Well: A Better Medical School Admissions Test

 Jesus Jauregui/Getty Images

Recently the college-age daughter of a friend talked to me about her dream of becoming a doctor. She was doing well as a psychology major and in her pre-medical courses, was working as a research assistant for a pediatrician at a nearby medical school and volunteered on the cancer ward at a children’s hospital.

I was impressed.

But her enthusiasm dipped sharply when she told me she was preparing for the MCATs, the Medical College Admission Test, the required standardized test that measures mastery of the pre-medical curriculum. She was putting all her extracurricular work on hold so she could focus on reviewing biology, physics, chemistry and organic chemistry for the exam. “Does my ability to memorize the Krebs cycle and Bernoulli’s equation really have anything to do with what kind of doctor I’ll be?” she asked.

The answer, it turns out, is yes — and no.

The first MCAT, then referred to as the Scholastic Aptitude Test for Medical Schools, was administered in 1928 and represented an effort to address the significant medical school dropout rates of the time. Up until that point, medical school applicants had been evaluated, and accepted, on the basis of stray bits of biographical information, random letters of endorsement, a few prior grades or the existence of a high school diploma. As many as half of those accepted eventually quit, resulting in huge losses of time, energy, educational resources and money. But thanks in part to the MCAT, by the mid-1940s the medical school attrition rate had plummeted to less than 10 percent, even as the standardized exam was becoming a much-maligned rite of passage for aspiring young doctors.

Over the years, the MCAT has gone through four major revisions and has only strengthened its ability to predict success in medical school, particularly when evaluated in combination with grades. Each year more than 70,000 students take the exam, vying for a little more than 19,500 medical school slots. These days, fewer than 4 percent of those finally accepted drop out.

But the MCAT has had one major failing in its otherwise brilliant performance: It has been unable to consistently predict personal and professional characteristics. As early as 1946, medical educators were trying to design the MCAT in a way that might tease out such information, but they, and those who followed, were unable to succeed.

Now the MCAT is about to undergo its fifth revision, the first in nearly 25 years. Last month, the Association of American Medical Colleges, the national organization that administers the MCAT, released the preliminary recommendations of a 22-member advisory committee that has been studying the issue for the last three years. They recommend, among other things, lengthening the four-and-a-half hour exam by 90 minutes and adding questions on disciplines like sociology and psychology. The new exam would also test analytical and reasoning skills in areas like ethics, philosophy and cross-cultural studies, which could include questions about how someone living in a particular demographic situation, for example, might perceive and interact with others.

Despite what some view as a long overdue re-examination of this linchpin of medical school admissions, many medical educators, including members of the advisory committee, remain cautious about tampering with a test that has proved successful so far.

“It’s like trying to improve a Honda,” said Dr. Ronald D. Franks, vice chairman of the committee and vice president of health sciences at the University of South Alabama College of Medicine in Mobile. “When you’ve got something that’s working extremely well, you can make improvements, but you’ve got to be mindful of the services it has rendered.”

Those services can be gargantuan. Jefferson Medical College in Philadelphia, for example, receives almost 10,000 applications each year and must whittle those numbers down to 800 for interviews for the 260 available slots in each class. In combination with grades, the MCAT can help admissions officers eliminate a quarter of the applications.

“But we and other medical schools have so many great applications from the standpoint of just numbers that we usually also need to go through other parts of the application as well,” said Dr. Clara A. Callahan, dean of student affairs and admissions at Jefferson and the lead author of one of the largest longitudinal studies on the predictive validity of the MCAT. “You want to make sure someone isn’t just saying that he or she wants to help people.”

It’s likely that Dr. Callahan and other medical school admissions officers will have to continue to look beyond the MCAT to learn more about their applicants’ personal qualities. The science of personality testing has advanced tremendously over the last 25 years, but the committee felt it was still unclear how accurately a test could predict traits like integrity, altruism and the ability to collaborate. Some members were uncomfortable, too, with the long-term implications. “Will we end up labeling someone forever with a 9.2 for their personality?” Dr. Franks asked.

