MMI is for Much Madness Involved

I have opinions about the medical admission process, some of which I recorded last year around interview time. Which may or may not be valid, as are all opinions, but here it is:

Now, however, I’m less bothered about the process and more bothered about the result, and not just that medical students are already a little bit fried when they start medical school.

Specifically, I wonder if the Multiple Mini Interview is the best method for selecting medical students. It truly is like speed dating—not that I’ve ever speed dated; this is just a simile I heard over and over again whenever the MMI came up in talks or conversation—and I think the impression a student can give is about as superficial.

I hear that the MMI is supposed to test for non-cognitive abilities, such as compassion and ability to handle pressure. I don’t dispute that these kinds of characteristics are important for a medical student to have. I do wonder if the MMI can actually pick them out.

I feel strongly that the MMI is a system that can be easily gamed, by which I mean that people can figure out what the best response to make is, even though that might not be representative of their actual impulses. I can’t disclose what happened at my MMI or the MMI that I volunteered for last year, but I can say that those of us who are on the other side of it really do wonder why we put people through these strange, and seemingly arbitrary simulations.

The ideal behind the MMI is probably that it is a very fair interview—but even this I dispute. I’m not sure that equality and fairness are the same thing. Equality in this instance is giving the same opportunity to everyone. But giving the same opportunity does not immediately mean that the test is fair. The fairest test, in my opinion, would be one that provides the best opportunity for each individual to showcase his or her abilities the best. This would be a test that the individual could mould as they take it. I’m not convinced that the sterile conditions of an MMI provide this kind of flexibility.

A truly fair interview would be one that flexes to accommodate student strengths, which students can direct for their own ends. This might decrease secret system gaming by making it obvious. It would also give a better chance to people who would be excellent doctors, but can’t necessarily game an interview as well as others. I doubt that being able to game a system is a necessary skill for being a good doctor—perhaps for being a high-ranking one, but not for necessary for patient care.

Unfortunately, I can’t think of a better interviewing system that wouldn’t be fantastical or expensive. The best I can come up with is returning to a more classic interview style, where people have to sit before a single person or a panel of people and talk about why they would make a good doctor. Being able to have a conversation is definitely a patient-care related skill, and a non-structured conversation can be influenced in the direction the student wants.

It’s hard for me to tell what I really want out of future medical interviews. A lot of it might be powered by personal disgruntlement at seeing very smart people who would make excellent doctors never even get close to it, and my own mixed MMI experiences. Whatever it is based on, I can’t help shake the feeling that an interview allows the candidate to be known, while an MMI allows a candidate to be measured. And I am not sure if we, as medical students, are measuring up to the right criteria.

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