The Multiple Mini Interview, or MMI, has become a common interview style within the last 5-10 years as an alternative or addition to the traditional medical school interview format. This type of interview is now used at a multitude of schools across the country in order to provide a wholesome review of an applicant. Importantly, some schools are currently using both a regular interview format along with an MMI, known as a ‘hybrid interview.’ Below are some tips to enhance your success during your medical school MMI.
The multiple mini-interview (MMI) is a style of interviewing that has become popular for evaluating medical school candidates in the United States and Canada. Candidates complete a series of short interview stations (typically around ten), in rapid succession. Each school structures the MMI slightly differently, but candidates generally receive a question or topic to address, have two minutes to gather their thoughts, and then have 5-8 minutes to deliver their answer. Some schools also include a more traditional interview as part of their overall evaluation of candidates. In some instances, the candidate will interact with an actor as part of one or more stations, while the evaluator observes. The MMI is different from traditional medical school interviews in that candidates are evaluated by more interviewers in a diverse set of topics, questions, and evaluators. This eliminates potential bias or personality incompatibility with a single interviewer, making the process more impartial. Also, the MMI is thought to be a better predictor of clinical performance than the traditional medical school interview format, though this has yet to be studied in a randomized manner.
The MMI is designed to evaluate a candidate’s non-cognitive skills, such as collegiality, teamwork, cultural sensitivity, and communication skills, which have been established as important traits for a physician to possess. Keep in mind that there are no right or wrong answers. Instead, candidates are being evaluated on their thought process as well as their ability to think efficiently and adapt correspondingly. Most importantly, interviewers are looking for candidates who can be objective, rational, and non-judgemental in a multitude of different circumstances. In this way, the best candidates will be those who are able to address both sides of any situation, rather than solely demonstrating knowledge or a stance for one side or another.
Although the MMI may be different from traditional medical school interviews, many basic interviewing skills still apply. Regardless of the type of interview, extensive research on the medical profession, the schools of which you are applying to, and the current challenges in medicine are imperative to succeeding in the interview. However, because the MMI is different from the traditional interview, a unique approach is also required. Applicants should focus on developing their ability to formulate a logical and thorough response within a rigid time frame. Analyzing medical ethics and healthcare policy issues will allow the applicant to weigh the risks and benefits of a particular concept in any medical school interview. Perhaps the biggest challenge of the MMI is the strict time frame, which interviewers may have recently become aware of due to completing the AAMC VITA. Therefore and understandably, practice under strict time limits is encouraged as well as recommended. With enough practice, candidates will realize that regardless of the scenario presented, there are basic skills that can assist in forming an articulate answer.
As with any interview, all specific questions are kept strictly confidential. However sample questions have been released by several schools that tend to serve as a model for the MMI. These questions are not necessarily exactly what you might experience, but serve as good practice as the general purpose or intent behind the scenarios is similar. There will almost always be some sort of conflict and it is important for candidates to correspondingly be able to objectively analyze the situation. As you will see, there are also some more traditional interview questions mixed in, allowing candidates the ability to address and articulate those parts of their application as well. Typically, the applicant will be allowed two minutes to read the prompt or question posted outside of the interview room, and then enter and respond in the remaining eight minutes. Often, the school or program moderator will supply a two-minute warning by knocking on the door or indicating the remaining time accordingly. If you finish your response early, there may be the potential for follow-up questions from the evaluator. Be comfortable and conversational, just as you would in a traditional interview.
We have also included some sample responses to each of the proposed sample stations. These are not meant to be comprehensive, but rather to serve as a way to understand how to approach different scenarios.
Sample response: “I would think that the first thing would be to make sure that my friend is genuinely doing okay and take the time to check to see if there was anything I could do in the immediate moment. Sometimes, all someone needs is a person to hear them out and express concern for them and their well-being. After that, I would communicate to her that I could not possibly understand what she is going through but that I am here for her no matter what she needs. In the event that she asked about advice concerning her circumstances, I would attempt to discuss the pros and cons for both sides, taking a leave of absence or remaining enrolled in school, objectively. If she took a leave of absence, she would be able to spend valuable time with her ill parent, assist as needed, and potentially attend medical appointments. On the other hand, if she remained enrolled in classes, it may serve as a mechanism to distract her from her reality. Similarly, given her challenges outside of the classroom, she may find it difficult to focus on her education. These are all topics that I would bring to her attention if she has not considered them already. Further, I would just ask her what her thoughts are. Sometimes, through just talking with another person, it can be therapeutic and she may arrive at the answer she was looking for herself. I would acknowledge and respect her decision making process on the basis that she was able to identify her options as well as pinpoint that family is an important component of her life and success. Either way, the most important thing for me would be to make sure she feels supported no matter what she ultimately does.”
