A comparison of statistical criteria for setting optimally discriminating MCAT and GPA thresholds in medical school admissions.
BACKGROUND
Using Medical College Admission Test-grade point average (MCAT-GPA) scores as a threshold has the potential to address issues raised in recent Supreme Court cases, but it introduces complicated methodological issues for medical school admissions.


OBJECTIVE
To assess various statistical indexes to determine optimally discriminating thresholds for MCAT-GPA scores.


METHODS
Entering classes from 1992 through 1998 (N = 752) are used to develop guidelines for cut scores that optimize discrimination between students who pass and do not pass the United States Medical Licensing Examination (USMLE) Step 1 on the first attempt.


RESULTS
Risk differences, odds ratios, sensitivity, and specificity discriminated best for setting thresholds. Compensatory versus noncompensatory procedures both accounted for 54% of Step 1 failures, but demanded different performance requirements (noncompensatory MCAT-biological sciences = 8, physical sciences = 7, verbal reasoning = 7--sum of scores = 22; compensatory MCAT total = 24).


CONCLUSIONS
Rational and defensible intellectual achievement thresholds that are likely to comply with recent Supreme Court decisions can be set from MCAT scores and GPAs.
Albanese
Mark A
MA
Department of Population Health Sciences, University of Wisconsin Medical School, Madison, Wisconsin 53726-2397, USA. maalbane@wisc.edu
Farrell
Philip
P
Dottl
Susan L
SL
D003099:College Admission Test; D006801:Humans; D015146:Midwestern United States; D016017:Odds Ratio; D012570:School Admission Criteria / Q000706:statistics & numerical data*; D012577:Schools, Medical; D012680:Sensitivity and Specificity; D035521:Supreme Court Decisions