What do you think of MMIs? What characteristics make someone successful in MMIs?

[veryborderlineapplicant]

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I've been to several MMIs and several traditional interviews, and I find the premise that MMIs are more fair to be very questionable. With traditional interviews you have time to actually get to know the interviewer, really elaborate on your perspective and answers significantly. Of course with traditional interviews first impressions do matter greatly, and that is the same in MMIs, so I don't really see how MMIs eliminate the "halo and horns effect", which is a fancy term for the fact that you are evaluated off of your first impression more than anything else. MMIs do the equivalent of adding more data points to an experiment when the results seem questionable, but how exactly does that make things more informative, give those interviewed more chances, and combat institutional biases? Instead of one "halo and horns effect" or one station where first impressions matter, you have somewhere from 8-12 where this is still the case. I've seen one study claim that MMIs eliminate institutional biases, but I'm baffled as to why this is the case.

Also what else bugs me about the questions at MMIs is that they're often very limited in scope, meaning they mostly cover ethical questions, acting scenarios, and maybe one or two personal questions and you only have a few minutes to talk and express yourself. You have a very short time to discuss your perspective on a question, and briefly go into the opposing perspective and barely have a conversation (more talking at the interviewer), so I'm not seeing how these paint a more telling picture of applicants personalities. It seems pretty easy for an applicant to fake their way through, given how little time each station is and how similar ethical scenario questions are, and on the opposite end, those who have really strong perspectives may not be able to flesh out their answers completely. Also because MMIs are blind and efficient (schools can use these as a way to herd 50 applicants in per day), interviewers do not have the time to know each student's file intimately and really get a context of who each person is, so it becomes even easier for them to generalize applicants unfairly based off very little information. In traditional interviews, I once had the issue of 2 interviewers in an open-file situation who didn't read my application at all, so they were in a very poor position to discuss my application and write an informed evaluation. Without a context of each applicant's application in MMIs, how are these interviewers any more informed than those two I had? Likewise the student has no/very little time to address anything that admissions committee may deem questionable about their application, and often no time to discuss what they like about this school (many schools don't even ask "why this school?" during MMIs), so how can these schools even choose people who personify the characteristics of their school and are genuinely interested in the school for the right reasons? You have people flying across the country to your school, and not even asking them about why they want to attend your school and why they applied is just baffling to me.

Acting scenarios also seem very artificial so they call more on an applicant's ability to act believably than what they would do in a given situation too. I'm not sure what can be done about that either. I had a school that hired very histrionic actors that were able to fake being in tears, but I'm not sure how having over-the-top performances can improve the evaluation of applicants, even if it makes things more realistic, it can just as easily intimidate applicants because it's so far over the time.

Not to mention, what steps are taken to make interviewers proper informed evaluators who won't just evaluate applicants based off of short-sighted biases and knee-jerk reactions, and aren't just searching for "one right answer", and one type of applicant, even though there are multiple different perspectives and emotional responses to every possible question? I would hope that schools would assemble panels of interviewers with very diverse life experiences to counteract institutional biases. There are also totally different personality types all of which can do well in medicine, and different specialities may attract different types of individuals. Forgive the generalization, but compare someone in pediatric oncology and pathology. These specialities select for totally different kinds of people, so why should applicants be evaluated the same way?

Finally in MMIs, schools often say things like "in a MMI if one station goes bad, you can still do well because you have more chances", but how is this actually the case when applicants are ranked against each other based off of their performance on each of these stations? Don't get me wrong, in traditional interviews at some schools you may only have one interview or chance at things, and that's harsh, especially if you get a controversial antagonist interviewer who isn't compatible, but I don't see how ranking applicants against each other based off of numbers in something so subjective in MMIs does applicants any less of a disservice.

Those are my thoughts on MMIs. What do you think of MMIs and what characteristics really make someone successful in MMIs? What steps could be done to make MMIs fairer to those being interviewed? I'm critical of both formats, but I just don't see how MMIs in their current form do the job much better aside from allowing schools to rapidly evaluate more applicants. Medicine brings people from all these different life experiences and backgrounds together and the interviewing system in place needs to recognize this and take it into account. Finally, if someone does poorly on MMIs does that mean they'll most likely do poorly on the Step 2 CS exam? There is a correlation between the two.

 

[Isocyanate]

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[veryborderlineapplicant]

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If you have something to say about MMIs please say it. I've devoted a decent amount of time writing my thoughts down and simply posting "." doesn't add anything to the discussion.

 

[Goro]

Try doing a Pubmed search on MMIs.

I've been to several MMIs and several traditional interviews, and I find the premise that MMIs are more fair to be very questionable. With traditional interviews you have time to actually get to know the interviewer, really elaborate on your perspective and answers significantly. Of course with traditional interviews first impressions do matter greatly, and that is the same in MMIs, so I don't really see how MMIs eliminate the "halo and horns effect", which is a fancy term for the fact that you are evaluated off of your first impression more than anything else. MMIs do the equivalent of adding more data points to an experiment when the results seem questionable, but how exactly does that make things more informative, give those interviewed more chances, and combat institutional biases? Instead of one "halo and horns effect" or one station where first impressions matter, you have somewhere from 8-12 where this is still the case. I've seen one study claim that MMIs eliminate institutional biases, but I'm baffled as to why this is the case.

