Illuminating who medical school applicants really are

	Amy Merino (left) was among the UMass Bacc-MD students who helped pilot-test the MMI.

The path to admission for the class of medical school students who will arrive on the Worcester campus in August of 2014 is changing. Beginning with this fall’s admission cycle, the School of Medicine will adopt an interview process known as Multiple Mini Interviews (MMI) that is designed to reveal qualities in candidates that are most aligned to the school’s core professionalism competencies.

The new interview process is similar to speed dating in concept: The applicant is presented with questions, issues or scenarios at eight separate stations, each of which is staffed with a different interviewer or rater who subsequently evaluates the candidate’s performance. The applicant spends eight minutes at each station. The interviewers are selected from among a pool of UMMS faculty, clinicians, educators, students and staff. While each rater is unique, they follow a script to ensure that all students have similar interview experiences.

“Students like the MMI because they have multiple opportunities to shine,” said Mariann Manno, MD, professor of pediatrics and emergency medicine and interim associate dean for admission for the School of Medicine. “With the traditional interview process, a terrific student could have a bad interview. With the MMI, a single bad review can be neutralized by the reviews by multiple other raters.”

The MMI was developed in 2002 by the Michael G. DeGroote School of Medicine at McMaster University in Ontario to address problems with the medical school interview, including lack of accuracy in predicting medical school performance and the inability to measure qualities such as interpersonal skills, professionalism and ethical and moral judgment.

For many years, the traditional medical school admission interview consisted of an applicant meeting one-on-one with two SOM faculty members or students who had been randomly assigned to interview the applicant. As with most interviews, the goal was to learn about the applicant in order to determine if he or she would be a good fit for the institution. But because of the subjective nature of such interviews, the results were not always a good measure of a candidate’s future success, not just as a student but as a physician.

Many medical schools, including UMass Medical School, have been trying to figure out how to redesign the interview process to be a more objective and comprehensive piece of the admission package. The American Association of Medical Colleges is also committed to rethinking how students are admitted to medical school and, as important, who is admitted.

While the traditional medical school interview provided a lot of information, it did not always reveal attributes that are aligned with the school’s mission, particularly as the curriculum has evolved.

“We have a lot of information about an applicant’s success as a student,” said Dr. Manno. “We want to be able to assess non-cognitive traits such as problem solving, communication, empathy and resilience.”

Terence R. Flotte, MD, the Celia and Isaac Haidak Professor of Medicine, executive deputy chancellor, provost and dean of the School of Medicine, was particularly interested in exploring the MMI as it creates a more standard and fairer process for all candidates.

As Manno explained, the scenarios that are used to assess students in the MMI are clustered around domains from which individual medical schools—there are 12 in the U.S. currently using the MMI—choose scenarios that fit best with their educational mission. In the case of UMMS, the scenarios chosen will align with the competencies of physician as professional, scientist, communicator, clinical problem solver, patient and community advocate, and person.

For example, a candidate may be presented with a scenario about patient visitation policies in a hospital to determine how well he or she can understand what it is like to be a patient or a family member advocating for a patient, or a member of the hospital staff attending to the patient. Interviewers presenting the scenarios are encouraged to challenge the applicants to defend their opinions by offering an alternative point of view.

A diverse pool of about 300 UMMS faculty, students and staff participated in MMI training, and it was also pilot-tested with undergraduate students enrolled in the UMass Bacc/MD pathway program. The MMIs will take place in the new iCELS center in the Albert Sherman Center, an environment that is ideally designed to incorporate multiple stations.

“I loved the fact that the MMIs tested to see the type of person you were,” said Amy Merino, a UMass Boston pre-med student who participated in the MMI pilot testing last spring. “The interview process definitely illuminated different characteristics that were necessary for working in the medical field. The different prompts that were given were meant to display your problem-solving abilities, your public health approach, as well as testing your ethics. I feel that having those qualities are crucial to becoming a good physician because it gives you a more holistic view of the patient.”

Studies from Canada and the U.S. suggest that the MMI is a good indicator of non-clinical skills in students. Given the mission of UMMS to train physicians who are not only technically skilled clinicians and scientists, but compassionate, resilient caregivers who advocate for their patients and their communities, this new way of evaluating applicants has the potential to more clearly illuminate a candidate’s suitability for medical school success here.

“The MMI produces more data about the things that we care about,” concluded Manno.