How to ace the multiple-mini-interview?

The modern trolley problem, in person Posted by Ahmad Azizov on January 17, 2021

How do I prep for the multiple-mini-interviews?

So you just got a multiple-mini-interview (MMI) style interview at Mac owing to your excellent CARS, Casper and GPA? Perhaps your MMI is at a different school and you have never heard of Casper (lucky you!). Regardless of this, I suggest you also give my Casper article a read as well, as the Casper test is really a mini-interview designed to lessen the cost of interviewing 5000 people and oftentimes tests many of the same things. 

Congratulations and take a deep breath. This is the most difficult part of the process for most premeds. Not only do you have a really high chance (~60% at Mcmaster) of making it in, but if you don't you will likely get an interview next year too, assuming things remain stable or get better. 

The good news is that just like Casper and CARS, the MMI is something you not only can but should prepare for. Once you are interviewed, your MMI score can determine 70% (at McMaster) or more of your post-interview score and determine whether or not you get accepted. 

What is the MMI?

Just like all great things Mcmaster, the MMI was also invented at Mcmaster university in the early 2000s. Since then many other medical schools in Ontario have managed to implement it into their admission process. Having said this, many others still use panel, traditional or a hybrid of MMI and traditional interview process. 

There are a number of stations (10 for McMaster) and a break station. The interviewees line up outside the doors of these stations and turn their backs to the doors. Once the timer goes off, you have 2 minutes (or more depending on the school) to read the question on the back of the door and go in to secure your spot in the next year's class. You spend 8 minutes in the room answering the primary question and then take any follow-ups. Then the bell goes off and you are off to the next station. I discuss the types of questions you will see in detail below

Tips and tricks 

Disclaimer: Most of these tips and tricks are for McMaster, although I suspect that these will work for other schools too. 

  1. You are a human first

There are 550 (more in 2021) people being interviewed for Mcmaster. Many are probably smarter and naturally better at interviews than you are. What you have to realize is that the only way of outdoing these people is to let your character/social skills carry you. Don't be too serious and act like the other 250 people who won't be accepted. This was my priority throughout all of the stations. Smile, shake hands, make low-risk jokes if appropriate. This is the only way you will be remembered. Think of the typical medical student who is as nervous as a cocaine dealer crossing the Russia-China border. Don't get me wrong. This is not the time to be disinhibited but at the same time, you can't act like you have no confidence and go to the interview by chance. 

When you get there on the day of the interview, talk to all the upper years and all the other people being interviewed. Not only will you be less nervous but also this will automatically put you in a social mood which will make you significantly better for the interview. 

  1. Framework

I don't know whether you had a framework for answering the Casper questions, but the MMI is very similar. Most of these questions can be answered in a minute but instead, you are expected to talk for 5-6 minutes (last 2 minutes for follow-up questions). The way you achieve that is by having a simple framework that is easy to explain and very well laid out. There is no one correct framework and you will make your own by practicing with others (tip #3 below).

I will use a sample ethics case to illustrate my framework for the ethics questions. Course grinder breaks this down under tip #4:

Case 1. A 14-year-old patient goes to the GP and asks for birth control pill.
Discuss the ethical issues involved.

Mine generally went like this:

a. Summarize the question

My understanding is that this case says wants me to talk about the ethics of providing a minor with a birth control pill.

b. Then I would give them a heads up of what I was gonna talk about:

Firstly i am going to tell you about all the pros and cons of managing thsi patient and then explain my reasoning in detail and then I will tell you about my take.

Right after this, I would try to have 2-4 points for each side(provide birth control vs don't) that I could utilize in my answers. In a way, this is similar to writing an essay. Body paragraphs each have a point, proof and analysis. The same way you state your points and then provide evidence in an essay is the same way you should arrange your answer. I found that including examples from your life often enhanced my answers as well (this is one time where ECs come in handy for Mcmaster).

My first option is giving the patient the pill without asking any questions. I think doing this would potentially protect this young teenager from a pregnancy. It might also increase her social and sexual awareness and contibute to ehr developement positively. At the same time, the negatives of this would be the risk of STIs (if the patient is not well educated on the matter), potential for sexual abuse (if we don't know who the partner is), inproper use leading to a pregnancy either way. Not providing this patient with the pill can lead to an unwanted pregnancy, collapse of her relationship with her parents and more .Worse yet I could preemptively contact this patient's parents which might lead to her drawing back from the healthcare and her parents, leading to a risk aversive lifestyle.

