In light of the structural and content changes to the Medical College Admission Test (MCAT) to be implemented in 2015 and the recent diversity- and social-accountability-based recommendations of the Future of Medical Education in Canada (FMEC) project, the authors review and reexamine the use of the MCAT exam in Canadian medical school admissions decisions.

This Perspective article uses a point–counterpoint format to discuss three main advantages and disadvantages of using the MCAT exam in the medical school admissions process, from a Canadian perspective. The authors examine three questions regarding the FMEC recommendations and the revised MCAT exam:

(1) Is the MCAT exam equal and useful in Canadian admissions?

(2) Does the MCAT exam affect matriculant diversity? and

(3) Is the MCAT exam a strong predictor of future performance?

They present the most recent arguments and evidence for and against use of the MCAT exam, with the purpose of summarizing these different perspectives for readers.