The Multiple Mini-Interview for Medical School Admissions

Carleen Eaton, MD

What to Expect and How to Prepare

by Carleen Eaton, M.D.
Prehealthadvising.com

Introduction

Originally developed by researchers at McMaster University1 and widely used by Canadian medical schools, the Multiple Mini-Interview (MMI) has recently been adopted by several U.S. medical schools as part of the admissions process. An MMI typically consists of six to ten timed stations through which applicants rotate. At each station, the applicant is presented with a question, scenario or task. Since MMIs are significantly different than the traditional interview, becoming familiar with the structure, logic and expectations of an MMI will help make interview day less uncertain.

Background

Understanding the reasons for the use of an MMI requires a look at the overall goal of the medical school admissions process. Medical schools seek to admit individuals who will make not only excellent students, but ultimately become outstanding physicians. As any patient knows, the best physicians are those who are not simply repositories of information; they are ethical, caring professionals and excellent communicators. The MMI was created as a potentially more effective means of assessing qualities that lie outside the realm of grades and test scores.1

The traditional interview process allows an applicant to interact with one or more interviewers and provides an opportunity for the school to assess the interpersonal skills of an applicant. However, each applicant will not necessarily be interviewed by the same interviewer or interviewers. Some interviewers may be less challenging in general or a better fit for particular applicants, thus providing those applicants with an advantage.1-3 In addition, standard interview questions may not reveal an individual’s communication skills, problem-solving abilities, level of professionalism or other skills important for the practice of medicine. The MMI approach uses a series of stations to assess specific skills and qualities and assigns the same interviewer to rate all applicants at a station in order to address some of the weaknesses of the standard interview format.1

Structure

Although the exact set-up varies from school to school, an MMI usually includes six to ten stations from eight to ten minutes in duration with a group of applicants rotating through the stations. The instructions for the station may be posted outside the room and the applicant is given two minutes to read and analyze the instructions prior to entering the room. Typically, six to eight minutes are allocated to completing the station before moving on to the next one. Types of stations may include:

  • Ethical dilemmas or questions about policy or social issues. The instructions describe a situation and then ask the candidate to discuss the ethical or other issues involved. The interviewer may follow up with questions designed to probe the applicant’s response.
  • Interactions with an actor. At these stations, the applicant is provided with a scenario involving an individual who is played by an actor. The applicant may need to give the individual bad news, confront the person about a problem or gather information. An observer present in the room will rate the applicant based on his or her interaction with the actor.
  • Standard interview questions. An MMI may include one or more stations with traditional interview questions such as “Why did you apply to this school?” or “Describe an obstacle that you have overcome.”
  • A task requiring teamwork. Since the ability to work as part of a team is essential to medicine, some stations involve two applicants working together to complete a task.
  • Essay writing. Some schools include an essay component as part of the interview process so a station may involve responding to a prompt in writing. This station may be longer than the others to allow for the applicant to formulate and write the response.
  • A rest station. An interview takes a lot of energy, since the applicant is “on” the whole time and being presented with challenging tasks at every station. Fortunately, many MMIs include a rest station. Avoid spending the break time rehashing previous questions and what you should have said or done. Clear your mind and get ready for the next station.

Preparation

MMIs are distinctly different from the traditional med school interview and therefore require a unique approach to preparation. Schools may provide you with a list of sample questions which you can use to help guide your preparation; however, preparing for these interviews does not require knowledge of the exact questions being asked. Instead, an applicant should focus on developing his or her ability to formulate a logical, thorough response within a strict time frame.  Although the scenarios may not involve medical issues, familiarity with bioethics issues can be helpful in understanding the approach to ethics issues in general. Also, start reading about current events and policy issues. This will hone your ability to analyze the various sides of a problem and to see the costs and benefits of a particular approach. To prepare for stations involving an actor, consider the steps you would take when interacting with an individual in a difficult situation. What questions would you ask?  What is required for effective communication?

One of the major challenges of this set-up is the strict time limit for each station; therefore, practice under timed circumstances is important. Once you have completed the initial phase of preparation, try addressing scenarios that you have not seen before within the ten minute total time allowed by a typical MMI.

