Medical School and the MCAT: A Guide to the Basics, Breakdown, and Scores

Medical School and the MCAT: A Guide to the Basics, Breakdown, and Scores

15 June, 2021

By Erik Kolb, Noodle Pros MCAT CARS Tutor

What Is the MCAT?
If you plan to attend medical school in the United States (and some places in Canada), you are likely aware that the MCAT (Medical College Admission Test) is a major factor in the application process. Developed by the American Association of Medical Colleges (AAMC), taking the MCAT is often the most daunting task facing prospective physicians who are competing for the limited number of spots available each year at medical schools.

The AAMC, which represents the nation’s medical schools and teaching hospitals and sets the national agenda for medical education and research, designed the MCAT to assess test-takers’ knowledge of scientific concepts as well as broader principles that are the foundation for the modern study of medicine. In addition to testing science, the MCAT is also designed to evaluate test-takers’ critical thinking, problem-solving, and analytical skills.

Many MCAT test-takers have a background in the sciences and find that the Critical Analysis and Reasoning Skills (CARS) portion of the exam is particularly challenging. On top of the very anxiety-inducing time pressure of the CARS section, the texts that examinees are required to read often come from genres with which students are not familiar, such as literary criticism, art history, and philosophy.

MCAT Basics

The current version of the MCAT, developed in 2015, contains four scored multiple-choice sections:

  • Biological and Biochemical Foundations of Living Systems
  • Chemical and Physical Foundations of Biological Systems
  • Psychological, Social, and Biological Foundations of Behavior
  • Critical Analysis and Reasoning Skills

The first three sections above are designed to test the scientific concepts that the AAMC deems foundational for success in medical school. Rather than simply requiring students to regurgitate a series of memorized factoids, these three sections are intended to evaluate students’ fluency in the major themes or big ideas within the sciences, often requiring test-takers to incorporate information from a variety of disciplines or sources in an integrated manner. While most people associate reading comprehension with the CARS section of the MCAT, a strong foundation in verbal reasoning is, in fact, essential for all sections of the test. According to the AAMC, the first three sections of the MCAT are written in order to evaluate students’ performance in four key domains:

  1. Knowledge of scientific concepts and principles
  • Demonstrating understanding of scientific concepts and principles
  • Identifying the relationship between closely related concepts
  1. Scientific reasoning and problem solving
  • Reasoning about scientific principles, theories, and models
  • Analyzing and evaluating scientific explanations and predictions
  1. Reasoning about the design and execution of research
  • Demonstrating understanding of important components of scientific research
  • Reasoning about ethical issues in research
  1. Data-based and statistical reasoning
  • Interpreting patterns in data presented in tables, figures, and graphs
  • Reasoning about data and drawing conclusions from them

The Critical Analysis and Reasoning (CARS) section, on the other hand, is similar to the reading comprehension portions of tests such as the SAT and ACT that most students took in high school. What makes the CARS section so tricky is that the passages presented on the MCAT come from a wide range of disciplines and are generally quite advanced. These passages are long (500-600 words), some of the authors write using complex syntax, and students often encounter jargon or vocabulary with which they are not familiar.

MCAT Structure, Timing, and Content

Test Section

Number of Questions

Time Allotted (Minutes)

Biological and Biochemical Foundations of Living Systems*

59

95

Chemical and Physical Foundations of Biological Systems*

59

95

Psychological, Social, and Biological Foundations of Behavior

59

95

Critical Analysis and Reasoning Skills (CARS)

53

90

Total

230

375 (6 hours and 15 minutes)**

*You will have access to the periodic table of elements during these sections

**With administrative matters and breaks, the total time can be more than 7 hours

The approximate discipline breakdown of the content in the first three test sections is as follows:

  • Biological and Biochemical Foundations of Living Systems

*65%, introductory biology

*25%, first-semester biochemistry

*5%, general chemistry

*5%, organic chemistry

  • Chemical and Physical Foundations of Biological Systems

*30%, general chemistry

*25%, first-semester biochemistry

*25%, introductory physics

*15%, organic chemistry

*5%, introductory biology

  • Psychological, Social, and Biological Foundations of Behavior

*65%, introductory psychology

*30%, introductory sociology

*5%, introductory biology

Unlike the other three sections of the MCAT, the CARS section is unique in that everything you need to answer the questions can be found in the passages provided. While there is no specific content that you need to know or prerequisite coursework you need to take in order to succeed on the CARS section, that doesn’t mean that it’s easy!

