Multiple Mini Interview (MMI) – Transcript

[00:01] Torah: Welcome to the Prep Me podcast, a podcast about pre-med stories, expert advice, and just a whole lot of talk about this wonderful world We call medicine. I’m your host. And with me today is Dr. Chansey Veinotte. He is one of the chief pediatric residents at CHEO, the children’s hospital of Eastern Ontario. Hey Chansey.

[00:19] Chansey: Hey Torah. How’s it going?

[00:20] Torah: Good. How are you?

[00:21] Chansey: Very well, thanks for having me.

[00:23] Torah: So today I wanted to talk about all about these MMIs, these multiple mini interviews, because of course most of the medical schools across Canada are using them right now, and they have a lot of myth behind them that’s not based in a lot of fact when it comes to students preparing for premed. So can you just give me a quick rundown of what the MMIs are?

[00:44] Chansey: The MMI is sort of like the postmodern approach to interviewing candidates. And a lot of you have probably Torah and myself included have done interviews that have been one on one or one person that is you with a panel of three people, that ask you questions over half an hour to an hour, depending on the interview format. The MMI is taking a different approach where it suggests that there are many different ways that we can evaluate a person’s character in attributes and problem-solving ability that maybe isn’t facilitated so fluidly in a one-on-one panel style. So in an MMI, so a multi mini interview status or set up, you’re essentially going to be doing eight sometimes 12 interviews back to back over 10 minute intervals to meet different interviewers, interviewees and essentially handle a variety of questions in which you’re evaluated on. And in the end, you’re scored on all of those stations. An accumulative score is totaled to be your interview score for something like medical school.

[01:39] Torah: Okay. So what are the kinds of questions that they’re asking?

[01:42] Chansey: It’s all over the map. The diversity of questions is sort of unpredictable, but the point is essentially to be able to learn about you, like you would in any other interview. Give you the chance to ask questions to the interviewer. Ask questions around your problem solving, your critical sort of appraisal of literatures or known medical problems that are past, present or future. And it can be just sort of your take on certain, more global topics, just to give you a chance to discuss and see how you approach an argument that maybe isn’t so clear cut, isn’t black or white, is very typical gray. And how do you appraise that situation? And ultimately voice what side you favor and what is your support or evidence for that?

[02:24] Torah: Okay. Can you give me an example? What’s a question? I mean, there are ones that are like, why do you want to go into medicine? But everyone knows that one. What are some other ones?

[02:32] Chansey: Yeah, I would say one question could be, Torah thanks for coming to the interview. We would like you to speak to perseverance. Perseverance is something that’s super important in not only medical school, but also as a practicing physician. Can you tell me about a time where you had to persevere and how you’ll utilize that experience in your medical journey?

[02:49]Torah: Oh my gosh. Do you want me to answer that? Should I answer that?

[02:53] Chansey: You could.

[02:55] Torah: I mean, okay. For the audience, I am not a medical doctor. I have no desire to go into medicine. I have a PhD in worm gonads and it’s amazing. And I teach molecular biology, but no, I don’t. Okay, give me a chance to answer one question. I forget the one that you just said. What’s another one? I’m going to do this.

[03:14] Chansey: We’ll just step back. We’ll step back a little bit. How about this? I’m going to make it more broad and more like involving yourself, your family, and sort of the way the public sees medicine. So your question is a member of your family decides to, let’s say depend or solely rely on alternative medicine for treatment for a very chronic or significant illness. They come to you and you hear about this. What do you do? What do you talk about with them?

[03:38] Torah: I’m given some time, right? I can take notes and I’ve got some paper.

[03:42] Chansey: Yeah. If we’re doing this live, it’s a real MMI, what’s going to happen is that question is going to be on a closed door, on a piece of paper that you’ll read over two minutes. So you get two minutes to read, collect your thoughts, think about your approach to answering and then a buzzer’s going to go or a bell that prompts you to open the door and begin your discussion with the interview room.

[03:59] Torah: Do people just start talking before they even sit down?

[04:02] Chansey: Not necessarily.

[04:04] Torah: I feel like, you’re like okay ready, ready.