Conclusion

Although MMIs can be challenging, they also offer applicants the chance to demonstrate skills and qualities that are not always evident on a written application. The existence of numerous stations, each with a different interviewer, also frees applicants from the worry of the med school interview consisting of interactions with only one or two individuals with whom they may not happen to “click.”  The use of MMIs has continued to expand and may replace traditional interviews at more medical schools in the coming years. Therefore, students preparing to apply to medical school would benefit from a thorough understanding of this interview method.

References

1. Eva, K.W.; Reiter, H.I.; Rosenfeld, J.; Norman G.R. An admissions OSCE: the multiple mini-interview. Medical Education. 2004, 38, 314-326.

2. Edwards, J.C.; Johnson, E.K.; Molidor J.B. The interview in the admission process. Academic Medicine. 1990, 65, 167–75.

3. Kreiter, C.D.; Yin, P.; Solow, C.; Brennan, R.L.   Investigating the reliability of the medical school admissions interview. Adv Health Sci Educ Theory Pract. 2004, 9(2),147-59.

Dr. Carleen Eaton is a graduate of the UCLA School of Medicine. She has been advising applicants to medical, dental and veterinary school as an admissions consultant for over seven years and is the founder of Prehealthadvising.com.  Her admissions blog is available at prehealthadvising.com/blog.

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17 Responses to “The Multiple Mini-Interview for Medical School Admissions”

  1. Sam says:

    This structure, is way better procedured. I recommend!

  2. Twinbird says:

    I wen’t to the McMaster medical school satellite campus in Waterloo and they described this method to me, apparently the ethics part can involve a question about Youthanasia, or, a specific example they give me was “If you caught your friend cheating on an important test, but the teacher (or professor) didn’t notice, what would you do?” And an acceptable answer may be “I would not tell the teacher as this could jeopardize my friend’s future in the school, but I would tell him I saw him cheating and help him to better understand the material he should be learning, and encourage him not to cheat.” Anyways, sorry for the long reply, this interview method definitely seems more challenging that the classic interview.

  3. Virchow's Spawn says:

    More hoops to jump through. Unfortunately there’s no way to judge someone’s personality or aptitude in these “speed dating” interviews. Look for review books and Kaplan hotel-based seminars on how to “communicate effectively” and “master the multiple mini-interview” soon. Scientific aptitude is devalued every year in this process. Pretty faces and customer service personalities are in. Thank god I’m going into pathology, although that field may not be immune to the touchy-feelies for long.

  4. Cane2011 says:

    I don’t think I agree with this new process. It’s way too stressful and may not necessarily allow the person being interviewed to think about what they have to say. I feel that by making the prospective student feel more relaxed, it will allow the student to think through their answers and better communicate why they are good candidates for the medical school.

    I am so upset that schools actually want this. What about the fact that students have been working so hard to keep up their grades and partake in meaningful extracurricular activities just to get in!?

  5. Twinbird says:

    I would have to agree that this new style does seem to put more unnecessary stress on the applicant. Interaction with an actor: “The applicant may need to give the individual bad news, confront the person about a problem or gather information” aren’t you supposed to learn that stuff during med school? Anyways, I’m sure any med school applicant would be capable of giving an actor bad news or asking them a few questions, it doesn’t really seem very skill-testing. Writing an essay, a rest station? It doesn’t even sound like an interview, why can’t an interview be just that, an interview?

  6. Mithril says:

    As a Canadian who has applied to Canadian med schools this application cycle, I was horrified to learn that nearly every single Canadian med school uses the MMI format. It takes a great deal of time to prepare for this type of interview and it’s a huge burden on the applicant to be in a suit for 3 hours during the most intense 3 hours of your life and be bombarded by interviewers asking you ethical dilemma questions or questions about little-known health care policies that you may not have an answer to.