At the end of the "body paragraphs", summarize the case again and state what you picked. Again keep in mind that there is a huger room for customization of this framework. Don't make it so complicated that the listener gets confused or bored and don't make it so simple that the framework is basically worthless. 

In summary, this is a 14 year old patient who is requesting access to a birth control pill. Giving her the pill right away could lead to a,b,c, while not giving culd elad to d,e,f. I would invite her into a private room and ask her about her reasons while stressing that I am not asking about the private details of her partner (ask how old the partner is, not whatt heir name is). I would also ask for her understanding of STIs, other methods of contaception being used and failure rates of contraception. Once she has a good understanding of the use cases and weaknesses of the pill I would provide her with a prescription without telling her parents (as long as there is no abuse). 

Keep in mind that, similar to Casper, it helps to have unique frameworks for the different types of questions you encounter. Review tip #3 from my Casper article if this is unclear to you. 

  1. Practice makes perfect

Practice practice and practice. Find a group at your school and meet up with them a couple of times a week. Have questions on the doors and time the entire thing like the real MMI, often with 10 stations. Give each other feedback at the end. You can do this with a group of friends or strangers. Strangers can be better because you will feel all the awkwardness and the pressure like you might on the interview day. The more time you have this the more natural the formatting and the time limitations will become to you. Under tip #4 I have linked a few resources I found super useful. 

  1. Types of questions

With McMaster, there will most likely be 1 station with an actor, a couple of ethical/policy questions, a collaboration station, and a few that test your knowledge of the medical systems (sometimes personal questions too). You can have different frameworks for different types of questions but try not going crazy. After all, you need to make it work on the interview day and having 50 different frameworks will just drive you nervous for no good reason. A special category of questions you might see is the ones that have been asked for years now. Questions such as:

What is success for you?

State a time you dealt with conflict with a supervisor.  

What are your strengths and or weaknesses?

A time you treated someone wrongly and what you did to fix this. 

A time you demonstrated professionalism 

Talk about coping with stress.  

State a time when you showed leadership. 

A time you collaborated effectively 

Who is your role model and why?

Why do you want to do medicine?

How do you deal with failure? 

In my opinion, you should come up with 10-20 of these and think about them beforehand. This isn't because these questions are super tough, but because everyone likely has practiced very well for these and you don't want your answers to look poorly compared to these. I remember my "why medicine" question took close to 2 months to perfect for me and I would just keep making improvements to it as I received feedback from other people. 

Collaboration stations involve you and another fellow premed. In part A, you give a series of instructions to the other medical student and in part B, you are the one receiving the instructions and asking the appropriate follow up questions to clarify. Rumour has it, the accuracy of the final task isn't assessed. Instead, it is the way you communicate and how you react to mistakes that seems to be the most important factors.

This website has all the types of questions commonly encountered and the common mistakes made by premeds.

This video series by Course grinder is simply amazing and played a crucial role in my frameworks. 

  1. Use technology for you, not against

Record yourself on your webcam while also timing yourself. Watch yourself afterwards to spot weird things you might do subconsciously. I often lost eye contact and looked at the ceiling while thinking. This was something that I discovered during the feedback from group MMI practice as well as the recording from my web camera. 

Frame 1. Me losing eye contact while thinking (from one of the recordings)

  1. Be authentic

Realize that at the end of the day they are testing you for who you are. Don't try to bs. If you are unsure of things just ask them to clarify or repeat. Try to have fun as you go through the stations and forget about the last station as soon as it is over. If you find the process fun this will show in your face and voice. This is impossible to fake and most people tend to fail at this. 

  1. Don't just take my word for it

7. The evidence behind all of these tips came from 3 months of MMI practice. Before my MMI I and a friend emailed a lot of people who got into McMaster after the MMI and asked them for their tips. Here is a doc of what they found helpful. While there is a lot of overlap between the tips I have highlighted and the ones they discuss, there are also a number of differences. This will simply come down to your preferences and customizations of the frameworks. Remember that there is an infinite number of ways of answering the MMI questions, you have just got to avoid the bad ones. 

Best of luck!

All information provided on this website is for educational purposes and does not constitute any medical advice. Please speak to you doctor before changing your diet, activity or medications. 

Written by
Ahmad Azizov Member since April 2020
Interested in vascular surgery, surgery, endovascular procedure

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