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The Changing Landscape of the Multiple Mini Interview

The Multiple Mini Interview (MMI) was first adopted by McMaster University in Ontario, Canada at the Michael G. DeGroote, School of Medicine back in the early 2000s. Initially, MMIs were used strictly during the admissions process for medical school.
For starters, depending on the specific program where you interview, your MMI circuit will likely consist of 6 to 12 stations and may include rest stations. There will be as many participants in your interview circuit as there are stations. The instructions for each station are typically posted directly outside of each room and you are given up to two minutes to carefully read the prompt prior to entering the room. At the end of the two minutes, a bell will sound and this is your cue to enter the room. Typically, a bell ringer type method is used to keep track of the time and you will be allocated six to eight minutes for each station before moving on to the next station.
Over the past decade, APE Advisor Prep® has worked with countless students seeking admission to a wide range of health professional programs inside and outside of medicine. Based on our experience, we’ve noted a drastic change in the landscape of the Multiple Mini Interview in terms of the programs implementing this interview format, the content of the MMI stations and MMI expectations.
We’ve found that MMIs have shifted in the following ways:
1. More programs are abandoning video based MMI stations. Video Stations typically require an interviewee to watch a short clip often less than 90 seconds. The video often highlights a type of relationship, its dynamics and generally revolves around a conflict/disagreement. Afterward, the interviewee is required to articulate pertinent details of the interaction to the interviewer succinctly and engage in standardized probing questions. These stations have fallen out of use significantly over the last 3 years.
2. More programs are adopting collaboration based MMI stations. Collaboration stations require working with another co-applicant or more recently, directly with the interviewer to complete a specified task. These scenario may involve a drawing, a math problem, a series of images or a phone conversation. The frequency of collaboration stations on MMI circuits has increased dramatically over the past several years.
3. More programs are adopting a shorter MMI circuit. At the majority of programs that have implemented the MMI over the past 3 years, we’ve seen a decrease in the total number MMI stations per interview circuit. This is most likely due to a combination of factors such as individual program resources and research literature which suggests that a 4-6 station MMI can be just as reliable as a longer MMI circuit.
4. More programs across all health professional disciplines are adopting the MMI. With approximately 33% of medical schools in the United States and 80% of medical schools in Canada favoring this interview model, it’s no surprise that other programs have followed suit. Over the past 3 years, we’ve seen the MMI make its way over to just about every possible health discipline you can think of.
5. More programs are assessing for professionalism directly within the MMI. Research has shown that the majority of medical complaints against providers are due to professionalism rather than medical expertise. As a result, over the past several years, many programs have begun to directly assess an applicant’s professionalism during the MMI in addition to their personal characteristics.
6. More programs are giving increased weight to an applicant’s MMI performance. There has been a noticeable shift in the weighting of the MMI at most programs across the globe. For example, the MMI now accounts for 70% of the post-interview decision at McMaster University, School of Medicine (significantly more than even the MCAT®)
The reasons for these changes are likely multifactorial but seemingly related to the fact that the type of applicant deemed desirable to admissions committees has changed in favor of individuals with more to offer outside of stellar GPAs and MCAT scores.  In addition, the interview process itself has become more data driven which typically favors applicants with more enriching life experiences, capable of sharing their personal characteristics.
Despite these changes to the landscape of the MM, applicants should not lose focus of their goal of being a competent, caring and compassionate health care provider.  If at the end of your MMI station, you leave the interviewer with the impression that he or she would approve of having you as a colleague, then you will be well on your way to becoming a doctor.

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