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It seems that every time I come across a MMI question that requires critical thinking I am stumped (I am fine with the ethical questions though). I find that I get overwhelmed because I just don't have the knowledge to answer the question.

 

My question is, how do I become more knowledgeable to be able to answer these questions?

 

What are some good topics to read up on (both health care related and non-health care related)

 

What are some good sources to read? 

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It seems that every time I come across a MMI question that requires critical thinking I am stumped (I am fine with the ethical questions though). I find that I get overwhelmed because I just don't have the knowledge to answer the question.

 

 

 

 

Do you have an example of what this type of question looks like for you? Different people might define 'critical thinking' in slightly different ways. In general keeping up on world events and major healthcare topics should be more than sufficient for the MMI, which is the other reason I'm asking if you have an example because it sounds like you might be getting some unusual questions.

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Maybe I used the wrong wording. What I meant are all the questions other than non-traditional questions (like why do you want to be a doctor) and ethical questions is what given me problems.

 

For example:

 

In June 2011, the infamous Vancouver riots took place after their hockey team lost in the Stanley Cup Finals. Stores were ransacked and cars were burned. Hundreds of people were injured and sent to overcrowded hospitals. As the police chief in Vancouver, what measures or policies would you put in place to make sure this does not happen again? 

 

 

I know many people say there aren't many of these questions, but frankly, where I interview (I only apply in my home province), I feel like these make the majority of type of questions and all I see people talking on here are about ethical type questions!

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The above is a type of non-medical question I am having difficulty with and the following is a type of medical related question I am having issue with (however I feel it would be easy to answer if I were more knowledgeable)

 

Recently, the Prime Minister of Canada raised the issue of deterrent fees (a small charge, say $10, which everyone who initiates a visit to a health professional would have to pay at the first contact) as a way to control health care costs. The assumption is that this will deter people from visiting their doctor for unnecessary reasons.

Consider the broad implications of this policy for health and health care costs. For example, do you think the approach will save health care costs? At what expense? Discuss this issue with the interviewer. 

 

 

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I feel I had the same issues when I first started practicing and what I found really useful was group discussions. So what our small group would do (3-4 people) is each person would get asked 2 successive MMI style questions. When everyone was done we would go through each question slowly, critique answers and offer multiple perspectives to get you thinking in different ways. I found this so helpful in jump starting my brain into seeing the question from a much more broad and general light. It's not about having specific background knowledge on every scenario possible because they know this isn't possible. It's more about taking the question and trying to ascertain what they're really asking. Seeing both sides of the equation and giving advantages/disadvantages to each then ultimately choosing what you think is more appropriate based on your reasoning.

That being said there are a few general topics I brushed up on myself which I found came up often in sample questions. Also I know you're trying for Umanitoba so some areas like rural and Aboriginal medicine are scenarios specific to here that are likely to show up. I'll PM you with some documents I found helpful.

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There isn't any 'knowledge' required for these kinds of questions-they aren't looking for experts on the city of Vancouver, police officers, or sporting events in that example. 

 

Just read more news, talk about events with people, etc. and you'll feel more comfortable. But really, it's just creative/on the spot thinking, not knowledge, for these kinds of questions

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 I think the biggest thing that could help is having discussions, debates, etc. about world events, politics, sports scandals, etc, AND having these conversations with people who don't agree/have the same opinions as you. And really trying to understand why they feel this way, what benefits/drawbacks they see in their own opinion and then how it relates to your own, or if it affects your own opinion.

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The first one is simple. To prevent hockey riots, get rid of the Canucks.

 

But in all seriousness, reading up on things like user fees, wait times, and other healthcare issues can easily be done online to get an idea of the arguments on both sides. Also learning the social determinants of health would probably be helpful as those seemed to come up often in interviews

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I definitely felt that having more life experience helped me on the MMI at Mac when it came to the "public policy" type of questions that you describe above. I'm fairly opinionated on most political issues and would like to think I have a solution for everything!

 

How do you get there? Definitely read up on current issues/events. Daily if you have the time. And if you don't understand an issue, spend more time reading up on that particular topic. My MMI had questions about fitness policy, aboriginal health, active transportation, immigration (related the "social determinants of health" as mentioned above), history, etc. Try to read up on all sides of an issue as well, not just the feel-good, politically-correct opinions that everyone shares on Facebook.

 

Having general knowledge of economics can really help you to understand political issues as well, because ultimately money drives decision-making. (As an aside, I find it interesting that they've added sociology and psychology to the MCAT, but not economics! It's just as important for understanding health care funding...)

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For those who were successful in the interviews, did you feel like you had already been exposed to the topics of the MMI questions, or were you finding yourself having to make up your opinion quickly on a topic that was completely new to you?

