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Should I Use Textbooks for MCAT Preparation-Importance For New Computer MCAT?

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June 3, 2007

Well…yes and no?

Paranoia seems to be the order of the day for a lot of students when they prepare for the MCAT. Additionally, even “discussions” with older and wiser compatriots who have taken the MCAT may convey inaccurate perceptions of what is needed to prepare for the MCAT. A combination of the paranoia and well-intentioned, even if occasionally, mis-informed, help from others, can result in exaggerated beliefs and expectations of preparation needs.

I remember clearly, and this is only one example, of a student who did poorly on a MCAT which had questions about bacteria on it. Fretting, he wanted to take a course in microbiology and buy microbiology texts for his next MCAT attempt. When I finally got a chance to see the test he had taken, it was clear that only basic but solid understanding of the subject was needed. And the knowledge required was consistent with the requirements published by AAMC This was the level of information found in a good introductory biology book or course on bacteria.What is difficult for many students to accept and believe is that the MCAT actually requires a relatively limited number of concepts to be successful. Since the version introduced in about 1977, AAMC has provided students with a listing of what will appear on the test in terms of science and math content. Analyses done by myself of the real MCATs demonstrate this list is very accurate and representative of what a student can expect on the MCAT. Equally important, it has shown me there are more concepts on that list than will appear on any one MCAT, and some concepts appear more frequently than others.

Furthermore, my analyses and working with thousands of students have demonstrated one of the most significant problems is depth of understanding of critical subjects and not simply the number of concepts known by students.My suggestions for approaching the subjects and math for the MCAT are:

1. Read the AAMC MCAT Student Manual which describes the requirements for the MCAT. You can find this at http://www.aamc.org.

2. If you have a prep course, or can go to a truly knowledgeable adviser or teacher regarding MCAT concepts (realize you may have a great adviser or teacher who is not aware of these specifics),  they should be able to advise you as to the key concepts you should know based on the Student Manual.

3. Then use your textbooks only to supplement the basic preparation of these limited concepts.

4. DO NOT try to read the textbook from cover to cover. This will result in a great deal of wasted effort and time. And, this results in one of the laments I often hear, “But, I studied hard for the test.” Yes, you did, but you studied excess  information. A lot of interesting and intellectually stimulating information is certainly found in college textbooks. If your goal is to do great on the MCAT, I would forego these pleasures, concentrate on the limited number of topics for the MCAT, and return to these other enlightening and fulfilling moments when you are sitting in front of your fireplace with your MD or DO degree firmly on your wall.

5. For Biology: This is the subject where you want to use the textbook most extensively. But, even for biology, there is a lot of information in a text which does not appear on the MCAT.

6. For General Chemistry: The MCAT covers a large number of general chemistry concepts. But, you need to be very careful in concentrating on those found on the MCAT which are still relatively limited.

7. For Organic Chemistry: The MCAT has even fewer organic chemistry concepts than for general chemistry. Absolutely, you should not try to go through an organic chemistry textbook in detail. Be very very selective in the concepts you choose to review.

8. For Physics: This is the same as organic chemistry and DON’T try to review a calculus based physics book for the MCAT. The number of physics concepts are likewise limited but you have to know them well.

9. For Math: This is barely 8th grade math. Do not worry about calculus, advanced algebra, geometry or other than the most basic trigonometry.A good MCAT prep course will not try to overwhelm you with everything. It should first determine the most important concepts for the MCAT, then should assess which of these you know and which you need to spend more time on. This is what you should do for yourself if you don’t choose to go with a prep course.

For the new computerized MCAT, it is even more critical to understand the key concepts in good depth. The reason is obvious, there are fewer questions and each one counts more. So, understanding this is even more critical now.There is no need for paranoia when you understand the reality and have a good plan and follow it.

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Retaking the MCAT-Folly or Vindication?

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May 18, 2007

There are a number of programs available which will predict your next MCAT attempt based on your prior attempt and the statistical evaluations of thousands of other students who have retaken the MCAT. Are these predictions accurate and will any attempt to retake the test just be a follytongue laugh on your part?

Typically these programs and even the AAMC itself only predict minor changes in your score if you retake the test. I think all of these are way off the truth if…

The fundamental question to ask yourself about this test is whether or not it is truly a test of basic intelligence or not. Why is this question critical? If the MCAT is a test of basic intelligence, and you are granted with a given amount of this based on your birth and opportunities to this point in your life, then there is no changing it and no use in retaking the test-other than achieving the minor statistical variation predicted by these programs. The fact is there is NO such thing as a basic intelligence factor (designated as “g” by IQ test hereditarians). Since there is no such entity, there is no test that can measure it. Least of all, these high-stakes standardized tests DO NOT measure your intelligence. So, just discard this as a factor.

