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Multiple mini-interviews, or MMI, are a novel way of assessing medical school applicants that have been adopted by many institutions around the world. Unlike traditional interviews, which consist of one or two long conversations with faculty members or students, MMI involves a series of short stations that test various skills and attributes relevant to the medical profession. The concept of MMI was first developed by McMaster University in Canada in the early 2000s, as a response to the limitations of traditional interviews, which were often subjective, biased, and unreliable. MMI was designed to reduce the influence of personal factors, such as appearance, charisma, or rapport, and to focus on the applicants’ abilities to handle realistic scenarios, ethical dilemmas, teamwork challenges, and communication tasks. MMI was also intended to measure a broader range of competencies, such as critical thinking, empathy, self-awareness, and maturity, that are important indicators of how an applicant would perform as a medical student and a future physician.

Since its inception, MMI has gained popularity and acceptance among medical schools across the globe, especially in the United States, the United Kingdom, Australia, and New Zealand. MMI is seen as a more valid, reliable, and fair method of evaluating applicants, as it reduces the chance of interviewer bias, halo effect, or impression management. MMI is also more reflective of the complex and dynamic nature of the medical profession, as it simulates the situations and challenges that doctors face daily. MMI is a crucial component of the medical admission process, as it provides a comprehensive and holistic assessment of the applicant’s potential and readiness for medical school. MMI is not only a test of knowledge, but also a test of character, personality, and values. MMI is an opportunity for applicants to showcase the skills and qualities that are essential for becoming competent and compassionate doctors. MMI is also a chance for applicants to learn more about the medical school and its culture, and to see if it is a good fit for them.

In this article, we will explore the MMI interviews in detail, their significance, structure, preparation tips, and how it is used in the medical admission process.

MMI Format

The format and structure of MMI vary slightly from one institution to another, but the general principle is the same: applicants rotate through a circuit of 6 to 10 stations, each lasting 8 to 10 minutes, with a 2-minute break between stations. At each station, applicants encounter a different question, scenario, or task, which they have to answer, discuss, or complete in front of an evaluator. The evaluator can be a faculty member, a student, a standardized patient, or an actor, depending on the nature of the station. Once you enter the station, you will have to respond to the interviewer, the actor, or the task in the allotted time. You will hear a bell or a buzzer when the time is up, and you will have to move to the next station. The stations can have different formats, such as behavioral questions, written prompts, personal questions, or acted-out scenarios. The stations are designed to test your capabilities in areas such as teamwork, communication, self-awareness, maturity, empathy, critical thinking, and ethical reasoning. Each station is different in its scope and significance.

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Common MMI Questions/Situations

Some common questions for MMI are:

Ethical scenario questions: These questions present a dilemma or a conflict that involves ethical principles or values. The applicant is expected to analyze the situation, identify the stakeholders and their interests, weigh the pros and cons of different options, and propose a reasonable and respectful course of action. For example, “You are a physician and you have a patient who is terminally ill and requests assisted suicide. What would you do?”

Character development questions: These questions ask the applicant to reflect on their own personality, experiences, strengths, weaknesses, goals, and motivations. The applicant is expected to demonstrate self-awareness, honesty, maturity, and growth. For example, “Tell me about a time when you failed at something and how you dealt with it.”

Teamwork questions: These questions assess the applicant’s ability to work effectively and collaboratively with others in different situations. The applicant is expected to show leadership, cooperation, conflict resolution, and respect for diversity. For example, “You are part of a group project and one of your group members is not contributing as much as the others. How would you handle this situation?”

Acting station questions: These questions require the applicant to interact with an actor who plays a certain role, such as a patient, a colleague, a friend, or a family member. The applicant is expected to demonstrate appropriate verbal and non-verbal communication skills, empathy, active listening, and problem-solving. For example, “You are a medical student and you have to break bad news to a patient who has been diagnosed with cancer. How would you approach this conversation?”

Quirky questions: These questions are designed to test the applicant’s creativity, originality, and humor. The applicant is expected to respond in a spontaneous and engaging way, without being too serious or too silly. For example, “If you could have dinner with any three people, living or dead, who would they be and why?”

