Upfront

If approved by the Association of American Medical Colleges (AAMC) next February, an entire section of the future MCAT will focus on social and behavioral science.

The proposed revision—announced March 31 and being evaluated by physicians and pre-med advisers—represents a shift in medicine toward appreciating the role of environmental and social factors in health, says Barry Hong, PhD, of Washington University in St. Louis School of Medicine. He sits on the advisory committee for the MCAT review.

"Psychology is being taken more seriously as a real science," says Hong. "People, in particular physicians, see how psychological principles are enmeshed in life and biology."

That's certainly the case for AAMC President and CEO Darrell Kirch, MD, who, over his career as a psychiatrist, medical school dean and health administrator, has seen firsthand the link between environmental and behavioral factors and disease.

"Just as it's important for physicians and future physicians to understand biological science, it's important for them to understand how social and behavioral factors are important in disease," says Kirch.

The MCAT was last revised 20 years ago. Since then, a flood of research has demonstrated the connection between behavioral and social issues and health. Some studies estimate that that as much as half of all morbidity and mortality is associated with behavioral and social factors, including socioeconomic status and poor health habits, says Pomona College psychology professor Richard Lewis, PhD, who also sits on the MCAT review committee.

The AAMC revision calls for one of the four MCAT sections to test students' understanding of behavioral and social sciences principles. The other three sections will focus on molecular, cellular and organismal biology; physics, chemistry and biochemistry; and critical analysis and reasoning skills. The test will also assess students' understanding of research methods and statistics.

"These changes are a signal to premed students of the importance of these concepts in training to become a physician," says Lewis.

APA's Education Directorate has been pushing departments in that direction for years, says Robin Hailstorks, PhD, who directs the association's precollege and undergraduate education program. "It's an opportunity to promote the idea that we're a feeder into other science classes," says Hailstorks. "We're focused on getting other disciplines to see psychology as a core discipline that is applicable to other sciences."

—B. Azar