MCAT Scoring

Contrary to some common misconceptions, the MCAT is not scored on a curve. Rather, the number of questions you get correct is converted to a scaled score that is normalized (or “equated”) such that it doesn’t matter when or where you test; all scores are comparable and evaluated equally by medical schools. Incorrect answers are counted the same as questions that you leave blank (which is to say that they are not counted at all), so you should always make sure to leave enough time to answer all of the questions, even if you’re just guessing randomly (and if you are guessing randomly, choose the same letter for all of your guesses; statistically, you will have a higher chance of getting a few correct accidentally).

Your raw score (the number of questions you get correct) for each section will be converted to a scaled score between 118 and 132 with a total combined score between 472 and 528 (the sum of the individual section scores). The mean score for each individual section is 125, and the mean score for the entire test is 500. Unfortunately, it is not possible to say definitively how many raw points would give you a certain scaled score because certain tests are slightly easier or harder than others (hence the equating process). In addition to your scaled scores, your MCAT score report will include your percentile rankings, which indicate how your scores compare to those of fellow test-takers. You can view the percentile rankings for the past few years here: MCAT Percentile Rankings.

Here is a nice visualization of the MCAT scoring system from the AAMC*:

*https://students-residents.aamc.org/mcat-scores/mcat-exam-score-scale

When Should I Take the MCAT?

There is no one-size-fits-all answer to this question. To a large extent, when you decide to take the MCAT will depend on when you want to enroll in medical school, when your prospective schools’ applications are due, and when you are fully prepared and ready to take the test. Because many test-takers attempt the MCAT several times before they are satisfied with their scores, you should be sure to leave enough time to re-test in case your scores on your first or even second attempt are not as high as you had hoped. Keep in mind, however, that there are limits to how often you can take the MCAT: the AAMC restricts testing to three times per calendar year, four times in a consecutive two-year period, and seven times per lifetime. Keep in mind also that medical schools will be able to see your scores from all of your scored tests, so it isn’t worth attempting the real thing until you are consistently scoring in your desired range on practice tests. AAMC does provide an option to void your MCAT on test day if you feel that you performed poorly, but if you choose to void your test, it will not be scored and you will never know how well or poorly you performed at that particular test sitting.

When Is the MCAT Offered, and How Do I Register?

The MCAT is offered in January and every month from March to September, with multiple testing dates each month (31 unique test dates). You can find more detailed information on the 2021 exam schedule here: MCAT test dates 2021. There are two different testing times, 7:30am and 3:00pm. Be sure to register for your preferred date early at aamc.org, as available time slots do tend to fill up quickly. When you register, you will need to select your date, time, and testing location. You must have a valid government-issued ID with you when you register, and you will need to bring that same ID with you on test day. Scores are typically released about a month after each test date.

What Should I Expect on Test Day?

The MCAT is a computer-based test that is taken only at Pearson-VUE testing sites (unlike the LSAT, GMAT, and GRE, which can be taken online from home). These testing sites have secure rooms with several computer stations (your fellow test-takers may be taking the MCAT or other computer-based tests). The only things you are allowed to bring into the testing room are your storage locker key, your ID, and eyeglasses (i.e. no study materials, phones, food, watches, etc.). The testing center will provide you with earplugs (if you want them), a noteboard, and a fine-point marker to use during the exam. Further details can be found here: MCAT Test Day.

Good luck!

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About the Author
Erik Kolb
Erik has worked with thousands of students of all ages and score levels and has helped them to meet and often exceed their score goals. Learn more about Erik on his Noodle Pro tutoring bio!

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