“The bottom line is that while you can’t predict exactly which MMI prompt you’ll be given, you can absolutely start preparing for the MMI. Become familiar with the format, practice your delivery, start reading about issues in health care, and start thinking about major points to discuss around these issues. While this won’t take away your anxiety, it can absolutely help improve your confidence and performance–so that the next time you’re faced with an “angry” interviewer, you’ll be prepared.”

Rajani Katta is a dermatologist and author of Conquer the Medical School Interview and The Successful Match.

She shares her story and discusses her KevinMD article, “The MMI: 3 strategies to help you prepare.”

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Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow.

Today we welcome back on the show Rajani Katta. She’s a dermatologist, and she’s the author of the books Conquer the Medical School Interview and The Successful Match. Her latest KevinMD article is titled “The MMI: 3 strategies to help you prepare,” the MMI being the multiple mini interview. Rajani, welcome back to the show.

Rajani Katta: Oh, thank you so much for having me back. I really appreciate it.

Kevin Pho: So we’ll get into the article in a little bit, but for those who didn’t get a chance to listen to our first episode together, which was over a year ago, just briefly share your story and journey to where you are today.

Rajani Katta: Well, I’m a dermatologist, and I was at the Baylor College of Medicine for most of my career in academics, where I was in charge of medical student education in dermatology for the basic sciences. During that time, I really mentored a lot of medical students, and I have written quite a bit on medical education and also written several books for pre-medical students on how to achieve success in their journey in medicine. So I really love mentoring and helping students.

Kevin Pho: So you’re at the forefront of the medical school application process. What do you see are some of the latest trends?

Rajani Katta: Well, the trends coming in last year were really surprising: an 18 percent increase in applications to medical school. That’s projected to continue to increase, maybe not quite as dramatically, but definitely increasing competition for medical school.

Kevin Pho: Now, for those pre-medical students hoping to be successful in their application and interview, what are some of the latest tips that you have that may not have been publicized out there? What’s something kind of behind the scenes that these applicants should know about?

Rajani Katta: Well, I think if you talk to pre-medical students, there’s a lot of emphasis on the MCAT and your GPA, like exactly what is your GPA? Is it a 3.5? Is it a 3.6? But I think one of the things that medical schools are really emphasizing a lot more is interpersonal skills, communication skills, those soft skills, those people skills. So medical schools are really trying to examine different ways of testing for that.

In the past, it used to be via the traditional medical school interview, but right now they’re trying to incorporate different methods. One of them is an online test called the CASPer test, and another method is a different format of the medical school interview called the MMI. So I think that’s one thing I really want to emphasize to students: It’s really important to think about how you are going to emphasize these non-cognitive skills when you’re applying to medical school.

Kevin Pho: And that’s the focus of your recent KevinMD article, “The MMI: 3 strategies to help you prepare,” the multiple mini interview. I have to say, this is something new to me, because when I applied to medical school, I actually went to one of those combined seven-year programs, kind of right out of high school, so I didn’t really have the full medical school interview process. So before talking about this article, give me a little background on the MMI: what exactly it is and how many medical schools actually use this tool.

Rajani Katta: Well, the MMI was developed over a decade ago, and it was developed at McMaster University in Canada. They were trying to test out different ways of evaluating these non-cognitive skills. How do you test for empathy? How do you test for creative problem-solving, for collaboration? So they devised a test that they continued to modify, but basically, the standard structure of the multiple mini interview is that you have probably anywhere from seven to 10 stations that you rotate through. It can be really anxiety-provoking, because at each station, it’s a different prompt.

Medical schools format it slightly differently from school to school, but let’s say the typical one is eight to 10 stations. You walk up to a door, and there’s a piece of paper on the door with a prompt, and you have two minutes to read that prompt. Then you walk into the room, and your interviewer’s in the room, and you’ll have maybe eight to 10 minutes, five to eight minutes, with the interviewer, and you’re responding to the prompt.

As of last year, the MMI was used in the admissions process by over 50 United States medical schools and multiple Canadian medical schools. So it’s actually continued to just expand in terms of how many people are using it.

Kevin Pho: So give us a sense of what exactly that experience is. What are some sample prompts that these applicants may encounter? Right, as you’re hearing that, you walk up, and there’s a piece of paper, and you have two minutes to read that piece of paper.

Rajani Katta: Well, some of them are scenarios where you’re asked to role-play or act. A really common one might be an angry patient. You’re given a little history that the patient was up all night and is now asking for the charge nurse because he’s really upset with the care that’s been given. You have to walk in and now play the role of the head nurse and help defuse the situation with the angry patient. So that’s one example: an acting station.

Another one is a task station, and an example is an origami station, where you walk in and there might be two applicants, and one of the applicants is asked to give instructions for somebody. You’re seated back to back, and one of you gives instructions, and the other one actually makes the origami paper crane. You’re graded on things like collaboration and communication and how well you respond under pressure. So that’s a really tough one, the task station.

Then the final station is a question station, and these can be all sorts of questions. I don’t know what’s asked at particular medical schools; those are confidential. Medical schools will provide samples of questions that they’ve used in the past, just to help students prepare for different kinds of questions, and they really cover the gamut. Ethical questions in health care might be one. I think this year they’re probably going to be asking pandemic-related questions. For example, how do you deal with vaccine hesitancy in a patient who is refusing a vaccine? That might be an example of one type of question. Then there are also traditional interview questions that they may ask. There are definitely ethical questions that have been covered in the past. So that’s the third type, the question prompt.

