Rajani Katta MD
How to Prepare for the MMI (Multiple Mini Interview): 9 Expert Strategies for Premedical Students
Updated: May 24, 2022
If you’re applying to medical school in the United States and Canada, you've no doubt heard of the MMI, the multiple mini interview.
This is a newer interview format, and judging from discussion forums and our conversations with premedical students, it inspires a great deal of anxiety.
Which is entirely understandable. The typical format of the MMI is that you rotate through a series of different “stations.“ At each station, you meet with a different interviewer who evaluates your performance. Each station is centered around a different prompt, and your goal is to respond to that prompt.
Although formats differ from school to school, one typical format is that you have 2 minutes to read the prompt and prepare, and then about 5 to 8 minutes with the interviewer. During your time with the interviewer, you'll either be responding to a question, completing a task, or role playing in a scenario.
How can a premedical student prepare for the MMI?
If you read the websites of multiple medical schools, some will tell you that there is no way to prepare for an MMI. In other words, “just relax, be yourself, and do your best.“ We disagree.
Can you predict which prompts will be used in your MMI? No, of course not. There are dozens and dozens of different potential prompts that you might be faced with.
Can you prepare for the MMI? Of course. Although you won’t know the prompts in advance, and therefore won’t be able to memorize your response, you can definitely prepare. In this post, we review 9 of our expert strategies to help you prepare for the MMI.
Strategy #1: Learn the different types of prompts that you might encounter in an MMI, so that you won’t be surprised, shocked, or paralyzed
It’s really important to become familiar with the types of prompts that you might encounter on the MMI. Some of these prompts are actually designed to test your poise under pressure, and recognizing that ahead of time can make a big difference. For example, you might be asked to role play a scenario with an angry customer. Mentally preparing for these kinds of uncomfortable, challenging, and sometimes even confrontational scenarios is very important. You don’t want to be paralyzed on the actual day.
Learn the three major types of prompts: the task, the scenario, and the question
We describe the major categories of potential prompts in more detail in our book, "The Multiple Mini Interview: Winning Strategies from Admissions Faculty". In general, you will encounter three main types of prompts.
The task station
The scenario station
The question station
Task stations test your communication, problem-solving, and teamwork skills
At the task station, you're basically asked to complete a task. Many times this task involves a collaborative task, in which you're asked to work with either a colleague or with the interviewer to complete a challenge.
One example of a task prompt is the origami challenge. In this challenge, two applicants are seated back to back, and one applicant is given directions while the other applicant is given paper. The two applicants work together to try to create a paper crane.
Remember that each station on the MMI is designed to test and evaluate a particular non-cognitive skill or trait. Task stations are used to help evaluate your communication skills and your teamwork abilities. The station also tests your problem-solving skills.
The MMI scenario station asks you to role play
in order to evaluate
your interpersonal skills, your problem-solving skills, and your sense of empathy
At this type of station, you'll read about a particular scenario. Then, as you walk into the room, you'll begin interacting with either the interviewer directly or with an actor (while the interviewer observes your interactions). There are lots of different potential scenarios that you might be asked to work through. Common scenarios include situations involving an angry customer or a distraught patient. You might be asked to play the role of the store manager or the head nurse on duty. You'll then act through the scenario, highlighting your response to the situation and the other actor.
The question station might ask you to respond to ethical issues or current events.
This station may also focus on behavioral interview questions or traditional interview questions
I want to emphasize one point before you start thinking about the question stations. The MMI is not a test of your scientific or clinical knowledge, so you don’t need to start cramming and memorizing information related to specific questions.
Having said that, you should become familiar with ethical issues in medicine and current events. (Although you don't need to be an expert.) Instead, this station is used to help provide insight into your values and professionalism, as well as your communication skills. Interviewers are really interested in hearing your thought processes, more so than your particular stand on an issue.
Typically, you'll have 2 minutes to read the prompt. Some schools allow you to take notes to help you prepare your response, while others do not.
As you walk into the room, you will typically have 5 to 8 minutes to discuss this question as well as answer follow-up questions from the interviewer.
Question stations might also focus on traditional interview questions
It’s really important to realize that some schools devote one or two MMI stations to interviewers who will ask traditional interview questions. In other words, the prompt may be “why did you apply to our medical school“ or “why do you want to be a physician?"
We have multiple resources available to help applicants who are preparing for the traditional interview questions. Here is our list of 350 common medical school interview questions.
**One important point: although we list out 350 different questions, most of these are variations of approximately 30 main questions. This list also includes links to some of our published expert guidelines on how to respond to some of these major interview questions.
Question Stations Might Also Focus on Behavioral Interview Questions
Behavioral interview questions are often found in traditional interviews, and they may be used in the MMI as well. Basically, proponents believe that past performance may predict future performance. We have more on behavioral interview questions in our post on common medical school interview questions.