Sample Response: “The most important thing here is to weigh the risks and benefits of having a drug produced in a certain timeline with the potential for adverse effects. Getting drugs approved quickly is important, or else patients may have to wait a significant period of time for treatment or alternately, may have to pay higher prices for drugs. Many drugs currently on the market bear high prices, such as hepatitis and HIV therapies, forcing patients to suffer as a result of inability to afford escalating prices. On the other hand, safety is also of utmost concern, and measures must be taken to ensure that any drug hitting the market will not cause any significant adverse effects. This comes in the way of clinical trials of which involve experimental studies of human patients. These trials serve as a mechanism to compare the risks and benefits of different treatments as well as answer the following questions: Is the treatment … Safe? Effective? Improve the health of the patient? Will it be able to stay on the market? These are certainly issues of which must be considered before a drug hits the market. On the other hand, if the drug or treatment was able to be marketed for widespread use quicker, then there may be the potential for helping a targeted patient population but the important thing to consider is if the potential benefits outweigh the potential risks. As healthcare practitioners, it is our duty to practice beneficence and nonmaleficence. In any case, proper regulation is needed to balance these risks and benefits and any breach of regulation should be investigated under due process.”
Sample response: The answer to this question will depend on an applicant individually. Be sure to tell a story, be genuine, and then connect back to how you perceive this hobby with help you with your medical education and future career.
Sample Response: “Of the utmost significance in this scenario is to ensure that the physician demonstrates respect for the traditional beliefs and remedies but also explains in a non-judgemental way the rationale and potential effectiveness behind your recommendations. I would never want to assume anything about a patient and would correspondingly ask them to describe their beliefs to me in more detail so I could better understand as well as acquire a more holistic view of the patient. I would then explain, in a non-judgemental and in a way in which the patient could truly understand, that there are some aspects surrounding the alternative medicine treatments that I am concerned about such as potential negative effects on Sharon’s health. I would indicate that the patient and family always has the autonomy to make their own medical decisions and that sometimes, alternate treatments have helped patients when coupled with traditional physician prescribed medications. Therefore, if she is adamant about using the alternate medications, I would inquire regarding her interest in using both medications concurrently in order to reduce any negative effects on Sharon’s health. While this still may not be the optimal treatment plan, at least we are beginning to build rapport and step in the right direction. This adapted plan is akin to modified vaccination schedules in which both the physician and parent are working towards the best interest of the patient. I would also inquire further regarding why the mother desires to deviate from the originally prescribed medication as well as take the time to explain the benefits associated with their continued use. I believe that over the course of a few visits, the mother may see the benefits of the prescribed medication as well as gain more trust in me as the provider in treating her daughter.”
Sample Response: “I would reach out to various community leaders to get their perspective on the events that have occurred in the past. This would allow me to visualize a clear and objective picture of the events as well as build trust within the community that may lead to better adherence to any proposed policies. I would emphasize to the community that I understand their desire to celebrate their team’s victories and successes as well as am happy to allow them to do so, so long as they abide by laws set in place to protect citizens of the community. Additionally, I would articulate that I share their excitement about the wins and successes of our city but I ultimately desire to celebrate in a safe way, so each of our citizens may thrive so that they can do so again next year. In close consultation with community leaders, I would propose having a scheduled celebration for the championship win that would allow people to celebrate in a safe and orderly way in order to prevent chaos and unnecessary injuries to those citizens of which I truly care about. Having a scheduled celebration would assumably reduce some of the uncertainty and unruliness that is coupled with excitement from the championship wins. All in all, I would be meticulous to explain that these guidelines are being enforced in order to protect citizens as opposed to control them and that the help of the citizens in this process would be greatly appreciated.”