Kevin Pho: So that sounds like a pretty high-stakes interview process. It almost sounds like some type of game show. So tell me, you’re talking in your article about three strategies to help you prepare. How can these applicants prepare for something like this?

Rajani Katta: Well, I have to say, one of them is really practice. You’re never going to know exactly what prompt you’re going to be given, and if you go online, there are blog posts with 200 different potential MMI prompts. So I wouldn’t say you have to try to memorize particular prompts, but I do think one key strategy is to practice giving short talks. By that I mean you only have five to eight minutes, and really you have a little bit less than that with the interviewer, because you want to give time for follow-up questions. So it’s really important to set a timer and to start feeling what it feels like to speak for about four to five minutes on a really challenging topic. I mean, vaccine hesitancy, you could write a book on that, or people have written books on that. So really practice those time-bound answers.

Another strategy that I recommend is that you want to be prepared for the different types of prompts. You really want to make sure, for example, that you understand the basics of medical ethics. If you’re a pre-medical student, and let’s say you’ve done shadowing or you’ve worked in a doctor’s office, that still is not enough to give you a really strong understanding of the basics of medical ethics. So it’s really important to start reading about some of these areas, the basics of medical ethics, and then certainly keeping up with current events in health care.

As I mentioned, I think this year: vaccine hesitancy, the concept of individual autonomy versus the public good, the ethics of quarantining, and racism in health care. So I recommend that students keep up with some of those current issues, and certainly via your blog, which is a fantastic place. I mean, we have some really wonderful clinicians and experts in their fields who are writing for the public, and so I think that’s a great place for students to start.

And then just being aware of what the MMI is like, so that you’re not horrified when you walk in and your interviewer is like, “Why have you kept me waiting? I’m so angry.” That’s another key strategy.

Kevin Pho: So in general, how much time should an applicant prepare if they know a school is going to give out the MMI as part of the interview process?

Rajani Katta: Well, I have to say that this is not a one-week intensive, one-and-done. This is really something that I would recommend that you start now. You spread out your preparation over several months, because the different pieces of it can really take a while. Other pieces of it are talking to your colleagues, your family members, and other people in medicine about some of these issues. You really want to become well-informed. And then the practice of giving short talks and getting feedback on that is also something that you want to spread out over a period of several months. So this is not pulling an all-nighter and cramming. This is a small bit of studying, or preparation rather, over a period of several months. I think that is the best way to go.

Kevin Pho: And does this replace a traditional medical school interview, or is this in addition to a traditional interview?

Rajani Katta: It will typically replace it at the schools that are using it, so most schools are using one or the other. Having said that, some schools have devised a hybrid form, where you have an MMI, but then you also have the traditional one-on-one interview with a faculty member. So some schools are using a hybrid. And even in the MMI, where at one of those stations you have your eight minutes with an interviewer, one of those stations might be, “Why did you apply to our medical school?” So that’s something that’s a traditional medical school interview question as well as an MMI question that you need to be really prepared to answer.

Kevin Pho: And in terms of resources, where can applicants prepare for the MMI? Are there courses available? Is this something where they just have to listen to podcasts like this to get tips? Where can they get resources to better help themselves prepare for something like this?

Rajani Katta: In terms of the MMI itself, there are certainly a lot of online sample scenarios. I do have to say, you’ve got to be careful when you’re going online, because there are a lot of sample scenarios, but you want to make sure that the sample responses are appropriate as well. So the resources that I would recommend are the ones that are put out by the medical schools themselves. McMaster has some resources online, and medical schools have some resources online to help you with some initial preparation.

But I’d also say be careful, because some medical schools say that you can’t prepare at all for the MMI. I disagree. I think it’s important to do the things that I’ve laid out. I have written a book on the MMI where I’ve provided 50 sample scenarios, so that’s another good place to start, meaning looking for sample scenarios with sample responses and what makes for a good response. So those are some examples of things that I would recommend.

Kevin Pho: We’re talking to Rajani Katta. She’s a dermatologist, and she’s the author of the books Conquer the Medical School Interview and The Successful Match. We’re talking about her latest KevinMD article, “The MMI: 3 strategies to help you prepare,” the MMI, which is the multiple mini interview. So Rajani, what do you see as the trend of the MMI? Do you see this growing, with more medical schools adopting it, and eventually is this going to become the norm?

Rajani Katta: You know, judging from the trajectory over the last decade, I do think it’s going to continue to be utilized by more medical schools. With the fact that medical schools are placing more and more emphasis on these interpersonal skills, these non-cognitive attributes, and they’re seeking ways to evaluate that, I think the MMI is going to continue to be used by more and more schools in the years ahead.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Rajani Katta: Well, I think my main take-home message is that you can start to prepare. You can never predict what scenario you’re going to be asked, but you can start to prepare, a small bit at a time, and the key is to use that preparation to help increase your confidence, so that when you see that two-minute prompt, you’ll be able to walk in that door with confidence.

Kevin Pho: And how can people reach you?

Rajani Katta: We have a lot of blog posts and some podcast episodes as well on our website, TheSuccessfulMatch.com. That’s the best place.

Kevin Pho: Rajani, thank you so much for coming back on the show and sharing your time and insight. I appreciate it.

Rajani Katta: Thank you.