Where I grew up, we had a psychometric test instead. I don’t know what my score was, since they did not share it with you, but only sent to to the universities to which you apply. That may have changed, though. In any case, it was high enough to get me invited to interview for acceptance to medical school (it was a seven year straight shot, not attending medical school after undergrad, and an undergrad was three years).
I bombed the interview, of course, since I was only marginally interested in a medical career to begin with, but my mother bugged me about it. And no, had I declined the interview, they wouldn’t have brought anybody else instead - you were invited to an interview if you applied to biological sciences, and your matriculation average and psychometric scores were above pre-set cutoffs, no matter how many people passed that cutoff.
To be honest, I went in seriously, but the first thing that they did was look at my activities in the past (including being an amature herptologist), and demand aggressively “how do these contribute to humanity?!” Any interest I had in learning medicine dissipated at that moment. I responded that some of them were for my personal enjoyment, and things went downhill from there. They asked at one point “so you think that you’re better than everybody else?”. I did have some self control, so I didn’t respond “isn’t that a prerequisite for medical school in this country?”
To be fair, it was just after getting out of the army and I was at the peak IDGAF period of my life.