[04:07] Chansey: Yeah. Like, I have eight minutes. I have seven minutes. I gotta get it out. You know what? The time’s always more than you think it is. And you do spend about 10 seconds just confirming your identity, shaking the hand perhaps of the interviewer, sitting down, taking a breath and then off we go.

[04:20] Torah: Okay. So, alright, you’re going to evaluate me.

[04:24] Chansey: Go for it.

[04:25] Torah: Okay. I’m coming to sit down. Hi, Dr. Veinotte. Hi. How are you? Okay. Unfortunately, I’ve actually been in this situation where I’ve had a friend who’s chosen to not follow traditional medical approaches, and passed away due to a cancer that was largely, at least had an intervention that could have prolonged their lives. And I had to watch this. It was a little bit of a distance, not someone super close to me or not a family member, but I feel like there’s a need to be able to have these conversations without putting someone off or putting someone on a defensive. And so for me, I think the most important way to be not just persuasive, but also communicate facts in a really effective way is to find that shared value, is to find that human connection.

[05:16] And so in this scenario, I’ve got a family member and let’s call it my cousin. So my cousin Alison has been diagnosed with something that she has decided to treat with alternative medicine. I think that me being in a position, that I’m more scientifically literate than most members of my family, there are a couple of doctors, but I’m sort of scientifically literate. I think that I could approach this person and say, I want to ask you, why. Why are you going this route? And where do you get your sources? And where are you getting your information? And really just provide a little bit of a platform and a peer-to-peer conversation instead of really talking down to someone. And I think that’s one of the threats of medical communications in general, is this feeling of you’re talking down to and you know more, and you don’t actually know more about that person.

[06:10] And so really asking them for their motivations, for their understanding and finding if there are ways to connect with that person. And so it might be my cousin who I said, we’ve gotta think about your son and at least let’s talk about this. I care about you. I want to help. And let’s talk about all the things that are affecting you and affecting this decision. And I think that if you open that equal platform for conversation, that her concerns or her position has merit, that it maybe comes from a place that is uninformed, but it doesn’t mean it doesn’t have merit. And there’s maybe some subtle corrections you can make along the way about her understanding of that particular cancer or the medical literature or which sources are valid sources of information. Is she getting her information from Mercola which is very much a bunk website that’s been de-platformed off of Google. So there are places where you go, okay, well, can I address and tackle what are the root causes of this particular hesitancy? Okay. So I do that for maybe like eight minutes, but I feel like I kind of, what if I make my point within eight minutes?

[07:22] Chansey: Yeah. Maybe you make your point, let’s say in the first four minutes, and you thought your eight minute prepared discussion on this scenario going in was going to take you the full time. And then yeah, it’s four minutes and you have a rough idea cause you haven’t heard the warning bell that you have only one minute remaining and often the interviewers don’t give you much feedback as to, okay you have three more minutes, would you like to keep going? I’ll literally look at you and I’ll try my best to maintain neutrality. I mean, I’m human, so I’m going to nod and I may have a follow up a question or two if you hit it on a certain point that I think we could dive a little bit deeper into, but otherwise I’m just going to sit there and say, okay, Torah, is there anything else you’d like to add to your response?

[07:56] Torah: What if you don’t finish the eight minutes? Because I think that I would probably, I talk really quickly, but what if I finish it in three? Do I sit there for five minutes?

[08:05] Chansey: You know what? You very well could, some people choose to sort of sit and maybe spend, say you’ve got three or four minutes left in the station. They might sit for a minute saying, okay, I’m going to just think about my response and see if there’s anything else I’d like to add over the next 30 seconds to a minute. And they’ll just sit there and silence, maybe just kind of look to the side, recap their answer. And if they think, oh gosh, and, oh, here’s a big take home point to my prompt I’d like to add. You’re very welcome to do that. Or you can sit in silence. And a lot of times I think like you, I’m a talker and I don’t love a lot of silence. Like if I’m not listening and there’s just silence, I like to fill it.

[08:36] Torah: I’d freak out at this point. I’d be like what else should I say, okay, how did I do, how did I do?

