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The maturation of Next Generation Sequencing (NGS) has been the biggest advance in genomics in the last 5 years. This has lead to the plummeting cost of sequencing our DNA. The cost of genetic sequencing has been dropping faster than Moore’s law. Although we have been sequencing genes in the clinical lab for over 20 years using Sanger sequencing, it was expensive and laborious and so it had to be done very judiciously. Turn around times were 4 months to more than a year. Insurance companies rarely paid for the testing and it was far too expensive for most people to afford. Genetic testing on affected people was rarely done and preventive genetic testing of healthy people was unheard of.NGS has made DNA sequencing affordable. Our health care system is really a sick care system-- it only pays for services if you are already sick. There is very little incentive for any health care stakeholders to pay for services that help keep people healthy. By making genetic sequencing affordable, we can get it outside The System. The incumbent health care system, in addition to not being incentivized to keep you healthy, is lousy with trolls that live under bridges and charge a tax to cross. By the time every troll takes their cut, the cost of testing is again out of reach for most healthcare consumers. But, once you are outside The System, the few stakeholders that are incentivized to help you stay healthy-- you and your employer-- can afford to make preventive genetics an option.We have been talking about the promises of preventive genetic testing my entire career. Companies like Color, using NGS to detect mutations in hereditary cancer genes, are finally making preventive genetics a reality. The long term implications of preventive genetics on the diagnostic testing industry will be interesting. Laboratories like Myriad Genetics who bill insurance are charging $3500 for the same test that Color now does for $249. First, why would any payer (insurance, institutional, self) pay for the $3500 test? Second, when everybody is tested preventively, the diagnostic market focused on testing high risk individuals ceases to exist.

I am a part of an organization called the National Association for College Admissions Counseling. Through it, they administer a survey to higher education admissions professionals. This is a self reported survey with a sample size of about 167, so please do not look too deeply into this data.The column that you want to pay attention too is the Admissions Test Scores. Notice that the percentage of admissions professionals attributing “considerable importance” to the SAT or ACT has decreased slightly year over year. 2016 was the year the SAT was revised.Couple this with the fact that many schools are now going test optional. As of 2018, there are over 1000 colleges that are now test optional.So to answer your test broadly, no, they are not used as widely as before. However, are they still used. Yes.

In a recent blog post, I focused on the ways that highly selective colleges and universities go about choosing the students who receive offers of admission. My starting point was a reexamination of Jacques Steinberg’s wonderful book, The Gatekeepers, written a decade ago, and whether it still accurately portrays the process of applying to highly selective schools today. For those not familiar with the book, Steinberg uses the individual stories of applicants to Wesleyan. He provides compelling narratives of their lives, stresses and ultimately outcomes when applying to Wesleyan and other schools. He also follows one particular admission office and one particular admission officer, Ralph Figueroa, as he travels across the country to recruit students at schools, interacts with students and college counselors, and then sets down to the hard task of making decisions. It is compelling reading. We get caught up in the each student’s story and we see how Ralph and his fellow admission officers go about making many difficult decisions. Of the many books written about admission, this is one of the best. I described some of the significant changes in admission since the book was written, but I missed a few.One of the great things about the education community is how often people reach out to help one another by sharing their experiences and expertise. Several wonderful people, on the college side and those who serve as counselors for students, have suggested that I update my overview to include several issues that have been the subject of many recent stories over the past several weeks. Over the next several weeks I will be doing just that, but here is one that has a lot of sides to it.