The Multiple Mini Interview (MMI) Format For Medical School Admissions.
The Multiple Mini Interview (MMI)
may be the wave of the future in medical school interviewing. The
MMI is now utilized at over 50 medical schools around the world.
I have been helping prospective medical students prepare for the
MMI format for some time now. This article lists a set of 12 success
strategies that have helped them do very well on it, and a checklist
of 14 mistakes candidates make on the MMI. My clients have access
to a list of hundreds of examples of MMI questions, scenarios and
tasks, some of which are shared in this article.
Acing The Multiple Mini Interview (MMI) Format
For Medical School Admissions
Bill Cole, MS, MA
Founder and CEO
William B. Cole Consultants
Silicon Valley, California
The Multiple Mini Interview (MMI) may be the wave
of the future in medical school interviewing. The MMI is now utilized
at over 50 medical schools around the world. Once a school has adopted
the MMI, they have retained it, and none have ever switched back
to more traditional interview formats. So the MMI appears to be
here to stay. Do you know how to prepare for the MMI? Do you know
how to succeed with this format and get a high score?
I have been helping prospective medical students prepare for the
MMI format for some time now, and I have discovered a set of 12
success strategies that have helped them do very well on it. I also
have a checklist of 14 mistakes I have seen candidates make on the
MMI and I have a list of hundreds of examples of MMI questions,
scenarios and tasks. I'll share some of those with you later in
First, let's discover what the MMI is all about.
The MMI assesses the "soft skills" of maturity, collaboration, communication,
empathy, critical thinking, the ability to cope with ambiguity,
ethical decision-making, attention to detail, cultural sensitivity,
and current healthcare and societal issues. The MMI is not intended
to test specific knowledge in the medical field or to assess prior
academic, scientific or clinical knowledge. Applicants are not tested
on mathematical or scientific formulas, not asked to solve scientific
problems, not asked to complete true-false or multiple choice test
questions, or asked to create diagrams or flow charts. The MMI allows
the school to systematically assess the characteristics and attributes
which are deemed to be important components in becoming a competent
physician. The MMI tests how well an applicant can "think on their
feet" and the degree of "emotional intelligence" they possess.
The MMI Process
The MMI is a series of seven to nine interview
stations consisting of timed interview scenarios. Candidates rotate
through the stations, each with its own interviewer and scenario,
question or task. Each module or station is about eight minutes
or less. There is usually a two-minute break between stations, with
a total of nine applicants participating. The entire MMI process
takes about two hours.
The applicant waits outside the examination room and reads, posted
on the wall, a description of the next task, scenario or question
they will need to face. They have two minutes to read and formulate
their strategy. Then a bell rings, and all candidates enter their
individual room to meet the interviewer. Some rooms will have an
additional "actor" who will assist in a role-play of a scenario.
The prompt is posted on the outside wall before going in to talk
with the interviewer and it's also in the room, so at any point
during the eight-minute interview the applicant can reference the
question. Applicants are given a clipboard with paper and pencil,
so they can make notes during the two minutes they have outside.
The MMI has three types of situations for the applicant to handle:
a question, a scenario or a task. Instructions for tasks and scenarios
given to applicants are vague by design. They are created that way
as a sort of "medical Rorschach test", so applicants can go in multiple
directions with their response. Interviewers may probe applicant's
answers, disagree with them, interrupt them, or even debate them.
The interviewers will not discuss any aspects of the MMI process
or of how the applicant is doing on the interview itself. Each station
is graded on a scale from 1 to 10, with 1 being the best possible
score. Applicants are given an aggregate interview score at the
end of the MMI based on their performance in each individual station.
If there is time, applicants may find themselves engaged in small
talk with the interviewers.
The MMI interviewer may provide prompts designed to direct the applicant
in each station. Applicants are urged to listen carefully to these
cues so they can take advantage of any new information that may
be introduced. Interviewers are a combination of school faculty,
graduates, staff, and students who have been trained specifically
for the MMI process at that institution. Each interviewer remains
at the same station through the MMI while the applicants rotate.
The MMI is a blind format. The interviewers do not have any background
on the applicants.
The MMI: Psychometrically Sound
The MMI has demonstrated an ability to minimize
unconscious interviewer bias (positive or negative) and to be more
reliable than one-on-one interviews by using multiple "raters",
or interviewers. Applicants who do poorly on one station (or who
don't have favorable chemistry with one interviewer) have the immediate
opportunity to perform better on another station.
The MMI test reliability is markedly higher compared to other interview
formats. This gives the MMI higher predictive validity, which can
predict future applicant performance much better than standard interview
styles, including panel, group or behavioral interview formats.
Traditional, one-on-one interview formats can be negatively influenced
by inherent biases, expectations, and perspectives of an individual
interviewer. The MMI overcomes these limitations. Harasym, et al.
showed that interviewer variability accounted for up to 56% of the
total variance in interview ratings.
