Validity of the Medical College Admission Test for predicting MD–PhD student outcomes

Bills, James L.; VanHouten, Jacob P.; Grundy, Michelle M.; Chalkley, Roger; Dermody, Terence S.

doi:10.1007/s10459-015-9609-x

Cited by 16 publications

(12 citation statements)

References 29 publications

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“…What happens to applicants who are not admitted is not known -nor is it known how many were denied admission because of less than spectacular MCAT scores, a metric that bears little relationship to success in research (21). We strongly support efforts to expand the pool of potential physician-scientist trainees through outreach efforts at all levels, greater engagement with undergraduate prehealth advisors, and an enhanced emphasis on characteristics that count.…”

Section: Action Item #3: Achieve Greater Diversity and Numbers In Phymentioning

confidence: 94%

Rescuing the physician-scientist workforce: the time for action is now

Milewicz

Lorenz

Dermody

et al. 2015

Journal of Clinical Investigation

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180

152

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In June 2014, the NIH Physician-Scientist Workforce (PSW) Working Group completed a year of data collection and deliberation, and released a report about the status of the PSW (1). The report is a combination of good news and bad news. The good news is that, despite the decline in the NIH budget, the size of the PSW has remained relatively stable. The bad news is that the current demographics, diversity, and career progression of this workforce raise concerns about the future. For a start, although apparently stable in size, the PSW is even smaller than many of us realized, and the apparent stability has hidden important demographic trends. In American Medical Association surveys of the nearly 1 million (and rising) MD physicians in the United States, only 14,000 (1.5%) consider research to be their primary focus (1). Even fewer have NIH grant support; only 8,200 physicians are principal investigators on NIH grants, split evenly between MDs and MD-PhDs (1). The number of extramural NIH-funded physician-scientists with research program (R series) awards has been essentially constant for the past 20 years, while the number of nonphysician (PhD) NIH-funded investigators has increased by half over the same period, reaching 19,400 in 2012 (1). As a result, the percentage of NIH awardees who are physicians has fallen to 30%. Although public policies have encouraged an increase in the number of medical schools and medical students in the US, and medical school admission policies have placed value on undergraduate research, the percentage of physicians focused on research has fallen.At the same time that the PSW has remained stable in size, data in the report show that the average age of the workforce is rising, as older investigators remain employed and younger investigators have not emerged in sufficient numbers. The average age at which a physician-scientist received his or her first NIH R01 grant in 2011 was 44 years for MD-PhDs and 45 years for MDs: approximately 10 years older than in 1980 (2). R01-funded investigators (physicians and nonphysicians) younger than 37 years have all but disappeared, and the time from graduating medical school to obtaining a first faculty position has increased to over 10 years for MD-PhDs and even longer for MDs without a PhD. Women and minorities are underrepresented, having opted not to enter or remain in the workforce. Thus, gathering places for physician-scientists look mostly like clubs for older white men. Without corrective action, the PSW appears headed for a population crash as older investigators retire. We recognize that younger physician-scientists have not entirely disappeared; they just take longer to obtain faculty appointments and independent NIH grants. This situation creates an extended waiting period that we call the holding zone, which contributes to the disturbing demographics (Figure 1). Enough talk, let's do somethingThe NIH advisory group noted these trends and made recommendations that should be considered (1). Rather than repeating them here, we would like t...

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Section: Action Item #3: Achieve Greater Diversity and Numbers In Phymentioning

confidence: 94%

Rescuing the physician-scientist workforce: the time for action is now

Milewicz

Lorenz

Dermody

et al. 2015

Journal of Clinical Investigation

Self Cite

180

152

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“…These elite positions are extremely competitive. In the USA, a Medical College Admission Test (MCAT) is valid for admission in all medical schools [ 21 ]. A similar admission test should be considered in China for entrance into a MD program to ensure fairness.…”

Section: Discussionmentioning

confidence: 99%

Why clinical training in China should improve: a cross-sectional study of MD graduates

