The SFFP Report

Effect on the MCAT and Medical School Admission

Henry Sondheimer, MDSenior Director, Medical Education Projects July 30, 2012

Agenda

• How we got to MCAT2015

• Components of the new test• Competency Based Admissions• Pre-requisites in the interim

Transforming Admissions

• Transforming admissions to keep pace with changes in science and medical education

• Preparing a physician workforce to improve the health of all

Blue-ribbon Panel Reports

Roadmap to Diversity: Integrating Holistic Review Practices (2010)

Scientific Foundations for Future Physicians Report (2009)

Behavioral and Social Science Foundations for Future Physicians (2011)

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SFFP Entering Competencies

1. Apply quantitative reasoning and appropriate mathematics to describe or explain phenomena in the natural world.

2. Demonstrate understanding of the process of scientific inquiry, and explain how scientific knowledge is discovered and validated.

3. Demonstrate knowledge of basic physical principles and their applications to the understanding of living systems.

4. Demonstrate knowledge of basic principles of chemistry and some of their applications to the understanding of living systems.

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SFFP Entering Competencies5. Demonstrate knowledge of how biomolecules

contribute to the structure and function of cells.

6. Apply understanding of principles of how molecular and cell assemblies, organs, and organisms develop structure and carry out function.

7. Explain how organisms sense and control their internal environment and how they respond to external change.

8. Demonstrate and understanding of how the organizing principle of evolution by natural selection explains the diversity of live on earth.

Evidence Base for MCAT2015

Fact-finding efforts:• Blue-ribbon panels• Holistic Review Project

Advisory Committee• Over 90 Outreach

events• Over 2700 completed

surveys

Roadmap to Diversity: Integrating Holistic Review Practices

Scientific Foundations for Future Physicians Report

Behavioral and Social Science Foundations for Future Physicians

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Biology

Cellular

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General Chemist

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Physics

Statisti

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Organic

Chemistry

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Combining Skills and Concepts

Foundational Concept 1 Foundational Concept 2Content

Category

1A

Content Category

1B

Content Category

1C

Content Category

2A

Content Category

2B

Content Category

2C

Skill 1

Skill 2

Skill 3

Skill 4

• Each cell represents the point at which foundational concepts, content categories, and scientific inquiry and reasoning skills cross

• Test questions are written at the intersections of the content and skills

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MCAT2015 – 4 Sections, 4 Scores

Biological & Biochemical

Foundations of Living Systems

Chemical & Physical

Foundations of Biological Systems

Psychological, Social, & Biological

Foundations of Behavior

Critical Analysis & Reasoning Skills

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Biological & Biochemical

Foundations of Living Systems

Concept 1

• Biomolecules have unique properties that determine how they contribute to the structure and function of cells, and how they participate in the processes necessary to maintain life.

Concept 2

• Highly-organized assemblies of molecules, cells, and organs interact to carry out the functions of living organisms.

Concept 3

• Complex systems of tissues and organs sense the internal and external environments of multi-cellular organisms, and through integrated functioning, maintain a stable internal environment within an ever-changing external environment.

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Biological & Biochemical

Foundations of Living Systems

Foundational Concept 2

• Highly-organized assemblies of molecules, cells, and organs interact to carry out the functions of living organisms.

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Concept 4

• Complex living organisms transport materials, sense their environment, process signals, and respond to changes using processes that can be understood in terms of physical principles.

Concept 5

• The principles that govern chemical interactions and reactions form the basis for a broader understanding of the molecular dynamics of living systems.

Chemical & Physical Foundations of

Biological Systems

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Concept 4

• Complex living organisms transport materials, sense their environment, process signals, and respond to changes using processes that can be understood in terms of physical principles.

Chemical & Physical Foundations of

Biological Systems

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Psychological, Social, & Biological

Foundations of Behavior

Concept 6

• Biological, psychological, and socio-cultural factors influence the ways that individuals perceive, think about, and react to the world.

Concept 7

• Biological, psychological, and socio-cultural factors influence behavior and behavior change.