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For those who were successful in the interviews, did you feel like you had already been exposed to the topics of the MMI questions, or were you finding yourself having to make up your opinion quickly on a topic that was completely new to you?

You'll inevitably find that you're knowledgeable in some topics and completely clueless at others. 

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I agree^, it's just a lot easier to have fleshed out arguments for an issue if you've already encountered it before, as opposed to thinking about it for 2 minutes before going in. Just wondering how many questions people tend to have seen before, and if it has an effect on their success at the MMI -- could help focus preparation a bit.

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I agree^, it's just a lot easier to have fleshed out arguments for an issue if you've already encountered it before, as opposed to thinking about it for 2 minutes before going in. Just wondering how many questions people tend to have seen before, and if it has an effect on their success at the MMI -- could help focus preparation a bit.

I felt that most topics I was comfortable with, because i had that in life experience - not because of interview prep. I did very little interview prep, aside from a few sessions. It helped that most stations were not directly medicine-related or the medethics type questions.  

 

I should clarify, i had never seen any of the questions i got before, but the basic concepts i had experienced in my day to day over and over.

Questions about interpersonal relationships? check

Questions about industry management and action plans/ "next steps"? Check

Questions about dealing with underprivileged and "outcasts"? check

Questions about decision making with regard to hiring? Check

 

goes on and on. I really advocate for gaining as much "life experience" whatever that means to you, and putting yourself in new situations and uncomfortable situations often. It helped me alot. Not universally applicable to everyone, but can't hurt.

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Aside from life experience, I find the more practice questions you do, the more parallels you see between the questions! If you see themes and are comfortable with talking about them for a while, you'll actually find that you start running out of time!! (Or at least that's what I found...)

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Maybe I used the wrong wording. What I meant are all the questions other than non-traditional questions (like why do you want to be a doctor) and ethical questions is what given me problems.

 

For example:

 

In June 2011, the infamous Vancouver riots took place after their hockey team lost in the Stanley Cup Finals. Stores were ransacked and cars were burned. Hundreds of people were injured and sent to overcrowded hospitals. As the police chief in Vancouver, what measures or policies would you put in place to make sure this does not happen again? 

 

 

I know many people say there aren't many of these questions, but frankly, where I interview (I only apply in my home province), I feel like these make the majority of type of questions and all I see people talking on here are about ethical type questions!

 

There will always be questions that refer to topics you don't really know about or haven't thought of. The first thing you must do is not even approach it like there is a way to do enough reading or knowing enough that you can know the question that is coming- because then you will feel super anxious and let down when the inevitable happens and there's questions you didn't see coming. It's just what the MMI is almost designed to do- see how you think on your feet. There are ways though to get better at dealing with these foreign questions. My strategy kind of goes something like this:

 

1) Acknowledge to myself that this is a question I don't know much about but let's take a deep breath, it's all about piecing it together (more to follow on what this means in the following steps)

2) Forget the specifics- what broader issues does this example actually point to? So in this case, we had a large group of fans who went ballistic when their team lost a major game (see how general I am making it?), people went crazy basically did things they never would normally sanely do, and it was way too much to handle at that point with people turning up injured everywhere and hospitals being overwhelmed and underprepared (likely) for the crazy influx of patients. The question asks specifically about how the police chief would handle it, but I would still talk about the broader societal reasons that these things can happen...some of it may be controllable by greater enforcement, other elements may not be. For example, mob mentality makes people do things they normally might not otherwise do...the police chief would first need to recognize that that could be a factor in a scenario like this and therefore treat it differently than a regular event, which maybe was not part of their approach before (most likely, given how many people got hurt). You can speak a little more here about the concept of mob mentality in a situation your familiar with, for example, it's a common part of how one kid might be really bullied in school and things could happen that wouldn't happen on a one-on-one basis with many of the kids that ended up being part of the bullying in a larger group setting

3) Now more get into answering specifically the last part- so what can the police chief do? How were these people able to get close enough to the cars etc to burn them? Maybe a much larger area surrounding the games should be barricaded off, so parking would be a good walk, but this way it would at least minimize some chance of the fans getting to the cars. What about checking whether they had weapons when they came into the arena? Like at the door. At that point, they aren't as rowdy so when tickets are taken, this could also be checked. Is there enough man-power? Would one of the things the police chief need to look into is how much man-power is going to be required to set up all these measures and then prioritize them based on their historical/other data on which are the most effective ways? Maybe a few policeman in each section of the arena patrolling especially towards the end of the game may be effective as well to deter this kind of behaviour. Then you can talk about general limitations of setting up these policies. No matter what, there is going to be the element that some people could get hurt or something could happen regardless of law enforcement (but again, this is a general thing about society, it's not specific to this example)...so then what to do if someone gets hurt? Were there first responders present? If so, did we need more? How many ambulances were on standby in the surrounding area? Do hospitals need to be more aware that this kind of event can lead to a massive influx of patients and perhaps try to allocate some resources towards having an area of ER ready to go post-game where there are some empty beds for the injured? If there are less injured than they are ready for, these beds can still be given to those regular patients waiting in the ER. In some hospitals (and yes, this comes from volunteer experience, but again as others have said, life experience is key), there are short-term stay units equipped with beds not used too often and not always staffed, for that reason, maybe it's a matter of organizing it so hospital staff are prepared in this area to take in some of the injured. Not all of this can the police chief implement alone, but he may be the liason or the main planner to basically decide on the different elements of the game plan that are required....and then partner with other agencies, like hospital admin, in order to address the other parts. See how this is general too? It does speak to leadership and partnership, two important skills as a physician as well.