***********************************************************************Test Optional SchoolsA counselor pointed out after reading my post that provided average SAT scores for Harvard and Wesleyan, that Wesleyan has recently joined the over 800 hundred colleges and universities that no longer require students to submit standardized test scores. more and more schools are giving students the choice about whether to submit standardized test scores as a part of their applications. Recently, another prestigious school, Bryn Mawr, joined the test optional group. It seems that every week another school makes this decision. Why are schools doing this and what does it mean for students?I will start to answer these questions by looking again at Wesleyan since that school was the focus of The Gatekeepers. Although the book focuses specifically on the admission process at Wesleyan, it still well serves as a representative of what goes on in the holistic evaluation that any highly selective college or university employs to meet their institution goals and needs. Here is the average test SAT score for Wesleyan’s entering class: 2100. Obviously, scores like this are quite high. Anyone looking at them might be either impressed or possibly intimidated or may be a bit of both. Why would a school that enrolls such great testers move away from requiring all students to submit scores? Here is what they say on their website about their decision to go test optional:Why did Wesleyan decide to become standardized test-optional in the admission process?Research released in February 2014 (Hiss and Franks ) and the upcoming revisions of the SAT and ACT prompted the change beginning for those who file applications for matriculation in 2015. We are unconvinced that standardized test scores accurately reflect college potential for all students, and believe that test scores unfairly advantage some applicants. Individualism and student choice are core values at the university; this policy extends that choice to applicants.Wesleyan states it has moved to test optional because of the changes that are forthcoming to both the SAT and the ACT. For some this might sound like a wise move, as they can then do research on the new tests to see how well they predict academic success. Defenders of the tests might point out that the SAT in particular will be tied to what students are expected to learn in the newly implemented Common Core standards and therefore will serve as added confirmation of what students have learned. As with virtually anything that has to do with standardized testing, in general, and more importantly, as a factor in admission decisions, there are very strong views on how much the tests should or should not be used.[i]I will apply to the rest of Wesleyan’s textual justification what literary critics call a close reading. I want to examine the underlying meaning of this particular sentence: “We are unconvinced that standardized test scores accurately reflect college potential for all students, and believe that test scores unfairly advantage some applicants.” This compound sentence, although seemingly transparent, compresses and elides over some of the biggest issues in admission today. On the surface, it might seem that Wesleyan dismisses the value of standardized tests altogether. They aren’t. If they did, then the sentence would simply have read: “We are unconvinced that standardized test scores accurately reflect college potential.” If the sentence was written this way, then Wesleyan would clearly would be a part of the educational community that thinks standardized tests are one of the biggest problems in education today.[ii] The phrase that follows, however, “for all students”, is ambiguous. If Wesleyan believed that testing is not useful at all, then this phrase is redundant and should be edited out. But I don’t think that Wesleyan has come to the conclusion that testing does not predict well for at least some groups of students. In other words, the way the sentence reads it indicates there are some students for whom testing is a useful predictor and who should, if they hope to receive an offer of admission, take the tests and submit the scores. The question then becomes who are these students for whom testing might be useful to Wesleyan? The answer comes in the second half of the sentence: “and believe that test scores unfairly advantage some applicants.” It may not be immediately clear how those who have an unfair advantage in doing well on tests should also be the ones that submit test scores, so let me try to supply the missing connection.There have been many stories lately about how test scores favor those who come from the high end of the income scale. The data on test scores by family income demonstrates that those who are in the upper middle class or above have higher test scores, in the aggregate, than those who are low or middle income. Some go as far as to say that standardized tests are nothing more than a substitute for family Page on income.it is true that some students grow up in families that can pay for test prep, private tutors, summer enrichment programs and can, in addition, pay for private education or at least live in an area in which the public schools are filled with other high achieving students and programs that emphasize academic excellence (many AP course offerings or the IB diploma, for example.) Students who have these advantages, not surprisingly, often do well on tests and this seems to be what is unfair. If Wesleyan (and other schools and educators) believe that these students have received an unfair advantage then should they not take the tests? I think the opposite it true: those who have these unfair advantages—and, this is a very important part of what I am asserting here--who are applying to the most selective schools are exactly the ones who should take the tests and submit their scores. Why?Because if they don’t those reading applications may assume that the scores are not close to the mean scores. If a student with all the unfair advantages cannot do well on the tests, then this might well mean they won’t necessarily be the best academic students that the school could enroll. The most elite schools have such deep applicant pools that they often turn down students with exceptional