2015 MCAT; cultural competence; culturally literate; patient-centeredness; health care disparities


There is broad consensus that reduction in health care disparities is an important and multi-faceted challenge. One possible approach, among many others, starts with the attraction of women and men to the field of medicine who have a broad based education and who can demonstrate cultural understanding and sensitivity. In this context, the Medical College Admissions Test (MCAT) has been revised, effective in 2015, to include many additional questions concerning the psychological, social, and behavioral sciences. There are important assumptions fueling the revised Medical College Admissions Test (MCAT) and these will need to be tested. These assumptions range from influencing course selection by undergraduates interested in applying to medical school to improving health outcomes and reducing disparities. The revisions in the MCAT embody the belief that future physicians must have a broader education than at present to be better responders to their patients and to their communities. There are three major expectations from the MCAT revisions. First, undergraduates interested in applying to medical school will be motivated to enroll in a broader range of courses in the social sciences and humanities to be better prepared for the MCAT. Second, the broader range of undergraduate courses will hopefully translate into physicians who are more intellectually diverse and culturally sensitive. Third, the new physicians will have a more active and direct role in improving the health of the populations including a reduction in the current health care disparities. While these bold expectations are untested and must be measured, there is evidence that provides a foundation for this hypothesis. Numerous studies indicate that racial disparities in health care quality and health care outcomes result from cultural barriers and provider’s insensitivities. The pathway to a reduction in health care disparities is clearly multi-dimensional with many causal factors in the way. Nevertheless, the revision in the MCAT may be an important step in preparing physicians for a more active role in reducing disparities. This essay recommends concentrated research to analyze the effectiveness of the MCAT revisions and their impact on health care disparities, focusing on the aforementioned three expectations. This requires both short-term and long-term analyses. While the methods to complete these analyses are clearly complex, they are necessary before any conclusions about the expected impact of the MCAT revisions on health care disparities can be made.


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