By: Savvy Pre-Med Staff
The unpredictability of the MMI interview is what makes it so challenging and nerve-racking. Past applicants have told us about prompts that asked them about establishing a colony on Mars, so anything goes.
However, there are common types of MMI interview questions that are most likely to be asked, so you’ll want to understand and practice them leading up to your MMI.
The bad news: the actual content of the MMI questions will be impossible to predict.
The good news: each type of MMI question has strategies and formulas that you can apply no matter what the content happens to be.
Down below, we’ll cover the most common types of MMI interview questions and illustrate some helpful tips through examples/samples of each.
Ethical Dilemmas are the most common type of MMI interview question. For this type of question, you’re put into a hypothetical situation and asked to take a stance on a particular problem or issue.
These questions usually come down to making a specific choice between two or three possible options. In some Ethical Dilemmas, you’ll be placed in the position of a physician, but in others, you might be a college student, medical student, parent, teacher, coach, etc.
Two patients need a liver transplant, but there is only one liver available at the time. Tell the interviewer how you would decide between: a 64-year-old retired politician who is a recovering alcoholic, or a 26-year-old mother of three who is on welfare.
Tip #1. Remember that you usually have 1-2 minutes to think and take notes after you read an MMI question, so use that time wisely.
Tip #2. We highly recommend using these five steps for any Ethical Dilemma, since they will give you a reliable formula that will help keep your answer structured (plus, it will give you more to say!):
Step 1: Restate the prompt
This gives you a little more time to think, shows the interviewer that you understand the situation, and gives the interviewer a chance to correct anything you’ve misinterpreted from the question.
Step 2: Pinpoint the competing ethical stakes (i.e. the central conflict)
Since these Ethical Dilemma questions often contain a lot of information, this helps you narrow your scope a bit and home in on what the prompt is asking. For our sample above, the competing ethical stakes are rather straightforward: the well-being of two patients is in conflict with limited resources (one liver).
Step 3: Discuss what else you’d need to know to make your decision (use if/then conditional statements)
This is KEY! The Ethical Dilemma questions will intentionally leave out details, and most of the time, these details would affect your decision. So you want to explore what’s being unsaid in the prompt.
For our sample, here are just a few if/then conditional statements you could use:
If the 64-year-old is still abusing alcohol, then I would likely be unable to give him the liver, but if he has been clean for many years, he might be a suitable candidate.
If either patient has any current conditions or past medical history that could compromise or complicate the liver transplant, then I would likely give it to the other patient.
If I knew that other livers would become available soon, then I could give this liver to the patient that’s in more urgent need and hopefully arrange a future transplant for the other patient.
If the younger patient doesn’t have insurance or if the costs of the procedure could essentially bankrupt her, then I might need to consider how that would affect her view of the procedure or my ultimate decision.
These if/then questions help you qualify your eventual stance, while also helping you fill time during your response. They could also show you as being particularly insightful or considerate compared to other interviewees.
Most of the 1-2 minutes before your response should be used to write down as many of these if/then considerations as possible.
Step 4: Take your stance (can be conditional, but must be clear)
At this point, you want to filter down all of those considerations above to give your qualified yet definitive stance:
If both patients had a seemingly equal chance of surviving the procedure and supporting the liver, and if both patients were fully aware of risks and willing to undergo the procedure, and if I had to solely make this decision as the physician without any higher authority, then I would choose the younger mother since she has more life ahead of her and three dependent children. But I would only do this if I were left with no other choice or alternative solutions.
Step 5: Cover your bases by including any ethical, legal, or professional limitations/restrictions you’d need to uphold
We put this step last so that you don’t forget to do it, but it could actually come up earlier in your response (perhaps during Step 2 or 3).
For our sample above, it would be important to bring up the idea of an organ transplant waiting list. Patients are typically prioritized for transplants based on this list, so it would obviously be crucial for your decision-making as a physician.
You might think to yourself - “This prompt wouldn’t exist if I can just use a transplant list!” But you can’t make assumptions! You need to bring this up so that the interviewer knows you’re aware of it.
Acting Stations or Roleplaying Questions are less common than Ethical Dilemmas, but the idea of having to act out a scenario can be intimidating.
You are working on a group project with 5 other students. One student, Emma, doesn’t show up for meetings or if they do show up – they are late and leave early. They have put very little effort into the group project, but they show up 15 minutes before the class presentation and act like nothing is wrong. Talk to Emma.
Tip #1. If the actor is angry at you for a mistake you made (i.e. forgot to do something for your boss or dented someone’s car, etc.), you want to “always be closing.” Go above and beyond, within reason, to provide ways that you’ll rectify the situation.
This doesn’t apply to our sample above, but there will be plenty of action stations where you need to quell someone’s anger.
Tip #2. If the actor is confused, scared, or withholding information, you want to “always be searching.” Make sure to ask questions (from a place of concern - not judgment) to learn more about the person and situation.
This would apply to any acting station where you need to confront someone or have a delicate/awkward situation, as in our sample above.