Only time will tell whether this newest version succeeds where earlier ones have not. But one thing is certain: Taking the MCAT is likely to remain a rite of passage for doctors-to-be for years to come.

“The reality is that we doctors are taking standardized tests – in-service exams, board exams, recertification exams – all our life,” Dr. Callahan said. “It’s something people have to master in medical school and beyond, so it’s nice to be able to accurately predict at the outset how someone will do with them in medical school and beyond.”

The MCAT advisory committee is continuing to solicit opinions through its Web site until February. The new exam will be administered beginning in 2015.

 

Global Update: Height: Very Poor Women Are Shrinking, as Are Their Chances at a Better Life

The average height of very poor women in some developing countries has shrunk in recent decades, according to a new study by Harvard researchers.

Height is a reliable indicator of childhood nutrition, disease and poverty. Average heights have declined among women in 14 African countries, the study found, and stagnated in 21 more in Africa and South America. That suggests, the authors said, that poor women born in the last two decades, especially in Africa, are worse off than their mothers or grandmothers born after World War II.

“It’s a sobering picture,” said S. V. Subramanian, a professor at the Harvard School of Public Health and lead author. “It tells you the world is not getting to be a better place for women of lower socioeconomic status. For them, it’s getting worse.”

The study, published last week in the online journal PLoS One, analyzed data on 365,000 adult women in 54 poor and middle-income countries from the hundreds of huge Demographic and Health Surveys paid for largely by American foreign aid.

Only women ages 25 to 49 were included to avoid counting those young and growing, or old and shrinking. Women from Senegal and Chad were the tallest, while those from Guatemala and Bangladesh were the shortest.

The study found that the richest 20 percent of women in all the countries surveyed have grown. Those born in the 1940s averaged 5 feet 1 1/2 inches; those born in the 1980s averaged 5-foot-2.

Those in the poorest 20 percent averaged 5-foot-1, no matter what decade they were born in. Guatemala and Honduras had the biggest gaps in height between rich and poor women; Uganda and Ethiopia (above, where women sorted coffee) had the smallest.

 

Global Update: Height: Very Poor Women Are Shrinking, as Are Their Chances at a Better Life

The average height of very poor women in some developing countries has shrunk in recent decades, according to a new study by Harvard researchers.

Height is a reliable indicator of childhood nutrition, disease and poverty. Average heights have declined among women in 14 African countries, the study found, and stagnated in 21 more in Africa and South America. That suggests, the authors said, that poor women born in the last two decades, especially in Africa, are worse off than their mothers or grandmothers born after World War II.

“It’s a sobering picture,” said S. V. Subramanian, a professor at the Harvard School of Public Health and lead author. “It tells you the world is not getting to be a better place for women of lower socioeconomic status. For them, it’s getting worse.”

The study, published last week in the online journal PLoS One, analyzed data on 365,000 adult women in 54 poor and middle-income countries from the hundreds of huge Demographic and Health Surveys paid for largely by American foreign aid.

Only women ages 25 to 49 were included to avoid counting those young and growing, or old and shrinking. Women from Senegal and Chad were the tallest, while those from Guatemala and Bangladesh were the shortest.

The study found that the richest 20 percent of women in all the countries surveyed have grown. Those born in the 1940s averaged 5 feet 1 1/2 inches; those born in the 1980s averaged 5-foot-2.

Those in the poorest 20 percent averaged 5-foot-1, no matter what decade they were born in. Guatemala and Honduras had the biggest gaps in height between rich and poor women; Uganda and Ethiopia (above, where women sorted coffee) had the smallest.

 

Global Update: Height: Very Poor Women Are Shrinking, as Are Their Chances at a Better Life

The average height of very poor women in some developing countries has shrunk in recent decades, according to a new study by Harvard researchers.

Height is a reliable indicator of childhood nutrition, disease and poverty. Average heights have declined among women in 14 African countries, the study found, and stagnated in 21 more in Africa and South America. That suggests, the authors said, that poor women born in the last two decades, especially in Africa, are worse off than their mothers or grandmothers born after World War II.

