Medical school training and admissions are going through many changes. The medical school entrance exam (Medical College Admission Test or MCAT) is one of the notable changes. For many years, the test focused on objective knowledge based on general chemistry and stoichiometry, organic chemistry.
The test made a drastic change in 2015 decreasing the questions regarding general chemistry, physics, biology and verbal skills. In place of the more traditional questions, the test creators added questions in the domains of psychology and sociology.
This shift in the entrance exam reflects that it is becoming more important that clinicians are able to engage patients in empathic and collaborative ways. It advances the notion that patients are the experts on themselves and that they should be involved in medical decision-making. Reorganizing the MCAT is one step toward advancing and transforming the culture of medicine.
There is growing evidence that medical students and trainees may have an unconscious (implicit) bias against overweight and obese patients. As training progresses, this unconscious bias may become more conscious (explicit). This may pose a challenge to the way that clinicians address overweight and obese patients, which is present in 69% of U.S. adults.
A research team at Mayo Clinic led by Sean Phelan,Ph.D. has been addressing these questions. Dr. Phelan states, “Providing positive learning experiences with patients who have obesity may reduce bias.”
The study team suggests that medical schools adopt a “zero-tolerance” policy of any discriminatory behavior towards obese patients, including stereotyping obese patients as “difficult.”
Another key step in improving attitudes and care of obese patients is the advancement of our understanding of the risk factors in this population. Population Health Scholar, Brian Lynch, M.D., from the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery is exploring the trend between psychiatric and substance abuse concerns with obese or overweight children when compared to underweight or healthy weight children.
Mayo Medical School is one of 11 schools that received grant funding from the, “American Medical Association (AMA) Accelerating Change in Medical Education” initiative. With this funding, the medical school is focused on, “expand[ing] its curriculum to close the gap between the traditional medical education curriculums and the challenges of the current health care environment.” This transformation could begin to address the issues of implicit and explicit bias.
If you’d like to learn more about the obesity bias, please read: "The mixed impact of medical school on medical school student’s implicit and explicit weight bias."
Or to learn more about Mayo Clinic’s Accelerating the Change in Medical Education initiative, click here.
Meghan Knoedler, M.S., R.N., is a Health Services Analyst for the Center for the Science of Health Care Delivery with a Policy and Practice focus.
Jon Ebbert, M.D., is the Associate Director of the Center for the Science of Health Care Delivery and is the Medical Director for the Office of Health Care Practice and Policy.