In a move to combat "premed syndrome" among undergraduate students who want to become physicians, officials at Johns Hopkins University School of Medicine are urging the nation's medical schools to join with them in dropping a required, standardized medical-admissions test used for more than 50 years and instead setting minimum science requirements so applicants can get a broader education.
"We feel that the undergraduate medical climate has been grossly distorted by the existence of this test," Dean Richard S. Ross said. "The premedical atmosphere is one of getting ready to take this test rather than getting a broad, general education to prepare yourself for medical school."
Hopkins would become the first top-ranked medical school to make the Medical College Admissions Test (MCAT) optional, effective with the class to be admitted in September 1986. Of the 127 American medical schools, only the University of Rochester School of Medicine and Dentistry does not require the MCAT for college applicants.
In recent years, there has been increasing criticism among educators of the "premed syndrome," characterized by grueling preparation for medical school, early specialization in science and cutthroat competition to get into a medical school.
To Hopkins' Ross and Dr. Norman D. Anderson, head of its admissions committee, the MCAT, generally taken by juniors, is the greatest symbol of the problem. The test involves questions in six categories: biology, physics, chemistry, science problems, skills analysis in reading and quantitative skills analysis.
"I think that the MCAT has a more compromising effect on undergraduate education than any other component of the medical school admissions process," Anderson said.
He said students spend "90 to 120 hours of a busy college life to review for the test," select courses they think will give them a better score, skip liberal arts or humanities courses, take expensive cram courses and sometimes drop jobs or extracurricular activities to study for it.
In addition to cost of the test -- about $45 -- he estimates that three-fourths of applicants are taking commercial preparation courses costing $325 to $485 each. Providing these courses is a booming $8 million annual business.
"We feel that we can admit students on the basis of their college transcripts, letters of recommendation and general record of experiences, plus an interview," Ross said.
But because students apply to an average of eight medical schools, Hopkins hopes its decision "will send a signal" to other schools.
Ross pushed the idea of making the MCAT optional at a recent National Forum for Medicine at Hopkins. Anderson said Hopkins officials will be meeting with officials of other leading medical schools to drum up support for a cooperative effort to set standard science requirements for admission to medical schools.
"The physicians that we would like should have a good foundation in science, but they should be mature, broadly educated men and women who can relate well to their patients, their peers and to other segments of society," Ross said.
He said Hopkins' decision is an outgrowth of recommendations published last fall by a 19-member panel established by the Association of American Medical Colleges (AAMC).
But officials at the AAMC, which sponsors the MCAT, say they think the test is important as a "minimum national standard for judging the degree of preparation for medical school."
Anderson counters that AAMC has a "vested interest" in maintaining the MCAT.
Dr. August G. Swanson, an AAMC official, calls it a "yardstick" that helps in sorting through applicants.
"There is always debate about the MCAT," he said. "But part of it is the way it's used, rather the test itself." Swanson said he is disturbed by medical schools that use the test as part of a numerical threshold for admission as well as by the widespread commercial preparation courses.
AAMC said the test is intended to measure only first- or second-year college knowledge. It was updated in 1977. And a study is under way of a new essay question administered for the first time in the spring MCAT exam two weeks ago.