MMI Interview Guide - Part 2: What You Should Know

[ArdentMed]

Part 2: What you should know

1.      What does “communication” or “rapport” really mean?

Communicator: Professional relationships with the patient for trust and autonomy to convey empathy, respect, and compassion.

Communicators understand that biases and values of patients and colleagues may affect quality of care. Modifications are made accordingly.

For example, consider the following question: Do patients who have beliefs against medical procedures have the right to reject vital treatment? (I.e.: Jehovah's witness and blood transfusion). How would you respond? 

I believe that a good answer would take the patient’s unique culture and heritage into account. Remember that competent adults have autonomy. As future physicians treating competent patients, we must accommodate the patient’s wishes. This may seem dark at first. But recall that the opposite, paternalism (deciding for the patient) is autocratic and dictatorial. Would you prefer to live in a society where healthcare professionals force-fed you medication telling you that it is for your own good, or would you rather have the right to decide? The latter is obviously the correct answer.

In addition to the above, an excellent communicator must respond to non-verbal behaviors, manage emotionally charged conversations, and is adaptive to unique needs of patients and their conditions. This means that you are empathic enough to view the situation from the eyes of others. Synthesize information from patient and family's POVs: from family (with patient's consent), gather psychosocial and biomedical information from interviews.

2.      Should I “be myself?”

Of course you should be as authentic as possible during the interview. Interviewers can spot lies based on your body language. Honesty often aligns with confidence.

However, that does not mean that you should not work on changing some aspects of yourself. This is especially true if you believe that you can improve in any of the following domains: becoming a better communicator, collaborator, leader, scholar and lifelong learner, as well as a health advocate who vouches for the well-being of the population at large.

The best way to cultivate the qualities that will help you perform well in the interview is through reviewing practice prompts with a partner frequently. After drilling through some prompts from websites such as those on http://TeachDoctor.com/interview-questions/ or https://www.ucalgary.ca/mdprogram/admissions/mmi/samples, review the ideal responses posted there. How does your answer compare? Are you demonstrating strong communication by viewing the situation from the patient’s point of view? Are you accommodating the patient’s beliefs, socioeconomic status, and values? Compare your answer with a friend and those posted on the website to determine what you must work on.

3.       How do I prepare for the acting prompts?

There is a certain structure for many acting prompts that you must familiarize yourself with.

Typically, you must do the following:

1.      Listen to the person without judging them. What are their concerns? How did the situation take place from their shoes?

2.      Convey that you understand what they mean. With that said, do not offer false reassurances that may end up promising more than you actually deliver.

3.      Demonstrate shared decision making. This is where you convey to the person that you want to work on a solution together. Find common ground with the person.

While keeping the above steps in mind, you should also bear in mind that criticism and judgments against the person are not indicators of communication and rapport. This is why you must listen patiently to the other person.

Once again, you need to review as many practice prompts as possible.

For example, here is a potential question.

You are a manager of a chain of restaurants. One 30 year old male worker received a complaint about telling a customer to never come back to the restaurant again. Arguing with customers is against company regulations. You need to lay this person off. What do you do?

With the above steps listed, you should listen patiently to the worker’s side of the story. While you must be firm about laying them off, ensure them that you can serve as a reference for other positions if they have other strong points to talk about. Do this calmly and without offering the false hope of rehiring them. Remember that the instructions have been given in the prompt and they clearly indicate that the worker must be fired. However, demonstrate your concern for their wellbeing and future by serving as a reference if they have other strong suits and this was a one-off case.

How do you prepare for acting prompts? That is an excellent question. As I previously mentioned, you need to understand what “communication” and “rapport” truly mean. These are qualities that ideal doctors demonstrate at the workplace.

Remember that working with others whether they are patients and especially if they are co-workers requires collaboration. You can read more about collaboration in the frameworks of an ideal physician on Queens University’s website (http://www.collaborativecurriculum.ca/en/modules/CanMedsCollaborator/)

In addition, you must expose yourself to as many practice scenarios as possible for acting prompts. Try acting them out with a partner and listen to their impression of how it went. You can find plenty of prompts at http://TeachDoctor.com/interview-questions/ or on the sites of many Canadian universities that have any healthcare programs that interviews its students in a multiple mini interview (MMI) format such as https://www.ualberta.ca/physical-therapy/msc-in-physical-therapy/admissions/application-requirements/sample-mmi-questions.  

As with the previous part of this guide, I emphasized how practice makes progress. You must be responsible enough to practice these interview prompts on a consistent basis. Find a partner to practice with. Ideally, have a model response to compare your answers to and have your partners provide feedback. 

Let me know if you have any questions. The above are simply answers to "high-yield" questions that others may have.