Concept 8

• Psychological, socio-cultural, and biological factors influence the way we think about ourselves and others.

Concept 9

• Cultural and social differences influence well-being.

Concept 10

• Social stratification and access to resources influence well-being.

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Psychological, Social, & Biological

Foundations of Behavior

Concept 7

• Biological, psychological, and socio-cultural factors influence behavior and behavior change.

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Critical Analysis & Reasoning Skills

Asks examinees to critically analyze, evaluate, and apply information presented in passages from humanities & social sciences, including:• Ethics • Philosophy• Population health• Cross-cultural studies

Specific disciplinary knowledge not needed

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Testing and Course CompletionSome examinees test for the first time as juniors, some as seniors, and some later:• Juniors - 41%• Seniors - 27%• Later - 27%

Before testing, many examinees complete biochemistry, psychology or sociology:• Biochemistry - 63%• Introductory psychology - 65%• Introductory sociology - 32%

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Applying to Medical School Some apply after junior year, some after senior year, and some while in post-bac or grad school:• As college seniors - 37%• During gap year - 44%• Post-bac or grad school - 19%

Many medical schools require or recommend biochemistry or a behavioral or social science course:• 83% biochemistry• 53% behavioral or social science

Where we are headed-

Competency Based Admissions

Competency-Based Admissions• Competency-Based Admissions (CBA) is an

approach to admissions that employs processes intended to determine each applicant’s ability to demonstrate a core set of entry-level competencies needed to succeed in medical school, residency and in practice.

• This core set of entry-level competencies includes both:• Interpersonal and intrapersonal

competencies• Academic competencies

COA-Endorsed Personal Competencies

Category Competencies

Interpersonal • Service orientation• Social and interpersonal• Cultural competence• Team work• Oral communication

Intrapersonal • Integrity and Ethics• Reliability and dependability• Resilience and adaptability• Capacity for improvement

The Prerequisite Landscape During the Transition to the 2016 Entering Class Application Cycle

What are medical schools doing?• 75% of schools that responded to a survey

indicated a willingness to create less-restrictive pathways.

• 43% of respondents answered “No” or “Sometimes” to the question:

“If an applicant does not meet your school's premedical course requirements, are they excluded from the applicant pool?”

• How schools create and show their flexibility will likely vary from school to school.

Schools with no required courses

• Hofstra North Shore—LIJ School of Medicine• Medical University of South Carolina• Raymond and Ruth Perelman School of Medicine

at the University of Pennsylvania• Southern Illinois University School of Medicine• University of Cincinnati College of Medicine • University of Virginia School of Medicine

Southern Illinois University

Hofstra – Northshore LIJ

University of Pennsylvania

University of Pennsylvania: Guidance to ApplicantsEnglish/Communications Competence in writing, speaking, and

reading the English language

Biology Understanding of the basic biological principles shared by all living organisms

Chemistry Understanding of the core principles of physical, inorganic, and organic chemistry

Physics and Mathematics Firm foundation in mathematics and physical science on which the medical science…can be based

Other Acquisition of an education that leads to continuous, lifelong learning

http://www.med.upenn.edu/admiss/admissions1.html

Other Current Models of Flexibility• Schools that don’t require organic chemistry:

• University of Minnesota Medical School• Cooper Medical School of Rowan University

• Schools that don’t require inorganic chemistry:• Central Michigan University College of Medicine • University of Rochester School of Medicine and

Dentistry• Northeast Ohio Medical University

• Schools with parallel pathways: • Harvard Medical School

Harvard Medical School 

Harvard Medical School: Changing course requirements

“Interdisciplinary courses that break down the

barriers among, demonstrate complementary

concepts of, and highlight collective wisdom in

biology, chemistry, physics, and mathematics are

encouraged.”

http://hms.harvard.edu/content/requirements-admission

Next steps

• The AAMC is recommending that medical schools reassess their current prerequisite course requirements with a focus on creating the least-restrictive pathway for applicants.