Then what do they measure? I believe they measure your level of achievement and ability to take tests of these types. This means you CAN do something about your results on these tests.

What you should do the first time is do an appropriate and thorough preparation because there is no doubt in my mind that this will result in optimal scores for you. If you have taken the test and not performed up to your expectations, I feel you can have a significant improvement in scores if any of the following were present and IF you correct them during your next attempt: 1) college courses that may have been inadequate in content or taken long ago, 2) college courses that did NOT emphasize higher order thinking skills (ie, more than just simple recall), 3) no preparation for the MCAT, 4) preparation for the MCAT that focused on content only and not higher order thinking skills, 5) preparation that did not FULLY use the AAMC practice tests, 6) preparation for the MCAT that was less than 3 months in duration, or 7) preparation for the MCAT that was secondary or tertiary to other concerns (work, courses, family activities or crises, etc).

Another factor to consider is that if you did use one of the commercial test prep programs, be careful about using a clone of it for next attempt. What you need to do is search out prep programs that have a different approach. You definitely want a prep program that combines DIRECTED and LIMITED content review, instruction in test-taking skills, opportunity to practice higher-order thinking skills and will allow continual feedback and monitoring. Always take advantage of the AAMC practice tests (aamc.org). Also, you must prepare seriously, in depth and with minimal distractions.

Students who do this will improve by more than the few points predicted by these programs. YOU WILL HAVE VINDICATION.grin

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What is the best college major for a Pre-Med?

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May 18, 2007

There are answers, but there is no one best answer. I will give you my opinion and I emphasize OPINION.

Some factors to consider are “What makes my chances best of getting into medical school?”, “What do I really want to do after medical school?”, “What do I really like?”, and “Do I want to spend 5 or more years getting through medical school?”

What makes my chances best of getting into medical
school?
  Based on the studies I have seen, students with degrees in engineering or physics have the highest percentage acceptance rates into medical schools. But, statistics may be deceiving as the numbers are smaller from these disciplines and possibly only the best students move on to consider medical school. This may also be responsible for the fact that humanities and some social science majors have higher percentage acceptance rates than biology majors. This is old data, from the 90’s, and I am uncertain if these rates have changed.

What do I really want to do after medical school? For most premedicals, if you “just” want to be good practicing physician, and nothing more, you should select biology as your major. If you have plans of academics or research or administration or politics, etc, you may as well select majors along those lines. Remember, you do not have to have a biology or science major to do well on the MCAT and get into medical school.

What do I really like? If you just love music, or history or art, then do it. Remember you don’t have to be a science major to get into medical school or do well on the MCAT. But, if you are a nonscience major, you had better make a point of doing well on the science portions of the MCAT…they will be looking!

Do I want to spend 5 or more years getting through medical
school?
Or, this may be framed as what major do I need to
compete with my peers in medical school?
  Medical school is grueling, especially the first two years. Courses like biochemistry and physiology and others are stumbling blocks for many students. This is why my number one recommendation is to be a biology major. To compete and to be ready to most effectively learn the massive amount of information you will be taught in medical school, it is very important to come in with some foundation. That foundation is found in biology. Most of your classmates will be biology majors and have taken physiology, anatomy, cell biology, genetics, microbiology and other advanced course to satisfy the major. If they are smart, like you, they will have also taken a solid biochemistry course. The reason you take advanced biology courses in college IS NOT to do well on the MCAT, the reason is to ease your transition into medical school during those difficult first two years. It will make a difference. It will help you compete and maintain your sanity. It will help you finish in four years.

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Free MCAT Prep Sources-What Value?

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April 30, 2007

The internet is an endless, and mostly free, source of information. But, is this limitless resource of value to a student seriously preparing for the MCAT?

First, what is really free on the internet for the MCAT? You will have to work your way through the endless promotions, gimmicks and misdirections of nearly every MCAT commercial prep company out there. The MCAT prep business is very competitive for a limited number of customers. So, if you type in “free MCAT Prep”, you get many leads which are simply doorways, some would say sinkholes, to Kaplan and Princeton Review among many others. There are some truly free sites which might benefit your MCAT prep. First and foremost is the aamc.org site which offers AAMC 3R free and with an analysis…take this offer seriously. After this, you can go to the Caduceus MCAT site at http://www.scientia.org/cadonline/home.html which has free content. And, there is always the Wikipedia offerings. There are others but I was going to the 4th page or more of the Google search and the pickings were thinning out. So, there are sites out there for free, but remember, the question was regarding serious study.

