MMI interview prep

Question 1

How to prepare for MMI interview:

Answer 1

• Use your work experience. Lean on this and use specific examples when giving a response.
• Know what it takes to be a good doctor.
  Make a list of qualities and practice demonstrating them in your responses.
• Practice giving eight-minute presentations in response to common MMI interview questions. This will help with time management on the day.
• Make sure you understand key ethical concepts relating to medicine, like the four pillars and patient confidentiality.
• Keep up to date with medical news, and check out our Hot Topics section.
  Questions may be inspired by stories or debates in the media.
• Get some help. Though you can rehearse certain scenarios, MMI interviews are a lot harder to practice at school or at home, so it’s worth attending our MMI circuits.
• Consider working with a Med School Interview Tutor who’ll help you focus on improving your performance or book a mock interview to get some detailed feedback.

Question 2

MMI’s involve different stations:

• Role play stations
• Professional judgement stations
• Prioritisation stations
• Giving instruction stations
• Calculation and data interpretation stations
• PBL stations

Answer 2

Role play stations:

• You’re asked to act out a pretend scenario with an actor.
  They usually last between five and seven minutes and involve you delivering some bad news, sharing an outcome, or another situation where you need to show empathy.

Professional judgement stations:

• You’re asked to act out a scenario with a colleague or patient. It’s designed to assess your ability to make professional judgements in pressured situations, your communication skills, empathy and ability to judge patient safety

Prioritisation stations:

• Here you’re asked to prioritise a number of things with a specific scenario in mind
• For example, you may be asked to choose five out of 10 items to take camping with you or be given details of six people and asked who you’d prioritise to take with you on a trip.
• This station is designed to test your ability to cope well under pressure in timed conditions, as well as your rational thinking.

Giving instruction stations:

• MMI station will ask you to do something like explain how to tie shoelaces without using your hands or give directions using a map.

Calculation and data interpretation stations:

• Involves you taking some key data and being able to make calculations or analyse and interpret the information.
  You’ll usually get between five and seven minutes to complete this mathematical station.
• At these stations, you will be asked simple calculations relating to a clinical scenario for example, you may need to calculate the correct drug dose to give to a patient, or convert metrics

PBL stations:

• A PBL station is when you experience a mini problem-based learning lesson alongside a group of other interviewees.
• A rough overview of how you work through PBL sessions would be as follows:
• Read through the scenario carefully and clarify any terms you’re unsure of.
• Talk through the issues raised in the scenario as a group.
• Turn these issues into learning objectives that you could research.
• Obviously, at an interview, you won’t have to go away and do the research, but you should treat as if you would research the issues raised.
  This will help you engage with it fully.

Question 3

Examples of MMI situations:

• Role play stations
• Professional judgement stations
• Prioritisation stations
• Giving instruction stations
• Calculation and data interpretation stations
• PBL stations

Answer 3

Role play stations:

• You’ve been looking after your neighbour’s cat whilst they have been away for a week but yesterday you found the cat dead on your driveway. Break this news to them.
• You were playing football in the garden and kicked the ball over the fence breaking the neighbour’s garden ornament, which you know had great sentimental value.
• You are captain of the Olympic hockey team and have to inform one of your squad members they haven’t made the team to travel to the Olympics this year.
• You’ve double-booked yourself and promised a friend you will go on holiday with them but realised later you have work commitments which cannot be changed. They have just got over a difficult breakup and were really looking forward to the holiday. Tell them.

Professional judgement stations:

• You’re told that you are entering a hospital staff room 10 minutes prior to performing surgery with Dr ‘X’. As you enter, you see Dr ‘X’ take a swig of a clear drink from a bottle and quickly close their locker, which you suspect is alcohol.
  Over the course of the conversation, the doctor beings to forget things and slur their words.
  You have five minutes to speak to Dr ‘X’.

Prioritisation stations:

• You’re told you’re going on a camping trip. Before you is a table of random objects.
  You have 20 seconds to pick five objects you deem to be of the most importance and value, and explain your choice.
• You are given details of 15 individuals, including their age, sex and occupation.
  A nuclear attack is imminent and you are only allowed to save five of them from destruction. Which ones and why?
• You are given details of six people, including their occupation and skills.
  You are asked which of them you would take with you on a trip to the jungle.

Giving instruction stations:

• You need to instruct somebody to pick up a small number of blocks and place them onto a particular point on an A4 card, using a clamp. The card has other blocks on it surrounding the point and knocking them over would lose you points.
  Explain how to lift the blocks onto the card.
• Explain how to tie shoelaces without using hand gestures.
• You are given a map and told to give directions from Door A to Door B.