Tell me about a time when you had a conflict with a classmate, and how you dealt with it
Tell me about a time when you had to deal with a stressful situation
Tell me about a time when you showed initiative
Tell me about a time when you had to motivate others
Learning the MMI format and being prepared for the different categories of prompts can help you stand out during your interview
Strategy #2: The MMI Mock Interview and Practice
If you’ve never had to practice speaking in a formal setting, you'll need to start practicing now. Why is practice so important? It's so that you can obtain feedback on both the content of your answers as well as the delivery of those answers.
When giving a talk, your message is conveyed in two different ways: verbal and nonverbal communication.
Verbal communication represents the content of your answers.
Nonverbal communication encompasses your eye contact, your voice, your body language, and more.
This post on how to give a medical talk goes into far more detail on delivery and other aspects of nonverbal communication.
The key strategy we recommend here is to practice your delivery during a mock interview with a colleague or a friend or a family member.
Practice giving a short talk. Ask for feedback. Did you maintain appropriate eye contact? Did you have appropriate pitch and pacing? Did you rely too heavily on the use of fillers such as "uh" and "umm"? Once you have specific feedback, you can work to improve on these areas.
Strategy #3: Practice with a timer and learn how to give a time-bound answer
Timing is a huge consideration in the MMI. At each station, you may only have 5 to 8 minutes to respond to a prompt.
Think about facing a prompt such as "Tell me how you would combat vaccine hesitancy in your community if you were a public health official." Giving a structured, well-thought-out response in under 5 minutes can be quite challenging.
That's why it's so important to learn exactly what 5 minutes feels like. The best way to get a good strong feel for time limits is to practice responding to multiple prompts and timing yourself.
Some schools will release information on how many stations they use. They may even tell you how much time you have at each station.
If you're provided with this information, that can help you as you’re practicing. However, remember that a 5-minute time limit is not just you talking. When responding to a discussion prompt, you typically want to end early so that your interviewer can ask follow up questions.
If, therefore, you have 5 minutes to speak, practice speaking for about 3-4 minutes so that your interviewer can ask follow up questions.
Strategy #4: Your preparation for each type of MMI prompt is different. Remember that some types of prompts allow for more preparation than others
As we go through these strategies, it’s important to recognize that your preparation for the major categories is of course going to be different.
In general, it’s harder to “prepare“ for role-playing scenarios or task collaboration scenarios. That doesn’t mean it’s not possible to practice. We'll outline some additional strategies below.
Strategy #5: Learn the four key strategies to respond to MMI scenarios or acting stations
The angry customer or the distraught patient are common MMI scenarios. We provide examples of our recommended approach to these particular MMI scenarios in our book, but you can get started now with an overview of our 4 key strategies.
One important reminder for this type of scenario. If you're role playing, there will usually be some emotion involved. Remember that this type of MMI scenario is used to evaluate your compassion, your interpersonal skills, and your problem-solving abilities.
Therefore, 1. Always start by acknowledging the emotions of the "patient." "I'm sorry to hear that you've had to deal with that. That sounds very frustrating."
2. Listen first. Ask the patient to share his or her story, so that you can listen, gather more information, and understand their emotions. "Can you tell me more about what happened?"
3. Your interactions with the patient, both verbally and nonverbally, should reflect your compassion and empathy for the patient.
4. Ask follow-up questions and then focus on problem-solving. Think about how you can help resolve the situation.
As you’re thinking through possible MMI scenarios, it’s really helpful to start thinking about how you have responded in challenging situations in the past. What did you do well? What do you wish you had done differently? This reflection can be helpful as you work through potential scenarios in your mind.
Strategy #6: Practice responding to high-yield MMI scenarios
We list multiple high-yield scenarios in our book. These include the angry customer, the distraught patient, having to break bad news to a patient, and more.
Since the angry customer is a common scenario, it’s really important to learn phrases and tactics that help de-escalate situations. There are multiple medical journal articles describing approaches, and we outline our approach in the book further.
The task or collaboration station is one of the hardest to prepare for in advance
I consider this the hardest to prepare for. As you’re working through this station, remember that some interviewers will deliberately try to fluster or frustrate you. Sometimes just knowing that may help you maintain your equilibrium.
Would you be able to teach a mentally disabled adult to tie his shoelaces? What if the actor was deliberately provoking you?
Throughout your response, remember to always center yourself on the values of patience, compassion, and empathy.
Strategy #7: For the MMI discussion station, learn the basics of medical ethics and be well-read on current events
Potential discussion prompts encompass a wide variety of topics. These might center on medical ethics or on current medical events. They might center on issues completely unrelated to medicine.
However, since medical ethics are such a rich source of discussion topics, I recommend that you start by learning the basics.
Do you know the four major ethical principles that underlie the practice of medicine?