Examples Of MMI Questions, Scenarios And Tasks
Remember, the MMI is not all scenario-based role-play,
which many people tend to believe. The MMI can ask you a standard
question, ask you to complete a task, or have you role-play a scenario.
Here are some examples.
- Enter the room and speak to the "patient" about their drug addiction.
- Enter the room and respond to a picture, photograph or painting.
- Respond to the question, "Should doctors be allowed to go on
- Tell a patient that they have less than three months to live.
Here you must actually role-play this scenario with an actor.
- A relatively healthy patient sees you and has a slight limp.
They immediately ask for a handicap car placard. How do you proceed?
This scenario could be answered verbally, as in "I would take
the following approach...", or this could be a role-play with
- Enter the room and sit in a chair, back to back with the "actor".
Describe to them the picture you have in your hand and guide them
in drawing that picture, without using terms that actually describe
what the object is.
- Enter the room and use the lite-bright machine to create what
you believe to be the best representation of "health or medicine,
or a doctor", in your mind. The interviewer will ask questions
as you go.
- Write an essay on how you would go about reducing smoking and
chewing tobacco use among teens at the national level.
There are generally no "wrong answers", but applicants
are encouraged to be open-minded on matters such as abortion, euthanasia,
and other common, yet controversial medical ethics issues. The goal
is to look at all sides of an issue, pro and con, consider all stakeholders,
and then take a stand on one aspect of that, and then to support
Once you begin coaching with me, I also have hundreds of specialized
medical school questions I help you with around medical ethics,
medical scenarios, traditional medical school questions, communication,
current healthcare trends and societal issues and many other topic
12 MMI Success Strategies
The MMI can be quite tricky and it can be intimidating.
The only way to become confident and turn in a great performance
is to prepare well, and to prepare early. Here is a sampling of
strategies that can help you in an MMI situation.
- Read the posted task, scenario or question carefully. Make
sure you understand it fully. Begin to formulate possible responses.
Think broadly and creatively.
- Visualize how you'd like this station to play out. Picture
yourself successfully navigating the situation.
- Organize your thoughts and have a mental checklist or outline
of your process.
- Compose yourself before you enter the room. Take three very
deep, slow breaths. Knock on the door briskly and enter with a
smile. Walk right to the interviewer and shake the interviewer's
hand, and introduce yourself, using your full name, not just your
- Be centered and calm and take your time when you move about,
and when you leave the room.
- You do not need to utilize the entire time you have in the
room. You will have two minutes to read and "game out" your response
to the post while you are in the hallway. You can end your response
early, as long as you've done and said everything you need. The
sooner you enter the room the more time you have to respond. If
you take too long in the hallway crafting your response, the interviewer
may perceive you as indecisive, afraid, disorganized or sloppy.
- Have a formula for answering questions. Paraphrase the question
back to the interviewer. Tell them how you will approach the answer.
Give them an outline or roadmap so they can follow you. Discuss
all sides of the issue. Conclude by taking a stand on one choice,
and back up your decision with solid reasoning. Use stories and
examples from your life if appropriate.
- Make sure you practice under timed circumstances. You must
feel in advance the urgency to rapidly formulate your ideas and
deliver cogent, thoughtful, reasoned, organized responses to each
challenge. You may find that hiring a coach to help you craft
these answers, role-play and prepare using mock interviews can
be very helpful. This creates mental toughness and poise under
- You may decide to leave two minutes for the interviewer to
ask you questions. If the interviewer doesn't have any questions,
you can summarize your comments.
- Remember that the MMI tests emotional intelligence, so you
want to use some rapport-building techniques in the room.
- While it is important to be "comfortable in silence", this
is not the time or the place to be silent! Utilize small talk,
get to know the interviewer and be personable and warm.
- Thank the interviewer and shake their hand one final time as
When you begin coaching with me, I give you a
specialized 20-point medical scenario-answer checklist tool that
helps you triage, organize and deliver potent scenarios.
14 Mistakes Candidates Make On The MMI
There is not a medical school applicant who is
not nervous about undergoing an interview. Interviews put everyone
on edge. When it comes to the MMI, an applicant's nerves are intensified,
due to the ambiguous nature of the test, the requirement to actually
act out responses, and the rapid pace of the entire day.
The worst mistake applicants make is to believe that the quality
of their answers is without flaws. I receive calls and emails from
students weekly who want last-minute coaching right before their
interview. Some want this session the day before the interview!
This is a disaster in the making. I have yet to encounter a student
who has ideal answers, and ideal delivery of that content. Everyone
needs to tweak and improve their material to some degree. If that
is the case, how can this be accomplished mere days before such
an important interview? It can't. How can these new answers be rehearsed?
They can't. This adds huge stress to the applicant and can cause
mental confusion. The remedy? Start early with coaching so you can
practice, practice, practice. Correct practice and high-quality
practice is what makes you feel confident going into the MMI. There
is no substitute for practice.