testing. Therefore, any student who is not in a special category and who has had the opportunity to go to a great secondary school, take great courses, and have the chance to do test prep etc. should submit scores to the most elite schools If not, then there will be many other strong applicants who have similar backgrounds who have high scores who will stand out ahead of them. Of course, there are exceptions, but most of these will fall under a special category. There may be a legacy whose parents have been big donors whose scores are not great, but who the school would still like to admit. The same will hold true for athletes and others who may have an exceptional talent the school is looking for. Or they may be a part of a group the school wishes to target—under-represented minorities in articular. But most applicants at the high-income end do not fall into these special categories.Another way of looking at this issue is to restate what Wesleyan has written, but to change one word to make it clear what they are saying from the other side: “and believe that test scores unfairly DISadvantage (my emphasis) some applicants.” If some students are unfairly advantaged, the corollary should also be true. If my syllogistic logic is accurate, then the question now is who are those students who are disadvantaged in the process? I have already stated that first generation, and low-income students, in the aggregate, score lower than those not in these categories. In addition, under-represented students score far lower than whites and Asians. Wesleyan, and a number of other highly selective schools, are committed to enrolling a diverse class. For those students who are part of the groups just mentioned they may benefit from not submitting scores if they are below the mean of accepted students. Wesleyan and other schools do not wish to say this directly however, as it raises issues of fairness in a quite different way. If, for example, a student who is the member of an under-represented group, but still has the upper middle class background and support of good schools and a stable family, has scores that are lower than those of most whites and Asians, the school may still choose to admit him or her. If racial diversity is an institutional priority (and it is at every elite school), then it may be that some of these students will be given more leeway when it comes to testing especially if there are no test scores to compare them to.Having students who the school wishes to admit not submit testing accomplishes three things that help the school to fulfill its self-defined institutional mission. First of all, the school can now do additional outreach to underserved communities in hopes of finding students who have “grit”. Grit is something that has received a lot of press over the last couple of years and is largely the brainchild of Penn Prof Angela Lee Duckworth. Grit means a student has the drive to succeed even if the circumstances in which she lives may be anything but great. Grit kids work hard and overcome adversity. Many grit kids don’t have top scores but they have what it takes to do well at virtually any college or university. Schools like Wesleyan want more of these kinds of students and telling a group of them in a rural high school or an inner city school that they don’t have to submit testing may encourage them to apply. They won’t look at the mean scores and simply say, “I have no chance”.Just last week Harvard’s application numbers were released and they shot up 8%. The Dean, William Fitzsimmons, thinks that their efforts to travel to many places where grit kids live has helped them diversity their applicant pool. (I mentioned this on my previous post, that while Harvard does require testing for all applicants, it does not post the average scores on its academic profile of the admission webpage). Since elite schools have received withering criticism by some educators for being bastions for elite rich kids, going out and visiting schools and holding special programs for grit kids is one way of demonstrating they care about low income students and care about racial diversity too.If Wesleyan and Harvard and other elite school downplay or waive testing to get the students to apply, the next step for them to achieve their institutional needs is to admit them, recruit them and enroll more of these students. Harvard can afford to do this, literally and figuratively. They received an additional $125,000,000 last year to put toward financial aid. They already have a huge fund set aside for aid but this gift makes them able to pay for as many low-income students as they admit and who choose to enroll. As a result, expect them to have a higher percentage of grit kids in the coming years. Wesleyan and some other elite schools, will likely admit more students who may not have great testing but who will add to the mix of the class, but they have to stop at some point because of the costs involved. The $60,000 price tag is staggering and it does not take many full need students to begin to drain the coffers of the financial aid office. Many elite schools are now need aware and even some of those who say they aren’t still look to get low income students who may also be members so of under-represented groups (this is not something they can say of course). The advantage of bringing in and under-represented grit student is that the school gets two for one. They will get a boost in the enrollment of students who are both low income