How to Excel at the Multi-Mini Interview (MMI)
Here we’ll cover some strategies to prepare for the MMI, discuss how the MMI works, and some suggested resources
What is the MMI?
The Multiple Mini Interview is many short, structured interview stations allowing interviewers to evaluate soft skills. The MMI was developed by McMaster’s School of Medicine in 2001 to address the concern that traditional interviews did not predict performance in medical school or ability with patient interaction.
Evaluating Candidates with the MMI
Why do PA schools choose to use the MMI instead of the traditional interview?
Problems with the Traditional Interview – Imagine sitting in front a panel of three judges who are overseeing your interview. They each take turns asking your questions. They have a list of questions on their sheet from which to pick, “What made you decide PA school? How do you handle pressure or criticism? What are your greatest strengths? What are your greatest weaknesses? How are you a good fit for the program?”
There can be a few issues with the “traditional” interview approach
An intimidating setting – A traditional one-interviewer, one-interviewee evaluation setting is a lot of pressure (or in the example above, a 3-interviewer on 1-interviewee).
You have one opportunity to make a good impression – If you “fumble” in one of your answers, this may paint the way the interviewers may view you for subsequent questions you answer. There is no opportunity for a real “fresh start” on a new question in a traditional interview.
If using “traditional” interview questions – some interviewees can anticipate and prepare for the questions ahead of time. Interviewers may get “canned” answers that have been doctored, memorized and rehearsed. PA Programs want individuals who will excel in their program and to be good representatives of the profession. However, some candidates that are not good fits may actually EXCEL at an interview, but turn out to be poor fits for the PA Program.
The MMI addresses several of these issues:
There is more than one chance to make a first impression, in fact, there are 12: McMaster has 12 station circuit, each station with its own interviewer who is listening to answers from different candidates from the SAME question. It is difficult to escape bias, or to make a fresh impression if you happen to not do so well early on in the interview. The MMI eliminates this, since each question you answer will be with a different interviewer. So if you felt you did badly early on in the MMI with a particular question, that interviewer’s impression won’t carry on to later questions (because you have different evaluators!).
Less predictability of Interview Questions: For interviewers, the structure of the MMI allows for less ability to express “rehearsed questions”. Imagine walking into an interview not knowing what questions to expect, you read the scenario on the door which has a question that they wish you to discuss at length with the interviewer inside. Content of the questions may deal with (not limited to) “communication, collaboration, ethics, health policy, critical thinking, awareness of society health issues in Canada and personal qualities. Applicants are not assessed on their scientific knowledge.” – McMaster Prospective Student Site. Most traditional interviews ask “Why do you want to be a physician assistant? Tell us about yourself, etc.”.
Candidates have to think on their feet. With the MMI, its nearly impossible to predict what questions will happen, thus the answers given by the interviewee are more spontaneous, more natural, and perhaps more “reflective” of the interviewee’s actual merit and character.
Format of the MMI
Multi-Mini Interview Circuit
The full MMI Interview may compromise of 8 to 12 “MMI Stations”. You start at Station 1 (or another station number) and progress in order. Each station has a different MMI question and MMI interviewer. You may also get 1 or 2 “rest stations” where instead of answering a question you simply sit and relax.
Format of a single MMI Station
Each station follows a similar format. You have an MMI question/prompt that you read and brainstorm ideas for 2 minutes. The buzzer goes off and you enter the room and discuss your response to the prompt in an interview in about 6-8 minutes. The interviewer may ask you a few follow-up questions with the remaining time. Then when time is up, the buzzer goes off and you exit the MMI station to start reading the prompt for the next MMI station.
Format of a Virtual MMI Interview
With the onset of the pandemic, many programs have turned to conducting virtual MMI interviews. The premise is the same (read a prompt, then discuss your response), however, instead of doing this in front of an interviewer, you are in the comfort of your own home, and recording your responses with your webcam.
The PA program conducting the interview may use a special platform to do the timing of MMI stations, and recording of candidate responses like kira talent, or other program.
