Applicants given extra time on MCAT have lower USMLE pass rates

1. Individuals with extra time testing accommodations on the Medical College Admissions Test (MCAT) had comparable scores and medical school admissions outcomes to those taking the MCAT in the standard time in this study.

2. Individuals with testing accommodations on the MCAT had lower United States Medical Licensing Examination (USMLE) pass rates and lower medical school graduation rates when compared to those who took the MCAT in the standard time.

Evidence Rating Level: 2 (Good)      

Study Rundown: The MCAT is a required part of the application package to most medical schools in the United States and Canada. Qualifying students with disabilities are allowed special testing accommodations such as extra time, large print, and nonstandard breaks. This study compared medical school application and performance outcomes between individuals taking the MCAT with and without accommodations during two time frames (students matriculating into medical school between 2000-2004 and students applying to begin medical school between 2011-2013). The majority of applicants applying between 2011-2013 took the MCAT in the standard time (99.7%), and the most common accommodation was 50% extra time. There were no differences in the section or total MCAT scores or medical school acceptance rates between individuals taking the test in normal time and those with testing accommodations in either time frame. Medical students who had extra time on the MCAT had lower passing rates on Steps 1, 2 CK, and 2 CS of the USMLE tests when compared to those who took the MCAT in the standard time. Students with extra time on the MCAT also had significantly lower medical school graduation rates. Strengths of this study include the large number of participants, the comprehensive MCAT and medical school application data available, and the exclusion of individuals enrolled in dual degree programs or other programs that involve spending greater than four years in medical school. However, this study did not include USMLE testing accommodations data, which may have biased results.

Click to read the study, published today in JAMA

Relevant Reading: The predictive validity of the MCAT exam in relation to academic performance through medical school: a national cohort study of 2001-2004 matriculants

In-Depth [retrospective cohort]: This study compared MCAT performance, medical school admissions outcomes, and medical school outcomes between individuals taking the MCAT in the standard time and those taking the MCAT with testing accommodations. The section and overall MCAT scores between the two groups were not significantly different, but the undergraduate grade point averages were lower for individuals requiring extra time in both time cohorts included (p<0.001 for both). The medical school admissions outcomes were comparable for individuals with and without MCAT accommodations (p=0.81). Pass rates for USMLE exams were lower among individuals who took the MCAT with accommodations when compared to standard MCAT administration (Step 1 first attempt p<0.001, Step 1 eventual pass p<0.001, Step 2 CK first attempt p<0.001, Step 2 CK eventual pass p<0.001, Step 2 CS first attempt p<0.001, Step 2 CS eventual pass p=0.02). MCAT testing accommodations were also associated with lower medical school graduation rates (p<0.001 for graduation within 4, 5, 6, 7, 8 years and did not graduate).

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