“It’s a sobering picture,” said S. V. Subramanian, a professor at the Harvard School of Public Health and lead author. “It tells you the world is not getting to be a better place for women of lower socioeconomic status. For them, it’s getting worse.”

The study, published last week in the online journal PLoS One, analyzed data on 365,000 adult women in 54 poor and middle-income countries from the hundreds of huge Demographic and Health Surveys paid for largely by American foreign aid.

Only women ages 25 to 49 were included to avoid counting those young and growing, or old and shrinking. Women from Senegal and Chad were the tallest, while those from Guatemala and Bangladesh were the shortest.

The study found that the richest 20 percent of women in all the countries surveyed have grown. Those born in the 1940s averaged 5 feet 1 1/2 inches; those born in the 1980s averaged 5-foot-2.

Those in the poorest 20 percent averaged 5-foot-1, no matter what decade they were born in. Guatemala and Honduras had the biggest gaps in height between rich and poor women; Uganda and Ethiopia (above, where women sorted coffee) had the smallest.

 

Bits: Is the iPad 2 a Lot Better Than the Original?

Justin Sullivan/Getty Images Apple says the iPad 2 is 33 percent thinner than the original model.

Over the weekend,?Chris Dixon, an?entrepreneur?and co-founder of the social site?Hunch, lamented on Twitter?that he still had not purchased a new iPad 2. Although Mr. Dixon hopes to buy the highly coveted device soon, he questioned whether it was a “must have” upgrade from the first generation iPad.

I responded, along with a number of other Twitter users, that the new model had changed everything for me.?I personally find that I use the iPad 2 for about 15 hours a week; when I owned the first-generation iPad, I used it for only one to two hours a week.

For me, there are several explanations. The iPad 2 answered a number of complaints I had with the previous model, which always felt a little too heavy and slow. Although the new model is only slightly smaller around the edges — Apple shaved millimeters off the exterior bezel — it is quite a bit thinner and lighter. As a result it is easier to hold when reading or surfing the Web. It is also more manageable on a morning commute.

Others I spoke with who have upgraded iPads also liked it better than the original version.

“Although the new iPad isn’t dramatically thinner, lighter or faster than the first, the collection of small improvements Apple has made make it feel like a huge deal,” said?Alex Rainert, a designer who is head of product at the location-based start-up?Foursquare. “The first iPad always felt a bit too heavy when typing or surfing the Web. The changes to the second generation make it feel like a fundamentally more usable device.”

For me, the iPad 2 also feels considerably faster than its predecessor. In part this is because the new smart cover, as I’ve written in the past, turns the device on as soon as you open it.? Typing is quicker, apps are more responsive, and the Web browser to me feels almost as fast as that of a desktop computer. In the past, the browser was extremely slow with image-heavy Web sites.

Justin Ouellette, a developer at BetaWorks, noted that the?small increases in performance on the iPad went further than they would on a desktop computer.

“The iPad kind of ‘becomes’ whatever app you’re currently running, and being more powerful and physically slighter allows it to deliver that transparent experience ever more convincingly,” Mr. Ouellette wrote in an e-mail. “The best user interface is one you don’t notice because it never lags or causes you trouble.”

What do you think? For those of you who have upgraded to an iPad 2, do you think it’s a big improvement? Is it a “must have” upgrade?

 

T-Mobile blesses contract-averse with Rocket 4G modem and better data plans

 By Terrence O'Brien posted Apr 14th 2011 3:29PM If you're waiting impatiently for the ability hook your laptop in to T-Mobile's blazingly fast 42Mbps HSPA+ network, you are going to have hold tight just a little bit longer. But here's some good news to tide you over: the 21Mbps capable Rocket 4G USB stick is here, and available starting April 17th with new prepaid data plans for those who prefer not to chain themselves to a two-year contract. The $30, 30-day plan will jump from 300MB to 1GB, and the $50 plan will be bumped from 1GB to 3GB. It's not as flashy as the 4G Mobile Hotspot nor as fast as the 42Mbps Rocket 3.0, but it's priced