To the Editor:  

The variables used to select medical school applicants should be robust and provide practical information. They should be valid, reliable, transferable from one context to another, and demonstrate candidates' effectiveness in decision-making processes. 

As medical school applicants progressed from high school through college, they demonstrated the ability to learn new material (ie, aptitude). Their undergraduate grade-point averages (GPAs) and Medical College Admission Test (MCAT) scores confirm that they have learned a substantial body of knowledge (ie, achievement). 

Since 2000, JAOA—The Journal of the American Osteopathic Association has published 12 articles examining various relationships between academic achievement and performance on the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA).^1–12 The most analyzed variables have been MCAT scores,^1,4,6–9,12 undergraduate GPAs,^1,4,7,12 individual course grades in osteopathic medical school,^1,4,5,7,10 and osteopathic medical school GPAs.^1,2,4–12 A number of conclusions are evident from these findings. 

First, the grades osteopathic medical students receive in individual medical school courses and their medical school GPAs are much better predictors of COMLEX-USA performance than are MCAT scores and undergraduate GPAs.^1,2,4–12 The former variables explain up to 72% of the variance in COMLEX-USA scores, while the latter only explain up to 20%.^1,2,4–12 The corollary of this statement is that COMLEX-USA performance is at least 80% dependent upon factors that seem unrelated to undergraduate GPAs and MCAT scores. We are left to wonder what these unnamed variables comprising 80% of students' potential success—as measured by COMLEX-USA—might be. 

The affective domain includes patterns of behavior that signify one's response to emotions. These characteristics may hold the answer for osteopathic medical schools that are seeking to screen and evaluate applicants for the personal traits that will help them become successful as medical students. 

In a 2002 book titled Primal Leadership: Realizing the Power of Emotional Intelligence, Daniel Golman et al¹³ describe emotional competence as a capability, based on “emotional intelligence,”¹⁴ that is related to success at work. Emotional competence is the product of varying degrees of personal competence (self-awareness, self-regulation, and motivation) and social competence (empathy and social skills). 

Goleman¹⁴ reports that emotional intelligence is a better predictor of career success than cognitive ability as measured through standard intelligence quotient tests. One study analyzed employees from 40 companies and demonstrated that emotional intelligence could differentiate the star performers (upper 10%) from average performers.¹⁵ In fact, emotional intelligence was twice as important as the results of standard intelligence tests in identifying the most successful employees.¹⁵ 

Presently, the selection of successful candidates appears to be more a matter of art than science, as admissions committees at osteopathic medical schools choose their candidates based on objective variables (ie, measures of aptitude and achievement) that predict—at best—20% of COMLEX-USA performance. 

I submit that the selection process for osteopathic medical school admission could be ideally served through the creation and validation of reliable assessment tools that identify potential star performers who have the qualities related to the “best” affect or emotional intelligence.