Also what else bugs me about the questions at MMIs is that they're often very limited in scope, meaning they mostly cover ethical questions, acting scenarios, and maybe one or two personal questions and you only have a few minutes to talk and express yourself. You have a very short time to discuss your perspective on a question, and briefly go into the opposing perspective and barely have a conversation (more talking at the interviewer), so I'm not seeing how these paint a more telling picture of applicants personalities. It seems pretty easy for an applicant to fake their way through, given how little time each station is and how similar ethical scenario questions are, and on the opposite end, those who have really strong perspectives may not be able to flesh out their answers completely. Also because MMIs are blind and efficient (schools can use these as a way to herd 50 applicants in per day), interviewers do not have the time to know each student's file intimately and really get a context of who each person is, so it becomes even easier for them to generalize applicants unfairly based off very little information. In traditional interviews, I once had the issue of 2 interviewers in an open-file situation who didn't read my application at all, so they were in a very poor position to discuss my application and write an informed evaluation. Without a context of each applicant's application in MMIs, how are these interviewers any more informed than those two I had? Likewise the student has no/very little time to address anything that admissions committee may deem questionable about their application, and often no time to discuss what they like about this school (many schools don't even ask "why this school?" during MMIs), so how can these schools even choose people who personify the characteristics of their school and are genuinely interested in the school for the right reasons? You have people flying across the country to your school, and not even asking them about why they want to attend your school and why they applied is just baffling to me.

Acting scenarios also seem very artificial so they call more on an applicant's ability to act believably than what they would do in a given situation too. I'm not sure what can be done about that either. I had a school that hired very histrionic actors that were able to fake being in tears, but I'm not sure how having over-the-top performances can improve the evaluation of applicants, even if it makes things more realistic, it can just as easily intimidate applicants because it's so far over the time.

Not to mention, what steps are taken to make interviewers proper informed evaluators who won't just evaluate applicants based off of short-sighted biases and knee-jerk reactions, and aren't just searching for "one right answer", and one type of applicant, even though there are multiple different perspectives and emotional responses to every possible question? I would hope that schools would assemble panels of interviewers with very diverse life experiences to counteract institutional biases. There are also totally different personality types all of which can do well in medicine, and different specialities may attract different types of individuals. Forgive the generalization, but compare someone in pediatric oncology and pathology. These specialities select for totally different kinds of people, so why should applicants be evaluated the same way?

Finally in MMIs, schools often say things like "in a MMI if one station goes bad, you can still do well because you have more chances", but how is this actually the case when applicants are ranked against each other based off of their performance on each of these stations? Don't get me wrong, in traditional interviews at some schools you may only have one interview or chance at things, and that's harsh, especially if you get a controversial antagonist interviewer who isn't compatible, but I don't see how ranking applicants against each other based off of numbers in something so subjective in MMIs does applicants any less of a disservice.

Those are my thoughts on MMIs. What do you think of MMIs and what characteristics really make someone successful in MMIs? What steps could be done to make MMIs fairer to those being interviewed? I'm critical of both formats, but I just don't see how MMIs in their current form do the job much better aside from allowing schools to rapidly evaluate more applicants. Medicine brings people from all these different life experiences and backgrounds together and the interviewing system in place needs to recognize this and take it into account. Finally, if someone does poorly on MMIs does that mean they'll most likely do poorly on the Step 2 CS exam? There is a correlation between the two.

 

[veryborderlineapplicant]

Try doing a Pubmed search on MMIs.

Will do, but this is the article I referred to in my original post, where it was claimed that MMIs eliminate cultural biases and gaps between students who are disadvantaged: http://journals.lww.com/academicmed...ncing_the_Reliability_of_the_Multiple.28.aspx

It may be "statistically reliable", but "statistically reliable" and "actually working properly + doing what it's supposed to" are two different things. MMIs do add more data points to the mix vs the one of standard interviews, but if you get enough data points for anything you can make a trend or line of fit with it (confirmation bias). IMO it's hard to say whether the interviewee's performance is actually being consistently evaluated or whether the majority of interviewers are thinking and evaluating applicants similarly based off of biases, and the interviewers who evaluate applicants differently and see things differently are considered outliers. Simply claiming the process is better without more supporting evidence (there are a lot of big claims in these articles) doesn't say much either.

I'd be very interested in hearing your thoughts on MMIs though, especially if there's something I'm missing. IMO in the best interview, the person who is interviewed is asked questions that aren't off the usual script and is really forced to think on their feet and into expressing themselves, so they can really be evaluated.

 

[barca4ever]

I felt asleep halfway through reading your post (it seems more like rant than a discussion post). Anyways, to reply to your answer, the MMIs definitely became more popular among medical schools so you should embrace the change. As much as I hate the MMIs, I actually thought it was fun and a better way to evaluate people based on their knowledge, experience, and interpersonal skills. Come on, who doesn't know how to prepare for a traditional interview? There is only so much that they can ask during the traditional interview. However with the MMIs, most interviewee walk in to the interview without any idea of what they are being asked, that's what makes it so much more intimidating (pre-interviewing) and interesting (post-interviewing). No matter what form of interview a medical school use, there is no perfect system to evaluate a candidate based on just a couple of hours. That's why they have to rely on statistics to pick a better interviewing form.

