Validity of the Medical College Admission Test for predicting medical school performance

  • Julian E
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Purpose Since the introduction of the revised Medical College Admission
Test (MCAT (R)) in 1991, the Association of American Medical Colleges
has been investigating the extent to which MCAT scores supplement the
power of undergraduate grade point averages (uGPAs) to predict success
in medical school. This report is a comprehensive summary of the
relationships between MCAT scores and (1) medical school grades, (2)
United States Medical Licensing Examination (USMLE) Step scores, and (3)
academic distinction or difficulty.
Method This study followed two cohorts from entrance to medical school
through residency. Students from 14 medical, schools' 1992 and 1993
entering classes provided data for predicting medical school grades and
academic difficulty/distinction, while their peers from all of the U.S.
medical schools were used to predict performance on USMLE Steps 1, 2,
and 3. Regression analyses assessed the predictive power of combinations
of uGPAs, MCAT scores, and undergraduate-institution selectivity.
Results Grades were best predicted by a combination of MCAT scores and
uGPAs with MCAT scores providing a substantia increment over uGPAs. MCAT
scores were better predictors of USMLE Step scores than were uGPAs, and
the combination did little better than MCAT scores alone. The
probability of experiencing academic difficulty or distinction tended to
vary with MCAT scores. MCAT scores were strong predictors of scores for
all three Step examinations, particularly Step 1.
Conclusions MCAT scores almost double the proportion of variance in
medical school grades explained by uGPAs, and essentially replace the
need for uGPAs in their impressive prediction of Step scores. The MCAT
performs well as an indicator of academic preparation for medical
school, independent of the school-specific handicaps of uGPAs.

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  • E R Julian

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