Zhang

Yue

et al. 2021

BMC Med Educ

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Background China is experiencing major medical education reforms that include establishing national training standards, standards for health professionals, and advanced health delivery system requirements. Graduate medical education (GME) is being piloted as a merger of Doctor of Medicine (MD) with PhD programs to improve academic research and clinical training. However, the academic degree-centred system has led to a preoccupation with research rather than clinical training. Unfortunately, there is a shortage of quality information regarding the clinical training of MD graduates from Chinese medical schools. To fill this gap, this general investigation aims to provide the perspective of recent MD graduates in China for the different subspecialties of clinical training as experienced in different contexts. Methods There were 432 MD graduates who participated in an online survey regarding their clinical training. Information collected included overall satisfaction, educational supervision, supervised learning events, curriculum coverage, local teaching, teamwork, educational governance, workload, supportiveness of the environment, feedback, clinical experience, patient safety, handovers, and reporting systems. Results Only 37.4% reported satisfaction with the overall clinical training quality; 54.6% rated the informal and bedside quality as “good”; 64.4% reported they knew who provided clinical supervision; but only 35.5% rated the quality of clinical supervision as high; 51.8% reported that they judged senior physicians as “not competent”; 41.9% agreed that the staff treated each other respectfully; 97.4% admitted that they worked beyond the mandatory hours and claimed they were regularly short of sleep; 84.2% raised concerns about patient safety; 45.3% reported that they received regular informal feedback; 48.1% believed that their concerns about education and training would be addressed. Conclusions This study suggests that the quality of clinical training for MD graduates should be improved. While the overall satisfaction with the teaching quality was acceptable, the quality of many clinical training aspects scored poorly. A major problem seems an undue focus on research in MD/PhD training at the cost of the quality of clinical training, due to career perspectives that undervalue clinical competence. The findings of this study should benefit from a deeper investigation to understand the causes and possible remediation. Suggestions include defining subspecialties and training lengths; monitoring, evaluation, and integration SST with MD degree; providing funds or rewards for academic and clinical training; establishing supervising teams to guide clinical training; and establishing physician scientist task force to help overcome challenges.

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“…The admission for MD graduates gradually transfers to the application, with no entrance examination. These silo positions are extremely competitive, to ensure fairness, the US's Medical College Admission Test (MCAT) is validity for admission 16 .…”

Section: Discussionmentioning

confidence: 99%

Clinical training in China needs to be improved: A cross-sectional study of MD graduates

Zhang

Yue

et al. 2020

Preprint

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Background: China is experiencing medical education reform to construct national quality standards, modernise and standardise health professionals, and advance health delivery system requirements. Graduate medical education (GME) is being piloted as a merger of Doctor of Medicine (MD) and PhD programs to improve academic research and clinical training. However, the academic degree-centred system has led to a preoccupation with academic research rather than clinical training. Quality information regarding the clinical training of MD graduates from Chinese medical schools is lacking. This general investigation aims to provide an overview from the perspective of recent MD graduates in China. Methods: Self-reports on MD clinical training were obtained from 432 MD graduates in 2017 via an online survey. The reports included information on overall satisfaction, educational supervision, supervised learning events, curriculum coverage, local teaching, teamwork, educational governance, workload, supportiveness of the environment, feedback, clinical experience, patient safety, handovers, and reporting systems. Descriptive analysis was used to summarise the outcome. Results: Of the 432 MD graduates surveyed, only 37.4% reported satisfaction with the overall clinical training quality; 54.6% rated the informal and bedside quality as “good”; 64.4% reported that they knew who provided clinical supervision; only 35.5% highly rated the quality of clinical supervision; 51.8% reported that they judged senior physicians as “not competent”; 48.1% believed that their concerns about education and training would be addressed; 41.9% agreed that the staff treated each other respectfully; 97.4% admitted that they worked beyond the mandatory hours and claimed they were regularly short of sleep; 84.2% raised concerns about patient safety; 45.3% reported that they received regular informal feedback. Conclusions: This study suggests that the quality of clinical training for MD graduates needs to be improved; however, even though most participants seemed satisfied with their clinical training. The overall satisfaction with the teaching quality was acceptable, whereas the quality of many clinical training aspects was scored poorly. Each aspect may encourage a deeper investigation into the understanding of causes and possible remediation. Some suggestions include improving safe and effective care, providing positive clinical supervision, offering appropriate practice opportunities, providing health care services, and maintaining optimal patient safety.

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Validity of the Medical College Admission Test for predicting MD–PhD student outcomes

Cited by 16 publications

References 29 publications

Rescuing the physician-scientist workforce: the time for action is now

Rescuing the physician-scientist workforce: the time for action is now

Why clinical training in China should improve: a cross-sectional study of MD graduates

Clinical training in China needs to be improved: A cross-sectional study of MD graduates

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