Guide to the MMI

There are several types of medical school interviews, and the MMI is just one of them. Maybe you’ve heard the MMI referenced in premed circles, or the first time you’ve heard about it is in an interview invitation. Either way, you might have questions about what it is, and how to prepare for it. Hopefully, we can answer those questions for you and leave you feeling confident and prepared to take on your MMI.

What is the MMI?

The Multiple Mini Interview, or MMI, was created in Canada and is becoming increasingly popular at US schools. The MMI involves a more objective evaluation of the student and aims to remove interviewer bias. The variety of skills used in an MMI will also hopefully allow students with more diverse backgrounds to display the skills they’ve gained through those backgrounds.

The MMI involves several stations that evaluate personal qualities like empathy, communication skills, critical thinking, knowledge of current affairs, and any other non-cognitive skills the school wants to assess. There’s no set number of stations, but five to ten seems more common.

What Happens in an MMI?

Before you begin the scenario, you’ll be given a set amount of time to read the scenario and consider your response. You’ll then get an indication, often a sound, to enter the room, where the interviewer or an actor greets you. An actor might be playing a patient, a friend, a classmate, or a customer. You’ll know the context of the scenario and how you should respond to the interviewer or actor based on the written description outside of the room.

The interviewer will typically have set standards they use to evaluate you. The criteria and rubric will vary between scenarios and vary between schools. Focus on familiarizing yourself with common scenarios so you can relatively easily decide your response.

You should also practice different scenarios enough that you feel confident in your responses and can defend them if challenged. There’s no single “right” response. It may be helpful to have a friend ask you hypothetical or ethical questions and then challenge you or play devil’s advocate. This can help you get over anxiety from being challenged in your opinions or answers. You should aim to come to interview day as your best self and be yourself in your answers. The point of the MMI is to understand how you communicate, how you think, and how you treat other people.

Below we’ll give you some example scenarios so you can begin practicing your responses or thinking about how you would respond in each situation.

Example MMI Scenarios

For some of these scenarios, our advisors will give you pointers on how you might want to approach similar prompts.

Roe v. Wade

The US Supreme Court recently overturned the Roe v. Wade ruling, ending the constitutional right to abortion. Discuss with the interviewer your thoughts on this decision and how your views might affect your future as a physician.

The question you should first answer is: Where do I stand with this decision? Answer truthfully. You don’t want to answer in a way you think the school wants you to answer. You have to be honest with yourself and the medical school and present your true self. Don’t try to hide your values because you’re worried about what they will think or that it will impact their decision on whether or not to accept you. If the school’s values don’t align with your own, you will not be happy there. So answer truthfully. State your opinion while being respectful of those with a different opinion. Then explain your reasons.

Also, applicants should have at least an idea of the laws around abortion in the state where the medical school is located. If the school is in a state where abortions are restricted or banned, they should research this and be aware of how this is impacting care in that state. Showing your knowledge of the school and state like this will demonstrate that you’ve done your due diligence and understand what your life will be like at that school. 

Balancing Friendship and Fidelity

You have recently found out that a friend of yours, Jordan, cheated on his partner of five years, Morgan. You have been good friends with both of them for several years. Do you tell Morgan what you know? Why or why not? If you do, how do you go about it?

Oof, this is a tough one! If they choose to tell Morgan the truth, are they doing so in a compassionate and empathetic way to support Morgan? Are they neutral and saying something like, “I have to tell you something that is very difficult for me to say; I don’t know all the details, but I witnessed this, and I want you to know because I care about you both and I hope you both can have a conversation about what happened. You’re both my friends, and I want to support you and do what is right for both of you. I will still be your friend no matter what you choose to do.”

If they choose not to tell Morgan, what are the reasons for not doing so? Are they defending Jordan’s actions and blaming Morgan? Or do the reasons make sense? Are they being really harsh toward one person?

Ultimately, what they say and how they say it is the most important thing. Are they supportive and empathetic? Are they remaining neutral or favoring/blaming one person over the other? Do they give sound and reasonable explanations for why they would behave the way they do? I would like to see the interviewee acknowledge that they may not know all the reasons for what happened and can’t just make a snap judgment but that they would do what they truly feel is the right thing to do.

