A perspective on the CARS section from an English major

One February morning in my junior year, sitting under the harsh lights of the reference room in my college library, I decided to open ExamKrackers’ 101 Passages in MCAT. While I bemoaned the fact that this moment heralded the beginning of the dreadful MCAT study period, I was secretly confident that CARS would be a feel-good start to my MCAT studying. After all, having read thousands of pages of the “great authors” and also having churned out page after page of essays, sometimes analyzing a single word, I thought that reading a few passages and answering some comprehension questions were what I have been training for during the entirety of my undergraduate years. So, I forged ahead, ready to crush the first batch of passages.

Boy, did I get my sorry behind kicked.

Upon grading, I was getting at least two questions per passage wrong. Deluding myself that what had happened was just a fluke, I went ahead with the next batch…only to realize that, according to MCAT, I was a bad reader. After such drubbing, I swallowed my pride and read through the reading strategy section available in the beginning of the book. While I won’t reproduce ExamKrackers’ strategies here, the main logic behind their recommendations is simple:

Summarize, Summarize, Summarize.

This is NOT to say that anyone will ace the CARS section once they can learn to summarize the main ideas of each passage—that would be a lower-order of reading comprehension that would have been tested at the SAT or ACT stage. The MCAT is much more subtle in its ask: it asks its readers to summarize how the main idea changes as the passage develops—requiring the reader to focus on how each sentence or paragraph adds to/negates/complicates the passage’s initial main idea. As torturous as that sounds, however, I have found that in most MCAT passages its proposed “main idea” rarely changes more than once (i.e. the passage will complicate its main idea only once).

This type of reading required by the MCAT is hyper-focused and reductive—sometimes to a bizarre extent. Considering that most passages in the MCAT are excerpts drawn from academic texts where the author is developing complex and nuanced arguments over several pages, this type of reading reduces the text down to one or maybe two main arguments. Furthermore, at times, it coerces the text to be internally consistent when, in reality, it is clear that the author is trying to nuance his arguments beyond simple logical statements (i.e. he is for/against X because Y). However, this is NOT to say that the MCAT doesn’t test one’s ability to read into nuances—it is very obvious when it does want you to—but the key is to not let little nuances detract you from accurately summarizing the main ideas.

As an English major, I was precisely taught not to read texts in such reductive manner. After all, how could one write a ten-page essay on anything if all one was reading for were the author’s main ideas? Conditioned to read for little nuances, I ended up being lost in the weeds, arguing myself out of obvious main ideas because of one sentence or a word. At the end, it took me a while to effectively “unlearn” my way of reading to do well in the CARS, making me feel cynical about medicine’s recent turn to humanities.

Looking back as a medical student, however, I now understand better why the CARS was developed this way. The ability to figure out the main idea and to quickly summarize how the main idea changes is essential to being able to take a patient’s history and write a condensed version on the patient’s chart. In fact, since it is the summarized version of the history that is being shared amongst the patient’s care team, the author has tremendous authority on curating the details of the patient’s history and guiding colleagues through his clinical reasoning. In that sense, medical professionals rely on each other’s ability to summarize to deliver the best care.

In closing, I will attempt to summarize(!) this post with a metaphor:

Great readers of Shakespeare may not ace CARS but great writers of Shakespeare for Dummies surely will.

Hopefully that is deserving of a 132. 🙏

TL;DR:

Remind yourself that AAMC has designed each MCAT section with a set of knowledge bases and skills that they deem essential for a clinician. In that sense, the CARS section is testing one’s ability to figure out the main idea and quickly summarize how the main idea changes as the passage develops. These reading comprehension skills are constantly deployed in the clinic when physicians take patients’ histories and then have to produce a written summary of their histories that can help guide other members of the care team on their clinical reasoning (i.e. what is most likely going on in the patient considering their signs, symptoms and history).