How to Prepare a Strong MMI Answer

 

When preparing for a PA school interview, understanding how you would respond to the standard questions is important, but you should also be ready for the interview format. 

 

PA programs often use group and one-on-one interviews to assess candidates, but the multiple mini interview (MMI) is growing in popularity. 

 

The MMI involves a series of short independent assessments, usually in a timed circuit lasting 5-8 minutes each, aimed at better evaluating the interpersonal skills, judgment, and professionalism of candidates.

 

This interview format helps programs understand how candidates would behave in a given situation, rather than focusing only on general beliefs or past experiences.

 

Often, the scenarios given are ethical questions, but the MMI format is unique and requires a more developed answer compared to a traditional interview format.

 

The multiple mini interview (MMI) format has been used by medical schools for a number of years. While most PA programs are not exclusively MMI style, more are incorporating MMI elements into their interview process.

 

[Not all MMI questions are scenario-based. Some are traditional questions or off the wall questions (like "If you were a piece of furniture, what would you be a why?") and just done as part of the timed circuit. Given that you'd practice traditional questions as part of your prep regardless of interview type, we'll focus on the more classic MMI scenario-based questions in this post.]

 

Being alone in a room with faculty members staring at you, even for only six minutes, can seem like an eternity. So, if you know your PA school interview will involve an MMI format, either entirely or partially, you need to have a framework to work through any scenario posed.

 

In this post, you'll learn the 6-part framework you can use to answer any MMI scenario question that comes your way.

 


Scenario

Let's start with an example scenario we can reference during each of our 6 steps (it's one I commonly use in one-on-one Mock PA school interview sessions). 

 

You are a PA working in a hospital, and your 79-year-old patient with end stage renal disease has chosen to transition to home hospice. He is being discharged later today. His daughter approaches you at the nurses' station in the morning asking you to find a reason to keep him in this hospital because she doesn't agree with his decision for hospice. What do you do?

 

1. Identify your problem through the "problem bringer"

The first step in working through an MMI question is identifying the problem. Only once you are clear on the issue can you know how to focus your answer. 

 

The problem of a scenario is usually presented to you by an individual, the "problem bringer." Do not get distracted by background information. The end-stage renal disease and choice for hospice is not the problem of this scenario. The problem bringer (the daughter) presents the issue at hand—her disagreement with her father's choice. 

 

So, before we have any other information, the presenting problem is "the patient's daughter disagrees with her father's choice for hospice and is asking me to keep him in the hospital unnecessarily."

 

 

2. Explore

You may be inclined to jump right into finding possible solutions, but it's important to take the time to learn more about the situation. Remember, part of the intent of the MMI is to test your interpersonal skills. Use those skills to ask questions and get as much information as you can to help frame your answer. 

 

This step is a parallel to what you would do as a provider. If a patient came in with a headache, you wouldn't prescribe them something or order testing as your initial step. You would first get more information. 

 

By asking questions up front, you will have a much better solution at the end of your scenario. 

 

In an MMI scenario, you may be asked a theoretical question or have someone (a faculty member or student) playing a role. If it's theoretical, state what questions you would ask — "I would ask the daughter..." If someone is role playing, address them directly — "Why do you think...?" 

 

With our example scenario, some questions you might ask include:

"Why do you want your father to stay in the hospital?"
"Do you hope that he might get better?"
"Do you think your father understands his decision?"
"Have you discussed your concerns with your father?"
"Do you have concerns about him being at home?"

 

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3. Clarify the specific problem

Asking questions may give you new information, which may slightly alter the presenting problem. 

 

In our example, let's say the daughter tells us that she thinks her father is "just giving up" and wants him to stay in the hospital longer so she can convince him to resume treatment. 

 

So, our new more specific problem from our problem-bringer is that "the daughter wants us to keep her father with end-stage organ disease in the hospital so she can convince him to resume treatment."

 

See how that's a bit more accurate from where we started? Now, we know how to focus our possible solutions. 

 

 

4. Walk through potential solutions & ramifications of each

Once we identified our specific issue, it's time to discuss possible solutions. Every option is on the table, including terrible ones you wouldn't choose. The idea is to demonstrate that you understand your options, and later you can identify your ideal solution. 

 

Typically, three is a good number of solutions to walk through. It shows you have considered enough options without overdoing it and using too much of your allotted time. 

 

Using our example, here are three solutions and ramifications that we could discuss:

 

  1. Keep the patient in the hospital as the daughter asked. This would go against the patient's wishes, but maybe things would change in a few days. 
     
  2. Tell the daughter that her father has the final decision in his care and you will not keep him in the hospital unnecessarily. This solution honors the patient's wishes but will not appease the "problem-bringer."
     
  3. Offer to meet with the father and daughter together to discuss her concerns with him openly. Acknowledge the daughter's request and explain that with his terminal diagnosis, he may be more comfortable at home than in the hospital. Suggest involving social work to help facilitate a discussion around any concerns regarding hospice care. This potential option addresses the daughter's concerns while respecting the patient's autonomy and wishes. 

 

Even if your other options aren't great, you have to show that you understand what they are. You might not choose them, but you should list them to demonstrate your grasp of the scenario. 

 

 

5. Pick the best solution

Our third option in the example is our best solution. It acknowledges the daughter's concerns and puts the patient's needs and wishes first. 

 

Keep your best solution as your last option in your list of three. It will make the transition from potential solutions to the next step seamless.

 

6. Offer your best solution to the problem-bringer

Once you've picked your best solution, present it as an option to the problem-bringer. In a theoretical MMI scenario, you would just say that would be your next step. 

 

However, you may be thrown a curve ball in a role playing MMI question. Your problem-bringer may not agree with your solution and may insist on doing it their way. 

 

If that occurs, don't panic. Your first duty should always be to the patient under your care (or, in other scenarios, what is ethical or lawful).

 

So, while not our first choice, the next best option would maintain the patient's best interest. In the example, that's essentially ignoring the daughter and following through with the patient's wishes by discharging him to hospice. It's less than ideal, but it is patient-centered and, therefore, should be your fallback. 


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Investigate the PA programs where you will be interviewing to understand the interview style beforehand. When you practice for an MMI format, give yourself a time limit for answers. You want to get comfortable with the time frame allotted by your interviewing program.

 

An MMI style interview can be a little intimidating, but if you get familiar with this framework, you will be able to use if for any scenario you encounter. 

 

Want some extra practice? Use this MMI question checklist to run through scenarios before your PA school interview