The MCAT is arguably the most difficult of the high-stakes mass-administered standardized tests out there. There must be a reason for this. Understanding its current difficulty can be understood partly by understanding its evolution. This is the sixth version of the MCAT which began in 1928..and they are not trying to make it any easier. My analysis, having taken an earlier version, is that the test has become much more difficult and sophisticated. It now requires a higher level of thinking skills than previously. More critically, it requires an interweaving of basic content and these thinking skills. The basic knowledge required is fairly precisely defined in the AAMC MCAT Student Manual. The skills needed are less precisely defined in the same Manual.

This means that even your study of the basic knowledge for the MCAT should be measured and specific. Some sources, like Wikipedia, have a tremendous amount information on a subject, but it may be way afield of the MCAT. This will only distract and confound you in your prep for the MCAT. For the MCAT, believe it or not, you don’t have to know a lot of topics, but you have to know a certain limited number of topics in depth.

The next issue is how the questions are posed. Prior MCAT versions focused on recall of information unrelated to passages. Now, you not only have to recall the specific information but recall and use that information in relation to passages. This is where the skills come about and lack of which result in the refrains of “I studied hard for this test, but I did poorly.” Most of the free sources of MCAT prep, other than the AAMC 3R test, fall woefully short in this respect.

Beyond the concerns of the proper content and appropriate questions are issues of evaluations of your status, determination of the best means for you to study and then monitoring of your progress to make sure you are on-track are rarely, I have not seen any, done with free MCAT preps.

If you have developed good skills of higher order thinking, know the basic content very well, then the use of the free information may be helpful as a review. For everyone, you should take advantage of the AAMC free test at the minimum. For most others though, the commercial preps, and AAMC is a place to start, with content and questions beyond the free preps, sinkholes or not, can have some value… but you must choose wisely.

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Techniques for Creating Effective Long-Term Memory for the MCAT-Part II

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April 12, 2007

Research has consistently shown that information is best retrieved when it has been stored based on several principles and techniques. These are: 1) sufficient preexisting knowledge base, 2) meaningful learning, 3) elaboration, 4) internal organization, 5) your optimal learning method, 6) spaced learning, 7) repetitive learning and 8) automaticity. Automaticity will be discussed at a later date. The essence of all of these is that knowledge which has been stored with the maximal number of connections or nodes and organization will be remembered better and retrieved optimally. Points 1 and 2 have previously been discussed.

3) Elaboration. Another means to entrench your knowledge in your Long-Term Memory (LTM) is by the technique of elaboration. Elaboration is similar to Meaningful Learning in that you have to have some preexisting knowledge in LTM. You can then use that knowledge to enhance or modify the new knowledge you are learning. This creates stronger and more easily accessible connections (nodes) for retrieval into Working Memory (WM).

4) Internal Organization (IO). Internal organization is when you reorganize the knowledge within itself. The Meaningful Learning and Elaboration were forms of external organization, relating the knowledge to knowledge outside of itself. Forms of IO include simply outlining the information, creating a concept map of how the different parts relate to each other or creating meaningful mnemonics. Any manner in which you can reshape the information which makes it make sense and relate to itself will result in more effective storage in LTM.

5) Optimal Learning Method. Whereas this isn’t a specific technique for LTM storage, it is important because all individuals learn information better in one format or another. None-the-less, it results in more effective storage and retrieval. You will have to determine how you learn the best. Visual imagery or depictions is generally helpful to all. But, some individuals may learn better by audio or by kinesthetic methods. For the audio learner, you may need to create your own audio summaries of material that you can listen to. This can be very effective if you commute a lot. If you are a kinesthetic learner, it will be important for you to rewrite the information. This can be combined with Internal Organization methods. Each of these will help store that info better in LTM.

6) Spaced Learning. Ineffective learning is often crammed learning. You will store info more effectively if there is spacing between the learning episodes. You should purposely learn it at one time and then plan to go over it again at some later interval. The intervals vary and you should determine which one is most effective for you. This is one reason to do your MCAT prep over time, probably a minimum of 3 months.

7) Repetitive Learning. Repetition is hand-in-hand with spacing. Repetition is not rote-learning or repeating. Rote-learning, learning lists, is the most ineffective way to learn anything. It is stored poorly and retrieved poorly from LTM. If you use repetition, do it with appropriate spacing and combine it with the techniques discussed above.

