For generations of pre-med students, three things have been as certain as death and taxes: organic chemistry, physics and the Medical College Admission Test, known by its dread-inducing acronym, the MCAT.
So it came as a total shock to Elizabeth Adler when she discovered, through a singer in her favorite a cappella group at Brown University, that one of the nation's top medical schools admits a small number of students every year who have skipped all three requirements.
Until then, despite being the daughter of a physician, she said, "I was kind of thinking medical school was not the right track for me."
Ms. Adler became one of the lucky few in one of the best kept secrets in the cutthroat world of medical school admissions, the Humanities and Medicine Program at the Mount Sinai medical schoolon the Upper East Side of Manhattan.
The program promises slots to about 35 undergraduates a year if they study humanities or social sciences instead of the traditional pre-medical school curriculum and maintain a 3.5 grade-point average.
For decades, the medical profession has debated whether pre-med courses and admission tests produce doctors who know their alkyl halides but lack the sense of mission and interpersonal skills to become well-rounded, caring, inquisitive healers.
That debate is being rekindled by a study published on Thursday in Academic Medicine, the journal of the Association of American Medical Colleges. Conducted by the Mount Sinai program's founder, Dr. Nathan Kase, and the medical school's dean for medical education, Dr. David Muller, the peer-reviewed study compared outcomes for 85 students in the Humanities and Medicine Program with those of 606 traditionally prepared classmates from the graduating classes of 2004 through 2009, and found that their academic performance in medical school was equivalent.
"There's no question," Dr. Kase said. "The default pathway is: Well, how did they do on the MCAT? How did they do on organic chemistry? What was their grade-point average?"
"That excludes a lot of kids," said Dr. Kase, who founded the Mount Sinai program in 1987 when he was dean of the medical school, and who is now dean emeritus and a professor of obstetrics and gynecology. "But it also diminishes; it makes science into an obstacle rather than something that is an insight into the biology of human disease."
Whether the study's findings will inspire other medical schools to change admissions requirements remains to be seen.
Because MCAT scores are used by U.S. News and World Report and others to rank schools, the most competitive ones fear dropping the test, admissions officials said. And at least two recent studies found that MCAT scores were better than grade-point averages at predicting performance in medical school and on the series of licensing exams that medical students and doctors must take.
"You have to have the proper amount of moral courage to say 'O.K., we're going to skip over a lot of the huge barriers to a lot of our students,' " said Dr. David Battinelli, senior associate dean for education at Hofstra University School of Medicine.
But, Dr. Battinelli added, "Now let's see how they're doing 5 and 10 years down the road." The Mount Sinai study did not answer the question.