Natural Remedies

A long-term patient of yours has recently been diagnosed with cancer. In your next appointment with them, they inform you that they plan to treat their illness solely through natural and homeopathic remedies, which you know will lead to their cancer progressing, worsening their prognosis. How do you discuss your concerns about this decision with them?

First, I want to see how they would react to the patient. Are they very judgemental and negative against natural remedies? Do they tell the patient in a very opinionated way that it is a “crazy” or “stupid” idea?

Ideally, they should first take the time to acknowledge the patient’s autonomy and tell them, “I hear what you’re saying, and I respect what you’re saying. As your doctor, your health is my utmost priority, so I’d like to know a little more about what natural remedies you are considering and why.”

Ask the patient probing questions about their experience with traditional cancer treatment and what they know about it. Ask the patient questions about their fears or concerns around traditional cancer treatment. Take the time to really understand their reasons for wanting to do this.

If the patient still insists on using natural remedies, explain that they respect the patient’s wishes and they want to make sure that the patient understands that natural remedies may only work so far or maybe not at all. Then, work with the patient to ensure that the patient doesn’t feel judged or that they are somehow doing something wrong, and ultimately support the patient. Research the natural remedies the patient is considering, tell them the pros and cons of each, and ultimately make sure that the patient is well-informed about their choices.

Negative Nelson

Lately, your colleague, Dr. Jones, has been complaining about patients and making inappropriate jokes at their expense. You have even heard him suggest giving patients who continue to have concerns after normal test results placebos in order to “get some peace and quiet.” Dr. Jones is in the room. Discuss your concerns about the potential for prescribing ineffective medication and about his overall attitude toward his patients.

First, how do you approach Dr. Jones? Are you attacking and threatening to report him, or do you approach him in a more non-judgmental way and just check in with him? Maybe say, “Is everything ok? I’ve noticed that you have not been your usual self and have overheard some of your jokes about patients. Is there anything going on that I can maybe help you with?”

Dr. Jones tells you something is going on that is really affecting him –> talk about how you can support him. Talk about your concerns about giving patients placebos and the potential for patients to get hurt if their medical concerns are ignored, and the possibility of Dr. Jones getting in serious trouble for something like that. Offer to take some of his patients if he is burned out and needs time off.

Dr. Jones tells you to mind your business –> Do you drop the subject, or do you still try to offer help, remind him of your responsibility as doctors to do no harm, etc., and again offer to help in some way if possible?

The key is to approach Dr. Jones with empathy and attempt understanding, regardless of his response. 

When asked a difficult question in an interview, don’t answer the way you think the school wants you to. Tell your truth and be respectful. Click To Tweet

More Example MMI Scenarios

You found out that one of your friends and fellow medical students, Anni, cheated off of you in last week’s test. How do you respond to Anni, considering both your personal relationship and your role as medical students?

Along with three other students, you are working to complete a group project as your final in one of your college classes.  One of your group members has been returning subpar work when they do complete tasks. They are also slow to respond to messages and have missed several group meetings. How do you handle this situation?

Several states allow for physician-assisted suicide, sometimes also known as humane euthanasia. Do you believe this should be legal in all states? What concerns do you have, if any? Discuss this issue with the interviewer.

Most Common MMI Mistakes

One of the most common mistakes students make is not listening. This is primarily the case in actor-based scenarios. You want to leave space in your responses for the actor to respond to you, or give additional information. If the actor is opening up and providing information beyond what’s in the prompt, you’re going down the right path. If they’re resistant to interaction, you might want to shift how you approach them.

The other biggest mistake students make is not treating it like real life. Whether it’s an actor-based scenario or one where you’re describing what you would do, it can be easier to think of a response if you approach the question as if you were responding to a friend or colleague in real life. Worry less about the perfect response and more about explaining how you would respond if this were happening in your real life. It may also even be helpful to imagine a specific friend and move through the scenario as if you are talking to them, still keeping in mind that you are in a professional environment.