 

[ConfusedChemist]

I did an MMI and I felt like it went so much better than traditional interviews (for me at least) because I hate feeling like I'm 'bragging' about myself in traditional setup's where you hsve to talk about yourself the whole time. I thought the MMI had some really interesting questions and showed more of who you are as a person than who can talk themselves up the best to an adcom

 

[veryborderlineapplicant]

I felt asleep halfway through reading your post (it seems more like rant than a discussion post). Anyways, to reply to your answer, the MMIs definitely became more popular among medical schools so you should embrace the change. As much as I hate the MMIs, I actually thought it was fun and a better way to evaluate people based on their knowledge, experience, and interpersonal skills. Come on, who doesn't know how to prepare for a traditional interview? There is only so much that they can ask during the traditional interview. However with the MMIs, most interviewee walk in to the interview without any idea of what they are being asked, that's what makes it so much more intimidating (pre-interviewing) and interesting (post-interviewing). No matter what form of interview a medical school use, there is no perfect system to evaluate a candidate based on just a couple of hours. That's why they have to rely on statistics to pick a better interviewing form.

It's long because I gave it a lot of thought and effort, rant or not. Yea, I could have made it shorter, and probably should have though. MMIs are fun, but most of the ethical questions follow the same formula, so it's just as easy to prepare and come up with a script. There's even less they can ask in a MMI because there's only a scenario and few followups making it way harder to put the applicant on the spot about their application or get a real context of their perspectives/way they think/who they are and why they're actually here at this school and interested in it. It's more organic than traditional interviews I'll give you that, but it has its fair share of troublesome flaws.

 

[barca4ever]

MMIs are fun, but most of the ethical questions follow the same formula --> not all questions are ethical. There are some questions that the interviewer is evaluating you on your thought process. How did you come to the decision? Some of these ethical questions are actually real scenarios, and some of them are very interesting and fun to answer.
In conclusion, I think some people prefer the MMIs, some prefer the traditional style. But the MMIs is definitely becoming more popular and I suspect more medical schools will be using it in the future.
I think you are not giving the MMIs a chance just because you didn't "like" or "excel" it. But try to keep an open mind and I think you will appreciate the MMIs better.

 

[barca4ever]

If you are looking for more info about the MMI vs traditional interview, you can read this thread. I personally agree with one of the poster that if I have to rank my preference, i would choose:
1) combination of MMI & traditional (I did have 1-2 questions to talk about myself during my MMI)
2) MMI
3) Traditional

http://forums.studentdoctor.net/thr...ultiple-mini-thoughts-and-preferences.992971/

 

[veryborderlineapplicant]

MMIs are fun, but most of the ethical questions follow the same formula --> not all questions are ethical. There are some questions that the interviewer is evaluating you on your thought process. How did you come to the decision? Some of these ethical questions are actually real scenarios, and some of them are very interesting and fun to answer.
In conclusion, I think some people prefer the MMIs, some prefer the traditional style. But the MMIs is definitely becoming more popular and I suspect more medical schools will be using it in the future.
I think you are not giving the MMIs a chance just because you didn't "like" or "excel" it. But try to keep an open mind and I think you will appreciate the MMIs better.

I went into all my MMIs liking them and it was fun game, the majority of the questions i had were ethical and I could easily create a pretty basic template to respond to any of them. I didn't like that. I also definitely didn't like how is it for us (those being interviewed) to be generalized by interviewers given the short time frame and blind files (no context of us), and the lack of clear of expectations of what's expected. They say everything is fair if you justify it but it really doesn't seem that way at all.

I gave MMIs a chance and still think they're fun, I just don't like them as an evaluation process and don't think they're fair. I'm also very critical of the traditional format as well. The combination idea is smart.

Interesting post I found in that thread worth quoting " Since everyone is pretty much going to do fine (unless you say something completely off) in an MMI, what's the adcom really going to use to determine the final status of your file? Numbers. That's fine if you have higher stats, but for me that doesn't work too well. I want to have long discussions about my passion for medicine, my experiences, what makes me unique, why I belong at the school. Not, "You have 8 minutes to tell me what you think about the new healthcare bill. Start now"

 

[LizzyM]

It is becoming obvious to me that some schools don't care about why YOU want to be a doctor and they don't care about why YOU want to attend their school. Your motivations are unimportant, in the adcom's opinion, to whether you will be a good fit and be a good student and a good doctor. They want to see that you can answer the questions posed by a number of individuals. The questions are not up to the interviewers and are the same for each interviewed applicant. That does decrease the likelihood of bias.

An interviewer in an MMI (or a closed file interview) can't decide pre-interview that your MCAT is crap, you are just like all the other applicants from your state, and that this is a waste of time. Such an interview might just make small talk with you for a half hour about your hometown and your school activities before hitting the "decline" button that he had decided to click before even meeting you. Ditto the interviewer who is always biased toward applicants who come from a specific social class or religious tradition and try to present their responses to a traditional interview in the best possible light (put a halo on them) despite an interview that anyone else would have found substandard.

Some biases are eliminated because the interviewer isn't automatically thinking highly of you because you have a stellar GPA from an excellent school or that you are a poor candidate because your application had a couple of insignificant typos that the initial reviewer missed.

 

[TabletTold92]

It depends on the way in which the MMI is done. Some schools do it terribly and it doesn't provide what students hope to show at an interview. I don't advocate for too many acting scenarios because they can turn out badly. Some schools know exactly what they want to get out of the process and format it so there's a good mix of personal, ethical and hypothetical stations.

I would say it's helpful to have two minutes of un-judged time to gather your thoughts over a question. And I would ask why you need more than six minutes to make a good impression on someone.

