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New sections on the social sciences and on critical thinking will be added to the Medical College Admission Test in 2015, representing the first major revision in the exam since 1991 and one of the largest ever since it was introduced in 1928.

The changes have been under consideration for three years and were first formally released to the public in draft form a year ago. On Thursday the board of the Association of American Medical Colleges, which runs the MCAT, approved the changes. Leaders of the association also said that they are embarking on efforts to encourage medical schools to embrace a more "holistic" approach to admissions, and to consider new ways to attract students with broader undergraduate training -- not just those with backgrounds in stereotypical areas as biology and chemistry.

"We haven't abandoned the foundational emphasis on the natural sciences," but "emerging social and behavioral sciences are equally relevant to medicine," Darrell G. Kirch, president of the medical school group, said in a phone briefing for reporters. More health issues in the future will require understanding of why people act as they do, of the conditions in which they live, and their behavioral patterns, he said, and the best physicians in the years ahead will be as educated on such issues as they are in genetics or anatomy.

The changes, Kirch said, should motivate many more pre-meds than has been the case to take courses in psychology or sociology or health behaviors or all kinds of interdisciplinary classes. "I think someone who is a psychology major or even a major in cross-cultural studies should have as much chance of medical school [admission] as a physics major," Kirch said. He said he wants undergraduates to know that one of the best ways they can prepare for medical school and for being a physician is "to read broadly" and "to be knowledgeable about the world at large."

The writing test that has been part of the MCAT is being dropped. Kirch said that admissions officers at medical schools reported that it added little. The total time for the test will grow from 5.5 to 6.5 hours, but Kirch said that previous iterations of the MCAT were that long, so he was not concerned about the endurance of test-takers being a problem.

The AAMC has been encouraging medical colleges to admit more underrepresented minority students, and has been making modest progress in this regard. But large gaps remain in the MCAT averages of different groups. In 2010, the median scores were 26.0 for white students, 25.7 for Asian students, 21.3 for Latino students and 19.7 for black students.

Kirch said that it was hard to predict whether the new MCAT would narrow those gaps. But he said that he didn't see the changes "working against this goal of having a more diverse group of students." He said that he thinks the changes will support the effort. Generally, he said, it was time for medical schools to embrace "an admissions process less bound by test scores," and to rethink all parts of their admissions procedures -- including letters of recommendation, interviews and the applications themselves. He said it was important to "move toward greater diversity."

Charles H. Hauck, pre-medical coordinator at the University of Iowa and president of the National Association of Advisors for the Health Professions, said that the AAMC has been working to "get the word out" about the changes so that he and his colleagues can help new students pick college courses that will prepare them for the MCAT. Hauck said he thought many more pre-meds than in the past would be enrolling in sociology, psychology and related fields.

Hauck said his only concern was about whether pre-med students would simply be adding those courses to an already full schedule of pre-med requirements, limiting their ability to explore other fields. "That's going to be the challenge," he said. "What we don't want to happen is create a premedical curriculum that is too difficult to fit in."

Robert Schaeffer, public education director of the National Center for Fair and Open Testing, which has periodically criticized the existing MCAT, said that the changes are "good as far as they go." He also applauded the AAMC's encouragement of medical schools to place less emphasis on test scores in the admissions process. Currently, he said, there is "a heavy overreliance" on MCAT scores.

The question going forward, he said, is whether medical schools will follow the advice they are getting from the AAMC. "It's all in the doing," he said.

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