In a paper published last month in the Annals of Internal Medicine, Inginia Genao,Yale’s graduate medical education director of diversity, equity and inclusion, proposed replacing the Medical College Admission Test, commonly known as the MCAT, with alternative measures for evaluating medical school applicants in order to increase diversity.
“We have shown that minorities under- perform in the MCAT — not just the MCAT, it applies to other standardized tests,” Genao said. This underperformance is due to economic disadvantages and societal stereotypes that deter underrepresented minorities from applying to medical school, she added.
The MCAT is offered by the Association of American Medical Colleges, a private association. To eliminate the MCAT as an admissions standard, the U.S. government would have to file a lawsuit showing that the exam has “a disparate impact on the basis of race,” according to the paper, which would mean the test ran afoul of Title VI of the Civil Rights Act. However, whether the government actually pursues such a suit would depend on the current administration’s priorities and litigation positions, said Jacob Gelman ’18, co-author of the paper.
The current presidential administration would probably not move to eliminate the MCAT as an evaluation standard, Gelman said, given its record of opposing affirmative action in certain policy statements. The president of the Association of American Medical Colleges has suggested the Trump administration’s statements in that area would make it significantly more difficult to increase diversity in the medical student population.
Additionally, Gelman said, the Obama administration applied disparate impact as a legal standard to the issue of housing, and the current White House is considering rescinding those housing bias protections. Based on these indicators, it is unlikely that the government would take a stand on the MCAT, he said.
Genao agreed, saying she doubts that medical schools will replace or eliminate the MCAT and follow the
lead of a few schools that use alternative standards in the admissions process, such as the FlexMed Program at the Icahn School of Medicine at Mount Sinai. More research on a larger scale is necessary, Genao said, to either identify possible drawbacks to replacing the MCAT or show that the MCAT is not necessary for admitting qualified students.
“My hope is that we’ll have additional medical schools that will become part of a study,” Genao said. “We’ll take the lead in helping out to demonstrate what is the value of MCAT and particularly how it impacts different groups.”
According to Ayaska Fernando, director of admissions at the Yale School of Medicine, the school receives more than 4,000 applications each year. Although most applicants are highly qualified, the school is only able to admit a small number to fill the 104 seats in the incoming class.
“As such, there is no simple formula for admission and our entire admissions process is a holistic and contextual one, which carefully considers every part of the application,” Fernando wrote in an email to the News. “It most definitely does not rely simply on MCAT scores/GPAs or quantifiable variables alone.”
The lack of diversity among medical school students, however, is not solely a result of minorities’ underperformance on the MCAT, Genao said. In addition to socioeconomic bias, there is a lack of diverse role models in the field of medicine. And, Genao added, students from disadvantaged backgrounds have no mentors in their households to guide them through the application process.
Genao said the School of Medicine aims to address minority underrepresentation by improving outreach in a number of ways: organizing campus visits at the University, providing information about the school to LGBTQ conferences and organizations such as the Student National Medical Association and the Latino Medical Student Association, and promoting the University in locations where there is a higher concentration of minorities.
“We need to think about diversity in a broad way that’s not just race and gender but also religion, culture and other backgrounds,” Genao said. “When there are people from different backgrounds, there’s a tendency to be more productive and more innovative — there are different ideas and perspectives that come together.”
Eui Young Kim | euiyoung.kim@yale.edu