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By Rohit Anand, MD

The MCAT is arguably the most daunting exam in the length of medical education. The idea that an exam controls to a large degree not just where, but if, a student will be admitted to medical school is intimidating to say the least. This challenge has only increased in recent years with ever increasing averages for the MCAT for medical school admissions. Despite this, the study plan for many students has remained the same over the years, with little changes made to the classic model of a dedicated set of weeks to study for the exam.

 There are multiple challenges with a dedicated study block for MCAT studying. For most students, the MCAT encompasses three or more years of undergraduate coursework from introductory biology to physics 2. Reviewing this amount of content in 2-3 months for a dedicated study window is arduous, as seen by the 62% of MCAT test takers that reported difficulty with content volume. On top of this, many individuals have to re-learn some of material that was earlier in their education adding to the review time for those subjects. This is particularly true for the ~50% of test takers who are no longer in school when taking the MCAT. Many sources online suggest a minimum of 300-400 hours of studying for the MCAT. If you divide that into a 2 to 3-month timeline, it is a significant portion of weekly hours, which is difficult for employed individuals, but also difficult for students who are focusing on other activities or school work at the same time. Lastly, many individuals split time in their dedicated study window between content review and practice. As a result of this, many have difficulty applying content as a large portion, sometimes 50%, of their studying was an unapplied attempt to memorize material.

While the exam to enter medical school has not had widespread changes in studying patterns, the medical school licensing exams have seen such changes. Even more than the MCAT, the USMLE 1 and 2 exams have seen significant increases in average scores in recent years, particularly for the most competitive specialties. As a result, student studying habits have changed dramatically. Multiple surveys have shown that most medical students started studying for USMLE step 1 prior to their dedicated period. Additionally, many of these students have started utilizing resources, such as ANKI, an online flashcard service utilizing spaced repetition for long-term recall, and picture-based memory devices to keep up with the breadth of material covered prior to a dedicated study time. This makes sense as the material learned longitudinally in the pre-clinical curriculum can be reinforced over time, allowing students to focus on application and gaps in knowledge during their dedicated study windows.

The MCAT is similar in concept to studying for the USMLE Step 1 exam. There is a vast amount of content that is covered over a long period of time, with the exam focusing more on application than rote memorization. Additionally, both exams have reported data for a positive linear relationship between the number of practice questions and test performance. Why then do most students still focus on only studying during a dedicated window? Pre-med students can learn from how medical school students have adapted learning styles to better suit these exams.

For one, longitudinal content review can reinforce class material and act as a link between class learning and retention for the MCAT. By covering content over an extended period, students can free up their dedicated windows to application of knowledge through practice questions and reviewing material where they have identified holes in their knowledge base. This focus on application would be particularly useful for students for whom multiple choice tests are not a strength by allowing them to learn test taking strategy and add time for practice questions.

Pre-med students can also learn from the types of resources used by medical students. Just like ANKI has become a preferred resource for USMLE, many individuals have started using it and other resources like Braniscape for the MCAT, with a publicly accessible set of card “decks” for students to use. The community R/MCAT has catalogued many of these decks. Students can look to these decks not only as sources for longitudinal content review, but as a possible bridge to reinforce class material while preliminarily studying for the MCAT. In addition to this, there’s multiple free video resources available including Khan Academy. These videos can serve a similar purpose if used in conjunction with classes or can be used to re-visit material from prior classes. Lastly, there are some more passive methods of learning that can still be helpful like utilizing review books and podcasts.

With the increasing pressure on the MCAT, cramming 300-400 hours of studying of subjects from three years of undergraduate studies into a set of weeks can be overwhelming. Once you get to medical school, this longitudinal studying style is likely what you will adopt, so why not start now? With all of these resources, students can begin a slow, small time commitment longitudinal study plan early in their undergraduate studies or soon after they decide to pursue medicine to make the most of their dedicated study window while ensuring their base knowledge to start practice questions is up-to-date.