Allison M. Greene and Christopher R. Bailey

Medical schools are continually developing novel strategies for recruiting students with the qualities that they believe will produce successful doctors.  Intelligence and academic achievement, attributes that are relatively straightforward to evaluate, were once the cruxes of the interview process. But people skills are becoming increasingly paramount and despite their significance medical schools have found them quite complicated to assess systematically.

A recent New York Times article describes the newest strategy designed to discern socially conscious medical students: the multiple mini interview or MMI.  Author Harris likens the process to speed dating, but rather than wooers perched on bar stools foraging awkwardly for words, imagine admissions personnel waiting behind closed doors equipped with sheets of paper that outline predetermined conversation topics. The controversial issues we’re warned to avoid on first dates are fair game for the dozen-or-so mini discussions between the interviewers and the applicants. This year, the MMI was used in at least eight medical schools in the United States and thirteen schools in Canada.

The technique is designed to assess how well candidates can think quickly, work collaboratively, listen well, demonstrate cultural competence, and form conclusions that are in accord with both their own and other people’s perspectives. The underlying idea is that these abilities are essential for interactions with patients and colleagues because they require fundamental communication tools. But does success in the MMI really translate to success in the professional world?

The MMI makes for an interesting icebreaker, but we question whether it assesses the right types of attributes in candidates.  Working with colleagues and patients does require listening skills and cultural competence, but it also requires aptitudes that are not necessarily measured in the MMI.  In fact, we argue that some personality traits that might help students in the MMI are the very traits that patients might find undesirable in doctors. Consider, for example, the strongly opinionated, outspoken applicant who knows to listen patiently while others speak but has no concern for what they say.  Conversely, consider the timid applicant with genuine intentions who is overshadowed by an outspoken peer.  The former might fare better in the MMI, but when it comes to building rapport with patients, the student with the ability to listen keenly to a patient will build a more intimate relationship, which ultimately translates to better care.

Though the MMI has the ability to assess an applicant’s endurance–the process can last as long as four hours–and facility to solve problems quickly and efficiently, it does not allow the interviewers the same detailed portrait of an applicant’s personality that a traditional interview affords. In a way, applicants should not be running a marathon that assesses one aspect of their persona. Instead applicants should be put through a sort of decathlon that assesses their whole character. The traditional interview is the proverbial decathlon that will, in due course, give medical schools a holistic view of their potential pupils and should remain the primary means of evaluating America’s future physicians. The MMI is not ineffective, but we believe that if medical schools choose to use it, they should use it in conjunction with more traditional interview methods.

Reference:

1. Harris, G. New For Aspiring Doctors, the People Skills Test. The New York Times. July 10, 2011.