[08:42] Chansey: So I think your response was really nice and actually very holistic to the topic and the question. And as the interviewer, I can’t grade you on or evaluate you on the exact scenario you’re giving. What I’m looking for is to see if you, without intention are hitting on some of the points and attributes that I see as someone coming into medicine that would make a good physician, a good person to work with, a good person to care for someone, a good person to medically manage and in this case advocate for treatments that are going to be more effective to perhaps prolong or even prevent chronic illness in a population for individual. So I’m listening to your response and I’m active and I know what’s going on. And then the conversation around your cousin with the illness to my alternative medicine example, but I’m looking and saying, okay, well, based on Torah’s example, she’s showing me that she was able to be the listener.

[09:29] She was able to be the teacher utilizing the platform that she has based on her experience, which came out and maybe I didn’t see your resume yet. I didn’t know that you were more scientifically sort of on a higher, conversational level than your family member or others in your family. So I’ve learned that I’ve learned that you clearly care for this individual and you’re advocating for their best possible outcome. And that is in this case going to be very important on the treatments that they ultimately decide. And like you said, you can’t push. You can’t be the person that says, you’re wrong, you need to do this. That’s absolutely absurd that you would go down the alternative route. And that comes into the listening and sort of just being there and knowing sort of your position.

[10:09] And I think the caring is obviously there, the teaching is obviously there and the advocacy is obviously there. So I’m hitting all these points and those are the comments I’m writing because I won’t remember, and I don’t need to write out your story in a paragraph. I need to write out what came out in your response that tells me about you, the way you approach the problem. And then ultimately if I jot down a fall question or two, I’ll have it there for at the end if we have time and I can choose to ask them, or I may not.

[10:31] Torah: In a lot of interviews, I mean, professional interviews and interviews for jobs, they always kind of recommend you steer the conversation towards your strengths. In these scenario kinds of interviews are we supposed to do that or are we given another opportunity in another question in another room that says, what are your strengths?

[10:47] Chansey: Yeah. And sometimes you will be, it really depends on the institution. And I’ve been part of sort of two MMI setups, sort of at different institutions when it comes to helping with question development and seeing and evaluating the approach. And sometimes there’ll be a circuit that is one year in an MMI circuit of 10 stations that has 100 or 200 candidates coming for interviews. There may be a question that’s very, very concise and says, tell me about three attributes that you have that you think are going to be incredibly essential to your success going through medical school and ultimately practicing medicine. And that’s going to be very clear. You’re going to have three things or four or five that you’re going to utilize.

[11:25] Sometimes it’ll be a little bit directed in the sense that here’s an example room. On the door, you’re given maybe 10 things, a list of 10 attributes, problem solving, leadership caring, empathy, you name it and you have to pick one of them to speak up and say why you think it’s the most important one on the list. And that’s so tough because all those things are important, but this is an opportunity now to gauge discussion, get to know you a bit, get to appreciate your understanding of the word or the attribute you’ve chosen and how you perhaps innately have that and how you’re going to employ it in this process.

[12:00] Torah: Do you think that the MMI is a really good decider of who gets into medicine?

[12:05] Chansey: I think it’s certainly a better decider as to who gets a seat in a med school. As somebody who’s obviously sat through it and I’ve gone through the process twice applying for medicine, it’s nerve wracking. And I think even when I was thinking of medicine back in undergraduate, because I applied after grad school and working for a few years. In undergraduate, there wasn’t a ton of MMIs. It was sort of still a newer thing. And there were still lots of panel interviews. And I think in a panel interview, you either walk out feeling great, neutral or terrible. And if you go in and the nerves get to you, you just feel like you’ve left such a bad first impression and felt like you really didn’t do justice to any of the questions they had for you.

[12:46] Maybe you felt flustered, you forgot a great example, like the one you gave for your question and you kind of picked one on the spot that maybe wasn’t so strong or didn’t address the question and you leave with that attitude and sort of all your marbles are in that one interview bag. But I like the MMI because it’s 10 sometimes 12 opportunities to make a first impression. So you go and you do your first 10 to 12 minute station and maybe it goes great. And you’re going to feed off that and you’re going to go into the next one and keep building on that momentum or say it was terrible. This first question I have asked you Torah, and you just didn’t have an example. And you tried to just think about like a scenario that you’re kind of making on the spot or something fictional just to guide your response.

