By: Ryan Kelly
How long does it take you to answer, “why medicine?”
Go ahead and try it. Time yourself if you’d like. Go on. I’ll wait.
Most students can answer that question in about 45 seconds to two minutes. Maybe more if you really stretch it out.
Most MMI stations, though, are 8 to 10 minutes long. And a common station asks, “why medicine,” which begs the question:
Do medical schools really expect you to use every bit of that time to answer a question that only takes you two minutes to answer? What if you run out of time and don’t have anything to say?
Though it seems awkward, it isn’t.
We’ve written articles in the past to help candidates eat up time during MMI stations, but here’s a little secret:
If you don’t use ALL the time in an MMI, it’s not the end of the world. In fact, it can be a good thing.
Use Leftover Time in an MMI for Follow-up Questions
It’s important to remember that the interviewers usually have follow-up questions based on your responses. By talking for all eight minutes, you will be depriving yourself the opportunity to receive these guiding questions.
For example, let’s look at an example MMI station and its follow-up questions given to the evaluator:
Prompt (What You Can See)
Dr. Blair recommends homeopathic medicines to his patients. There is no scientific evidence or widely accepted theory to suggest that homeopathic medicines work, and Dr. Blair doesn't believe them to. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle aches, because he believes that it will do no harm, but will give them reassurance.
Consider the ethical problems that Dr. Blair’s behavior might pose. Discuss these issues with the interviewer.
A. What's wrong with the way Dr. Blair treats his patients? Why?
B. Why do you think Dr. Blair does it?
C. Can you see any circumstances under which recommending a placebo might be the appropriate action?
D. What is the difference between (C) and Dr. Blair’s practice?
E. What action would you take regarding Dr. Blair?
Instructions for the Interviewer
In assessing the student, consider the following issues:
Did the applicant express balance and sympathy for both intellectual positions?
Was there a clear analysis of the ethical problems paternalism raises?
Did the applicant suggest a course of action that is defensible and moderate?
If you follow our five steps to answering MMI ethical dilemmas, you’ll have answered most of the follow-up questions already, but you may have not considered Dr. Blair’s motivations (B) or the larger ethics surrounding placebos (C). These are more nuanced questions that are impossible to predict.
So, you should certainly be prepared with things to say, but having some wiggle room for a follow-up discussion lets the interviewers cover important parts of their rubric or guidelines, thus making a huge difference in how you’re evaluated.
The interviewers are not playing a game of “gotcha,” where they let you squirm nervously in your chair as they silently jot down notes of judgment (unless you let them). In fact, the interviewers should be viewed as a lifeline. It might feel intimidating to talk to them, but your conversation with them will make it easier for them to assess you.
However, it’s important to note that every MMI is different, and there’s a chance your evaluators will have much different directions than the ones listed above. There’s even the possibility of no follow-up questions at all, which brings us to…
What If My Interviewer Doesn’t Ask Any Follow-Up Questions?
Our five-step approach to MMI ethical dilemmas involves: listing the competing ethical stakes, discussing what else you’d need to know to make your decision, and outlining any legal, professional, or ethical limitations/restrictions you’d need to uphold.
The notes you write down for these steps are great fodder for conversation-starters if your interviewers happen to give you the silent treatment. Don’t let the conversation die!
Competing Ethical Stakes
“I’m curious about your thoughts on placebos? Have you ever prescribed one or seen another physician prescribe one?”
“In your experience, what is the best way to engage with patients who have misconceptions about the efficacy of certain treatments?”
What Else You’d Need to Know
“I couldn’t help but wonder whether the prompt was hinting at cultural beliefs surrounding homeopathic medicine. Do you think it’s implying that Dr. Blair’s patients have traditional beliefs in these treatments?”
“Since the prompt doesn’t indicate my relationship with Dr. Blair, I approached it from my current positions as a shadow and medical assistant. But I’m curious - in your experience, how often do you see the hierarchical structure of the medical team challenged by nurses, PAs, etc.?”
Limitations/Restrictions You’d Need to Uphold
“Does leading someone astray with a false understanding counteract the ‘do no harm’ oath?”
“Have you ever been in a position where you disagreed with a colleague’s course of action? Do you mind sharing your experience?”
Asking questions like these does more than just break the ice. It shows your genuine curiosity to learn from your interview, as opposed to just viewing it as a means to an end. Plus, it gives you another opportunity to convey some of the ideas and qualities that the interviewers might be looking for (empathy, critical thinking, moderate course of action, etc.).
All the tips in this article can be applied to the acting stations in MMIs as well. There’s no reason why you can’t engage with the actor once your scenario has finished playing out.
It might be a bit trickier to ask them direct questions about your roleplaying scenario (you don’t want to sound like you’re fishing for clues on your score/evaluation), but you can still ask them valuable questions about the school or their experiences as doctors/medical students.
Get inspired by our best and worst questions to ask at your medical school interview.
Remember - forcing yourself to use all the time in an MMI response is like adding to a secondary essay simply to meet the maximum word or character count. You think it’s making it stronger, but most of the time, it’s only detracting from your answer.
No doubt - there’s such a thing as TOO short, but overall brevity is a strength during MMI interviews. You can fluff up your response until you’re blue in the face, but your best bet is to focus on delivering a balanced, quality answer and let the conversation build from there.
Best of luck!