Calculation and data interpretation stations:

• You are asked to give a patient 1ml of 1% lidocaine. How many mg are you giving the patient?
• You are asked to give a patient weighing 50kg a 1mg/kg IV injection.
  The syringe contains 100mg in 2 ml.
  What volume of the solution in the syringe do you need to give?
• A graph showing plasma insulin levels of different patients over one day, with the times that meals were eaten.
  You may then be asked to talk about a specific patient on the graph.
• A graph that represents the effect of different antibiotics and their effectiveness for combating a particular illness.
  You may then be asked to interpret which antibiotics should be selected for treatment.

Question 4

How to tackle these MMI situations:

• Role play stations
• Professional judgement stations
• Prioritisation stations
• Giving instruction stations
• Calculation and data interpretation stations
• PBL stations

Answer 4

Role play stations:

The first tip for tackling your MMI role play station is to read the scenario in detail.
Think about your role is in the scenario:

• are you a first-year medical student being asked to talk to a senior?
• are you a junior doctor on the ward being asked to speak to a patient?
• are you a friend being asked to speak to one of your own friends?
• is there a conflict that needs resolving for example is a group member not completing delegated tasks?
• are you being asked to break bad news?

Pay attention to how you communicate, you should:

• maintain good eye contact with the actor
• make sure you’re actively listening, and nod your head occasionally to demonstrate this
• don’t go over-board with your hand gestures
• speak slowly and clearly, and allow the actor as much time as possible to speak so they can tell you their story
• briefly repeat some of the things that have been said by the actor at an appropriate interval, to show you have taken in the information they’ve given
• don’t interrupt or talk over the actor
• change the tone of your voice when appropriate, adapting to the context.
  For example, if you’re speaking to a young patient, you’ll want to use different vocabulary

Show empathy, to help you show this:

• the best way to break bad news is to give a brief reintroduction or catch up depending on the scenario
• give the actor a ‘warning shot’ before delivering the bad news. For example, say clearly ‘I’m afraid I have bad news which I have to share with you…’ or ‘I’m in the difficult position of having to tell you…’. This will soften the news for the recipient.
• deliver the bad news and, most importantly, pause straight after giving it
• give them space to react to the news.
  The actor may begin to cry or become angry and visibly upset.
  Your next response will depend on theirs, so make sure you’re really engaged with the conversation.

Empathy is all about putting yourself in the other person’s shoes and you can do this by using phrases like, ‘I know this must be really difficult for you’. If the actor begins to cry, you could offer them pretend tissues or a pretend glass of water if available.

Professional judgement stations:

Make a conversation;

• Make sure you spend some time making conversation at the start.
  For example, if you are faced with a situation where you need to confront a colleague about taking painkillers from a drug cabinet in the hospital, make sure you politely make conversation first, before asking them about the painkillers.
• Doing this will demonstrate your ability to judge a potentially volatile situation and put others at ease.
  This scenario is all about communication skills and building trust while making professional decisions and you can show this skill by making sure they’re comfortable.

Be sensitive;

• Many scenarios may involve taking a colleague to one side and asking them about sensitive topics, so it’s important to demonstrate empathy.
• If the station is a role play, the person acting as your colleague may become defensive, embarrassed or upset, and you’ll need to make sure you show sensitivity.
  Remember to ask them how they’re feeling and if you can help.
  Make sure your tone is understanding and kind, rather than accusatory.
  This will show your examiners you’re able to handle difficult and emotive situations sensitively and sympathetically.

Prioritise Patient Safety;

• Remember that, despite your relationship to your colleague in the scenario, patient safety is crucial so you’ll need to show that you understand this.
  For example, if you’re approaching a scenario where you have seen a fellow junior doctor drinking alcohol on shift, and they are adamant that they’re capable of continuing work, it’s important to prioritise patient safety above all else.
• In this scenario make sure you demonstrate that you know the situation is unsafe and come to an agreement with your colleague whereby they take the rest of the day off and offer a private talk the next day to discuss any issues they may be having.
• This will show that you understand the emotive nature of the situation, that you are able to show empathy, and that you also prioritise patient safety.

Prioritisation stations:

Think rationally;

• Take a moment to calm yourself and consider each object or individual given.
• Ground your selections in rational thinking and make sure you consider each object carefully so you can explain your reasoning to your interviewer.
• Another way to approach this, after considering each object you chose and explaining your reasoning, is to briefly explain why you didn’t select certain objects

Voice your reasoning aloud;

• The best thing to do in these situations is to communicate your thought process aloud to show that you can think clearly in these circumstances.
• Be prepared to explain aloud why you chose each one

Don’t panic;

• All stations during your MMI will be timed, but this one may feel particularly pressured. However, it’s important not to panic.
• Don’t feel so overwhelmed by the time frame that you rush straight into selecting objects or individuals immediately without considering why. Taking a few moments to calm yourself at the beginning of the station will make your decisions much better.

