The Predictive Validity of Three Versions of the MCAT in Relation to Performance in Medical School, Residency, and Licensing Examinations: A Longitudinal Study of 36 Classes of Jefferson Medical College

Jefferson Medical College, Philadelphia, PA, USA.
Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 2.93). 06/2010; 85(6):980-7. DOI: 10.1097/ACM.0b013e3181cece3d
Source: PubMed


The Medical College Admission Test (MCAT) has undergone several revisions for content and validity since its inception. With another comprehensive review pending, this study examines changes in the predictive validity of the MCAT's three recent versions.
Study participants were 7,859 matriculants in 36 classes entering Jefferson Medical College between 1970 and 2005; 1,728 took the pre-1978 version of the MCAT; 3,032 took the 1978-1991 version, and 3,099 took the post-1991 version. MCAT subtest scores were the predictors, and performance in medical school, attrition, scores on the medical licensing examinations, and ratings of clinical competence in the first year of residency were the criterion measures.
No significant improvement in validity coefficients was observed for performance in medical school or residency. Validity coefficients for all three versions of the MCAT in predicting Part I/Step 1 remained stable (in the mid-0.40s, P < .01). A systematic decline was observed in the validity coefficients of the MCAT versions in predicting Part II/Step 2. It started at 0.47 for the pre-1978 version, decreased to between 0.42 and 0.40 for the 1978-1991 versions, and to 0.37 for the post-1991 version. Validity coefficients for the MCAT versions in predicting Part III/Step 3 remained near 0.30. These were generally larger for women than men.
Although the findings support the short- and long-term predictive validity of the MCAT, opportunities to strengthen it remain. Subsequent revisions should increase the test's ability to predict performance on United States Medical Licensing Examination Step 2 and must minimize the differential validity for gender.

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    • "Another US study also indicated that scores on the admission test for medical students (i.e., the MCAT) had a positive relationship with GPA in the first two years [40]. One recent analysis has shown that scores on all three versions of the MCAT were moderately correlated to performance measures in medical school in the US [7]. In China, a few previous studies explored the association between NCEE total scores and academic performance in medical school, but none of them observed a significant association, which was most likely due to the use of improper statistical methods [9-11]. "
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    • "We found supportive evidence for the assertion that the UKCAT is better at predicting performance in the later years than in the earlier years of medical school. This is in contrast to the pattern of decline observed in studies involving the MCAT [12,14] and with generally larger validity coefficients than reported by Yates and James [17]. "
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    • "They are felt to be measures of potential and to be independent of formal schooling, and in many ways can be regarded as overlapping with measures of basic mental ability or intelligence. Tests such as the Medical College Admission Test (MCAT), used to select medical students in the USA [11], measure substantive academic understanding of a range of material from biology, chemistry, and physics, and are therefore primarily measures of attainment rather than of aptitude. "
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