What is an MMI?
Many Canadian medical schools have begun to handle the interview stage of the application process differently over the past number of years. The Multiple Mini Interview (MMI) is a multi-stage interview process that allows a number of interviewers to witness the applicants in a variety of interview situations in the hopes that it will increase their chances of selecting the most qualified candidates.
The MMI consists of a large number of short stations, each with a different examiner. Each station focuses on a different knowledge base or skill set that is important for success in medical school and the medical profession. Depending on the focus of the station, you may be asked to partake in a discussion, a role play, or answer an interview question. Typically these stations do not test clinical skills, but rather, your ability to respond to unique situations.
What Can I Expect?
The MMI process involves you spending a short, pre-determined length of time (typically 8 minutes) at a number of unique stations (likely 10-12). When you arrive at each station, there will be a description attached to the door that you must read before entering. This description explains the station and what you are expected to do there. Once you hear a bell ring from inside the room, you will enter and begin the station. Once the pre-determined amount of time has elapsed, a bell will ring again and you will move onto the next station and repeat the process.
Advantages of MMI
The strengths that the MMI as an interviewing technique include:
- It allows multiple samples of a candidate’s abilities across a spectrum of skill sets.
- It reduces the effect of examiner bias as there are multiple examiners.
- Stations can be structured so that all candidates respond to the same questions/situations.
- Stations can be created to reflect the qualities that the admissions committee would most like to see in a successful candidate.
- Candidates have the chance to recover from a station they performed poorly on as each new station reflects a new skill and is run by a new interviewer.
How Do I Prepare for an MMI?
It is difficult to prepare for an MMI as the stations you will encounter are so diverse and are meant to see how you react ‘on the fly’ so are often hard to predict. However, here are some suggestions for preparing for the MMI:
- Understand the goal – aim to respond in a way that demonstrates skills and attributes necessary to be a successful medical student and doctor.
- Work on time management – practice 7 to 8 minute presentations to get comfortable with the timing. During the MMI, once the bell rings to signal the end of your time at that station, your answer must end immediately so getting used to responding within the time limit is key.
- Listen carefully – pay attention for cues provided by the interviewer that will help you to address the necessary issues for that station.
Typically, some stations will involve a more formal interview process, so it is important to prepare by practicing answering interview questions that are common for a medical school interview. It is also common for at least one station to ask about current events so keeping up-to-date on local, national, and global news will be helpful.
As with any interview, the interviewer is looking to see how you react to the situation so it is very important to remember to remain calm, think carefully before responding, and try your best to be yourself. The admissions committee is trying to determine who will be the best fit for their program and for the profession so it is important that they get to know the real you.
Examples of MMI Stations
- A man has been responsible for taking care of his wife who has been in a vegetative state for 6 years after a car accident. She can breathe on her own but that is the extent of her abilities. He requests that her feeding tube be removed. What should you, as her physician, do? Why?
- You are a second year student shadowing a doctor in the O.R. Once the patient, an obese female, has been given general anesthetic and the procedure is underway the doctors start to make comments about her weight and call her names that you find inappropriate and, most of all, unprofessional. Do you talk to the doctor about his comments or do you keep your comments to yourself? Why?
- Two patients need a liver transplant, but there is only one liver available at the time. Tell the interviewer how you would decide between:
- a 64-year old retired politician who happens to be an alcoholic, or
- a 26-year old mother of three who is on welfare.
- Discuss the social, legal, medical implications of a needle-exchange program with the interviewer. (Consider a needle exchange program to be a free service in which screens for STIs are provided, along with immunizations, physician referrals, and exchanging used needles for new ones). Follow up question: What are some viable alternatives?
- In your opinion, what is a primary flaw in the health care system? How would you address it?
- There are two people in the next room that are in a conflict. Mediate the discussion and find a way to resolve the situation.
- Recently, a drug company has been aggressively marketing their HPV vaccine for young girls to protect young women from cervical cancer. The vaccine has gained support because it will be protecting girls from this potentially deadly and costly disease. However, some people think there haven’t been enough clinical trials. Pick a stance on this issue and prepare to support your argument.
- Dr Smith recommends homeopathic medicines to his patients. There is no scientific evidence or widely accepted theory to suggest that homeopathic medicines work, and Dr Smith doesn't believe them to. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches and muscle aches, because he believes that it will do no harm, but will give them reassurance. Consider the ethical problems that Dr Smith’s behaviour might pose. Discuss these issues with the interviewer.
- The parking garage at your place of work has assigned parking spots. On leaving your spot, you are observed by the garage attendant as you back into a neighbouring car, knocking out its left front headlight and denting the left front fender. The garage attendant gives you the name and office number of the owner of the neighbouring car, telling you that she is calling ahead to the car owner, Tim. The garage attendant tells you that Tim is expecting your visit. Enter Tim's office. Tim will be played by an actor.
- The government wants to track citizens across the country in order to maintain public safety in the face of growing terrorism. How would you advise the government to do this?
- The Canadian Pediatric Association has recommended that circumcisions 'not be routinely performed'. They base this recommendation on their determination that 'the benefits have not been shown to clearly
- outweigh the risks and costs'. Doctors have no obligation to refer for, or provide, a circumcision, but many do, even when they are clearly not medically necessary. Ontario Health Insurance Plan (OHIP) no
- longer pays for unnecessary circumcisions. Discuss the ethical problems that exist in this case.
- Discuss health care issues that have been in the news in the last month.
- Due to the shortage of physicians in rural communities such as those in Northern Ontario, it has been suggested that medical programs preferentially admit students who are willing to commit to a 2 or 3 year tenure in an under-served area upon graduation. Consider the broad implication of this policy for health and health care costs. For example, do you think the approach will be effective? At what expense?
- You are on duty in the ER when an unconscious three –year-old girl is brought in. It’s clear that she needs an immediate blood transfusion to survive, but her Jehovah’s Witness parents are adamantly against it. What would you do and why?
- Some people think that the new or younger generation of physicians are not as hard-working (i.e., wanting to leave right at 5:00 p.m., not wanting to put in as long of a work week) as previous generations. How do you feel about this perception?