United States Medical Licensing Examination Step exams. This study examined whether MCAT scores predict students' unimpeded progress toward graduation (UP), which the authors defined as not withdrawing or being dismissed for academic reasons, graduating within five years of matriculation, and passing the Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills exams on the first attempt.


Students who matriculated during 2001-2004 at 119 U.S. medical schools were included in the analyses. Logistic regression analyses were used to estimate the relationships between UP and MCAT total scores alone, undergraduate grade point averages (UGPAs) alone, and UGPAs and MCAT total scores together. All analyses were conducted at the school level and were considered together to evaluate relationships across schools.


The majority of matriculants experienced UP. Together, UGPAs and MCAT total scores predicted UP well. MCAT total scores alone were a better predictor than UGPAs alone. Relationships were similar across schools; however, there was more variability across schools in the relationship between UP and UGPAs than between UP and MCAT total scores.


The combination of UGPAs and MCAT total scores performs well as a predictor of UP. Both UGPAs and MCAT total scores are strong predictors of academic performance in medical school through graduation, not just the first two years. Further, these relationships generalize across medical schools.

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In a recent study performed at a single medical school, researchers looked for factors that could predict underperformance during the first year of medical school. Underperformance was defined as any academic situation that resulted in the student's appearance before the school's Student Progress and Promotions Committee. Underperforming students were found to have significantly lower mean undergraduate science and total GPAs.

Although most of the current research on MCAT and USMLE scores considers the full range of participants’ scores, admissions committees are most concerned with the students at the extreme ends of the scoring ranges and are less concerned with middle ranges. For students scoring in the middle range of those generally accepted by the institution, the MCAT may not be an important factor for admission. However, admissions committees faced with a candidate who has a low MCAT score but an otherwise strong application need to know whether that student's low MCAT score should be sufficient to preclude that candidate from admission to the institution. They wonder whether other impressive components of the application might be able to compensate for a low MCAT score in indicating the candidate's potential to succeed in medical school. However, since success on the USMLE is necessary for licensure, low USMLE scores can outweigh other measurements of success, such as course grades or even clinical performance, if they preclude the student from licensure or from a successful residency match. Therefore, it is important to determine whether a student who scores in the bottom range of MCAT scores is particularly likely to also score in the bottom range of USMLE scores.

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Medical schools will also look at your science or BCPM (Biology, Chemistry, Physics, Mathematics) GPA. Studies have shown that the undergraduate science GPA is a good predictor of medical school performance. 

A particularly useful tool is the MCAT and GPA grid available at the AAMC website. This grid provides applicants with acceptance rates for varying combinations of MCAT and GPA scores. There are separate grids for Hispanic or Latino, Black of African American, Asian, and White medical school applicants. 

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In an AAMC survey, 8% of applicants with a GPA of at least 3.8 and MCAT scores of 39 were not accepted by any of the medical schools to which they applied. Although you may expect that sky high scores would guarantee admissions, these statistics clearly indicate otherwise. This should serve as a reminder that every component of your application is important to medical schools. 

Tips To Help Medical School Applicants Overcome a Low GPA

1. If you're applying to medical school at the end of your junior year, do everything you can to achieve great grades during your senior year. In the event that you have to reapply, academic excellence during the senior year will raise your GPA and strengthen your overall application. 


2. Some applicants have struggled academically because of personal or family illness. Medical schools understand that adverse life situations can affect applicants at any point in their lives. Consider explaining the cirumstances that led to lower grades in your application. 


3. Although it can be difficult to discuss your academic struggles with your advisors or professors, this can be a very useful approach, especially if you know them well. By informing them of the reasons for your struggles, you give them an opportunity to include the information in their letters of recommendation. When others advocate for you in this manner, it can have a powerful effect on the medical school admissions committee. These letters can reassure schools that your previous struggles should not be a concern moving forward. 


4. Perhaps the most common advice applicants with low GPAs receive is to take and achieve a high score on the MCAT. This is sound advice that can certainly help you secure interviews. Don't be surprised, however, if you're asked about the discrepancy between your GPA and MCAT during the interview. 


5. You are more likely to persuade medical schools to invite you for an interview if you have a strong record of community service and extracurricular involvement. Get involved in different endeavors and make the most of these opportunities. 


6. Leadership is important to medical schools, and will be seen as a plus in the application. Run for positions, and put in the time to advance the organization's mission or initiatives once elected. 


7. Medical schools prefer to interview applicants that have had significant clinical experience. In fact, motivation for a career in medicine is an important factor used to make admissions decisions. It's difficult to stand out in this area unless you have substantial experiences in medicine. These include, but are not limited to, volunteering in hospitals, shadowing physicians, serving as a nurse's aide, and working in a free health clinic. 


8. Some medical schools seek applicants dedicated to their own mission. A medical school which was established to meet the primary care needs of a rural population would understandably be interested in an applicant with substantial experiences serving the rural underserved population. If the applicant's track record in this area was robust, then the school may be willing to extend an interview offer even for applicants with lower GPAs. As you read over the descriptions of different schools, look for schools where you may be an excellent fit. 


9. Although every applicant must submit a compelling medical school application, applicants with lower GPAs cannot afford to make mistakes in content, grammar, or flow in their AMCAS or secondary applications. Superbly written applications are a must. 


10. Some applicants will be best served by completing courses after graduation as a post-baccalaureate or graduate student. Many students who were unsuccessful in securing spots in medical schools were accepted after completing and excelling in coursework following graduation. 

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