Redesigning the MCAT exam: balancing multiple perspectives.

The authors of this commentary discuss the recently completed review of the current Medical College Admission Test (MCAT), which has been used since 1991, and describe the blueprint for the new test that will be introduced in 2015. The design of the MCAT exam reflects changes in medical education, medical science, health care delivery, and the needs of the populations served by graduates of U.S. and Canadian medical schools. The authors describe how balancing the ambitious goals for the new exam and the varying priorities of the testing program's many stakeholders made blueprint design complex. They discuss the tensions and trade-offs that characterized the design process as well as the deliberations and data that shaped the blueprint.The blueprint for the MCAT exam balances the assessment of a broad range of competencies in the natural, social, and behavioral sciences and critical analysis and reasoning skills that are essential to entering students' success in medical school. The exam will include four sections: Biological and Biochemical Foundations of Living Systems; Chemical and Physical Foundations of Biological Systems; Psychological, Social, and Biological Foundations of Behavior; and Critical Analysis and Reasoning Skills.The authors also offer recommendations for admission committees, advising them to review applicants' test scores, course work, and other academic, personal, and experiential credentials as part of a holistic admission process and in relation to their institutions' educational, scientific, clinical, and service-oriented goals.