Also not all ethical questions are difficult. The whole "would you treat if the patient says no/withdraws consent" question is a no-brainer. Doctors are not gods. Your patient says no, you don't do it. Unless you're prepared to lose your license in a lawsuit over it. In which case, go ahead. And if you're not, the answer is no. No, even if it will save their life. No, even if it's their only hope. It's always no. At least if you're practicing medicine in the US.

That said, lol at this not actually asking what people think, but ranting about what you think.

 

[ConfusedChemist]

I went into all my MMIs liking them and it was fun game, the majority of the questions i had were ethical and I could easily create a pretty basic template to respond to any of them. I didn't like that. I also definitely didn't like how is it for us (those being interviewed) to be generalized by interviewers given the short time frame and blind files (no context of us), and the lack of clear of expectations of what's expected. They say everything is fair if you justify it but it really doesn't seem that way at all.

I gave MMIs a chance and still think they're fun, I just don't like them as an evaluation process and don't think they're fair. I'm also very critical of the traditional format as well. The combination idea is smart.

Interesting post I found in that thread worth quoting " Since everyone is pretty much going to do fine (unless you say something completely off) in an MMI, what's the adcom really going to use to determine the final status of your file? Numbers. That's fine if you have higher stats, but for me that doesn't work too well. I want to have long discussions about my passion for medicine, my experiences, what makes me unique, why I belong at the school. Not, "You have 8 minutes to tell me what you think about the new healthcare bill. Start now"

A handful of Canadian schools do a combo actually-i think it's a really good way to go about it. You start with half a dozen MMI stations followed by a short (20-30min) "traditiona;" station were you get to talk about why medicine, etc.
I feel like thats the best way to do it, but it's definetly not a common approach for schools since they usually pick one or the other

 

[ConfusedChemist]

It depends on the way in which the MMI is done. Some schools do it terribly and it doesn't provide what students hope to show at an interview. I don't advocate for too many acting scenarios because they can turn out badly. Some schools know exactly what they want to get out of the process and format it so there's a good mix of personal, ethical and hypothetical stations.

I would say it's helpful to have two minutes of un-judged time to gather your thoughts over a question. And I would ask why you need more than six minutes to make a good impression on someone.

Also not all ethical questions are difficult. The whole "would you treat if the patient says no/withdraws consent" question is a no-brainer. Doctors are not gods. Your patient says no, you don't do it. Unless you're prepared to lose your license in a lawsuit over it. In which case, go ahead. And if you're not, the answer is no. No, even if it will save their life. No, even if it's their only hope. It's always no. At least if you're practicing medicine in the US.

That said, lol at this not actually asking what people think, but ranting about what you think.

I liked the acting stations! We had one were you had a very realistic interaction with a 'patient' who was just sat there and denied that there was any illness the whole time. I feel like seeing how people handled that (since it was unexpected to have a literally silent actor) shows a lot about who a person is, and how patient and understanding they are. But I do see how it isn't the most fair thing-I was expecting something extreme in the actors response (like either silence or crying) but I know a lot of people said they panicked and got really frustrated becuse they thought they were supposed to make them talk/agree to a plan for treatment in the 9 minutes in order to score well...

 

[f4reignbeauty]

I prefer the MMI experience, it's a chance to actually talk about what you believe, and why you believe it. It forces you to take a stance on issues, as well as shows you the importance of understanding and respecting someone else's experiences.

Each school had questions, or scenarios, that aligned with their mission. For those that were focused more on increasing wellness in communities where health disparities are evident, they had scenarios related to that. Also, I've had combination MMIs where at the end of the MMI you have a traditional interview where you discuss your motivations for medicine.

I won't say that I've had a bad interview experience (loved them all actually), but I will say that I felt like the MMI was the best format for me.

 

[ASD2019]

OP few points I think you are missing:

- You are taking the MMIs questions at face value (hence your use of some sort of a "formula"). For example, the interviewer might ask you what you think leads someone to become a teenage shooter? However, the school doesn't give a **** about the many causes you can come up with. They might be simply using this station to assess you compassion and critical thinking.
- It is nearly impossible to eliminate all bias. So the only thing schools can do is try to minimize it. When you ask a school to look at your answers in context - you are simply asking them to be biased towards you. You want the interviewer to swallow some of your ridiculous answers simply b/c they like the 40 next to your mcat score.

- After the MMIs are done then you are reviewed in context. Your MMI evaluations are reviewed within the context of the rest of application before any decision is made.

I personally think most traditional interviews are bs. People prepare answers for months, come up with various stories to look good, rehearse these answers for months, attend mock interviewers, get all of their answers filtered, and get coached on how to seem like something they aren't. Majority of the time it is just an invitation to see who can bs the adcoms the best.

 

[Goro]

Concur. FYI, U Edmonton reports that MMis are better at picking people with more empathic qualities.

I can't comment directly on them as my school does group interviews.

I felt asleep halfway through reading your post (it seems more like rant than a discussion post). Anyways, to reply to your answer, the MMIs definitely became more popular among medical schools so you should embrace the change. As much as I hate the MMIs, I actually thought it was fun and a better way to evaluate people based on their knowledge, experience, and interpersonal skills. Come on, who doesn't know how to prepare for a traditional interview? There is only so much that they can ask during the traditional interview. However with the MMIs, most interviewee walk in to the interview without any idea of what they are being asked, that's what makes it so much more intimidating (pre-interviewing) and interesting (post-interviewing). No matter what form of interview a medical school use, there is no perfect system to evaluate a candidate based on just a couple of hours. That's why they have to rely on statistics to pick a better interviewing form.

