The Multiple Mini Interview (MMI) is becoming increasingly popular in medical school admissions. Here are tips to avoid MMI pitfalls this interview season!
Some of the country’s top medical schools use the MMI format to evaluate candidates. The interview forces students to think on their feet, synthesize problems, and both take and articulate their position in a short amount of time. Some students thrive in this setting, while others flail.
It was my great pleasure to work with UCLA premed undergrads this week at an evening practice multiple-mini interview (MMI) session. After a pizza dinner in our student lounge, each medical student was paired with an undergraduate to begin the MMI. We sat in comfy chairs across from each other, and on the coffee table between us was a half sheet of paper with a number on it, 1 through 8 for each of the 8 MMI scenarios. At the direction of the MMI moderator, each undergrad flipped the piece of paper and spent one minute reading the scenario. He or she then had eight minutes to discuss the scenario with the medical student interviewer before moving on to the next station.
In total, I interviewed five students over the course of an hour. These premeds had moments of brilliance and moments of disaster. Luckily, this was a safe venue to make mistakes, and we gave each student feedback between each station, allowing him/her to adjust for the next interviewer.
Real MMI is neither flexible nor forgiving, and your interviewers may not even give you feedback in their tone of voice or body language, much less direct input on your responses. The time limit is the time limit, and once you have finished one scenario you will immediately move to the next station (between 8 and 10 total) with little time to reflect or decompress. Interviewers score each applicant on a numerical scale based on communication skills, the strength of the argument displayed, and the applicant’s suitability for the medical profession.
Based on my interviews, I would have given a high score to one student, and low scores to the others. The following is the scenario that was at my station and some memorable moments from my interviews with students.
Scenario summary: You are a family physician working in a practice with three colleagues. As a practitioner of family medicine, you treat people from “womb-to-tomb.” You are not on call today, but late in the afternoon you receive a call saying that one of your patients that is living in a nursing home is failing. Her family has signed a do-not-resuscitate (DNR) order, but they are now reconsidering and ask that you come immediately to discuss their options. You have already made a commitment to your spouse to come home for a family event. Discuss your course of action.
Student 1: “I would attend to my patient and then go home to the family event when everything was under control.” Student 1 oversimplified the scenario. She did not recognize that the problem was about tradeoffs, prioritizing, and time management. She generated a generic best-case-scenario answer. As a result, I had a lot of space as the interviewer to aggressively press her on possible caveats – “What if the family has changed the DNR order several times already?”, “What if you have a responsibility to a patient in your office instead of your spouse?”, “What if your spouse has a work-related emergency at the same time and you have to figure out which of you will pick up your child?”, “Why is it important for doctors to balance their priorities?” These are complex questions that demand thoughtful, complex answers, which she struggled to provide or reason out.
Student 2: “As a premed I understand that going into medicine is a major commitment. For example, last Saturday I stayed in the lab to finish a project instead of going to the movies with my friends.” Student 2 tried to bring personal experience into his answer. However, by drawing a non-relevant parallel, he actually weakened his case. By touting his dedication to meeting a deadline, he may have demonstrated that he is responsible, but not that he understands why time management in medicine is particularly important. He could have been applying for a job in finance and hawking his love of working long hours on weekends. He also jumped straight to himself, and did not address the scenario or the gravity of his patient’s situation.
Student 3: “Well a DNR exists so that people don’t have to suffer when they die. When we euthanize mice in my lab, we make sure that they have a peaceful death.” I would suggest avoiding any mention of euthanasia, or any comparison to the death of a human to the death of a laboratory animal.
Student 4: Did not understand the prompt, and repeatedly stared at the prompt and then back at me without saying anything. When I probed this student, it was clear that he was too hung up on trying to unpack the scenario to take a position. It is really important to reveal your thought process to your interviewer. If you don’t understand something, it is okay to ask for clarification, or state your assumptions out loud before making your point. I suggest first synthesizing the problem for the interviewer out loud, and stating what you think the prompt is about – in this case, “work-life balance,” “crisis situations,” “time management,” “end-of-life decisions,” etc.
Student 5: “This scenario really speaks to me, because both of my parents are physicians, and I have seen and experienced first-hand the types of tradeoffs that they had to make when their professional duties took them away from time with the family.” The student went on to give specific examples and talk about what strategies for time management were effective, which were ineffective, and what he would do in this particular situation. This was a perfect use of personal experience – it was directly applicable to the scenario, and enhanced the way he addressed how he would handle his own dying patient.
Comparing notes with my peers, the most common MMI pitfall was drawing a non-relevant parallel about a personal experience (especially from research, volunteering, or leadership positions) to the scenario at hand. Students did not think about the fact that they were being evaluated on their handling of a specific question, and not on their ability to impress their interviewers with their experience coaching a girls’ soccer team. The admissions committee already knows about those experiences – in fact, they used them to select you for interviews. Now they want to know how you think and communicate.
So on interview day, stay focused on the scenario before you, take a deep breath before you enter the room, and spend eight minutes strongly and confidently making your case.