If you’re reading this post, you’ve likely passed the first few hurdles of Medical School Admissions. Congratulations! You’ve submitted your AMCAS application (if you’re applying to MD) or your AACOMAS application (if you’re applying to DO), and you have completed dozens of secondary essays. Medical schools begin sending out interview requests in late August with the first interview dates in early September. Now is definitely the time to start thinking about honing your interview skills and familiarizing yourself with the different interview formats that are possible.
In this blog post, I am going to focus specifically on the Multiple Mini Interview (MMI), which is an increasingly common interview format for Medical School Admissions.
What is the MMI?
The MMI is an interview format that was first developed by McMaster University. According to the AAMC, the MMI is “designed to measure competencies like oral communication, social and nonverbal skills, and teamwork that are important indicators of how an applicant will interact with patients and colleagues as a physician.” The goal is to assess an applicant’s interpersonal skills, ability to communicate effectively and the capacity for critical thinking about current events and ethical issues.
Unlike a traditional 1:1 interview, the MMI consists of a series of interview stations (6-10) in which applicants are prompted to answer a question or solve a problem in a hypothetical scenario. Applicants generally have 2 minutes to prepare (by reading a prompt) and are given 5-8 minutes to complete. The stations may include working with another applicant on a team or even role play with a simulated patient.
In advance of any interview, it is important to review the AAMC Interview Procedures report, which gives applicants an overview of how each medical school approaches the interview process. Medical Schools tend to like MMI interviews since it gives applicants several opportunities to showcase their skills through the interview and also provides for greater standardization and assessment compared to traditional 1:1 interviews.
What are the categories of the MMI scenarios?
The following are the types of MMI scenarios you are most likely to encounter in this process. Please note that this is not a comprehensive list.
There are 3 main MMI scenario types:
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Ethics/Morality or Policy Scenarios: These questions present an ethically difficult scenario and require the interviewee to describe their thought process to work through the situation. Applicants may also be asked to describe thoughts on an aspect of the healthcare system, usually with respect to current events.
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Acting and Role Play Stations: These are stations where interviewees interact with a professional actor under the purview of an evaluator to work through a scenario.
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Collaborative Questions: Here, interviewees must work together, usually in pairs, to complete a task that requires communication and teamwork.
Less frequently, the following can also appear during an MMI interview:
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Personal Questions: At these stations, the interviewee is asked to discuss an anecdote from their life in response to a prompt.
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Quirky Questions: These stations consist of unusual questions to inspire creative thinking from the applicant.
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Traditional Mini interview: These stations are usually longer than the normal MMI stations where applicants sit with a high-ranking faculty member and have a traditional interview.
What is the standard approach to MMI scenarios?
The MMI gives medical school admissions committees an opportunity to see how applicants (1) think critically about an issue (2) balance ethical and moral responsibility with patient care needs and (3) create an argument. Nearly all scenarios involve some form of bioethics principles so it’s useful to spend time reviewing the four key bioethical principles: autonomy, beneficence, nonmaleficence, justice. For additional review, the University of Washington has an excellent Ethics in Medicine website.
When responding to MMI scenarios, we recommend a structured approach. One type of approach is called the STAR (Situation, Task, Action, Result) method, which is an effective framework for structuring your responses to behavioral interview questions. This method helps provide a well-rounded response to showcase problem-solving skills clearly and concisely.
Situation: Provide the interviewer with a brief context of the example. This allows you to restate the prompt and stay on topic with clarity and direction.
Task: Summarize the problem or challenge that was a direct result of the situation. This is where you should identify the ethical principles involved in the scenario and describe all sides of the issue. You should explain the perspective of relevant stakeholders as well as your role/responsibility.
Action: Describe the steps taken to overcome the problem or challenge. You must take a stance in MMI scenarios. Articulate your decision and back it up with sound justification.
Result: List the positive outcomes of your actions.
Tips for ethical MMI scenarios
Example MMI: You are a resident working at a clinic associated with your program, and over a few weeks you become very close to a particular patient. This patient is a single mother and currently works in a restaurant as a server. You first saw her as a patient when she received a 2nd degree burn to her hand while she was at work.
Since the accident, she has been unable to work, and she also does not have health insurance. The bills are very burdensome for her and not being able to work is compounding this situation. One day, at the clinic, she asks you if you can take some bandages and other materials from the clinic supplies for her because she cannot afford to buy them on her own.
Using a structured approach will allow you to break down the scenario into it’s component parts:
Situation: This patient has limited resources and medical needs and is asking for assistance obtaining supplies for free.
Task: The key bioethical principle here is justice. Patients should have access to the care and supplies they need without undue burden.
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Patient perspective: Obtaining medical supplies has been challenging for her given her finances and lack of insurance.
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Your role: As her physician, you need to ensure the patient gets good care but also understands the rules of the health system and the impact on other patients. If all patients were given free supplies, for example, patients who present to the clinic for acute needs may not be able to receive the care they need.
Action: The physician should give enough bandages so that the patient is safe, but should make a plan for how the patient will receive ongoing care. The physician will need to be explicit and set expectations about not being able to give free bandages for an extended period time.
Result: The acute issues are resolved and the patient-physician rapport is strengthened. In addition, the patient understands the kinds of requests of the clinic that are appropriate.
Tips for actor/role play scenarios
Example MMI: You are a medical resident and have to tell a patient the result of her CT scan, which shows cancer. After telling her the news, she gets understandably upset.
For actor/role play scenarios, students will have to show their communication skills, which often involve emotional situations with patients, family members, or friends.
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Be clear in delivering the news and try to use 1-2 sentences.
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Expect emotion and respond with empathetic statements.
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Resist the urge to make a plan or minimize the patient’s feelings.
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Ensure the patient receives the needed information and is supported.
Tip: For scenarios with friends, (e.g. not being able to attend a wedding unexpectedly due to illness in the family), these same techniques will work.
Tip: Structured approaches to communicating serious news and responding empathically have been developed by the VitalTalk Organization.
Tips for teamwork/collaborative scenarios
Example MMI: Explain how to tie shoelaces with only words and no hand gestures.
In teamwork scenarios, applicants are often assigned a specific role, either the instructor or the performer. It’s important to familiarize yourself with how to respond from both perspectives.
Tips for the Instructor Role
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Be patient and put yourself in the performer’s shoes.
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Use clear instructions and simple language.
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Ask the performer if your instructions are effective.
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Don’t rush and sacrifice clarity of communication. It is ok not to finish the project.
Tips for the Performer Role
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Ask questions to clarify what the instructor is telling you.
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Don’t get flustered if you need multiple instructions. It is expected.
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Again, don’t rush for the sake of finishing the project.
Tip: Sometimes a rater is in the room observing the interaction and may take 2 minutes to ask how the scenario went at the end. Be kind to your partner, don’t blame them for anything, and be thoughtful about what you could have done better.
Key takeaways
The MMI is an opportunity for you as the applicant to demonstrate to medical school admissions committees your critical thinking skills and your ability to clearly communicate yourself. It is also an opportunity for you to showcase your understanding of the patient-physician relationship.
In many ways, the MMI is easier to prepare for than traditional 1:1 interviews. You don’t need to memorize answers! Instead, you should focus on using a structured approach (i.e. the STAR method) to think carefully through each scenario.
With all interviews, make sure to maintain your professionalism at all times. This means keeping good eye contact, having appropriate attire, being timely, and treating interviewees and admissions staff with respect. First impressions do matter!
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