The fight continues over whether the Association of American Medical Colleges (AAMC) should continue administering its Medical College Admission Test (MCAT) in person, and whether medical schools should waive the MCAT as an admissions requirement.
Reports of several medical school applicants testing positive for COVID following their MCAT exams — though their result could not be directly linked to the test — and a campaign by Students for Ethical Admissions (SEA), an activist group of medical school applicants, prompted Sen. Elizabeth Warren (D-Mass.) and Rep. Ro Khanna (D-Calif.) to send a letter to the AAMC asking about its testing protocols and why it hadn’t moved to an online exam.
The AAMC responded to the letter, noting that it had “suspended administration of the test between mid-March and the end of May and resumed it only when we had developed and implemented a safety protocol that adhered to public health guidelines.” Out of 75,000 in-person test-takers, the organization said it had received five reports of applicants testing positive for COVID-19 after taking the exam, including two examinees who reported developing symptoms within a week after their exams and tested positive; one who reported experiencing symptoms on the day of their exam with a subsequent positive test result; one who, after the exam, reported testing positive 12 days prior to taking the test; and one who “reported experiencing symptoms after the exam but did not disclose a positive test result or otherwise respond to our follow-up request for information.”
“Our investigation into the testing centers on the dates these students tested did not uncover any lapses in health or safety protocols, nor did we receive any reports of illness from other students who tested with them. While it is difficult to determine the timing or location of a given instance of transmission of COVID-19, the small number of reports of infections and the fact that we have not been contacted by any health department alerting us to a possible transmission gives us confidence that the MCAT health and safety protocols are effective,” the AAMC said.
Hygiene Measures Taken
The AAMC told Sen. Warren and Rep. Khanna that the accommodations it developed with its testing center contractor, Pearson VUE, included:
- Requiring examinees to provide a digital signature acknowledging they have not tested positive for COVID-19, haven’t recently experienced symptoms, aren’t under quarantine, and agree to follow guidelines while testing.
- Reducing the number of allowed test-takers for each site by 50% and providing 50% more testing appointments than a typical year by adding testing dates, reducing the exam length, and scheduling morning, afternoon, and evening exams.
- Requiring masks for all staff and test-takers while in the test center.
- Maintaining at least 6 feet of distance at all times, including at check-in and in waiting rooms.
- Limiting the number of students testing per room, spacing all testing workstations at least 6 feet apart, and separating them by partitions.
- Permitting gloves and making hand sanitizer available during testing.
- Cleaning high-touch areas frequently and cleaning work spaces between testing sessions.
The AAMC’s results contrast with those of SEA, which reported in July that it had received reports of eight students and four of their family members testing positive for COVID-19. The SEA also conducted an informal survey of test-takers and found that of 199 test-takers, 64% said they weren’t screened at all when they arrived for their exam, only 7% said they underwent temperature checks, and 50% said they did not witness their personal spaces being cleaned before, during, or after their exam. In addition, 27% said masks were not enforced in their test center, and 29% said social distancing was not physically possible in their center.
Campaign to Waive the MCAT
SEA has been advocating for medical schools to waive the MCAT requirement during the pandemic; so far, four medical schools, including Stanford University in California and Dartmouth College in Hanover, New Hampshire, have agreed to do so, while four others say they’ll consider it on a case-by-case basis. Another 11 schools are accepting a January 2021 MCAT. Several medical organizations, including the American College of Physicians, have issued statements in support of the #WaiveTheMCAT campaign.
In response to the congress members’ questions about whether the association had considered online rather than in-person testing, AAMC said that although the organization had considered it, “Ultimately, given the length of the exam, the technical and graphical complexity of its questions, and its particular susceptibility to cheating (unfortunately, a real problem), remote testing is not suitable for an exam like the MCAT exam at this time.”
The association listed several reasons for its decision, including that online-proctored testing “would undoubtedly disadvantage many examinees with inadequate technology resources or insufficient internet speed, as the complexity of the graphics might result in lower-quality images, slow refresh rate, and other burdensome technology interruptions. Millions of American households do not have access to broadband internet.” In addition, concerns have arisen regarding test “harvesters” who attempt to steal MCAT exam questions nearly every year to sell them to applicants. “Online-proctored tests cannot yet replicate in-person security measures that protect the fairness and validity of a high-stakes exam like the MCAT exam,” the AAMC said.
In response to the AAMC document, a spokesman for Khanna said in an email that “Rep. Khanna was glad to see AAMC’s thorough response, but is planning on meeting directly with the organization’s president after the election to ensure that students are as safe as possible when they begin taking the MCAT again in January.”
In-Person Osteopathic Exam Also Questioned
As the AAMC wrestles with the testing issue, the National Board of Osteopathic Medical Examiners (NBOME) is also getting complaints about its in-person testing for the COMLEX-Level 2 Performance Evaluation (PE) exam for osteopathic medical students, which is being given in-person at test centers in Chicago and Philadelphia. Osteopathic physicians and medical students are complaining on Twitter that the Chicago exam continues to be given even though the city requires a 2-week quarantine for anyone entering the city from places experiencing a surge in COVID-19 cases — currently 25 states plus Puerto Rico.
“What is the @NBOME’s answer to local quarantine guidelines…? Just assume they are not being enforced!” a Twitter user called Lowly Medical Student tweeted on Oct. 12. “It doesn’t matter, so long as they get to keep your money! They will administer COMLEX Level 2 PE at ANY cost!” The cost of the exam is $1,300. The tweeter said that NBOME’s assertion that the quarantine isn’t being enforced came in the form of “an email sent to the student body of a large, and well known DO school.”
“@NBOME, can you please provide your justification for continuing to require this dangerous disregard for students and the community?” tweeted Brian Fishman, DO. “You are training physicians who are supposed to listen to science. You should do the same. This is reckless and embarrassing.”
In response, an NBOME spokesperson said in an email that the board “does not suggest or state that anyone violate quarantines imposed by local jurisdictions. NBOME recommends that candidates consult with their school advisors and reschedule their Level 2-PE test date (without any rescheduling fees) should any local travel quarantines apply, particularly if they feel local travel quarantine time periods would in any way negatively affect clinical learning opportunities (e.g., clinical rotations) or GME/residency virtual interviews in the 2020-2021 application cycle. Candidates who prefer to delay testing for whatever reason are encouraged to do so, and most should have more than ample opportunity to test when they feel ready and safe to do so, and before they are then eligible to take the next examination in the series.”
The spokesperson added that the exam “is scheduled to resume on November 2. It will be conducted in-person, with significant health-safety modifications in place,” including health and temperature screenings, enhanced cleaning procedures, larger-capacity rooms, and issuance of face masks to candidates and standardized patients. Because the exam involves student-patient interaction, “this isn’t something that can be accomplished through virtual interaction while maintaining the validity of the examination,” the spokesperson said.
Source: MedicalNewsToday.com
