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Tolerance for Ambiguity in Medical School Applicants and Students

An article published in 2013 in Academic Medicine posed a novel and interesting way to select medical students based on their tolerance for ambiguity (TFA). The upcoming changes to the 2015 MCAT, with its inclusion of new sections on behavioral and social science, are designed in part to include broader ways to assess medical school applicants. The authors of this article claim that the MCAT changes may not be comprehensive enough to select students who will become humanistic physicians.

Instead, the authors believe that testing applicants for their ability to handle imprecise situations–with no black and white answers–would be a good way to assess their capability for providing high-quality care in ambiguous medical situations. They also theorize that students’ comfort with unclear situations would help foster their humility and that this, in turn, would help develop their moral character.

A subsequent article in Academic Medicine examined matriculating medical students’ tolerance for ambiguity and found that it was higher in men and nontraditional, older students. Those who scored higher on the TFA scale also indicated a stronger desire to work in underserved areas.

In commentary on this article, Dr. Vera Luther states that the results of the TFA survey raise more questions than they answer. For example, she believes that there are some positive traits associated with a low tolerance for ambiguity.

Finally, a personal reflection on the clinical application of tolerance for ambiguity is shared in this blog post by Dr. Marie Caulfield of the Association of American Medical Colleges. More studies need to be done to track this trait and see if it remains stable over time and if the predictions being made about its effect on medical students and their ability to handle specific situations are accurate.

–Liza Thompson, Expert Medical School Admissions Consulting

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