Currently, the most important test prospective medical students take is the Medical College Admission Test, or MCAT.
Despite what schools say, an MCAT score holds tremendous weight, more so than a brilliant essay or a stellar recommendation letter.
In an interesting New York Times piece, Pauline Chen wonders whether that score itself leads to a great physician. She discusses an article showing that students’ cognitive traits may be equally important.
Although students go through several interviews to get an assessment of their personality, these are rarely standardized, and certainly not quantified. It’s important to know, for instance, how a student responds to stress: “If I know someone is not just stress-prone, but stress-prone at the 95th percentile rather than the 65th. I would have to ask myself if that person could handle the stress of medicine.”
The concept of using cognitive traits as part of medical school admissions raises interesting questions. Can one “improve” a trait that he is deficient in? And which traits are deemed most important for a future doctor?
For the latter question, Dr. Chen notes it depends on what kind of doctors medical schools are interested in graduating. Physician-researchers would require a whole different profile from, say, a primary care doctor.
But lets take it one step further. Can cognitive traits be used to differentiate students inclined to go into procedure-based specialties? With the dire primary care shortage, maybe medical schools can preferentially accept students who have a personality more inclined towards generalist care.
I’m just kidding, of course. But don’t tell me that didn’t cross your mind.
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{ 17 comments }
The short answer is no. There should be no personality tests for applying to medical school. How boring would the medical profession be if every doctor had the same personality trait?
Personally, I think the ONLY way you could get into Med school is via the EMS route.
I think ANYBODY that wants to be a nurse or MD should be an EMT for minimum of 2 years. The beginning step for entry to the hallowed halls of medicine should be the lowly EMT, then LPN, then RN and then finally MD. That way the people that are really book smart would have some real life experiences to back up that book learning!
We have too many folks, that have the MD behind their names, that would benefit from some humility.
Steve
Yes, there should. I would have been steered away from clinical medicine (which I hate) and toward a non-clinical specialty. Or perhaps I’d have chosen a different graduate degree altogether.
Ahh????? So they still have not identified the desired milquetoast drone gene so that a population of easy to pacify, fool and control candidates can be “selected for”….fascinating.
I had to take a personality test for my first employer prior to starting and having my offer contingent on the resulting interpretation. The two partners let me look at the results after I had been there for a year. Interesting but meaningless.
Terminology in the questions that had multiple interpretations pivotal to the answer etc, see “competitive.” I had some time to kill so I called the testing center to clarify some issues on the test. I was put in touch with the Psychology Ph.D. that developed the test and we had a spirited discussion of the test. After a few minutes he told me that the testing was sooo good that it indicated that I would be one of those people to call and challange the voracity of the test! Conversation over by mutual decree.
It is a dangerous game this type of “testing.” In my world, I would like to see people of character, honor, honesty tenacity, intelligence and determination prevail in admissions to competitive programs. An astute interviewer can sense a lack of compassion and/or empathy. Ultimately, the job is best perfomed by people with these traits as they make the MOST EFFECTIVE providers in my experience.
The work needs to be challanging and rewarding on many levels if it is to retain “smart” people. The MCAT and other objective measures of assessment through prior acheivment are probably the best basis for admissions so far. They cannot always, however, parse out what often is termed as “smart.”
“Smart” is a cagey and elusive identifier for a person, multifacited in its constitution and mastered by no known testing. The soup of “smart” has at its core some basic yet powerful ingredients. Accumulated knowledge, innate computation, facility of intergration, cleverness, experience, grit, success of execution determined by quality and quantity of desired result and grace. I am sure there are others, but these work for me.
The numero uno in my class was one of the least effective students in getting the job done on a day to day basis, thus making more work for those of us on his rotations. Photographic memory, enormous fund of knowledge but not able to execute a plan.
Very inteligent guy, just not very smart. I want smart people in this field when it’s my turn to need them.
The medical school I attended gave everyone a MMPI, Minnesota Multiphasic Personality Inventory, at the time of medical school interview.
As best I could gather, from actually attending the place, there was a psychologist doing a study of medical students. Who was admitted, how well they did, correlating with MMPI findings.