Writing station questions: These questions require the applicant to write a short essay or a letter on a given topic or prompt. The applicant is expected to demonstrate clear and coherent writing skills, logical reasoning, and relevant content. For example, “Write a letter to your future self in 10 years.”

Giving instruction stations: In these stations, you will have to give clear and precise instructions to another person, who may be a candidate, an actor, or an interviewer. The instructions may be related to a task, a procedure, or a situation. For example, you may have to instruct someone on how to perform CPR, how to use an EpiPen, or how to evacuate a building in case of a fire.

Calculation and data interpretation stations: In these stations, you will have to perform some calculations or interpret some data related to a medical or scientific topic. You may be given a calculator, a pen, and paper to help you. The calculations or data may involve statistics, graphs, charts, or formulas. For example, you may have to calculate the dosage of a drug, the sensitivity and specificity of a test, or the correlation between two variables.

PBL stations: In these stations, you will have to participate in a problem-based learning (PBL) session with other candidates or actors. PBL is a common teaching method in medical schools, where students work in small groups to solve a clinical case or a scenario. You will have to demonstrate your ability to collaborate, contribute, and learn from others in the PBL session. For example, you may have to discuss the diagnosis, treatment, and ethical issues of a patient with a certain condition.

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MMI Scoring

Each station has its own evaluator, who will score your performance based on a standardized rubric. The evaluator may be a faculty member, a medical student, a healthcare professional, or a trained actor. The evaluator will not know your scores from other stations, and will not give you any feedback during or after the station. Your final score will be the sum or the average of your scores from all the stations. The MMI Scoring is based on a scale of 1 to 10, where 1 is the best possible score and 10 is the worst. Each station in the MMI has a different interviewer who grades the applicant according to a predefined rubric. The rubric may vary depending on the type of station, but generally, it includes criteria such as:

Clarity and coherence of the response
Ability to identify and analyze the key issues
Demonstration of relevant knowledge and skills
Use of evidence and logical reasoning
Consideration of different perspectives and ethical implications
Expression of empathy and respect
Engagement and rapport with the interviewer

The MMI Scoring is then calculated by adding up the scores from each station and dividing by the number of stations. The MMI Scoring is usually weighted along with other factors, such as academic performance, personal statement, and reference letters, to determine the final ranking of the applicants and the admission decision. The MMI Scoring is designed to reduce the bias and subjectivity that may occur in traditional or panel-type interviews, where the impression of one interviewer may influence the outcome. By having multiple interviewers and stations, the MMI Scoring aims to provide a more reliable and valid assessment of the applicant’s suitability for medical school.

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Universities that Use MMI

MMI is used by many medical schools in the United States, United Kingdom, and Canada to evaluate candidates holistically and beyond their academic performance.

Some of the top universities that use MMI in the United States are:

Stanford University School of Medicine
University of California, San Diego School of Medicine
Duke University School of Medicine
Chicago Medical School at Rosalind Franklin University of Medicine & Science Kaiser Permanente Bernard J. Tyson School of Medicine

Some of the top universities that use MMI in Canada are:

McMaster University, Michael G. DeGroote School of Medicine
University of British Columbia Faculty of Medicine
University of Toronto Faculty of Medicine
McGill University Faculty of Medicine
The University of Calgary Cumming School of Medicine

Universities in the UK that use MMI:

University of Aberdeen School of Medicine and Dentistry
Brighton and Sussex Medical School
University of Cambridge School of Clinical Medicine
University of Edinburgh Medical School
Imperial College London Faculty of Medicine
Keele University School of Medicine
Queen’s University Belfast School of Medicine, Dentistry and Biomedical Sciences

Preparation Tips for MMI

Review your application materials and reflect on your experiences, strengths, weaknesses, and motivations. Be ready to discuss them with specific examples and relate them to the qualities of a good professional in your field.
Research the school and the program you are applying to. Know their mission, vision, values, curriculum, and expectations. Think about why you want to study there and how you can contribute to their community.
Understand the MMI format and the types of questions you may encounter. There are different categories of MMI questions, such as ethical scenarios, character development, teamwork, role-play, and personal questions. You should familiarize yourself with the common themes and frameworks for answering each type of question.
Practice answering MMI questions with a timer and a partner. You can use sample questions from online sources or books, or create your own based on current issues and trends in your field. Try to simulate the MMI environment as much as possible, and get feedback from your partner on your performance.
Be confident, respectful, and professional during the MMI. Dress appropriately, arrive early, and follow the instructions carefully. Listen attentively to the questions or scenarios, and ask for clarification if needed. Respond with clear and logical arguments, and show compassion and empathy when appropriate. Don’t second-guess yourself or change your answer midway through. Thank the interviewer and the actor (if any) at the end of each station.