Here are the most common mistakes applicants make when it comes
to preparing for and performing at the MMI.
- Applicants guess about the quality of their body language and
- Applicants practice only in their heads. The actual interview
requires verbal responses.
- Applicants don't know how to structure their answers so they
are logical, organized and understandable.
- Applicants don't time their practice sessions.
- Applicants don't understand how to use rapport techniques.
- Applicants don't know how to identify and handle "trick" questions.
- Applicants don't know how to tell a story properly.
- Applicants don't know how to gracefully "control the clock"
so they feel more in control.
- Applicants don't understand the method called "active listening",
so they can deal with behavioral, hostile, personal, or baiting
- Applicants don't know how to "sell themselves".
- Applicants don't know how to artfully recover if they lose
their place or go blank.
- Applicants don't know how to ask questions to create a conversation,
or how to find unusual questions that make them stand out from
- Applicants don't know how to use mental training techniques
to help them remain calm and focused throughout the entire MMI
- Applicants don't know how to prepare to get in the "zone" so
they can give a great interview.
History Of The MMI
The MMI began at McMaster University Medical
School near Toronto Canada in 2004, and since then, has been used
by many medical, dental and pharmacy programs, and in other schools
around the world. The MMI was developed from the Objective Structured
Clinical Examination (OSCE). The OSCE is used by many health and
medical programs to assess a student's application of clinical skills
and knowledge. Reference: https://en.wikipedia.org/wiki/Objective_structured_clinical_examination
The MMI is being used as a medical school program admissions test
by the majority of schools in Canada, and Australia since 2008.
The University of Cincinnati College of Medicine initiated an MMI
pilot program in 2008, and launched their official MMI testing program
that same year. This was the first use of the MMI at any medical
program in the United States.
The MMI is also utilized in schools for chiropody, dental hygiene,
medical laboratory technology, nuclear medicine technology, pharmacy,
physiotherapy and occupational therapy, veterinary medicine, ultrasound
technology, and X-ray technology.
Medical Schools Using The Multiple Mini Interview
In The United States:
- Albany Medical College
- Central Michigan University College of Medicine
- Cooper/Rowan School of Medicine
- Duke University School of Medicine
- Michigan State University College of Human Medicine
- New York Medical College
- Oregon Health and Science University
- Robert Wood Johnson Medical School, at Rutgers University
- Stanford Medical School
- David Geffen School of Medicine at UCLA
- New York University School of Medicine
- Universidad Central del Caribe School of Medicine, in Puerto
- University of Arizona College of Medicine
- University of California Davis School of Medicine
- University of California Riverside School of Medicine
- University of Cincinnati College of Medicine
- University of Massachusetts Medical School
- University of Mississippi School of Medicine
- University of Missouri-Kansas City School of Medicine
- Virginia Tech Carilion School of Medicine
- Western Michigan University School of Medicine
- McMaster University Medical School
- Queens University
- McGill University
- UBC Faculty of Medicine (British Columbia)
- Northern Ontario School of Medicine
- University of Alberta
- University of Calgary
- University of Montreal
- Dalhousie University
- University of Sherbrooke
- University of Laval
- University of Manitoba
Prepare Well, And Prepare Early For MMI Success
Navigating the MMI so you can arrive at a high
score is a major accomplishment. When you can do that, you are well
on your way to a satisfying career in medicine. You have just spent
many years as an undergraduate, and studied long hours. You have
spent a lot of time on medical school applications. When it comes
to preparing for the MMI, don't sell yourself short. Prepare fully,
and prepare well. Do that and you'll walk into the MMI and actually
look forward to showing the interviewers "what you have", and how
you can become a wonderful medical professional. Good luck!
Additional valuable information about interviews
can be found in the Interview Success Guide, an indispensable
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is a 216-page master blueprint that helps you understand and navigate
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Everything you need to do, from the moment you begin your job hunt
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it in pdf format, downloadable directly from this website. The
Interview Success Guide eBook is also available in Amazon
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To learn more about how interview coaching can help you improve
your abilities in media situations, oral test and exam situations,
and job interviews visit Bill Cole, MS, MA, the Mental Game Coach,
Bill Cole, MS, MA. All rights reserved.
Bill Cole, MS, MA, a leading authority
on peak performance, mental toughness and coaching, is founder and
CEO of William B. Cole Consultants, a consulting firm that helps
organizations and professionals achieve more success in business,
life and sports. He is also the Founder and President of the International
Mental Game Coaching Association (www.mentalgamecoaching.com),
an organization dedicated to advancing the research, development,
professionalism and growth of mental game coaching worldwide. He
is a multiple Hall-Of-Fame honoree as an athlete, coach and school
alumnus, an award-winning scholar-athlete, published book author
and articles author, and has coached at the highest levels of major-league
pro sports, big-time college athletics and corporate America. For
a free, extensive article archive, or for questions and comments
visit him at www.MentalGameCoach.com.
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