[13:25] And then you walk out of my session. You’re like, oh gosh, that interviewer must think I’m terrible. I had nothing to talk about. I rambled the whole time. So be it I’m one of 10 or one of 12, the next one you might go in and dominate and get that perfect example in and really shine in the station. And that builds confidence. So I like that in an MMI. And I like the ability for multiple interviewers who evaluate a candidate. You don’t feel like there’s one person and Torah and that one person decides what happens with Torah. No, it’s 12. Sometimes it’s up to 20 if you have two interviewers in a room, because we use simulated patients, which are people in the rooms that are acting with you pretending to maybe to be a patient, pretending to be maybe a stranger that you’ve just had a confrontation with on the prompt on the door and you need to go and work through the situation with one another.

[14:11] Torah: Wait, take me through that one. What do you mean there’s someone else like your role playing? Are you role playing as a doctor already?

[14:18] Chansey: You may not be role playing as a doctor. You may be role-playing as sort of, you could be like a healthcare professional. You could be, like a public situation where I’m just kind of thinking on the spot here. Let’s say you’re in a grocery store and you’re in line up and somebody cuts in front of you. And obviously you’re in a long line of people and this person just cut in front of you. They have a huge cart of groceries. They’re being very rude to you as they pass. They’re being very rude to the cashier. What do you do in that scenario? Do you address it?

[14:44] Torah:  I mean I’m Canadian. I sit back and just go, okay, sorry, did I get in your way?

[14:49] Chansey: Sorry. My bad. You must have been first. Or if it led to somebody being very rude and maybe upsetting the cashier, what would you do? And let’s say I don’t give you the option to do nothing. I say you’re going to say something. What do you say? How do you approach this confrontation? How do you prevent it from being sort of a negative or heated confrontation? What can you do? How would you address this scenario? And that’s tough because it puts you on edge from the get go, but I’m not looking for you to, like you don’t pass the station by diffusing and having this person become your best friend by the end of it. I just want to see how you communicate through the scenario. How do you listen? How do you give that silence when needed and how do you phrase and formulate your responses to again, avoid confrontation that is negative and hopefully better the situation in the end, but it can go so many different ways.

[15:32] Torah: How do you prepare for this? Like how do you prepare for these random situations? You’re asking me about myself and you’re asking me about my dying cousin and you’re asking me about my grocery habits. Like how do I get ready for this?

[15:42] Chansey: Yeah, isn’t that tough? You know what the MMI, the best thing that people can use is to sort of control the things you can predict. You can predict on an MMI that you’re going to see questions that are maybe more ethically driven, maybe questions about medicine directly, patients directly. And then of course you’ll have these real life sort of problem solving examples. So there’s lots of good books. I won’t name drop. The one that a lot of people tend to use would be ‘Doing Right’ it’s an ethical book that covers [16:10 inaudible], capacity, autonomy of a patient and it’s a fairly short read, but essentially it’s medical ethics. And it’s really good to prep yourself with that book because you know there’s going to be something ethical on your MMI. For all the other stations that are again, a real life scenario or perhaps a team building scenario where you and a fellow candidate enter a room together, you have to work on some problem.

[16:32] Perhaps there’s a divider and one person has the instructions on how to draw a certain picture. And they’re going to instruct you on how to draw it on your blank piece of paper. And then you’ll swap roles. You go to the other side, a new candidate comes in and you give instructions. So in ways you can prep on some of this stuff at home with your partner, with a family member, otherwise there are courses on MMI. Unfortunately not enough if you ask me, they’re very hard to find. There are online forums that people essentially just throw in all the prompts they can think of or variations of prompts they’ve heard that have existed on MMI so that the forums can discuss maybe how you would approach the problem. So you definitely need to prepare, but the prep is very different for say.

[17:11] With Prep101, we prepare for the MCAT. We have a very regimented schedule. We know exactly what topics we want to cover. We know exactly the practice time. The MMI is a little bit more uncharted, but it certainly still relies on your commitment to prepare and what that prep looks like as a bit of reading, a bit of practice and honestly speaking out loud with someone, like we’re doing right now. I had this thing with my wife when I was doing one of my MMIs where I had prompts in a jar, like in a Mason jar and I would try to take one out of the Mason jar, look at it and then say, okay, I’ve got eight minutes to speak to this topic. And I’m sure I printed them out, but I don’t remember what they said. So I really had no prep to the exact words on the page, but then I would speak out loud and honestly have my wife give me very critical feedback as to my response, like areas where I was.