and racially diverse. Those who are white or Asian and poor may not receive quite as much push if the ability to pay is an issue. (I cannot prove what I have just written, as to do so would mean that schools would have to release data that only a court order could get. I could well be wrong about this at many schools, but I know that this does happen at a few.)The last thing that getting rid of mandatory testing will do will is to help improve the school’s academic profile. If the schools no longer have low testers submitting scores, but who are still getting in, when the time comes for them to report their average scores to the US News the average scores will actually rise. Taking out the low testers will mean scores for the overall incoming class will make the school look even better in the methodology of the US News. To sum up: schools going test optional will benefit the schools themselves and some groups of students. Schools get a more diverse class and they get to report even higher testing averages. If what I have said is accurate, then I would expect other schools at the top to begin going test optional too. There may be a day in the not too distant future when almost all schools will be test optional.A recent survey of private colleges that have gone test-optional backs up some of what I have just written:Andrew Belasco, CEO of College Transitions, a college consulting firm in Athens, Ga., conducted the recently published study that looked at 180 selective private schools including 32 that have test-optional policies. Overall, Belasco says, the main beneficiaries of the test-optional policy could be the private colleges themselves.A peak into test-optional policiesWhen schools become test-optional, it encourages more students who might have previously considered their chances of admission to be weak, to apply. More applications can lead to higher admission rejection rates, which make schools look more selective. At the same time, the published test scores of individual colleges could rise because freshmen with lower scores never submit them.Our findings suggest that test-optional admissions policies, as a whole, have done little to meet their manifest goals of expanding educational opportunity for low-income and minority students. However, we find evidence that test-optional policies fulfill a latent function of increasing the perceived selectivity and status of these institutions. In doing so, these policies may serve to reproduce and maintain the current social structure -- and its inequalities -- within U.S. higher education.**********************************************************************For some, the move toward more and more schools going test optional is a cause for celebration.[iii] This includes both the schools that benefit from having higher average scores but also those groups who may not have applied and may not have been admitted because of their scores. But before everyone who thinks testing is not useful and who do not have great scores decides not to submit them let me reemphasize an important point. I have tried to prove, there are some students, those unfairly advantaged, for whom test optional is not really an option should they hope to be admitted to the most selective schools. Those who are “unfairly advantaged” by testing may find that it will take even higher scores. If this turns out to be accurate then parents who have the money will use it to hire more tutors, private counselors and test prep experts than ever. The stress among students whose goals include the most elite schools will increase and so will the demands on students to do more in order to stand out. Where this might end is anyone’s guess, but for those who have economic means and children about to enter into middle school or high school and who have very bright kids with high aspirations, get ready for some tough years ahead if getting in to a top school is what you dream about for your children.If I have just depressed a number of parents and educators with what I have written, let me try to add something that might make at least those who can pay full fees feel better. In the ice cited above about who benefits from testing optional policies there is another whole side to the issue:Tony Bankston, dean of admissions at Illinois Wesleyan University and a skeptic of test-optional policies, believes some of the main beneficiaries of the no-test admission route are likely affluent and wealthy students."Everybody is struggling with enrollment, and colleges are looking more and more for students who have the ability to pay a substantial portion of college," Bankston observed. Test-optional policies open the door to take wealthy students who would have been borderline applicants. "I think a lot of this is going on behind the scenes," he suggested.If what Mr. Bankston says seems to refute much of what I have written, that is because it does. But does that mean people should dismiss what I have written or side with me against Mr. Bankston’s assertions? As is so often the case with college admission, any attempt to generalize about a huge group of schools often leads people to assume things that are only partially accurate. Context is, if not everything, it is at least important enough to note that the variables that go into individual schools’ institutional priorities differ sufficiently to undermine virtually any overarching opinion on an issue. In this particular case Mr. Bankston asserts, “Everybody is struggling with