Medical School Interview

How effective are MMIs in assessing medical school applicants?

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MMIs are a type of interview format used by many medical schools as part of their admissions process. Timed stations where applicants rotate through a circuit of scenarios or questions are used to assess a range of different skills including knowledge, communication skills, ethical judgment, and professionalism — these are all important aspects of being a competent and compassionate healthcare professional. At each station, candidates encounter a different scenario and interact with an interviewer.

Astudy highlighted a comparison of MMI results of students who attended onsite and online MMI, along with the evaluation of overall GPA and the modules they studied in the first year of Medicine. As a preliminary study, this study indicated that an appropriate MMI score was achieved during the student selection and entry process, which was a predictor of useful academic performance. MMI provides a valid indication of a candidate’s non-cognitive characteristics than other traditional admissions tools. There is a strong relationship between practical interpersonal communication skills and healthcare outcomes.

Multiple Mini Interview Acting Stations can be dreaded because the candidate might not know what to expect. In this kind of station, you are given a role and there is an actor in the interview room and you must interact with them. The best way to answer these questions is by assessing how you communicate and engage with others.

Here are a few example scenarios:

Scenario 1:

It is essential to know your personal statement inside out because you may be asked about a specific point in your personal statement. For example, tell us about a time when you had to work under pressure. Whilst it’s important for you to have good knowledge of your statement and experiences, be careful not to overthink the question.

Mention a scenario (from your personal statement) and explain in more detail.

“During my work experience at a care home, I had the privilege of working with a group of elderly adults who had learning disabilities. I once had to produce a project to increase social interaction and activities among older adults. By prioritizing my responsibilities, working effectively with my colleagues, and putting in the extra effort, I was able to come up with an effective project ahead of time and avoid any unnecessary stress. Most of the time, communication with the team and utilising resources available to you are essential in reaching effective strategies.”

• Talk about how you thrive under pressure and how you deal with stress
• The STAR method is a useful framework to help design and analyse behavioral questions. It stands for Situation, Task, Action, and Result.
• Reflect on your past experiences dealing with stress and identify what your action patterns were.
• Some of the skills you can mention include being focused, adaptable, being able to plan, assess and have a positive mindset throughout.
• Remember to connect it to how the skills acquired will make you a great doctor!

Scenario 2:

Medical ethics are a set of principles and values that are based on treating patients as individuals. Ethical dilemmas arise when respecting one of these principles become difficult without compromising another. When answering an ethical question in an interview it is important to discuss the multiple issues and perspectives of a situation. Be open and respectful of different viewpoints and evaluate them thoroughly whilst answering the question.

For medical ethics interview question, gain the understanding of the 4 pillars of medical ethics which include:

• Patient autonomy: respecting patient’s right to make their own decision
• Non maleficence: Ensuring there is no harm to the patient
• Justice: This involves considering fairness and consequences to the rest of the community
• Beneficence: this involves thinking about the benefit to the patient.

“What would you do if a patient with an infection tells you they have not disclosed to their partner. Most ethical questions are open ended and there are no definitive answers. The main pillars that are tested here are patient autonomy and doctor-patient confidentiality. There is also the question either patient’s actions are causing harm to another person.”

Consider whether it is necessary to disclose information about patient’s illness to their partner. When deciding whether to disclose information about a patient’s illness to their partner, we must weigh the principles of beneficence and non-maleficence. Our primary concern is providing the patient with the best possible care and acting in their best interest. However, we must also balance this with the duty to protect the patient’s confidentiality and safeguard their health against the potential harm of breaching confidentiality. Please refer to GMC on when information can be disclosed.

Scenario 3

Communicating uncomfortable information:

You are staying at your friend’s house during a holiday. You are using your friend’s iPad. Whilst using the iPad you drop it and break the screen. You’ve been thinking about how to discuss the incident with your friend. Your friend has just come back from a long shift and looks very tired. He asks you about his iPad. Discuss the damage:

• Carefully explain the situation, even if the friend might become upset from the news. Try to find an appropriate time to discuss the situation. Honesty and transparency is important.
• Pay attention to eye contact, body language and be assertive and attentive
• Work together to produce a solution.
• If you need some time to think before you respond, then verbalise this and spend a short while thinking about how you will respond.
• Use ICE technique to address your friend’s concerns and address any issues they might be facing (ideas, concerns, and expectations)
• You can use SPIKES framework to present any information (especially distressing information) in an organized and sensitive manner to your friend. (Setting: Choose an appropriate setting for the conversation; Patient’s Perception: Understand your friend’s perspective; Invitation: Ask if your friend is ready to discuss the issue; Knowledge: Present the information clearly and sensitively; Emotions and Empathy: Acknowledge emotions and offer support; Strategy and Summary: Discuss next steps and summarize the conversation.)

In conclusion, MMIs have many advantages such as assessing knowledge but also soft skills such as how to use effective communication, decision-making under pressure, empathy, and ethical reasoning. There are various scenarios which give a holistic picture of the applicant’s capabilities. On the contrary, it can be a challenging experience due to the rapid succession of scenarios and limited time available per scenario.