It’s important to learn about the concepts of beneficence, non-maleficence, autonomy and justice
If you're not familiar with the basics of these principles, you may want to start with one of my podcast episodes.
On the Step 2 Success podcast, we help medical students prepare for the USMLE Step 2 exam. Since ethics is one of the subjects covered in the USMLE exam, we recorded two episodes on this topic.
In these two episodes, I discuss representative cases involving medical ethics, as well as specific cases related to patient autonomy. These two episodes provide a very quick overview of these concepts, but should be a helpful place to start.
Beyond ethical principles, it’s really helpful to read the news.
Stay abreast of current events. Talk to your family, read the news, discuss events with your friends. As you read cases in the news, jot down a few points.
As I'm writing this in 2021, I expect that pandemic-related issues will be a ripe area for discussion. "If you were a public health official, discuss how you would make the case to your community of the need for a lockdown."
How would you respond to this prompt? Reading the news and learning about the viewpoints of people on both sides of an issue can help strengthen your response.
Check global, national, and local news outlets to further your insight on current events, both medical and non-medical
Strategy #8: Learn key principles and general structure when responding to discussion questions
You’ll never be able to memorize responses to discussion prompts, because there are, obviously, just too many potential topics. Instead, what I find helpful is to keep abreast of current events and to try to follow a general framework when formulating your response.
When formulating your response, first keep some key principles in mind. Second, providing some structure to your response will be helpful.
The key principles of discussion questions: patient care first, but always consider all stakeholders
Put care for the patient at the heart of your decision-making
It’s also important to consider all stakeholders in this issue. Beyond individual patients, you should also consider the impact of any particular issue and response to that issue on multiple stakeholders. This may include the healthcare team, the patient’s family, the employer, the hospital, the insurance company, governmental payers, the public good, and others.
A structured response is a stronger response
When you're providing your response, it's helpful to provide an overall structure. Instead of rambling, you want to provide the interviewer with a reasoned, well thought out response or argument. A basic structure can help.
Identify and verbalize the underlying issue
In the introduction, explain your own position, which should be congruent with the values of physicians
Demonstrate that you have considered other points of view
Deliver your argument in a structured way. "First, we need to consider...Next, we should consider...Finally, we need to consider..."
Most importantly, articulate your thinking process. "In thinking about the needs of the patient in this situation, I believe that we need to consider..."
Strategy #9: Have some introductions ready to go
Sometimes having a few phrases that you can use in the introduction can be very helpful.
"I don’t know, but here’s how I would go about making a decision."
"This is clearly a very complex issue, but I would begin by considering the effects on ..."
"Although this issue brings up a lot of strong emotions, I believe it's important to begin this discussion by..."
Bonus Strategy #10: Bring in Your Personal Experiences Whenever Possible
For discussion stations especially, it's helpful to include any of your personal experiences with this question or issue. This can highlight some of your insights based on personal experience, or just highlight the fact that you've spent time thinking about this issue.
Highlighting your personal experiences can also make for a significantly more memorable response.
"I know how difficult that can be. When I was working as a waitress, I had several frustrated customers, and this is how I approached that issue..."
"That's a challenging issue. I remember when my family member had to deal with..."
"I know that brings up a lot of complex issues. When I was volunteering in the family practice clinic, we had several patients who had to deal with end-of-life issues..."
"Medical misinformation is such a challenge. I didn't realize how much of a challenge until I heard my very well-educated relative talking about the risks of masks..."
Remember: There is no right answer, but there are stronger responses and weaker responses
Clearly, there's a lot more that we could say about preparing for the MMI. (I mean, we wrote an entire book about this topic!) But the bottom line is that there are no "right" answers when you're discussing an approach to vaccine hesitancy (for example).
In the setting of an MMI, they're not looking for the "right" answer. They're looking for an answer that reflects the attributes that make for a strong physician.
Unfortunately, we've worked with wonderful, strong medical school applicants who absolutely possess these attributes-- yet who haven't been able to convey that well in this type of interview format.
That's where preparation and practice can make all the difference.
Even if you're reading this and feeling very-not-comfortable at this point, we can reassure you. We know that with preparation and practice you'll be able to excel. Our advisees have demonstrated that to us many times, and we're proud to now be able to call many of them our colleagues.
We wish you all the best with your MMI prep and interview season. If you'd like a free excerpt of our medical school interview book and MMI book, please sign up below.
Dr. Rajani Katta is the creator of Medical School Interviewing 101, the course that teaches students how to ace their interviews. She is also the author of the Multiple Mini Interview: Winning Strategies from Admissions Faculty, the Casper Test Prep Guide, and The Medical School Interview. Dr. Katta is a practicing dermatologist and served as a Professor of Dermatology at the Baylor College of Medicine for over 17 years.