enrollment” I agree, but it is necessary to distinguish the way highly selective and well funded schools struggle with enrollment from the way nearly all the other schools do. The schools that accept under 20% of their applicants have to decide which of the chosen few will make the greatest contribution to the life of the school. They spend untold hours trying to pick the best among an exceptional applicant pool. These schools also tend to be the ones that can offer admission to as many low-income students as the school feels have earned a spot. The number of schools that fall into this category are very small but they are the ones who garner the most media coverage and the most attention from parents and students. But to reemphasize what I have already said, students who are unfairly advantaged because they come for the high end of the economic spectrum should submit scores to these schools for the reasons I have outlined above.The schools that Mr. Bankston points to in his quote are not, however, these schools. The ones he is talking about are the majority of other colleges and universities that are struggling to fill their classes, especially with students who can pay full fees. There are hundreds if not thousands of schools that fall into this category. There simply are not enough students who come from families who can afford to pay the $60,000 a year it takes to pay for private education at many places now. There are many who cannot afford to pay the in state fees of their State institutions either, despite significantly lower costs. One reason that the U Cal schools have increased their out of state and international students percentages so dramatically over the past decade is that these students pay full fees that match the cost of private colleges and universities. Budget cuts from the State governments have forced some State schools to bring in more full payers into the mix. Schools like this have to approach the admission process far differently than the ones at the top of the US News. Many of these schools, both public and private, are, at the very least, need-aware when making admission decisions. The ability to pay has become an increasingly important part of the admission decision for these schools. Given this, Mr. Bankston is giving good information to those students whose scores are low but who can pay. These students should not submit scores in most cases. If these are the two ends of the spectrum when it comes to advice about full payers with low scores submitting them, there is one more category that falls in between the extremes and this is where advice about submitting scores should be interpreted as a best guess rather than anything definitive.Somewhere just outside of the most elite schools there are a group of highly selective schools that are also, at some level (and this differs from school to school), need aware. In other words, they have far more applications from qualified students than they need to fill their classes but they do not have the money to admit all the students who might qualify academically but do not have the money. In a few cases the schools read application through the first round of evaluation without looking at the ability to pay, but after that, when the data comes in, they may end up cutting out some students who do not have the ability to pay. So they both are and are not need aware, depending at what point they are in the overall admission process. If this is true when it comes to money it is harder to tell whether those who submit scores that are low but are full payers (unfairly advantaged) might be looked at a little bit better or a little bit worse than those who may have as good but better overall academic credentials.If I had to guess (and I do have to guess as I do not know what goes on behind the closed doors of colleges and universities), I would say that some admission readers and some schools will potentially mark down an unfairly advantaged student who does not submit scores and some will not. I am not trying to dodge the issue, but I think there will be different “right” answers depending on the school and in some cases individual readers within a school. If schools would release data on who was admitted without submitting scores and whether they were low income or under-represented students or not this would certainly help student, educators and families get a sense of that particular school’s priorities and approach to these issues. But it would not help the schools themselves, since to do so would raise a lot of tough questions. Don’t expect this information to be forthcoming anytime soon. What is a bit frustrating is that it is exactly these schools, the ones that great students have a realistic chance of getting in, that are approaching these issues in ways that make it hard for those on the outside to know what the best approach to submitting testing (and some other issues too) should be.Rather than end on this less than happy note let me state again what is far more important about students applying to colleges and universities. There are spaces for everyone at schools all over the country. Some may not have famous names but schools are looking for students who can add their intellect, talent and grit to their campuses. It is not the name of the school that matters to a child’s education; it is how they do at a school that fits. I have written about this many times and it is not just an opinion, it is backed up by a lot a great data. If