Tip #3. In most cases, use small talk to simulate real life and ease the actor into the conversation.
Tip #4. If the scenario calls for a confrontation, make sure you broach the sensitive issue and hold the person accountable, even if it’s awkward.
Tip #5. Always ask questions and give the actors options; that way, you’re not doing all the talking and you’re driving towards a resolution (without forcing one).
For our sample above, here are the steps you could follow:
The “friendly ultimatum” is a great strategy to avoid sounding cold and unforgiving while also making sure that you hold people accountable at the same time.
The Critical Thinking Stations are somewhat similar to Ethical Dilemmas, but they’re more open-ended. Rather than making you choose between a few options, the Critical Thinking Stations provide less guidance and fewer parameters.
A co-worker shows you the “rate my doc” website where many of your patients have anonymously complained about your apparent lack of concern about their health and the high cost of your services. What would you do?
Tip #1. Unlike the ethical dilemma prompts, it’s more acceptable for you to draw upon stories from your own experiences when responding to these hypothetical situations.
Tip #2. Many of these questions will ask you to create something - a course, program, event, etc. Think about what has been lacking from your school or community, so that you can base your answer on past experience.
Tip #3. Make sure to accommodate both perspectives in any given situation and provide the pros and cons while weighing your decision/stance.
Tip #4. Try to mention any possible complications that could arise as a result of your decision. It’s good to show that you’re forward thinking and anticipatory.
In our sample above, the dilemma would stem from you discovering dissatisfaction with your performance as a doctor and having to address it in an appropriate way that maintains professional boundaries and facilitates improvement in the long-term.
You’d definitely want to explore the “rate my doc” website. Based on what you find (very few vs. many reviews, legitimate vs. questionable criticism, what’s in your control vs. what’s not, etc.), you’ll want to isolate possible trends in the feedback and create concrete plans of action.
Use if/then construction to present different likely scenarios. Don’t feel the need to discuss every single potential factor at play, but it’s okay if you have three or four conditional solutions.
If I reviewed the website and found only a small amount of anomalous complaints, then I would avoid an overreaction, make a mental note of what I could change, and then continue monitoring the website in the future.
If most of the patients’ complaints were about financial issues beyond my control (like insurance coverage), I would make a point to have discussions with patients individually to see how we could optimize their coverage and work within the system together.
Make sure to discuss the issue of patient confidentiality and the ethics you’d strive to uphold in terms of respecting the anonymity of the reviews. It’s not wise or appropriate as a physician to address the website’s criticism publicly or directly in your future patient interactions. You want to create concrete plans that help you be more conscientious, so that you can ensure your credibility through your actions.
The Healthcare Policy questions will present a real or hypothetical healthcare policy and then ask you to assess its implications and whether you think it’s a worthwhile or viable policy.
Due to the shortage of physicians in rural communities it has been suggested that medical programs preferentially admit students who are willing to commit to a 2- or 3-year tenure in an under-serviced rural area upon graduation. Consider the broad implications of this policy. Do you think the approach will be effective? At what expense?
Tip #1. If you’re stumped about a medical topic, spend some time researching (sound familiar?).
Tip #2. Be prepared with references, whether they’re articles you’ve read or discussions with actual physicians about the topic. It’s not good if your answer is merely conjecture or generalization.
Tip #3. Many issues presented will be controversial and they won’t have a clear answer. It’s in your best interest to explain what’s valid about the different positions (i.e. pros and cons) before taking your own stance.
Tip #4. Sometimes it’s smart to go micro with your answer, rather than trying to tackle all the complexities and nuances of a topic. For example, you could focus on the problem of high premiums instead of speaking broadly about the Affordable Care Act.
Tip #5. If you don’t know very much about a topic that’s brought up during an interview, don’t try to fake it. Discuss what you DO know, and then comment about what you’d need to research in order to make an informed decision.
Tip #6. Most healthcare policy questions are essentially asking “Do the ends justify the means?” Or in other words, are the benefits of this policy worth the drawbacks and costs of its implementation? Focus on this central question when giving your response.
In our sample above, let’s consider the pros and cons of the policy and then figure out whether the ends justify the means.
Pros: alleviate provider shortage in underserved areas, incentivize doctors to live and work in rural communities, increase healthcare access and detect preventable problems earlier
Cons: could potentially recruit people who aren’t committed to rural medicine and simply want an admissions advantage, could potentially lead to high physician turnover every two or three years as the required tenure ends, could limit the diversity within these medical programs
Ultimately, the provider shortage in rural areas isn’t going to solve itself, so it seems like the drawbacks of this policy would be worth the benefits it’s going to provide.
However, it seems best to propose modifications that would incentivize doctors to remain in these areas more long-term, as well as greater vetting/recruiting policies by the programs to ensure they’re attracting candidates who are truly committed to rural medicine.
Have any questions about the different types of MMI stations, questions, and prompts? Let us know in the comments below and we’ll respond to you personally!