 

[veryborderlineapplicant]

OP few points I think you are missing:

- You are taking the MMIs questions at face value (hence your use of some sort of a "formula"). For example, the interviewer might ask you what you think leads someone to become a teenage shooter? However, the school doesn't give a **** about the many causes you can come up with. They might be simply using this station to assess you compassion and critical thinking.
- It is nearly impossible to eliminate all bias. So the only thing schools can do is try to minimize it. When you ask a school to look at your answers in context - you are simply asking them to be biased towards you. You want the interviewer to swallow some of your ridiculous answers simply b/c they like the 40 next to your mcat score.

- After the MMIs are done then you are reviewed in context. Your MMI evaluations are reviewed within the context of the rest of application before any decision is made.

I personally think most traditional interviews are bs. People prepare answers for months, come up with various stories to look good, rehearse these answers for months, attend mock interviewers, get all of their answers filtered, and get coached on how to seem like something they aren't. Majority of the time it is just an invitation to see who can bs the adcoms the best.

The whole assessing someone's compassion in 5 minutes is pretty artificial, compassion is a lot more than that and no 5 minutes can do it justice.

Traditional interview answers may be BS, but arguably you BS just as much in MMIs because you only have to talk at someone for 5-8 mins, which makes it pretty easy for people to "fake it". At least with traditional interviewers the "BSing" and preparing answers for months and being able to use all these methods to succeed through hard work is indicative of what a lot of learning in medicine boils down to: hard work, large amounts of studying, and a strong work ethic. It also makes things a bit more objective because it can be treated like a test or term paper and prepped for, which is a blessing with all of the randomness and subjectivity in this process. I'm not saying traditional interviews aren't subjective, they most definitely are, and do have a lot of randomness as flaws as well, but I like being able to bypass some of the BS with hard work and self-improvement. One flaw of the traditional interviews is expecting people not to be scripted after all that prep work is silly tho because everyone is scripted to a degree, and all that criterion screams is "you're allowed to get away with being scripted if you fake it better than most". It's very ironic.

It depends on the way in which the MMI is done. Some schools do it terribly and it doesn't provide what students hope to show at an interview. I don't advocate for too many acting scenarios because they can turn out badly. Some schools know exactly what they want to get out of the process and format it so there's a good mix of personal, ethical and hypothetical stations.

I would say it's helpful to have two minutes of un-judged time to gather your thoughts over a question. And I would ask why you need more than six minutes to make a good impression on someone.

Also not all ethical questions are difficult. The whole "would you treat if the patient says no/withdraws consent" question is a no-brainer. Doctors are not gods. Your patient says no, you don't do it. Unless you're prepared to lose your license in a lawsuit over it. In which case, go ahead. And if you're not, the answer is no. No, even if it will save their life. No, even if it's their only hope. It's always no. At least if you're practicing medicine in the US.

That said, lol at this not actually asking what people think, but ranting about what you think.

Bolded emphasizes why a lot of the questions in MMIs don't really show much practically speaking. I don't consider ethical questions to be difficult, just very formulaic and derivative to answer. My post is a Rantflecton (rant+ reflection), and I'm sure you can relate given your response to my comment with U. Cincinnati. With the interviews I've been in a rant is long overdue. Albeit, I still want to hear other's perspectives on MMIs to get more insight into the process and other's experiences.

I liked the acting stations! We had one were you had a very realistic interaction with a 'patient' who was just sat there and denied that there was any illness the whole time. I feel like seeing how people handled that (since it was unexpected to have a literally silent actor) shows a lot about who a person is, and how patient and understanding they are. But I do see how it isn't the most fair thing-I was expecting something extreme in the actors response (like either silence or crying) but I know a lot of people said they panicked and got really frustrated becuse they thought they were supposed to make them talk/agree to a plan for treatment in the 9 minutes in order to score well...

I've had scenarios like the one you mentioned and I was wondering, what would you consider to be a right response to that realistic patient scenario? I did the whole stand my ground and working from multiple perspectives, but there's only so much you can do in a situation like this realistically.

It is becoming obvious to me that some schools don't care about why YOU want to be a doctor and they don't care about why YOU want to attend their school. Your motivations are unimportant, in the adcom's opinion, to whether you will be a good fit and be a good student and a good doctor. They want to see that you can answer the questions posed by a number of individuals. The questions are not up to the interviewers and are the same for each interviewed applicant. That does decrease the likelihood of bias.

An interviewer in an MMI (or a closed file interview) can't decide pre-interview that your MCAT is crap, you are just like all the other applicants from your state, and that this is a waste of time. Such an interview might just make small talk with you for a half hour about your hometown and your school activities before hitting the "decline" button that he had decided to click before even meeting you. Ditto the interviewer who is always biased toward applicants who come from a specific social class or religious tradition and try to present their responses to a traditional interview in the best possible light (put a halo on them) despite an interview that anyone else would have found substandard.

Some biases are eliminated because the interviewer isn't automatically thinking highly of you because you have a stellar GPA from an excellent school or that you are a poor candidate because your application had a couple of insignificant typos that the initial reviewer missed.

Very informative post. Thank you so much for your response, it make a lot of sense. The interviews where an interviewer just makes small talk with applicants before hitting the decline but which he or she decided beforehand is a waste of time for both of applicants and interviewers, so anything to counter that is positive.