When you enter a “virtual MMI station” you may see a timer on the screen (counting down for the “2 minutes of prep time”), and the text of the MMI prompt/question.
Instructions from the PA program may indicate whether or not you may have a piece of paper nearby to jot down some notes. (See tips below on how to use this effectively).
When the 2 minutes are up, the screen will change and a new timer will appear for 6-8 minutes. This screen records your discussion of your response. It may feel strange because you are speaking by yourself into a camera, so some tips below on how to practice for this!
Once it is done recording, you will be taken to another screen for either a short rest period, or to the next MMI station.
There is usually no opportunity to re-record your responses.
Format of an In-Person MMI Interview
If your MMI interview is taking place in-person (not virtually), you will arrive on campus into a facilitate with multiple rooms (that act as “MMI stations) labelled (Room 1, 2, 3 etc.).
The MMI Prompt/Question for that station is attached to the front of the door. Candidates begin by facing AWAY from the door, when the buzzer goes off to indicate the timer for “2 minutes of prep has started”, candidates turn around and read the prompt. Candidates may (or may not) have a piece of paper to write down notes during this time.
Once 2 minutes is up, the buzzer goes off and candidates then enter the room and sit down in front of the interviewer. A copy of the prompt is often available on the desk for you to reference just in case you need to remind yourself the details of the MMI prompt. Candidates have 6-8 minutes to discuss their response to the interviewer. If there is time left over, the interviewer may (or may not) ask follow-up questions.
Candidates remain seated until the buzzer goes off, and they exit the room to start on the next MMI station.
What this may look like with multiple candidates:
Keys to Performing well on the MMI
Tip #1: Familiarize yourself with the MMI format
Before you start practicing MMI questions, read as much as you can (from multiple sources whether online, speaking with other Pre-PAs, books, etc.) about the format of the Multi-Mini Interview.
The Multi-Mini Interview is not a traditional interview format where the interviewer asks you a question, and then you answer. As outlined above in the “MMI format”, there are various stations each with a different interviewer and question where you get an opportunity to read the stem (also known as the “MMI prompt/question”, have a few minutes to brainstorm and prepare, then enter and start discussing your response.
Whether your MMI is in-person or virtual, it all follows a very similar format (prompt, prep time, discuss your response within a limited time frame).
Learning about the format will help reduce stress levels and build confidence as you get familiar with how the Multi-Mini Interview works!
Tip #2: Learn about & practice different types of MMI Questions
A common mistake I see candidates make is practicing only 1-2 types of MMI questions (e.g. ethical questions or health policy questions only). In fact, when you google “MMI practice questions”, many of the sample questions consist of those main types.
This can throw candidates off when they reach the actual MMI interview and come across another type of MMI question.
Here are the possible types of MMI questions you may come across:
Ethical Questions – e.g. Would you withhold diagnosis of a terminal illness of an elderly patient if the family requests it?
Social Issues & Health Policy – e.g. To help raise money for health care and reduce unnecessary use, the Prime Minister of Canada has proposed a $10 fee for first-time contact of seeking care of a health care provider. What are the implications of this?
Situational – e.g. What would you do if as a PA student, you were tasked by a preceptor to perform a procedure that you had never done or learned about before?
Quirky Questions – e.g. If you were a tree, what kind of tree would you be and why?
Roleplaying/Acting – e.g. You are volunteering at a medical clinic when a patient starts to express anger and frustration about waiting over an hour to see their healthcare provider. The healthcare provider is in the room with a complex case, and may need extra time. The admin staff are busy intaking patients, so you have decided to approach the patient. Enter the room and speak with the patient.
Traditional Questions – e.g. Why do you want to become a PA? Why do you want to attend our institution (you are more likely to receive this on a “traditional” interview, and less likely to receive during an MMI interview…but not impossible)
Behavioural Questions – e.g. Provide an example of a time you were demonstrated problem-solving skills within a group setting? (you are more likely to receive this on a “traditional” interview, and less likely to receive during an MMI interview…but not impossible)
Tip #3: Don't just read about the MMI, practice MMI Questions regularly!
