Will med school entrance tests be changed to vet the values of future doctors?

Mark Blocher  ·  Jun 27, 2018

The test that all aspiring doctors are required to pass for admission to a U.S. medical school was expanded in 2015 from five hours to eight, the first revision in the test in 25 years.

Why should we care? Because the change may eventually weed out applicants with Biblical viewpoints.

The Association of American Medical Colleges (AAMC), which administers the Medical College Admissions Test (MCAT), made the changes that may affect who gets into medical school. Devorah Goldman, writing about the changes in The Weekly Standard  says, “”The AAMC is also planning to add ‘situational judgment tests,’ carefully crafted interviews in which applicants will be presented with a variety of hypothetical scenarios involving ethical conflicts.”1

If you are a pro-life Christian who aspires to a career in medicine, you should care. If you want a doctor who shares your Christian beliefs and pro-life values, you should care.

Look no further than the words of Dr. Darrell Kirch, president/CEO of the AAMC, to get a sense of the threat. In a speech given at the University of California, Davis, Kirch declared, “I am a man on a mission. I believe it is critical to our future to transform health care. I am not talking about tweaking it. I am talking about true transformation.”

What does he want to transform? We find part of the answer in the AAMC’s “Holistic Review Project,” the goal of which is “redefining what makes a good doctor.” Kirch explained, “The goal is to improve the medical admissions process to find the people you and I want as our doctors.”

According to Kirch, this is necessary to shift medical school admissions toward a new standard that considers the “attitudes, values and experiences of applicants, to not just test what students know, but how they think.” To select the right people, Kirch wants to revise the MCAT and admissions process to include “situational judgment tests.”  The situational judgement tests currently being piloted in several American medical schools use seemingly benign ethical scenarios. However, one MCAT practice question asking test-takers to select from a list of debatable definitions for the terms ‘sex’ and ‘gender’ and others that ask applicants about sexism, racism and even the wage gap between men and women reveal a disturbing infiltration of politics into admissions testing. It is not difficult to imagine future test revisions to include more nuanced ethical scenarios such as what applicants would do if a 15-year-old patient requested medical assistance transitioning from female to male, or how one would counsel a pregnant adolescent about her pregnancy, or an elderly person facing the end of life. What would the applicant advise the pregnant woman whose “fetus” is likely to be born with a genetic defect?

Although Kirch claims the goal is to discern how the applicant thinks, what he really means is he wants to know what the applicant thinks. Knowing how someone thinks is a proper function of education. Focusing on what they think is entirely different. This is especially alarming given that a growing movement within the medical establishment wants to jettison professional conscience protections for medical personnel. Under Kirch’s leadership the AAMC joined a coalition opposing the Department of Health and Human Services proposed rule to require professional conscience protections for those working in federally funded medical facilities and programs like Medicaid. Articles in medical journals such as the New England Journal of Medicine and the Journal of the American Medical Association argue that aspiring pediatricians, obstetricians and gerontologists must be those who not only can think, but whose thinking brings them to the right conclusions.

The purpose of these “situational judgment interviews” appears to be screening out applicants whose attitudes and values would not be acceptable for someone Kirch would not want as his doctor. Kirch’s vision of transforming health care is not merely to improve the technical expertise and bedside manner of physicians. The goal is to transform medicine by populating it with only those practitioners whose attitudes and values trend leftward.

Medicine is not the only caring profession experiencing a stampede to the left. The American Psychological Association, which accredits a variety of graduate-level psychology programs, has been moving in that direction for a number of years. Christian colleges and seminaries with counseling programs have felt the pressure to conform, at the risk of losing accreditation and students losing access to federal student loans. The Council on Social Work Education travels a similar path.

What attitudes and values do Kirch and the AAMC find essential for the next generation of doctors? Kirch insists that medical education must include social justice as a “core tenet of medical ethics.” For instance, in a 2015 essay, Kirch praised the White Coats for Black Lives Movement, a medical student organization that staged on-campus “die-ins” and lobbies for medical school education reforms that would mandate teaching about the “structural racism” and “unconscious racial bias” in medical schools. Although the AAMC supports the work of Medical Students for Choice, it offers none to groups of pro-life medical students. Another example of what Kirch believes are the right attitudes and values for aspiring doctors is his leadership in the AAMC’s adoption of 30 core competencies now required in medical education directed at how doctors provide care for LGBT patients. We can assume that Christian doctors who hold Biblical views on marriage, sexuality and gender will eventually suffer the same plight as cake bakers, florists, and photographers.

The AAMC’s advocacy for abortion is clear from a letter to House Speaker Paul Ryan defending Planned Parenthood’s complicity in selling fetal body parts and excoriating the House Select Investigative Committee’s investigation of their practices. “The AAMC is well-known for its left-leaning political advocacy, and anyone who registers to take the MCAT automatically receives ‘action alerts’ from the organization’s Government Affairs and Advocacy division. Kirch brags that the AAMC was the author of some of the most “vague language in the Affordable Care Act.”2 Is that something the head of our medical school accrediting organization should be proud of?

“One would expect the leaders of a scientific discipline to carefully distinguish between verifiable facts and opinion; the new MCAT blurs that line.”3 They have chosen indoctrination over education, imposing moral and political litmus tests that could invariably force Christian medical school applicants to choose between fidelity to their faith and values or a career in medicine. If someone is willing to compromise her beliefs before her career even begins, is this the sort of person we would want as our doctor? And what does it say about the integrity of the only government-approved accrediting entity for American medical schools when they go to such great lengths to screen applicants deemed to have the wrong attitudes and values? If they succeed in excluding young aspiring doctors due to their life-affirming Christian values, what does that mean for the practice of medicine itself? Would we want a doctor who is willing to subordinate her beliefs and conscience to secular medical imperialism? Where does a pro-life Christian go to receive medical training if she is shut out of every U.S. medical school because her values conflict with those of the establishment? As daunting as it sounds, the time may soon arrive when Christians must create a dissident medical education system and a dissident health care system as well. 

[1] D. Goldman, “The Politicization of the MCAT: The Weekly Standard. April 16, 2018, p. 19.

[2] Goldman, p. 19.

[3] Goldman, p. 20.

Samaritan member Mark Blocher is the president/CEO of Christian Healthcare Centers. He served as Professor of Interdisciplinary Studies at Cornerstone University for 15 years. He is the author of The Right to Die? Caring Alternatives to Euthanasia and Vital Signs: Decisions that Determine the Quality of Life and Health.

This article has been revised from the July 2018 print version.