Ok Steve, EMT for 2 years (to age 20), then go to LPN school for 2 years and work for 2 years (age 24), then RN school for 2 years and work for 2 years (age 28), then med school for 4 years, and residency for 3 years (age 35), then a job at an HMO where you could watch your inflation-adjusted salary shrink year by year and get told to do by a guy with an MBA and the brains and responsibility of a medium-sized turnip for the rest of your working life. Indeed, such a career path would indicate humility.
Every medical student who will gradudate with the MD in 4 years knows enough about her personality; many of them have already taken the tests in college or before. The information would not be valuable or useful.
Maybe every patient needs a personality test so we can screen which ones are going to be pleasant and which ones are likely to become addicts, whiners or control freasks – no, that’s too ridiculous.
IF THERE IS ONE THING THEY NEED TO TEST ” Are you in it for the money? ” Maybe they can use those fancy fMRI to figure the if they telling the truth.
The word “cognitive” is misused in this post. Cognitive functioning is approximately equivalent to intellectual functioning and is measured by the many tests that pre-meds and med students take, including the MCAT.
Sometimes i do wish the medical admissions process was more rigorous. 90-95% of people entering med school will become doctors. The med school admissions process is essentially the gateway to becomming a doctor. This has both good and bad consequences.
Since the med school application process is so weighted toward the MCAT, the end result of this process is that we have alot of smart people becomming doctors. This is a good thing.
On the other hand since the admissions process is ineffective at screening out negative characteristics, it’s almost envitable that some bad apples will become doctors. These are the people who will end up killing people, end up on TV for all the wrong reasons, end up tarnishing the reputations of doctors everywhere. As a future doctor, i’m concerned about this. Remember the craigslist killer? He was very smart, and very disturbed and he got into med school
I would be less concerned about this if med school were a place that could turn “bad apples” into good doctors. But my first hand experience with med school is that it’s still very centered around studying, and it’s less concerned about developing cognitive abilities and correcting personality flaws.
Is a personality test the answer- probably not, because almost all mulitple choice questions can be “crammed for” over time. But i would like better screening process for becomming a doctor- it should be more that getting a 30+ MCAT, acquiring 3 decent letters of recs over 4 years of college, and a 30 minute to 2 hour interview.
Why am I not surprised to learn this idea was aired in the New York Times? That paper, whose audience is shrinking both in numbers and (for better or worse) cultural significance, seems to have a new prescription for what ails medicine in the USA about every three months. If it isn’t something wrong with payment (Rx=single payer), then it is something about insurance (Rx=Medicare for all) and now, the answer about who becomes a doctor (Rx=those who pass a personality litmus test.) Very predictable. And we’re to assume that this study of Belgian medical students is as good as anything in predicting who will become a good doctor, anywhere. Right. The presumptuousness just makes me laugh.
Folks, the process of becoming a doctor is a decade-and-a-half trial. Becoming a doctor is a test. It imposes fatigue, frustration, self-reliance, fortitude, stamina, self-denial and many other experiences and requirements. It is capable of weeding out those who may be very nice people, full of the best intentions but are just not cut out to be doctors. This is a silly and wasteful conceit to conclude that there is somehow this better, more suited, somehow overlooked pool of (willing? interested?) people who if we could just pick them out with the right test (a personality test!) then all would be right with medicine and the world.
And sorry, becoming and EMT and then successively a group of other healthcare workers before becoming is bunk. The truth is you don’t need to do any of those things to become a good doctor and you never have had to. That is a silly conceit wrought of resentment and envy.
Why the h*ll does it matter if a patient is a “whiner” or a “control freak”? First, they’re SICK — no one’s at his/her best when injured or ill. Second, you’re being PAID, and paid very well, to provide your services. Who exactly is the whiner here: the patient who seeks help, or the doctor so wrapped up in his/her own personal comfort that empathy and patience are simply out of the question?
W:
I think you missed the point. The comment was to point out the absurdity of imposing some kind of arbitrary test criteria on medical school applicants beyond the knowledge-based testing criteria already in place (along with recommendations and undergraduate grades.) It seems there is no end to satisfying the public’s desire for testing the physician end of the doctor-patient relationship and no end to imposing new requirements. Medical boards-general and specialty, ever-increasing (and politically-motivated) continuing medical education requirements to keep both license and certification, re-certification exams, maintenance of certification programs, institutional re-credentialing processes, state medical board oversight and of course, the day-in, day-out supervision through hospital and surgery center incident reporting. If there is a major occupation subject to more overall and day-to-day performance scruitiny than medicine, I have yet to see it. (and I have worked the nuke weapons arm of the military, and it ain’t them, either.)