I have one question for you: from your perspective would you say that MMIs do have a good correlation with the STEP 2 CS examination, meaning would a weak performance in a MMI be indicative of one on the STEP 2 CS examination?

 

[ConfusedChemist]

The whole assessing someone's compassion in 5 minutes is pretty artificial, compassion is a lot more than that and no 5 minutes can do it justice. I've had scenarios like the one you mentioned and I was wondering, what would you consider to be a right response to that realistic patient scenario? I did the whole stand my ground and working from multiple perspectives, but there's only so much you can do in a situation like this realistically."]

I don't know how 'good' my approach was, but once I realized the 'patient' was not going to admit there was a problem I just said that "I realized I'd given them a lot to think about at once, and that maybe it was best if we left it there for today, I asked them to think about what I said and we agreed to meet again in a week so I could see how things were going and maybe we could discuss a plan then"
I just firgured that pushing to try and get an answer was what most people were doing, and I thought I go a different route 😛[/QUOTE]

 

[VitaminVater]

This is my response from another thread. I'm currently applying this cycle, have done 2 MMIs and been accepted to both of the programs that had them. YRMV.

Prepare depending on your level of experience.
By this I mean can you have an intellectual conversation on health in various aspects of life? Not just the simple stuff, but maybe prison health, end of life care, availability of healthcare, social determinants of health, etc..

I'm not talking about quoting statistics or quotes by researchers/activists, this isn't extemporaneous debate. I'm talking about being able to consider multiple perspectives on a dilemma/issue. Be able to think outside your own shoes, not to justify the actions of others whether they are good or bad, but to understand. Your patients will not look like you, talk like you, or have had the same experiences as you. It is crucial for you to be a good provider that you be able to relate and understand them outside of just knowing what's happening scientifically in their body.
Most of the questions won't be about social/political issues, they'll be regular life dilemmas. The point is the same, to see whether you can empathize and think critically.
If this is stuff completely new to you, I recommend you read up some on these issue. Don't try to memorize though, just educate yourself.

TL;DR:
1. I read up on the kind of questions they would ask, got tired, closed the tab and got a good night's sleep. Anything differently done? Maybe drinking more coffee beforehand since they gave the long tour first.
2. Don't write anything down, like I said, this isn't high school debate. If you wanna stay on track, set yourself to talk about 2-3 points and speak eloquently and slowly, do not rush.
3. See above.

 

[jqueb29]

MMIs suck

 

[veryborderlineapplicant]

I don't know how 'good' my approach was, but once I realized the 'patient' was not going to admit there was a problem I just said that "I realized I'd given them a lot to think about at once, and that maybe it was best if we left it there for today, I asked them to think about what I said and we agreed to meet again in a week so I could see how things were going and maybe we could discuss a plan then"
I just firgured that pushing to try and get an answer was what most people were doing, and I thought I go a different route 😛

[/QUOTE]

I like it. Your response is very realistic and professional, I bet you got accepted to the school because your thought process is good. I thought of doing similar, but I didn't want to be interpreted as being unassertive, so I stuck with a more assertive answer, but tried different ways of having them look at it. In your response did you include things like "I understand your perspective (little bit about why), but consider the fact that there are serious consequences and I'm very concerned for your safety and I'm here to help you come to grasp with your circumstances". IDK if the tone is right, but I'm giving this some thought.

This is my response from another thread. I'm currently applying this cycle, have done 2 MMIs and been accepted to both of the programs that had them. YRMV.

Great response! I have one question about the way you structured your responses to ethical issues. Say the ethical issue was abortions, what I'd do is assemble like 3 points for and against it that mirror each other. like, assuming I'm for abortion:
Against:
1) Ending a human life is wrong.
2) If the mother isn't prepared either emotionally, financially, or if the baby is a product of difficult circumstances (e.g, rape), she can seek out support from social services or be assisted to make things easier
3) The baby doesn't have a choice or say in the argument when it's the baby's life.
For:
1) Morals aren't black and white, ending a human life may be wrong, but let's talk specifics. Depending on the stage of pregnancy (first trimester) the baby might not even be alive. Religious objections are very valid and must be respected, but keep in mind beliefs of individuals differ drastically and there is no "one-size fits all", especially when it comes to different cultures and backgrounds.
2) A mother is a very important part of the picture, the baby is after all a part of her, and a integral provider to the child. If she isn't prepared emotionally or financially or the child is a born into a broken home, it's hard to undo the damages done, especially the trauma inflicted to her if she was raped, and difficult circumstances growing up for the child are hard to undo, and she has every right to call for an abortion. For example, I've read a study about children who are bullied and that it not only more rapidly ages them, but makes them more prone to depression, anxiety, mood disorders, and even developmental disorders. Much of these can ideally be avoided if the mother waits to have a child when she is ready.
3) The baby may not have a say in the argument, but we don't choose to be born, particularly, into a lifetime of struggles. A mother and a well-informed doctor can work together to make a proper responsible decision, that is just as valid given the fact the baby can't exactly make its own decision from the womb. This is very similar relatives deciding in the case of PAD.

What I would do is quickly state an opposing view, and go into my perspective that mirrors it. Do you think is acceptable? What feedback would you offer regarding how I structured this? I'd really appreciate constructive criticism.