You can read as much as you want about the MMI, different questions and scenarios etc. but to actually improve your performance, it is so important to practice questions regularly!
The point of practice is not to give a perfect answer each time, but to help increase your comfort level with the timing, and discussion (hearing the sound of your own voice speaking for 6-8 minutes continuously), making eye contact with the interviewer/camera, reducing filler words (e.g. ‘umm’s’ and ‘ahhh’s’).
My suggestion is to start with 1 or 2 questions a day, and as you get closer to the MMI date start practicing more questions more frequently (a few times a week/daily) as you approach the actual interview date.
Practice according to the format of your interview.
For IN-PERSON MMI interviews: Print some sample questions (some sources for MMI questions are listed below). Paste the first sample question on a door (don’t read it yet!)
Get a timer, give it to a friend who will act as a timer and interviewer.
With the friend sitting inside a room, and you positioned outside the room, have your friend start timing 2 minutes while you read the question on the door.
Have the friend knock, when the two minutes are up, walk in.
Begin speaking about the subject while your friend times for 6-8 minutes.
For VIRTUAL MMI interviews: Due to recent events, some programs have started doing Virtual MMI interviews, which simply means you record a video response for your MMI answers. Here is an outline of how to practice for that format.
What you need:
Copy and paste some sample MMI questions in a Word Document or Google Doc
Set up your webcam – you will be recording your response
Have a digital timer ready (the first timer will be set for 2 minutes for reading the question and brainstorming your response, the second timer will be for 8 minutes to discuss your response).
Start your Practice MMI Question!:
Step 1: Start the timer for 2 minutes, and read the question. You have the entirety of the 2 minutes to brainstorm ideas. You can choose to use a piece of paper to jot down ideas
Step 2: Now start the timer for 8 minutes, and hit “record” on your webcam. Start discussing your response.
Step 3: DONE! Now watch the playback and evaluate your response. What did you do well? What could you improve?
Tip #4: Do some background reading
Health Care Policy: Because you are applying to become a health care provider in the Canadian health care system, it’s important to understand the context in which you will be working with patients. Familiarize yourself with the Canadian health care system, as well as the health care structure within each province.
Health Care and Social Issues: Read and learn about different social issues affecting Canadians and familiarize yourself with the social determinants of health. PAs see patients from all walks of life, backgrounds and different and unique circumstances. Suggested resources include reading health sections of local Canadian news/media outlets, HealthyDebate.ca and following journalists like Andre Picard on Twitter.
CanMEDS-PA competencies: CanMEDS-PA outlines the competency standards that all PAs should demonstrate after completing their PA education. I suggest reading and reflecting on the different competencies outlined
PA Program websites: Learn about the philosophy and approach to education from the PA programs that are you are applying to. Check the “about” section to see “Mission and Values”. Read any links to papers or resources that the program has included. From this reading you can envision what type of candidate they are looking for that would be a good fit for their program, and reflect on why this program is a good fit for you.
Tip #5: Structure your MMI Answers
Ideally, the discussion of your MMI response should be easy for the interviewer to follow. What helps is having an outline or structure that you can put your response into!
There are many suggestions for how to “format” your answer, for example, the “5 Pocket Method” from MMI for the Mind (you can buy a used version for a better price), or the “18 Proven Strategies to Prepare for and Ace Any MMI Question” from BEMO’s Ultimate Guide to the MMI.
You do not have to adhere to any “answer” structure strictly, in fact you can modify suggested outlines that you find online, or create your own. As long as you find it a useful way to organize your ideas and thoughts in a coherent way to the interviewer.
Tip #6: Focus on sounding conversational, not over-rehearsed
One of the risks of practicing for the MMI so much is that you end up sounding over-rehearsed, robotic, and like you’ve memorized your answers.