[17:53] Torah: Was she tough?

[17:54] Chansey: She’s tough lady. Yeah, she’s a lawyer now and she is a very intelligent lady and kept me humble and honest.

[18:02] Torah: So she’s cross-examining you basically.

[18:05] Chansey: Yeah that didn’t seem genuine or I really didn’t like the example or I didn’t like the way you formulated that question and she would give me feedback of ways, maybe as a listener, I think I would’ve understood your scenario or your response better and that’s what you need. So essentially you’re going to be practicing doing interviews with loved ones and friends or fellow candidates, which is what a lot of these prep courses, when they do exist say at the university level. It’s just getting people in a room together to talk through prompts.

[18:30] Torah: Alright, well, this is a good time to take a quick break from a word from our sponsor. Prep101 is the most comprehensive prep company in North America with over 140 hours of instruction from expert instructors, personalized study plans, flexible schedules tailored to suit your life and more practice exams and material than you could ever want. Take the Prep101 MCAT course to realize your dreams of medical school.

[18:53] Alright. I want to come back to this idea of prepping for it because the question is, if you go into a room of peers who are all pre-med or they’re staring down a interview, how do they know what’s good?

[19:10] Chansey: Good in terms of?

[19:11] Torah: A good response.

[19:13] Chansey: And you know what, that’s tough because we do have numerics to it. Ultimately we’re grading individuals to one another. So it’s nice as an interviewer to be part of an MMI and see not just 10 candidates in one cycle because if you could imagine, say at, Ottawa, Dhai Calgary, I’m interviewing 200 people. I can’t interview all 200 at the same time, I’m going to do it in tracks we call them. So track A through F let’s say. And in track A it’s just 12 people coming in, going through my 12 stations with the same 12 interviewers. And we try to have some continuity. So that in the run of a day after I’ve seen 12 people, 24, 36, I can go back and if I need to adjust the scale, meaning that, oh, I was really hard on this first person at the beginning and actually comparing their response to the next five people I saw they did quite well. And I have the fluidity and the option to go back and obviously change my score or put comments on their actual card. So that would be the main thing.

[20:05] Torah: I mean, we’re both talkers. And I feel like if I wanted to pursue medicine and doing an MMI, be like, yeah, this is going to be fun. What if you’re not a talker?

[20:18] Chansey: Yeah. That’s it. And that’s part of the prep is you have to sort of not necessarily learn and become a talker, but learn how to essentially have mini conversations with strangers and you’re committing to that in medicine. And you don’t have to be the extrovert like yourself or me. And sometimes I feel like depending on the scenario, I can be introverted. But if you’re coming in as a full on introvert, I’m not comfortable talking with people. I’m not comfortable having to lead a conversation, that’s where you’re going to focus your practice. I’m not saying you have to change who you are, but you need to be able to feel more comfortable in those social settings. So the practice will be again, whether who it is. Like I mentioned, family, friends, stranger, classmate, Prep101 instructor. You’re just taking these times to practice having very candid conversations and whether or not there’s a prompt to guide it, so be it, but just practice having conversations.

[21:04] I don’t expect you to be the one that comes in and is animated with your hands and has like three examples you’re using for a question that really only needed one. You know what’s being asked, speak slow and confidently, which for me, I don’t know about you but sometimes I get so excited that my speech frequency and pace goes so far and then it’s hard to follow along as an interviewer. So maybe the introvert is going to outcompete us because they can speak, good tone at a good pace, being very articulate and very thoughtful in their responses. You can hear it in my voice, right?

[21:35] Torah: Yeah. Undoubtedly my mouth sometimes moves faster than my brain. So I understand that. Can you stand up? Can you wander around? That’s what I feel like I would want to do. Can you use humor? Because I think if I was getting nervous, I would use humor. I’m not that funny, but I would try. Can you?

[21:52] Chansey: Of course, again you have to be yourself throughout all these. Yes, there are props to guide where the conversation goes, but it’s you answering it. It’s your mannerisms; it’s your body language. Be you. And for me, just like you, I’m a goofball. And I try to obviously answer the question in front of me, but if there’s a spot for a little bit of humor to make me comfortable and perhaps get a little smile from the interviewer that just gives me more confidence going through.