  7. achilles tendon says:

    I would say that this is just a sort of subjective evaluation. Nobody can tell the personality of an individual by such questions, but his own family living with him under the same roof. This is a method of exclusion of valuable candidates who do not have any family member within the medicine sector. Otherwise, these interviews might be just tests already prepared from psichiatrists, psychanalists.
    I would give just an example for Colonel Lesli Williams in Canada to challenge all this bullshit. He had passed many such interviews but at the end it was found that he was a killer etc etc

  8. Derek B says:

    I’m a first year allopathic medical student in the US. I interviewed at one school with an MMI format and others with the traditional kind. I greatly preferred the MMI.

    Traditional interviews have you rehashing components of your application such as volunteering and research and answering canned questions about why you want to go into medicine. The MMI, by contrast, allows the interview committee to bring in interesting questions and scenarios, promote a lot of dialogue between the applicant and the interviewer and even allows interveiwees to interact.

    Honestly, I was much more relaxed during the MMI than I was during more traditional interviews. They are fun, and because the interviewers don’t have access to your file they can only go off what they get in that 10 minutes – no preconceived notions of who you are, no lasting biases in their evaluation formed by a bad first impression (because they have a strict rubric by which to score you). What they are looking for is not the “right answer” but an ability to come up with something coherent based on what you’re presented, to explain it to others in a clear fashion, and to take the opinions/viewpoints/data given to you by others into account. Sound like skills physicians may need?

    Like it or not, medicine is a profession in which you will deal with actual, non-medical people every day. Your grades, research and test scores prove you can do the bookwork, and (in my opinion) the MMI provides a better way of assessing how you think, communicate and interact with others.

  9. Sean P says:

    I am currently a senior undergrad and have interviewed at multiple schools so far, one of which used the MMI. I greatly preferred the traditional interview.

    The primary issue I have with the MMI is that its purpose, as stated in this article and at my interview, is to test communication skills. While communications skills are essential in any applicant, the traditional interview’s primary purpose in most of my interviews is to get to know the applicant personally and their motivations. Basically, “does this person have the right motivation, reasons, and mindset that he/she will become a successful doctor?” When an applicant talks about/rehashes their clinical experience, is there passion behind what is being said?

    The loss of this personal evaluation for a more thorough evaluation of communication skills that can be prepared and practiced for isn’t worth it, imo.

  10. Steve H says:

    I interviewed at a school that used MMI. I don’t know about the format overall but I know I didn’t like the acting stations. I mean, it seems to bring another, unimportant, factor into the equation: our acting skills.

    While I know the judges don’t have the pre-conceived idea that they will be looking for the most passionate and convincing actor but I think they could likely give higher scores to those who are better actors.

    It’s a strange situation to begin with: you’re given the scenario and told to deal with someone facing difficulties. You go into the room and there’s someone inside acting out this part – for example,your friend who just found out they have only a few months left to live. How should I react to this situation? Like I see on tv medical dramas? Or should I try to imagine this person as one of my friends and imagine them in this situation – which honestly would probably just to sit with them and listen for at least 10 minutes before trying to give any advice. The point I’m trying to make is that I think this is a bad predictor of how one would really react in such a situation; it’s a fake situation that results in variable reactions….

  11. mmi says:

    A technical issue: some schools will provide 1-2 minutes to read the question on the door, then the bell rings, you enter and the question is asked. You don’t have to memorize the question since it is usually also on a paper inside the room.

    SDN’s interview feedback is helpful. Some of the videos on Youtube are pretty good.

  12. Gagan says:

    There have been studies demonstrating that the MMI format can better evaluate a candidate than traditional interviews. Traditional interviews are heavily subjected to bias–you make one mistake early on, and the interviewer’s impression is forever altered. MMI stations test specific skills, and having multiple/different interviewers reduces bias. Moreover, the MMI is modeled after clinical exams used my many medical schools.

    While I think I would do better in a traditional interview, I can see the merit of MMI.

  13. Emil Chuck says:

    I’m developing a freely open-source set of MMI questions that I’m creating on my own, without any influence from other people who use MMI. We do not use MMI at our institution at all, so none of these questions breaches any confidentiality agreements. It is meant to help you think about different scenarios, and I welcome anyone who would like to try to reply to each.

    I also welcome anyone who would like to suggest scenarios for presentation through private message. No one gets paid for any of this.