Patient expectations seemingly have no brakes. And unless you have been hanging out in Sleepy Hollow these past two decades, being PAID, as you so emphatically put it, ain’t what it used to be. If anything, patients have become ever more demanding over the years while putting up far less for their side of the bargain, proportionally-speaking,than they did in the past, if not themselves, then through their proxies, their insurance carriers. There is a limit to what can be demanded for diminishing prices.
The suggestion that a new screen should be placed to sort out who should go into medicine is both stupid and laughable. We have shortages of the very doctors supposedly needed at the front end of the profession, mostly because they aren’t getting PAID enough to put up with the aggravation, from low levels of payment, from gross excess of paperwork, from the worry of liability, from the annual brinksmanship of Medicare cuts and yes, from whiny, entitled patients who really do have endless demands at times.
Be careful what you wish for when you say you think you deserve what you say you have PAID for. The day is coming when you might have something very close to that.
Dear W,
While I still maintain the authority to control reasonable aspects of my practice, I will, by matter of MY policy, fire patients that are abusive to me and or my staff either verbally or physically, do not show up to appointments without good reason, have no intention to pay for services if we (and/or government) determine that they in fact DO. I find that I cannot contribute to good outcomes for these patients under these conditions and suggest that they seek care elsewhere. Controlling and whining I can deal with. Veiled or open litigious threats beyond the saber rattling of discontent with prior providers is a one way ticket to the parking lot as well. Sorry pal, didn’t sign up to be a slave for assholes.
As someone who chose not to take the MCAT (and deeply regrets it), I actually like the idea of having a personality assessment for med school, but not necessarily for admission – more for selection of specialty.
The MCATs do allow for many smart people to enter med school, but it’s more an assessment of who is a good standardized test taker – not necessarily who the smartest people are.
As a recent cancer survivor, I’ve had more than my fair share of interaction with physicians (as well as a long career in the pharmaceutical industry). There are physicians practicing clinical medicine who have NO social skills and really should be in specialties such as Pathology, Nuclear Medicine, Radiology because of their anti-social, akward interpersonal skills. I’ve met many Endocrinologists who fit into this category. In the case of my Oncologist, at first I really didn’t like his frank, candid bed side manner. I accepted his brilliance because his RN is an angel. His manner has subsided as my prognosis has continued to improve (14 months of completely clean PET and CT scans).
Unless you have given birth, had a bone marrow biopsy, survived a plane/car accident, you really don’t know how your instincts will kick in during a stressful/traumatic experience. NO test can assess that effectively.
I sat for a voluntary “Personality Test” when I was doing my college/pre-university/matriculation study in Adelaide South Australia in 1978.After the test,the evaluator sat with me and discussed the results.The conclusion was,Medicine was quite suitable for since my score on the social and humane components of the tests were quite high-more of less like that..
Of course this test was voluntary and it wasn’t even considered in the university entry application which depend purely on the academic results.
I guess the issue of what constitute a good doctor still remains elusive now as it was before.
The controversy of the artistic(subjective) trait vs scientific(academic/technical) ability in making a good/competent medical practitioners still challenge medical schools to innovate their curricula from time to time.
Personality test is a subjective exercise to try and help prospective students and medical schools to make a right decision.I think it is useful to some degree but the final decision of entry into medicine should still be largely based on academic ability…
The questions and responses remind of the blind and the elephant…descriptions of only what the blind perceive. Only students who are able to manage the knowledge acquisition of the medical curriculum should be admitted..the course is short and intense. However, It is marvelous to behold within the medical classes admitted the diversity of types and their eventual gravitation to speciality areas.
The problem with medicine is the lack of actual physician leaders produced from this diverse group of students..the medical business has been taken over by a variety of businesses….medicine is an outlet for pharmaceutical companies…surgical supply…imaging technologies..worker unions. Where is the medical leadership that should be deploying these tools to the full benefit on society? The Obama “Health Plan” moves far in the wrong direction to evenly more firmly plant “business” as the source of healthcare. We need innovation in medicine…new approaches and most of all we need the “participation of patients” within a setting of physician leadership.
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