 

There are more things that will pop into your head as you think of this, but just think BROAD...don't freak yourself out thinking I don't know the minutia of detail that had to do with this riot...it's a riot...and shit happened...now how can I use my critical thinking skills to a) tackle the general issues that lead up to basically anything like this , b)think of ways to potentially minimize this occurrence in the future and c) better deal with bad outcomes, as bad outcomes are a fact of life everywhere. The interviewer will see you've made an honest effort to think hard, be comprehensive and use your analytical skills. They will be happy with it and your score will reflect it. After doing the MMI's, I really have come to realize knowing the specific question is just not as important as your ability to relate it to the broader threads of society. If you can emphasize some canMEDS qualities (which is often hidden in the broader theme of the question like this one was)...then that is for sure a bonus, if it slips your mind in a station or two or you don't quite get to hit that part, don't stress, the thinking piece I really do believe is what's most evaluated. For ethics questions, I'd say it's far more important to emphasize the relevant canMEDS throughout (often, it's much easier to pick out the canMEDS at play in an ethics question too though).

 

What makes an answer even better I think is if you can inject even a little personal example that can touch on any of the things mentioned....because we are talking in a more general way (while still answering the specific question), it allows for room for you to pull examples from your life and for them to still sound relevant to the question. Now you've personalized it more, made your answer more memorable (and hopefully emphasized a canMEDS quality of yours in your example!) and it's that much better. Make sense?

 

Hopefully that helped. Other than this, what really helped me was reading about social determinants of health, how to make health care most cost effective, current issues like the aging population situation (this reading will also talk about the overburdening of the system), of course Doing Right (this actually helped the least as most of my questions were not ethical in nature) and also reading a little about other health care systems...some to look into are USA, Australia and France. You'll see why, it gives you different approaches to thinking about health care delivery and also health care focus..as well as health outcomes in different areas, like mental health etc...there may even be some others I haven't thought of etc. Whenever you see something that talks about overburdening health care system (like this question did), I would also inject one thing I had read that could make health care more streamlined, efficient and less burdened...just to show that I had thought about this before and to fill some time. Not too much to get off topic, just a few seconds on it to complement the question stem.

 

Hope I was clear enough here and that this helps your prep!! We've all been there, and it really can be a stressful experience...but you can turn it into a fun experience because it's cool to see what they come up with and it's time for you to show off how you can come at a question in different ways, relate it back to you and think like a boss! B)

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There will always be questions that refer to topics you don't really know about or haven't thought of. The first thing you must do is not even approach it like there is a way to do enough reading or knowing enough that you can know the question that is coming- because then you will feel super anxious and let down when the inevitable happens and there's questions you didn't see coming. It's just what the MMI is almost designed to do- see how you think on your feet. There are ways though to get better at dealing with these foreign questions. My strategy kind of goes something like this:

 

1) Acknowledge to myself that this is a question I don't know much about but let's take a deep breath, it's all about piecing it together (more to follow on what this means in the following steps)

2) Forget the specifics- what broader issues does this example actually point to? So in this case, we had a large group of fans who went ballistic when their team lost a major game (see how general I am making it?), people went crazy basically did things they never would normally sanely do, and it was way too much to handle at that point with people turning up injured everywhere and hospitals being overwhelmed and underprepared (likely) for the crazy influx of patients. The question asks specifically about how the police chief would handle it, but I would still talk about the broader societal reasons that these things can happen...some of it may be controllable by greater enforcement, other elements may not be. For example, mob mentality makes people do things they normally might not otherwise do...the police chief would first need to recognize that that could be a factor in a scenario like this and therefore treat it differently than a regular event, which maybe was not part of their approach before (most likely, given how many people got hurt). You can speak a little more here about the concept of mob mentality in a situation your familiar with, for example, it's a common part of how one kid might be really bullied in school and things could happen that wouldn't happen on a one-on-one basis with many of the kids that ended up being part of the bullying in a larger group setting