For the MCAT, you are better off knowing a select number of concepts very well via the techniques discussed above rather than trying to know a large number of concepts poorly. They will be poorly organized and poorly entrenched in your LTM, and you will NOT be able to retrieve them effectively during test time. If your preparation program does not use the techniques above, you should learn and use them yourself during your study. Your MCAT will improve…guaranteed.

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The Harvard Years

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April 9, 2007

I had finally made my way to Harvard Medical School (HMS) despite my misgivings of leaving my wife, 2 year old son and the baby on the way back in Milwaukee. It couldn’t get any more difficult, right? On September 26, about 2 weeks into my medical school education, my wife delivered the baby…and a baby. She had twins and the doctor did not even know. Now I had a family of four and was two weeks into being educated at the top medical school in the country and maybe the world. And, my family was not well off financially. It had been difficult enough to just get the money to get to Boston, and now…?

I was supposed to have attended a summer pre-entry program that summer, but my wife’s pregnancy and my need to work had precluded that. One thing I did was to buy and read the Lehninger book on biochemistry. I never had a true biochem course and had been told how difficult this was. So, during my first week I decided to take the exam to place out of biochemistry, it would give me time to work. The other students taking the placement test had had biochemistry at some of the best schools in the country…the Ivy League, Stanford, MIT and others. I had come from a small midwest liberal arts college that had no formal biochemistry course. Out of the 160 entrants, not all took the exam, I was one of eight to place out of biochemistry. So, those hours other first year students were spending in biochemistry, I spent working as an instructor for the Greater Boston Collaborative, an alternative high school. That was during the year. I had the summer off that first year, and I had to work.

I contacted Dr. William Wallace who was the director of the Harvard Health Careers Summer Program (HCSP). He initially stated there were no jobs left for students during the summer. But, he needed someone to teach a MCAT prep, and with the help of Dr. Alvin Pouissant’s intervention, I was able to get the job teaching the MCAT prep. I had told both that I could do it even though I had not one bit of material to teach it. I used the fact that I had scored in the 99th plus percentile on the science and math portions to push the issue. I needed a job. They agreed to give me the chance. Now I would have to deliver.

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Keeping the Promise to Dr. Wallace and Dr. Pouissant

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April 9, 2007

That summer of 1974 I began teaching the pre-medical students in the Harvard Health Careers Summer Program (HCSP) how to think about the MCAT. This was the third version of the MCAT that had begun in 1928 as the Moss Test. It was changed in 1946 and 1962 (I believe). This was the version I had taken. It was graded like the SAT. There were several components including Science, Quantitative (Math), Verbal and General Information. Medical schools, at that time, were primarily concerned with the Science and Math subtests. Since I had scored in the 99th percentiles in Science and Math, these topics were what I was going to focus on in the classes.

Prior to the summer program, I compiled an outline and some basic materials for the students. I really had no clear scheme to follow. There still were very poor commercial materials available. So, I started to create a syllabus which I thought was appropriate. Additionally, we had no actual prior tests to model. All I could do is remember what was on the MCAT I had taken a few years previously. Unlike now, there were no passages in either the Science, Math or Verbal. All questions were stand-alone or non-passage questions. This made the test a little easier.

That first year, we were placed in a basement classroom in one of the older buildings in Harvard Yard…talk about starting from the ground-floor, or below it. Yet, how could I complain? After all, it was Harvard’s basement. There, I had my first group of students to prepare for the MCAT. I would lecture and go over questions for them. I really cannot remember all of the details. But, I remember the students were very appreciative and must have been satisfied with the course. This had to be the case. I was asked back each year as students had reported back to Dr. Wallace regarding my performance. And even Dr. Wallace started to like me after a couple of years.

Over the years, for whatever reason, my reputation grew as a good or even great preparer of students for the MCAT…I always figured this was because no-one else had wanted to take on the task…no competition. I then taught the summer MCAT prep every summer during my medical school career. By my third year in medical school, I had accumulated a great deal of material and had impressed Dr. Wallace that my promises of teaching the course were not just a desperate mischaracterization, also known as a “lie”, to get a job.

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Genesis of the “Harvard Manual”

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April 9, 2007

I had now completed my third year of medical school and was beginning my fourth year, it was 1976. I definitely wanted to complete my medical education in four years and get back to Milwaukee…don’t ask me to explain that. OK, I will…its called family. During this time, I had already completed the requirements for a MPH (Masters’ of Public Health) from the Harvard School of Public Health, and had participated in the Harvard-MIT Program in Health Sciences and Technology. This had allowed me to experience courses and classes at the Massachusetts Institute of Technology as well. But, now I had three years of solid MCAT preparation and the creation of a set of materials for that preparation. I would not be around for the summer of 1977 to teach the new group of the Harvard Health Careers Summer Program (HCSP) the MCAT prep…I just felt that all of this effort COULD NOT be lost.

