The year was 1989. Late summer. The pressure was on to perform. Whether it was due to studying inertia, laziness, or simply hubris — I elected to take the dreaded MCAT (the medical college admissions test) at the latest possible offering. Yes, I was reasonably confident of my standardized test-taking abilities, and I knew that my GPA could definitely hold its own. Still, as I look back on my senior year in college, delaying such an important and redoubtable requirement was pretty foolhardy.

Nineteen eighty-nine was also approximately the period in which the test gurus who formulated the exam took a curious turn and seemed to bend over backwards answering critics’ and educators’ assertions that the exam was too narrowly focused on the left-brain aspect of scholarship. What was needed, the sage designers of the MCAT decided, was a tool to measure the non-scientific literacy of those who were audacious enough to consider a career in medicine. Thus, the maligned essay question was introduced.

The body tasked with reviewing the MCAT’s current state of affairs has made its concerns with the exam’s future known, and it reflects a growing reality in the state of preparing those with an interest in medicine to be able to succeed in medical school. That medicine is constantly changing with respect to rapid advances in basic science research and social and economic healthcare policy trends is a complete understatement, one that is highlighted by the committee’s recommendations.

The new MCAT will preserve the best features of the previous exam, while ineffective sections (e.g.,the writing sample) will be jettisoned. The two natural science sections will be revised to focus on relevance to living systems, emphasis on critical analysis, and reasoning skills will increase in a revised verbal section; and a section on behavioral and social sciences will be added.

Yes, it has taken the testing gods some twenty years to kill the essay section. Well, here’s hoping that future practitioners of medicine will have the intestinal fortitude that successive iterations of the MCAT (starting in 2015) will now require — the quality of endurance. As it stands, testing length will increase by over 40 percent — to 6 hrs and 15 min. Ouch! Guess I’m glad my laziness didn’t get the best of me some 22 years ago! | LINK [PDF]

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In a way, the “predation” of pharma companies on medical students on their home turfs reminds me a lot of the controversies surrounding the tactics of credit card companies on unsuspecting students on college campuses.

When there’s an opportunity….

We’re all familiar with the remedies both university leadership and even some states’ legislative bodies have enforced in the past in the wake of arrgessive marketing techniques by banks designed to incur long term loyalty (in the form of massively needless student debt) at the hands of those just looking for a “free lunch”.

Well, some medical schools are going a similar route with their student bodies, and the target is Pharma. (Full disclosure: yes I was a starving beneficiary of pharma companies’ largesse when it came to accepting my free luches…and pens, and textbooks, and…well…when you’re a starving med student — you’ll take what you can get.) The AMSA, the largest association of med students in the country, has taken to scoring medical schools based upon their policies with respect to approaching pharma marketing on their campuses.

Many proactive medical schools are even incorporating the lessons learned in this exercise as the basis for ethics courses in their curricula. Good move. After all, regardless of where med schools “score” on the AMSA ratings list on this issue, its awareness by students represents a kernel of knowledge from which a career lifetime of good ethics habits is fostered. | LINK

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On 1/1/09, Pharma instituted a voluntary ban on all gifts to physicians — the mugs, pens, post it notes, and all of the other materials involved in even further promotion of their products. The first group to applaud this move is the American Medical Student Association, to which I belonged many, many years ago.

AMSA’s PharmFree campaign has educated and trained thousands of medical students across the country to interact professionally and ethically with the pharmaceutical industry. “Banning gifts from the drug companies is a good first step,” says Dr. Brian Hurley, AMSA’s national president. “There is no role for marketing masquerading as education when our patients’ lives are at stake.”

LINK | AMSA LINK

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