Giving instruction stations:

Break the task down into smaller steps;

• One of the best tips for the giving instructions station is to break the task down into smaller steps to complete the task and try to verbalise a clear, logical thought process.
• For example, if your task is to give directions, locate your position on the map and the destination, and work out a route.
• Getting from Door A to Door B, for example, will involve several turns through different rooms and opening doors so try to break these steps down in your head to guide your instructions.
• Tips to break down information:
• Separate each instruction according to each step ( for example, ‘firstly, turn left onto the corridor, then turn right’ )
• Use clear transitions, such as ‘next’ and ‘then’, to make your instructions clear to your interviewer and help you to focus on each step

Be as specific as possible with your word choice;

• For example, you may be asked to give instructions to build a certain shape with coloured blocks, or you might be asked to explain to somebody how to tie shoelaces so it’s crucial you pay attention to your verbal communication skills
• With these stations, the trick is to begin by stating what the goal of the task is ( ‘our goal is to tie these shoelaces and I’m going to give you instructions’ ) and then check that the actor or interviewer is ready.
• The person following your instructions may deliberately misinterpret what you say to test your ability to re-word your instructions.
  For example, they may try to tie the wrong shoelace or put a red block in the wrong place. In these situations, it’s best to use specific, instructive words for example, ‘use the shoelace on the left’ or ‘using your right hand, stack the red block on top of the yellow block’.
• The key here is to be ready to re-word what you say to suit the actor’s behaviour.

Keep calm;

• It’s frustrating when the actor will continue to misinterpret your instructions but you must stay calm
• The interviewers are assessing your approach to the task, not the outcome of the task, so don’t worry if you don’t manage to guide the actor successfully.
  As long as you have attempted to instruct them to the best of your ability, stayed calm and reworded your instructions where appropriate, you’ll be marked well.

Calculation and data interpretation stations:

• At some Medical Schools, you won’t be given a calculator during this station, so a good way to prepare for these is to practice your mental maths beforehand.
• You may be given a sheet of paper for your calculations, so practice working out basic sums by hand and completing practice questions.
• Be mindful of the units in drug calculations, and practice your conversions between metrics
• for example, converting from micrograms to grams and between decimals and percentages.
  It may be a good idea to memorise some of these basic conversions to assist you such as 1g equals 1000 mg, and so on.
• At a station on Data Interpretation, you may be given data to discuss this could be on anything from study findings on blood glucose to heart monitors.
  This doesn’t involve calculation but assesses your ability to analyse data and this may take a number of forms ( Examples are present )
• To interpret data the key is to vocalise your ideas and don’t be afraid to state the obvious. Spend some time establishing what the graph is showing.
  What does the x or y-axis show?
  What are the variables?
  Is there a sudden rise or decline and what does that suggest?
• Remember to vocalise these things aloud, using the numbers from the graph.
  Then remember to focus on what the interviewer has asked you for example, with the insulin graph, look for the specific patient and describe any trends you see in their insulin levels.
• Another way to prepare for this kind of question is to keep on top of the content covered in A-Level Biology.
  Take a look at some of the graphs from past AS papers and the kinds of questions that were asked to familiarise yourself with interpreting graphs.
• These questions may draw on basic Biology knowledge you will have covered at school for example, insulin levels or antibiotics so these past papers will also be useful to get used to these kinds of graphs as well as refreshing your knowledge.

PBL stations:

Make sure you speak up but not over everyone;

• Although it’s important that you have your voice heard, don’t speak over other people in your group during PBL sessions that’s not demonstrating good teamwork or listening skills! Listen to what other people have to say and respond accordingly.
  It’ll help you gain a better understanding of the problem and is key to any teamwork-based exercise.

They’re not trying to trick you with the scenario;

• Everything you need to form your learning objectives is in the scenario.
  Don’t go off course trying to think of complicated or abstract learning objectives.
  Think about what’s in the scenario and why it is there.
  This is where the learning objectives come from.

Think of the underlying science behind the case;

• Clearly, if a disease or treatment is mentioned in the scenario, you’re going to need to look into it, but also consider the basic science.
  For example, if someone has broken their leg, don’t just think about how to fix it but also the basic anatomy of the leg.

Use what you already know in PBL sessions;

• If you know something about the topics covered in the scenario, don’t be afraid to share it.
  This will help people think more about the problem and show the observers that you have read a bit around the subject of medicine.

Encourage everyone to have their say;

• This is the role of the chair in a normal PBL situation but you may not have one at interview. By encouraging everyone to take part, this will show you understand that PBL is a team sport and you’re interested in what everyone has to say.