From an admissions perspective, candidates ideally would come in unprepared, so you get to hear and see the authentic side of candidates. This allows admission committees to find candidates who are the best fit for the programs, while also ruling out those who would not be good fits for the program/profession. However, in a high-stakes assessment of whether or not you’ll get into a PA program, candidates feel a lot of pressure to prepare and polish their performance as much as possible.
Sounding robotic, over-rehearsed or memorized can make you seem rigid and stressed rather than passionate, interested and engaged.:
Prepare, but do not memorize MMI answers. First off, you can’t anticipate any questions that the actual MMI interview will consist of. Some candidates focus on having the “right” things to say in an interview and ‘look up’ answers to MMI questions online (and sometimes the answers provided in some forums or articles may not be reflective of how health care practice works in your jurisdiction).
In my opinion, it is more useful to PREPARE by developing your general approach to an MMI scenario, then come up with your own original ideas and thoughts about the issues brought up in the MMI response. This will help you come across as original and authentic.
Do NOT read off the page or your screen. In some MMI interviews, you may have a piece of paper to jot some ideas. Although this is a good way to help organize your thoughts and decrease stress because you are writing down ideas, DO NOT read off the paper when it comes to providing your response (glancing down once or twice is okay). In a virtual interview, DO NOT type something on-screen and read off your screen.
Manage your stress by taking pauses. It’s okay to re-group in the middle or providing an MMI response with a short pause (a few seconds) to catch your train-of-thought and continue going. When practicing I recommend trying this method rather than “starting over because you messed up the first half of the response”. The ACTUAL MMI will not allow you to re-start or re-record your responses. This strategy helps take to the pressure off of sounding perfect or giving the ‘perfect’ response, which isn’t really the point of the MMI as there are no ‘right answers’.
Reframe the MMI interview as an opportunity to have interesting discussions! In speaking with PA students who successfully got into PA programs, some successful candidates often recount the MMI as a ‘fun experience’. Once they got over the initial nerves, they often say its a lot like ‘having fun discussions about interesting scenarios’. This is a GREAT way to approach preparation and the interview day to help take the stress off.
Some final thoughts on not sounding over-rehearsed. As a practicing PA, I would much rather a candidate tell me conversationally about their motivations of pursuing PA, and what they genuinely think about the scenario rather than spewing memorized responses they prepared ahead of time. Remember that admissions committee members are humans too, they can often tell when an answer is memorized, or being read.
Resources for MMI Prep
Online Guides to the MMI:
MMI Resources for Pre-PAs by Canadian PAs/PA Students
Practice questions and guides are available online which you can find with a simple Google Search. Often using the search term “MMI” or “Multi Mini Interview” or “Medical School MMI”
The McMaster MD Program, of which the McMaster PA Education Program is based off of, has a website with information of the MMI as well as a PDF Training Manual for interviewers of the MMI.
A quick Youtube search of “Multi Mini Interview” reveals helpful videos and sample scenarios that you may view.
PA Blogs that discuss MMI strategies:
Eden, now Manitoba PA Graduate from University of Manitoba discusses MMI strategies: http://eden-pa.blogspot.ca/p/pa-interview-mmi.html
McMaster PA Student Resources has a whole page dedcated to Application Tips, including a section on the MMI.
Sandy Vuong, now McMaster PA Graduate recounts her day at the MMI for her interviews.
Books:
BeMo’s Ultimate Guide to MMI by BeMO Academic Consulting
Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians by Philip C. Hebert
Multiple Mini Interview (MMI) for the Mind by Kevyn To M.D.
Mock MMI’s Practice Groups:
I have had many Pre-PA students ask me about that one. Although good in theory, it may be difficult to find “local” mock MMI groups (again, you’d likely have to do a google search or skim through Canadian premed forums). Otherwise you can request an MMI practice partner on our Canadian Pre-PA Student Network Facebook Group.
I found practicing on my own, with a friend or family member serving as the interviewer very helpful. They could watch my body language as I got to practice building comfort around interviewing.
You may also practice in a mirror so you can get used to hearing the sound of your own voice.