parents and students step away from the Olympic level competition to get into elite schools and concentrate on learning and developing passions at the school they get in and that fits them well, then the whole way of looking at enrolling in schools might improve for everyone at every end of the economic spectrum. I don’t expect that the way many look at the college application process will change, but I can say that on virtually every forum I visit that consists of educators, the mantra about fit instead of name and rank is what everyone agrees should be the focus for students and families. Maybe if enough of us keep saying this again and again the race to the top won’t get even more competitive. Maybe, but not likely. We are wired for competition and the media makes so much of ranking and names that it is hard to escape the frenzy. Even if there were a marginal change in the approach, however, this would improve the lives of lots of individuals who choose to follow the less stressful and possibly more successful path to preparing oneself for a bright future.*******************************************************************[i] I would highly recommend readers to go to the website cited. Bill Hiss, one of the authors, has been at Bates College for many years and he was one of the first to push his school to go test optional. The paper has a lot of data to support the view that standardized testing is not the best measure of academic success.[ii] One group in particular, Fair Test, has been fighting the battle against testing for many years. One of the main things they see is that testing is an instance of the tail wagging the dog. Schools want to enroll high testers, as it is one of the factors that is a part of US News rankings. Given this, the emphasis on testing has taken on, according to Fair Test and many other others, a disproportionate place in evaluating students for what is supposed to be a holistic approach. A glance at the average scores at places the top 50 schools provides some support for this belief. For some of these schools most students who do not have at least 700 on each of the subscores on the SAT are not likely to get in. No school will come out and say they have cut offs because they in fact don’t, but for some students who are members of certain groups, high testing is not just expected but pretty much required.[iii] In her new book, The Tyranny of the Meritocracy: Democratizing Higher Education in America, Lani Guinier takes about as strong a stance against testing and the current way students are accepted to highly selective colleges and universities as anyone currently writing on this issue.In an interview with Inside Higher Ed she gives her solution:"We can alter how we think about merit, from something a child is born with to something that she (and/or we) can help cultivate. We can shift from prioritizing individualized testing to group collaboration among all stakeholders, including students, parents, teachers and administrators. Unfortunately, it’s not going to be easy, as the entire undergirding of our educational system rests upon notions of individual achievement and the promotion of competition. But somehow we must shift from promoting testocratic merit, which has produced dubious results, to developing democratic merit, because the latter is the foundation upon which our national values truly ought to rest.Current admissions systems are based on tests, rankings and prestige -- in ways that undermine American democracy."Ms. Guinier, a high profile public figure and a prof at Harvard, suggests that testing undermines democracy. She is for getting rid of testing and essentially recreating education from the ground up by emphasizing collaborative learning instead of competition. Should her efforts succeed then make up of students at what were once highly selective schools would be far different than what it is it is today.At the other end of the spectrum, is Joel Klein. As chancellor of the New York City School system he implemented many changes, led the way for charter schools and for instilling learning based in part on what is now the common core and from ideas put forth a generation ago E.D. Hirsch in his Cultural Literacy approach to education. He is all for tests and he was a figure who was savaged in the media. At least one of his former teachers disagrees with the teachers unions and others. He basis much of his praise on data that seems to demonstrate that his small schools, his emphasis on accountability and his belief in testing helps prepare even students from the lowest economic levels a chance at a better future:"A documentary, Waiting for Superman, compellingly portrayed charter schools as beacons of civil rights and equality, opposed by unions for reasons of self-interest and ignorance… Dana Goldstein, an education journalist whose recent book, The Teacher Wars, is generally sympathetic to the unions, told me that she credits Klein with “presiding over an era of increasing optimism and higher expectations for public schools in New York City. His reforms brought new talent into the system at every level, from classroom teachers to the top of the bureaucracy.”The testing wars will continue even if schools all go test optional. I have no doubt that many more colleges and universities will be going test optional in the near future. Whether this will produce better students or better educational outcomes is something that will be the subject of competing opinions and data.