3) Now more get into answering specifically the last part- so what can the police chief do? How were these people able to get close enough to the cars etc to burn them? Maybe a much larger area surrounding the games should be barricaded off, so parking would be a good walk, but this way it would at least minimize some chance of the fans getting to the cars. What about checking whether they had weapons when they came into the arena? Like at the door. At that point, they aren't as rowdy so when tickets are taken, this could also be checked. Is there enough man-power? Would one of the things the police chief need to look into is how much man-power is going to be required to set up all these measures and then prioritize them based on their historical/other data on which are the most effective ways? Maybe a few policeman in each section of the arena patrolling especially towards the end of the game may be effective as well to deter this kind of behaviour. Then you can talk about general limitations of setting up these policies. No matter what, there is going to be the element that some people could get hurt or something could happen regardless of law enforcement (but again, this is a general thing about society, it's not specific to this example)...so then what to do if someone gets hurt? Were there first responders present? If so, did we need more? How many ambulances were on standby in the surrounding area? Do hospitals need to be more aware that this kind of event can lead to a massive influx of patients and perhaps try to allocate some resources towards having an area of ER ready to go post-game where there are some empty beds for the injured? If there are less injured than they are ready for, these beds can still be given to those regular patients waiting in the ER. In some hospitals (and yes, this comes from volunteer experience, but again as others have said, life experience is key), there are short-term stay units equipped with beds not used too often and not always staffed, for that reason, maybe it's a matter of organizing it so hospital staff are prepared in this area to take in some of the injured. Not all of this can the police chief implement alone, but he may be the liason or the main planner to basically decide on the different elements of the game plan that are required....and then partner with other agencies, like hospital admin, in order to address the other parts. See how this is general too? It does speak to leadership and partnership, two important skills as a physician as well.

 

There are more things that will pop into your head as you think of this, but just think BROAD...don't freak yourself out thinking I don't know the minutia of detail that had to do with this riot...it's a riot...and shit happened...now how can I use my critical thinking skills to a) tackle the general issues that lead up to basically anything like this , b)think of ways to potentially minimize this occurrence in the future and c) better deal with bad outcomes, as bad outcomes are a fact of life everywhere. The interviewer will see you've made an honest effort to think hard, be comprehensive and use your analytical skills. They will be happy with it and your score will reflect it. After doing the MMI's, I really have come to realize knowing the specific question is just not as important as your ability to relate it to the broader threads of society. If you can emphasize some canMEDS qualities (which is often hidden in the broader theme of the question like this one was)...then that is for sure a bonus, if it slips your mind in a station or two or you don't quite get to hit that part, don't stress, the thinking piece I really do believe is what's most evaluated. For ethics questions, I'd say it's far more important to emphasize the relevant canMEDS throughout (often, it's much easier to pick out the canMEDS at play in an ethics question too though).

 

What makes an answer even better I think is if you can inject even a little personal example that can touch on any of the things mentioned....because we are talking in a more general way (while still answering the specific question), it allows for room for you to pull examples from your life and for them to still sound relevant to the question. Now you've personalized it more, made your answer more memorable (and hopefully emphasized a canMEDS quality of yours in your example!) and it's that much better. Make sense?

 

Hopefully that helped. Other than this, what really helped me was reading about social determinants of health, how to make health care most cost effective, current issues like the aging population situation (this reading will also talk about the overburdening of the system), of course Doing Right (this actually helped the least as most of my questions were not ethical in nature) and also reading a little about other health care systems...some to look into are USA, Australia and France. You'll see why, it gives you different approaches to thinking about health care delivery and also health care focus..as well as health outcomes in different areas, like mental health etc...there may even be some others I haven't thought of etc. Whenever you see something that talks about overburdening health care system (like this question did), I would also inject one thing I had read that could make health care more streamlined, efficient and less burdened...just to show that I had thought about this before and to fill some time. Not too much to get off topic, just a few seconds on it to complement the question stem.

 

Hope I was clear enough here and that this helps your prep!! We've all been there, and it really can be a stressful experience...but you can turn it into a fun experience because it's cool to see what they come up with and it's time for you to show off how you can come at a question in different ways, relate it back to you and think like a boss! B)

 

I'm very impressed with this. Congratulations on your achievement and it's clear you've demonstrated many intellectual and personal skills necessary to do well in your future role. I'd look forward to working with you if we cross paths. 

 

- G

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I'm very impressed with this. Congratulations on your achievement and it's clear you've demonstrated many intellectual and personal skills necessary to do well in your future role. I'd look forward to working with you if we cross paths. 

 

- G

 

Thanks G!! That's quite the compliment coming from you. It would be awesome to work with you too, who knows what the future holds! This is going to be such a ride, I'm getting ready for the ride of my life (in reference to both the ups and the downs!!). Thanks again for your warm wishes.

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