[22:16] Torah: But the interviewers are staring at you just like stead stone faced. Oh my God that is so intimidating.

[22:24] Chansey: You might lean that way. You might have a pencil tooling around the ear over here, but they’re just five feet, six feet away from you sitting in a chair across the small clinic room and you are sitting. I don’t think people typically stand up unless it’s an activity they’re supposed to perform, but there’s no dancing in the MMI. There are no jumping jacks or physicals. So standing doesn’t typically happen and you wouldn’t want to be distracting. So usually you’re sitting in a free chair. Sometimes you’ve got a copy of the question that was on the door, sitting on a small table to your right or your left. So you can refer to it. But otherwise it’s just like we’re doing now. It’s face to face. You might be writing a few notes and then looking at me, writing a few notes, repeat, and I’m just off to the races with you.

[23:04] Torah: I was going to ask that so you can ask them to restate the prompt if need be, right? If you’re getting distracted, if you’re getting nervous, you start babbling, can you go, okay, I just need to stop and re-center myself?

[23:14] Chansey: Yeah. And you know what? I’ll give you my personal approach to MMIS is, again, it’s 12 stations. So imagine a long hallway with 12 doors. Every door has its own prompt on it. You’re given two minutes to read your prompt and then a buzzer will go off that allows you to enter the room. You enter the room. I may show my name tag saying, yeah, I’m Chansey. This is my interview number that I’ve been assigned. And then you’ll say, great, have a seat. I sit and I often would start the station as long as I think I have enough time. I’ll start the station by recapping the question. And I’ll say, it’s my understanding from the prompt that you’d like me to discuss the following scenario, quote, end quote. And then I go into it. At any point in the time, like you mentioned that I feel like I’ve lost or forgotten what I’m trying to answer because I’ve started rambling or I’m getting a little nervous. Often there’ll be a hard copy right beside me that is the exact same prompt that I can look down to, reread, summarize, and then get back into my discussion. If there’s not, of course, you’re always welcome to employ and ask the interviewer to repeat the prompt for you because I also have a question sort of bolded on my clipboard of the evaluation form.

[24:20] Torah: Okay. By the way, you’re listening to the Prep Me podcast and I am Dr. Torah [24:25 name] speaking with Dr. Chansey Veinotte. And Chansey, I want to know your most important advice for someone who is not necessarily ready to walk into the interview room, but is ready to start thinking about, they’ve got an interview date. They’ve just been announced. They’re really excited. It’s coming up in February. What do you tell them right now?

[24:47] Chansey: I’d say, first of all congratulations, because it can be tough to get an interview. We talk about the stats all the time in our other seminars and not everybody gets one. You’ve had to perform on paper. So now it’s your time to perform in person, which is, I think the ultimate objective for anybody applying to medicine, is it’s hard to tell yourself on paper, in a CV, in an autobiography, but now it’s you in the flesh in the conversation. So I would say, be excited and utilize the success you’ve had so far and the congratulations to motivate you, to get ready for the interview. And the first thing I can say is I would probably say two things. One, get a copy of a medical ethics book because that’s something you can control as we mentioned. And then number two is tell people around you that you’ve got an interview.

[25:30] Tell them about the MMI. If you don’t know much about it, you haven’t listened to this podcast until the day before. Perhaps you’ve heard about it through other medical students or other doctors. So educate and start practicing, start thinking of where can I get good prompts? What are the online resources? And now who is going to listen to me, do 50 to 100 prompts and give me candid feedback and I won’t take it hurtful or storm out of the room, but I’ll be a better interviewee for it. So read your ethics, tell people you’ve got the MMI and what it is. And then thirdly, so I have three things. Thirdly, start practicing, responding to prompts.

[26:08] Torah: Alright. Thank you, Chansey. We will chat again. He will be a regular feature on this Prep Me podcast. So I want to appreciate everyone for listening and our sponsors again, Prep101, the most comprehensive prep course out there. You can visit us at Prep101.com. Thank you.

[26:23] Chansey: Thanks guys.