Multiple Mini-Interview process helps select the best future physicians

Prospective students

David Hungate

Prospective students study their scenarios before entering the interview rooms.

It’s a little before 8 on a Saturday morning, and there is palpable tension in the air at Riverside 3 in Roanoke. Forty-four men and women in dark suits, carefully groomed and polished, mingle in the café of the Carilion Clinic medical building. Some are sipping coffee, while others are nervously chatting. All of them look alert and eager to begin a high-stakes circuit of interviews. After breakfast, the group is called to come forward to start the much-anticipated event.

And so it begins.

An exciting day of interviews for prospective students at the Virginia Tech Carilion School of Medicine. The school uses a nontraditional method of assessing an applicant’s potential—the Multiple Mini-Interview, or MMI for short. While certainly a highlight, the MMI is by no means the only tool the school’s admissions committee members use. Other factors they consider are an applicant’s academic record, and Medical College Admission Test scores, personal statements, academic records, recommendations, research experience, and community and volunteer activities, along with evidence of teamwork and leadership.

Candidates rotate through a series of nine short scenario-based interviews, along with a longer, more traditional interview. The process is well-orchestrated, and it runs like clockwork. The ringing of a hand bell indicates when everyone must stop reading the scenario posted on the door and enter the interview room. The bell rings again when everyone must move in unison to the next interview station. And so it goes. By the end, all 44 applicants have been interviewed 10 times.

During the process, interviewers evaluate applicants, within their respective scenario, to determine the interviewees’ potential to develop into excellent physicians and researchers. Interviewers allow the applicants to communicate their analysis of the scenario prompt and pose follow-up questions as necessary. The interviewers then score the applicants on a scale of one to 10 and provides written comments on their non-academic qualities such as communication skills, cultural sensitivity, maturity, teamwork, empathy, and reliability. The day also includes presentations about the school’s curriculum, a tour of the facilities, a bus tour of downtown Roanoke, and lunch with some of the medical school’s current students.

The MMI technique was originally developed and implemented by McMaster University’s Michael G. DeGroote School of Medicine in Ontario in 2004. Since then, it has been adopted by an ever-growing list of medical, dental, and pharmacy schools around the country. Currently, about three dozen medical schools in the United States use the format.

Why the MMI model?

Criticism of traditional interview formats not accurately predicting performance in medical school and patient complaints regarding physicians’ bedside manners led McMaster University’s medical school to develop the MMI in order to address these issues.

Those who use it say the MMI gives medical schools a more detailed picture of each applicant’s personal qualities and characteristics. It also gives them a realistic look at how the applicant performs under pressure, a critical quality for physicians.

“Scenario-based questions enable the candidates to demonstrate reasoning skills, interpersonal skills, and effective communication-key attributes for our problem-based curriculum, which is administered through team-based student groups,” said Barbara Parshall, admissions director at the Virginia Tech Carilion School of Medicine.

The process also helps avoid a decision based solely on a single impression with either a negative or positive bias from the interviewer.

MMI interviewers at the Virginia Tech Carilion School of Medicine are a mix of clinicians, administrators, and members of the community, who have all been trained in the MMI interviewing technique. The community involvement in selecting Virginia Tech Carilion School of Medicine students is what sets apart the MMI format from the more traditional one-one-one interviews.

"From the beginning, we have always looked for ways to involve the community with our school," said Cynda Johnson, dean of the Virginia Tech Carilion School of Medicine. "Who better to help select our students than prospective patients?"

The community interviewers also serve as ambassadors for the Roanoke area.

“The role of the MMI interviewer is such a critical factor in not only helping us select a high-caliber medical student, but it also helps the students choose to come here,” Parshall said. “When applicants who have received multiple acceptances recognize the involvement of our community and how special that makes Roanoke, it really makes an impact.”

Between August and the following February of each year, the Virginia Tech Carilion School of Medicine interviews approximately 260 prospective students through the MMI process.

“For the interviewers, volunteering one Saturday per admissions cycle is a commitment they’re eager to make in order to help select future physician thought leaders who deliver patient-centered, compassionate care,” Johnson said.

Parshall noted it’s an invaluable payoff for the school and society.

“Having leaders participating in our program has a profound impact on the quality of the interview experience that we strive to create: a fair and enjoyable one and one that allows the applicants to truly be themselves.”

Written by Catherine Doss

Applying to medical school is not for the faint of heart. A rigorous interview protocol for aspiring students at the Virginia Tech Carilion School of Medicine includes a day-long event in which each student is interviewed 10 different times. Take a look at a day in the school's Multiple Mini-Interview process.

Learn more about the Multiple Mini-Interview by watching this video.