In a departure from the traditional admissions process for medical schools in the United States, the Stanford School of Medicine has just completed its first year using the Multiple Mini Interview (MMI) process–a method that splits the traditional hour-long interview into several smaller ones–to assess its candidates.
The MMI framework, used by 13 medical schools in Canada and championed by McMaster University in Hamilton, Ontario, aims to innovatively rework the interview process.
“While our first commitment is to educate outstanding physicians, we have the unique mission of seeking individuals who also will be leaders and who will seek to transform medicine over the years and decades of the future,” School of Medicine Dean Dr. Philip Pizzo wrote in an email to The Daily. “We also want students who will combine excellence in science and critical thinking with compassion, sensitivity and humanism.”
While, traditional, hour-long medical school interviews occur with a faculty member or current student and include a discussion of both the candidate’s qualifications and his or her questions about the institution, MMIs offer eight- to 10-minute conversations with several different interviewers.
“We felt, based upon the data from Canada and from other places, and based upon common sense, that if we had more individuals regarding our students, we’d have a richer profile of what the students were like, at least from a personality standpoint and their ability to think on their feet, show empathy, reason and so forth,” said associate dean for medical education Charles Prober.
MMI interviewers assign each candidate a rating on a 10-point scale, based solely on their discussion. In an additional departure from traditional methods, the interviewers know absolutely nothing about candidates before meeting them.
“The raters do not know the candidates at all, they have not seen their files, they do not know which undergraduate school they went to, they don’t know anything other than their name, and that’s because the candidate’s wearing a name tag,” Prober said. “We don’t want any bias whatsoever to be introduced into the process.”
He added that this practice also eliminates dependence on the interpersonal compatibility of a single interviewer and interviewee, which is critical to the success or failure of a single, longer interview.
Associate dean of medical school admissions Gabriel Garcia cited the MMI’s predictive validity as critical to its relevance.
“The issue is to use a tool that has studies behind it that say, ‘if you use this interview, you will choose folks who later on have better clinical skill and make better decisions as physicians,’” he said.
In contrast to the traditional faculty or student interviewers, the MMI recruits from a broader pool. Raters have included former patients, nursing groups, faculty from various departments, representatives from Human Resources and Communications and community members.
“We have a wide range of different kinds of people who will be rating the students, each of whom will have their own perceptions on what might make a good doctor in terms of the personality issue,” Prober said.
The content of the conversation differs as well. The MMI formula places a hypothetical situation on the door of each rater’s room, which the candidate reads before entering. The eight minutes inside are spent entirely playing out that situation, which, according to Prober, can provide an “enriched personality profiling” of the candidate.
Hillary Lin ’11, who will be attending the School of Medicine in the fall, compared the MMI to speed dating.
“You’re asked to discuss a given scenario with your interviewer, which I thought was a comparatively objective way to evaluate applicants,” she wrote in an email to The Daily. “Although the combined time is similar to that of the combined time of interviews at other schools, it’s a bit more draining since you’re constantly being confronted with a new scenario and new interviewer.”
As Lin pointed out, there are certain personality types both favored and hindered by the MMI.
“The ‘thinking-out-loud’ process during the MMI can reveal what kind of rationale an applicant has,” she said. “On the other hand, I felt like the MMI selected for “smooth talkers,” people I don’t necessarily think the school is looking for but might admit because of their success in the MMI.”
The School of Medicine receives about 7,000 applications a year and accepts 86 of those candidates, according to Pizzo. About five percent of applicants, or 350 individuals, receive interviews.
Although feedback regarding the MMI has been generally positive, the evaluative process is ongoing.
“We need to assess its impact over time and view it as a complementary tool to the others we use to determine who can be offered a spot at Stanford,” Pizzo said.
“You can’t ask the MMI to do everything,” Garcia said. “What it will do is select students who have better communication skills, better critical thinking skill and better ethical grounds.”