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Common Mistakes to Avoid

Some common mistakes to avoid in MMI interviews are:

Memorizing responses: Trying to memorize responses for every possible scenario or question is not only impractical but also counterproductive. Memorized responses may sound rehearsed, unnatural, or irrelevant to the specific context of the station. Instead of memorizing responses, candidates should focus on developing a general framework or strategy for approaching different types of scenarios or questions, such as identifying the main issue, providing relevant information, weighing the pros and cons, and proposing a solution or action plan.

Interrupting: Interrupting the interviewer or evaluator, or failing to actively listen to their questions or feedback, can hinder candidates’ performance in MMI interviews. Interrupting may signal a lack of respect, patience, or interest in the conversation. Active listening, on the other hand, shows that candidates are attentive, engaged, and respectful of the interviewer or evaluator’s perspective.

Overlooking ethics: Ethics is a crucial aspect of MMI interviews, as it reflects candidates’ ability to deal with moral dilemmas and conflicts that may arise in the medical field. Overlooking ethics, or failing to consider the ethical implications of a scenario or question, can negatively affect candidates’ performance in MMI interviews.

Ignoring time limits: Ignoring time limits, or spending too much or too little time on a station, can compromise candidates’ performance in MMI interviews. Candidates should be aware of the time limit for each station, usually around 6 to 8 minutes, and allocate their time accordingly. Candidates should also pay attention to the cues or signals from the interviewer or evaluator, such as a bell or a knock, that indicate the end of the station or the remaining time.

Becoming defensive: MMI interviews can be challenging and stressful, especially when candidates encounter difficult or controversial scenarios or questions. Becoming defensive, or reacting negatively to the interviewer or evaluator’s comments or feedback, can harm candidates’ performance in MMI interviews. Candidates should maintain a calm and professional demeanor, and avoid arguing, blaming, or criticizing the interviewer or evaluator.

Neglecting non-verbal communication: Non-verbal communication, such as eye contact, facial expressions, body language, and tone of voice, can have a significant impact on candidates’ performance in MMI interviews. Neglecting non-verbal communication, or displaying inappropriate or inconsistent non-verbal cues, can undermine candidates’ credibility and rapport with the interviewer or evaluator. Candidates should pay attention to their non-verbal communication, and ensure that it matches their verbal communication.

Getting overwhelmed: MMI interviews can be overwhelming, especially when candidates face multiple stations with different scenarios or questions. Getting overwhelmed, or letting stress or anxiety affect their performance, can hinder candidates’ performance in MMI interviews. Candidates should try to stay calm and focused and treat each station as a new opportunity to showcase their skills and abilities. Candidates should also use the breaks between stations to relax refresh themselves and prepare for the next station.

Overthinking: MMI interviews can be complex and ambiguous, especially when candidates encounter scenarios or questions that have no clear or definitive answer. Overthinking, or spending too much time or energy on analyzing or second-guessing their responses, can impair candidates’ performance in MMI interviews. Candidates should trust their instincts and judgment, and provide responses that are reasonable and realistic. Candidates should also avoid changing their responses or opinions unless they have a valid reason or new information to do so.

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Conclusion

In conclusion, MMI interviews are extremely intensive and challenging, requiring applicants to demonstrate a range of skills and qualities in various scenarios. Therefore, it is essential to properly prepare for MMI by practicing different types of questions, researching the medical schools and their values, and reflecting on one’s own experiences and motivations. However, MMI is not the only factor for medical admission, as academic performance, MCAT scores, extracurricular activities, and personal statements are also important components of the application. You should strive to present a balanced and holistic profile that showcases your suitability and passion for medicine. For more information about the same, reach out to our admission experts at Gyanberry. Book your free video call appointment!

A Deep Dive into MMI Interviews