 

[ConfusedChemist]

I like it. Your response is very realistic and professional, I bet you got accepted to the school because your thought process is good. I thought of doing similar, but I didn't want to be interpreted as being unassertive, so I stuck with a more assertive answer, but tried different ways of having them look at it. In your response did you include things like "I understand your perspective (little bit about why), but consider the fact that there are serious consequences and I'm very concerned for your safety and I'm here to help you come to grasp with your circumstances". IDK if the tone is right, but I'm giving this some thought.



What I would do is quickly state an opposing view, and go into my perspective that mirrors it. Do you think is acceptable? What feedback would you offer regarding how I structured this? I'd really appreciate constructive criticism.[/QUOTE]
thanks! haha I hope so too because it is my first choice school
I can't remember details but I took a really similar approach to what you said there. But given I won't know if I got in until March I'm not sure if it's the 'right' approach. But I you're thought process there shows consideration and empathy, which in my mind are good things to show!

 

[cs24]

Whew that is a long OP. Knowing I'll probably miss a few things you talked about, I'll try to defend MMIs a bit.

First, the MMI is not meant to go over your application, have general context, let you explain deficiencies in your app, etc. That's what your application is for. The MMI is just a tool for us to assess you in person, looking at maturity, empathy, perspective, humility, ability to think under pressure, general congeniality, etc etc. Every question is new to you, so you can't script an answer to make yourself look better.

In short, if I interview you, I am asking 1) is this a person I would like to work with as a classmate and future colleague, and 2) is this person someone I would trust to treat a family member of mine as a physician? It's all about personal interaction and trying to get a better idea of who you are as a person by having a conversation with you. The conversation itself is meaningless, it could be about almost anything, but the ethical scenarios give us something to talk about so I can see your reasoning. It's not about gaming the interview or answering questions "correctly". If you sat on the other side of the interview room, you might be surprised at how much we can learn about you in an 8 minute conversation.

Finally, you mention the inability for an interviewer to advocate for you like a traditional setting where the interviewer would present you to the committee. In my mind, this is a good thing, because it is another way to eliminate interviewer bias from overly influencing the committee just because they thought you were super awesome, or went to their son's high school, or had similar taste in movies. Your application should be good enough to make the case for yourself, just like everyone else's has to be.

 

[LizzyM]

I have one question for you: from your perspective would you say that MMIs do have a good correlation with the STEP 2 CS examination, meaning would a weak performance in a MMI be indicative of one on the STEP 2 CS examination?

I am not sure of this but I would imagine that a school may see some applicants as educable... the raw material is there as evidenced by the MMI and with some additional coaching and training on specific clinical skills the candidate will do well on the Step 2 CS exam. In other cases, it may show that, in the interviewer's opinion, the applicant just doesn't have what it takes to do well. It might be somewhat like looking at 15 year old jocks to determine which can be coached to gold medals or professional contracts and which don't have what it takes.

 

[VitaminVater]

I like it. Your response is very realistic and professional, I bet you got accepted to the school because your thought process is good. I thought of doing similar, but I didn't want to be interpreted as being unassertive, so I stuck with a more assertive answer, but tried different ways of having them look at it. In your response did you include things like "I understand your perspective (little bit about why), but consider the fact that there are serious consequences and I'm very concerned for your safety and I'm here to help you come to grasp with your circumstances". IDK if the tone is right, but I'm giving this some thought.



Great response! I have one question about the way you structured your responses to ethical issues. Say the ethical issue was abortions, what I'd do is assemble like 3 points for and against it that mirror each other. like, assuming I'm for abortion:
Against:
1) Ending a human life is wrong.
2) If the mother isn't prepared either emotionally, financially, or if the baby is a product of difficult circumstances (e.g, rape), she can seek out support from social services or be assisted to make things easier
3) The baby doesn't have a choice or say in the argument when it's the baby's life.
For:
1) Morals aren't black and white, ending a human life may be wrong, but let's talk specifics. Depending on the stage of pregnancy (first trimester) the baby might not even be alive. Religious objections are very valid and must be respected, but keep in mind beliefs of individuals differ drastically and there is no "one-size fits all", especially when it comes to different cultures and backgrounds.
2) A mother is a very important part of the picture, the baby is after all a part of her, and a integral provider to the child. If she isn't prepared emotionally or financially or the child is a born into a broken home, it's hard to undo the damages done, especially the trauma inflicted to her if she was raped, and difficult circumstances growing up for the child are hard to undo, and she has every right to call for an abortion. For example, I've read a study about children who are bullied and that it not only more rapidly ages them, but makes them more prone to depression, anxiety, mood disorders, and even developmental disorders. Much of these can ideally be avoided if the mother waits to have a child when she is ready.
3) The baby may not have a say in the argument, but we don't choose to be born, particularly, into a lifetime of struggles. A mother and a well-informed doctor can work together to make a proper responsible decision, that is just as valid given the fact the baby can't exactly make its own decision from the womb. This is very similar relatives deciding in the case of PAD.

What I would do is quickly state an opposing view, and go into my perspective that mirrors it. Do you think is acceptable? What feedback would you offer regarding how I structured this? I'd really appreciate constructive criticism.[/QUOTE]

Hmm honestly it seems like you're still in that whole competitive debate mindset for these questions.
The topic will never be "abortion", it'll be some situation where you have to call forth ethical concerns for both sides of the "argument" and should only raise points that are relevant to the specific circumstance. You're not gonna have time make a 3-bullet point back and forth debate and overview of abortion; it'll be very broad and unappealing, as if you're checking off boxes of things you HAD to say.
Instead, just casually walk into the issue, consider the first thing that comes to mind about the situation. Then go on about how we also have to consider X and it might conflict with Y, and overall how you think that although W, it's a difficult situation because abc. Please do not frame it like a debate or persuasive essay, you'll just send up boring the interviewer. Also, although in some the interviewer will stay quiet the whole time, in most that I've had after I gave a quick initial response, they would give me follow up questions. That's what you want, a natural flow of an intellectual discussion.

