Multiple Mini Interview (MMI) format is a method of interviewing candidates that is increasingly being used by US medical schools and PA schools.  If you have been invited to interview for a PA program, you should be ready a *unique* experience.

Where Did MMI Come From?

To answer that, we need to talk first about the most common type of interview format, which I will call “traditional” format.  For eons, “traditional” interviews have been conducted like conversations: the applicant sits down with one or more interviewers and is asked questions about their beliefs, experiences, education, and skills.

“Traditional” Interview Format

Most job interviews are in traditional format, and until recently, most professional and graduate school interviews were too.  Traditional format is still very common, because it has two important characteristics.  Traditional format is:

• easy to plan and execute for the interviewer
• familiar format for the interviewee

But traditional format has more than a few drawbacks for interviewing PA school candidates.

Specifically, they:

• invite scripted / rehearsed answers from interviewees
• are pretty far removed removed from “real world” relevance (think validity).
• can have very different outcomes, depending on who is doing the the interviewing.  Different interviewers can have pretty different assessments of a candidate.  (Think reliability)
• aren’t very good at evaluating for abstract things like professionalism and moral judgment
• they tend to be time consuming / inefficient

McMaster University and the Introduction of MMI Format

In the 1990’s, it became clear that there were problems with the traditional interview format for medical school interviewing.  They made it hard for schools to predict from the interview how well their candidates might perform in the real world as physicians.  In 2001, researchers at McMaster University’s school of medicine pointed to Multiple Mini Interview format as a better way to choose their medical students.  According to Wikipedia, compared to traditional format, for MMI:

Overall test reliability remained high,^[1] and subsequent follow-up through medical school and on to national licensure examination (Medical Council of Canada Qualifying Examination Parts I and II) revealed the MMI to be the best predictor for subsequent clinical performance,^[5][7] professionalism,^[6] and ability to communicate with patients and successfully obtain national licensure.

Because MMIs function a little like an assembly line, they are more time efficient.  Each applicant is interviewed by multiple interviewers, which reduces the chance that any one interviewer’s bias can creep in, and they simulate “real world situations” such as live problem solving, role playing, and dealing with ethical situations.

McMaster University’s recommendations have since made MMI the most popular format for medical and PA school interviews, and their use in other healthcare disciplines is growing.

So What Exactly is MMI?

MMI interviews are conducted as a series of short interviews, all conducted simultaneously by different interviewers.

How it works:

1. The interview is structured as a series of “stations,” each each evaluating the applicant in a different domain that doesn’t change throughout the day.  Commonly there are 4-8 stations.
2. Students rotate through each station, one at a time, until completing all stations.  Before beginning a station, they are given 1-2 minutes to read a brief instruction sheet about it.
3. Time in each station is limited.  Typically interviewees are given 5-8 minutes to complete room.
4. Each station has one interviewer who does not change, and he or she conducts only that particular station for all candidates.
5. Once the interview is over and the applicant has left, evaluators score each applicant’s interview by summing his/her scores from each station.

Common MMI Interview Stations

1. Role playing with a patient actor — dealing tactfully with an angry, grieving, or evasive patient is common in role plays.
2. Ethical dilemmas — asking the patient how they would deal with an ethical dilemma such as a cheating PA school classmate or a supervising physician who asks them to do something unethical.
3. Conflict management — the student might be put in the position of needing to talk with another healthcare professional about some conflict between them, such as a supervising physician asking them to perform a procedure in which they are not proficient.
4. Teamwork Tasks — two or more interviewees are asked to come up with a solution to a problem in real time, such as building a bridge between two tables out of only the materials that are provided.  This could also be done with an actor portraying a coworker or classmate.
5. Character and personality questions — in a station the student could be asked about their weaknesses or strengths, a bad habit, a time they made a mistake, a patient interaction that they were proud of or didn’t like, etc.

What Students Think of MMI Interviews

Because MMI questions tend to be harder to predict, and put interviewers “on the spot,” they tend fear and struggle with the format, which requires them to make decisions quickly, in real time, and to demonstrate higher level communication skills (e.g. dealing with someone who is upset with them) while they make them.  Younger applicants may have limited interviewing experience, and those that they have done have usually been in the traditional format, such as for jobs or internships.  The unfamiliar, higher stress environment of MMI can make it hard to focus, and the result is often an interview that showcases their weaknesses instead of their strengths.

Can You Prepare for MMI Interviews?

Absolutely!  It’s a common misconception that in MMI “You just have to wing it.”  In fact, going into MMI interviews without adequate preparation is unwise.  As in any interview, there are always surprises, but much of the stress and fear of this type of interview can be managed with practice and good interview preparation.  Preparation for MMI format is similar, but not identical to traditional format.

Some things to keep in mind for this format:

1. In dilemma scenarios, keep in mind that there may not actually be any “good” answer — only an answer that is less harmful or problematic than others.  Look for it.
2. Think aloud.  Your interviewers want to know what your thoughts are, so share them.  Keeping a running commentary of your ideas (what you might or might not do and why) for an MMI situation can help you develop them.  Doing so can also show the interviewer how much thought you are putting into your decisions.
3. Remember to default to public safety, then patient safety, then your safety and that of your staff.
4. When role playing with patient actors, remain nonjudgmental and do your best listening, reflecting back to them what you hear them saying.  (“It sounds like you felt anxious when I asked you about your weight.”)  Even if you can’t solve their “problem,” you will leave them feeling heard.

With good preparation, MMI interviews are nothing to be afraid of.  In fact, if you are well prepared, they may offer you a distinct advantage over other applicants, who in most cases aren’t ready for them.