Also, I knew I would have to move my family, which now included four children, my wife and my mother who came out to help us, back to Milwaukee. I had already decided to do my residency there. So, I would need money and that meant I would need work. So, I went to Dr. Wallace and made a proposal and a plea. I would write a manual that would collect and summarize what I had been doing over the last three years that I could leave behind for others to use and teach MCAT Prep.

Dr. Wallace liked the idea. He negotiated with his director, Dr. Crooks, to secure $5000.00 to pay me to write the book. I would retain rights to it, but Harvard and Dr. Wallace would also be able to use it at will for their programs. We did this in the summer of 1976. So, now I had to complete my senior year of electives at Harvard Medical School and write a MCAT prep book. I was glad to have the opportunity.

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The Philadelphia AAMC Meeting, Mr Angel and a New MCAT

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April 9, 2007

I really cannot remember the exact timing of this, but sometime in 1976, Dr. Wallace asked me to go to an AAMC (Association of American Medical Colleges) meeting in Philadelphia. This was a final or near final meeting in which they were discussing the new version, the fourth version, of the MCAT which would begin in 1977. Dr. Wallace wanted me to be up-to-date since we were considering writing the MCAT prep. He had me contact a Mr. James Angel, who had been a consultant to AAMC regarding the new test.

I met with Mr. Angel, who was a very nice and considerate man. We attended meetings and discussed what was to happen with the new MCAT. From that meeting, I learned there would be some significant changes to the MCAT beginning in about 1977. First, they would now have three separate tests for the sciences. One for biology, one chemistry and one for physics and would have a score for each. Also, there would be a separate Quantitative Section and a separate Verbal section. These would be scored separately. The scoring would no longer be like the SAT. I believe they had a scoring similar to the current scores. One other thing they were going to do is to publish a more specific outline of what was to appear on the test. But, I did not get that outline during that meeting.

So, a big change was on the way the MCAT. I was about to complete my medical education at Harvard. And, meeting Mr. Angel and being at the AAMC meeting had placed me a nice position to move forward in the MCAT prep arena. First, though, a MCAT prep manual had to be written. I had to complete my medical education, take the second part of the National Boards, select a residency program, and I had a family of six to support, and now I had pledged to write a MCAT prep manual from scratch. I had to figure out a way to do this.

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The Writing of the “Harvard Manual”

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April 9, 2007

Dr. Wallace and Dr. Crooks were able to get funding for writing of the manual. I began sometime in the summer of 1976. An outline was created from scratch as the AAMC had not yet published their outline for the new test to be given in 1977. So, I based my outline on my own preparation for the sciences and for math. Since I could not type at that time, and since my writing was already on the way to the illegibility I would perfect during my residency and practice years, I decided I had better print everything.

Over the next few months ending in December of 1976, I wrote the manuscript for the MCAT prep. We contracted with another student, who also lived in the Peabody Terrace student apartments, to type the manuscript. My daily schedule to complete this was fairly well set for those months. During the first part of the day, from about 8 am to 6 pm, I would do one of my rotations, clinical clerkships. When I got home, I would take care of the kids for a few hours while my wife and mother got some rest. Then I would go to sleep until about midnight to 1-2 am. Getting up at that time, I would do any studying I needed for the clerkships. But, most of the time was spent writing the MCAT prep. At 5 am or so, I would get cleaned up, dressed and would nap, sitting up, until I had to leave for the hospital. This was done nearly every day until the book was done.

Sometime in either late 1976 or early 1977, I obtained the AAMC outline for what would be on the new test. This was a very specific listing but there were not the details for each item…this was to be left up to the student. What became evident is that I had completed a manuscript that was too difficult and overstepped what the AAMC had in mind for the MCAT. I was thinking like a PhD student and not like a MD student. The physics and chemistry, especially, were too difficult. So, I had to rewrite most of the book.

Finally, with over 800 pages of printed material and 400+ pages typed, this was done and by the time of graduation, which I skipped to go back home, Dr. Wallace had the manuscript printed and available. The “Harvard Manual” was born. I had called it “A Comprehensive Preparation for the MCAT”. The manual was eventually published by Angel Publishing, yes Mr. Angel, and then by Betz Publishing, his wife, well into the 1990’s. Eventually, Williams and Wilkins purchased rights from Betz. The book has been used by hundreds of thousands over the years, became probably the best seller in its class during this time, and became the model for many MCAT prep books that followed.

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