 

[veryborderlineapplicant]

I like it. Your response is very realistic and professional, I bet you got accepted to the school because your thought process is good. I thought of doing similar, but I didn't want to be interpreted as being unassertive, so I stuck with a more assertive answer, but tried different ways of having them look at it. In your response did you include things like "I understand your perspective (little bit about why), but consider the fact that there are serious consequences and I'm very concerned for your safety and I'm here to help you come to grasp with your circumstances". IDK if the tone is right, but I'm giving this some thought.



Great response! I have one question about the way you structured your responses to ethical issues. Say the ethical issue was abortions, what I'd do is assemble like 3 points for and against it that mirror each other. like, assuming I'm for abortion:
Against:
1) Ending a human life is wrong.
2) If the mother isn't prepared either emotionally, financially, or if the baby is a product of difficult circumstances (e.g, rape), she can seek out support from social services or be assisted to make things easier
3) The baby doesn't have a choice or say in the argument when it's the baby's life.
For:
1) Morals aren't black and white, ending a human life may be wrong, but let's talk specifics. Depending on the stage of pregnancy (first trimester) the baby might not even be alive. Religious objections are very valid and must be respected, but keep in mind beliefs of individuals differ drastically and there is no "one-size fits all", especially when it comes to different cultures and backgrounds.
2) A mother is a very important part of the picture, the baby is after all a part of her, and a integral provider to the child. If she isn't prepared emotionally or financially or the child is a born into a broken home, it's hard to undo the damages done, especially the trauma inflicted to her if she was raped, and difficult circumstances growing up for the child are hard to undo, and she has every right to call for an abortion. For example, I've read a study about children who are bullied and that it not only more rapidly ages them, but makes them more prone to depression, anxiety, mood disorders, and even developmental disorders. Much of these can ideally be avoided if the mother waits to have a child when she is ready.
3) The baby may not have a say in the argument, but we don't choose to be born, particularly, into a lifetime of struggles. A mother and a well-informed doctor can work together to make a proper responsible decision, that is just as valid given the fact the baby can't exactly make its own decision from the womb. This is very similar relatives deciding in the case of PAD.

What I would do is quickly state an opposing view, and go into my perspective that mirrors it. Do you think is acceptable? What feedback would you offer regarding how I structured this? I'd really appreciate constructive criticism.

Hmm honestly it seems like you're still in that whole competitive debate mindset for these questions.
The topic will never be "abortion", it'll be some situation where you have to call forth ethical concerns for both sides of the "argument" and should only raise points that are relevant to the specific circumstance. You're not gonna have time make a 3-bullet point back and forth debate and overview of abortion; it'll be very broad and unappealing, as if you're checking off boxes of things you HAD to say.
Instead, just casually walk into the issue, consider the first thing that comes to mind about the situation. Then go on about how we also have to consider X and it might conflict with Y, and overall how you think that although W, it's a difficult situation because abc. Please do not frame it like a debate or persuasive essay, you'll just send up boring the interviewer. Also, although in some the interviewer will stay quiet the whole time, in most that I've had after I gave a quick initial response, they would give me follow up questions. That's what you want, a natural flow of an intellectual discussion.[/QUOTE]

Hmm, I'll give it a shot. So something more like "I support abortion because I think it's very important to understand the mother's concerns, especially if the child is the product of a difficult circumstance, and the mother cannot possibly support the child. It'd be wrong and have far-reaching consequences to bring the child into the world in such a situation. Although, I can see reasons equally valid to be against abortion because of religious concerns, the fact that baby itself has no say over it, and there are resources available to help children and their parents through such situations".

It's still very methodical, but i'm trying my best to keep it short and simple. Do you think this is better or more appropriate? You're definitely right that I had the wrong mindset for these questions and I really appreciate your feedback.

 

[Eugeneese]

I went into all my MMIs noticing these folks and it also appeared to be pleasurable activity, a lot of the queries i'd had been ethical so i might effortlessly develop a quite standard theme to answer any of them.

 

[barca4ever]

You either love it or you don't. No matter what the OP's opinion on the MMIs, I can tell that more medical schools will be using the MMIs format in the future. Several surveys after the MMIs often show that the applicants actually enjoy this format. So OP, quit ranting and just take the MMIs as a challenge. Enough said.

 

[Shams al Deen]

The whole debate can be summed up like this.

If you got accepted at schools that do MMIs then you automatically love MMIs and think they will 100% predict how good of a doctor you'll be.

If you got rejected from schools doing MMIs then you think they're just some fad that will be out of style in a few years and are not nearly as effective as traditional interviews.

 

[Eppur Si Muove]

I favor a combination of both. MMI is more high stress and uncomfortable but I can't deny its effectiveness. However, I believe that traditional interviews definitely have their place. It's good to sit down with an applicant and get to know them. At my MMI, some members that interviewed me were just volunteers. No disrespect to them but I don't want a random person that speaks to me for five minutes determining how effective of a med student I will be. Also, while many people think that you can't bs an MMI, all my ethical questions were very predictable and expected. I had pre- thought out answers for many of the questions I thought I would see