Sample response: The answer to this question will depend on an applicant individually. Remember to tell a story in order to lead the interviewer through your thought process. This will clue him/her into really who you are as an applicant. Then, do not forget to reflect about this experience and then link it to how you anticipate it will allow you to succeed in the future.
Sample Response: I would initially reach out to the co-worker and simply ask how they are doing and whether or not they need anything. I would prefer to give someone the benefit of the doubt about their habits, for all I know, they could be going through a significant challenge in their lives and not have the proper support system for dealing with it in a healthy manner. I would offer my support to this person and gently explain to them that whatever they are going through, they can count on me for support in order to avoid resorting to alcohol, especially in the hospital where patients depend on our care and clear-minded approach. I would make it a point to continue to check in on them as to how they are doing to ensure they feel supported and less of a need to depend on alcohol. Should I continue to have the suspicion that their actions have not changed, even after reaching out to them, I may have to consider a discussion with management to avoid any harm to patients or other staff. I believe the lesson here is that it is generally inexcusable to arrive at work under the influence or have anything cloud your judgement when caring for patients. Obviously, the situation would not always be black and white, per se, as there is often a grey area, but I believe I would be capable of being adaptable to a wide array of different circumstances in order to address the situation effectively.”
Sample Response: “I would primarily reach out to this other group member in private about my concerns regarding their participation. I would be sure to do so in a non-judgmental, non-confrontational manner, inquiring regarding their well-being and the circumstances surrounding the completion of the work. I am aware they could be going through something in their personal or academic life that is impinging on the completion of their portion of the task. I would offer my assistance if needed, while also making sure they understand the concerns of the rest of the group regarding the completion of the task. I know that many students have different ways of working towards completing a task as well as have other obligations in addition to their commitment to their education. For instance, some students may work full-time in addition to attending school, have families or children to care for, or be struggling with personal challenges. For this reason, I would remain open-minded to their circumstances in order to ultimately ensure the success of all members of the group. Then, I would report back to the remaining group members in order to facilitate clear lines of communication as well as relay anything that the other group members can help with. Perhaps there was a misunderstanding or other lack of communication that can be remedied by communicating effectively. In the end, I think remaining open-minded, transparent, and articulate can help overcome challenges the group may encounter as well as lead to a final product each group member can be proud of.”
Sample response: The answer to this question will depend on an applicant individually. This question is tremendously important, so it is essential to be prepared for this question or a derivation of it on interview day. Be genuine and specific with your response. Being vague with your interest about their school will only come off to interviewers as uninterested. Pinpoint things about the school that really caught your interest and show passion when conveying them, interviewers look for these things!
Sample Response: “As far as my response to the patient, I would be certain to remain non-judgemental and simply ask them about their concerns and thoughts regarding the influenza vaccine. Perhaps the reason for their apprehension is that they simply have a misconception regarding an aspect of the flu shot that can be cleared up with clear lines of communication. Regardless of the reason, I would adapt my response based on an perceived understanding of their feelings and knowledge regarding the flu shot. This would allow me to gauge their understanding and correspondingly explain the medicine behind vaccinations while also taking care to be respectful and empathetic concerning the patient’s beliefs and autonomy.
As far as the public health issues at stake, this seems to be a conflict of individual choice against the betterment of the community as a whole. By receiving the influenza vaccination each year, you not only protect yourself but also enhance herd immunity as well, potentially protecting the community around you. In a perfect world, both the individual and community well-being would be preserved, but in cases of vaccination, there is often conflict between the two. Furthermore, in terms of public health, I think it is essential to educate the patient on influenza and if he/she is not receiving the vaccination, the importance of staying home from work/school IF he/she has flu-like symptoms or is diagnosed with influenza. This will potentially prevent further transmission of the virus. Ultimately, patients have the autonomy to make decisions whether the provider agrees with them or otherwise as well as are also entitled to an informed decision making process. Therefore, the patient’s decision should not ultimately affect their care and they should not be treated any differently as a result. It is important to remember that the end goal is a patient’s beneficence or well-being. ”
According to the 2020 Application Cycle
Hybrid = traditional interview with MMI stations
Additional Resources and Questions: