Door No. 1
The buzzer sounds. An applicant, standing with her back facing the interview room, turns around, finds a piece of paper posted to the door and has two minutes to read and think about this scenario: “Dr. Blair gives his patients sugar pills. He acknowledges that he uses the placebo effect. His reasoning is that it does no harm and makes people feel better. Consider the ethical problems that Dr. Blair’s behaviour might pose.” The buzzer sounds again and the applicant enters the room, introduces herself to the interviewer and begins discussing the problem for up to eight minutes.
This example is typical of MMI questions because it has no correct answer. Rosenfeld explains: “You can go either direction because some doctors use the placebo effect very effectively, very skilfully.” What’s important, he adds, is that applicants demonstrate an ability to consider and articulate both sides of an argument, then come to a position and be able to defend it.
The judges
Who is listening to the applicant wax on about the ethics of the placebo effect? Not expert profilers, but rather a mix of members of the local community, medical students and medical professionals.
The interviewers are given a general overview of how MMI works a couple of weeks in advance—but they don’t receive their specific MMI question and background information until a couple of hours before the interviews start. “We can’t risk giving those stations out ahead of time,” Rosenfeld explained. “If some applicant somewhere catches a glimpse of a station, there will be the devil to pay.”
Because interviewers aren’t experts on the topic they are assessing, they aren’t looking for in-depth knowledge from applicants. “One of the most important things is the attitude of the applicant and their mannerisms,” said Jeremy Hernandez, a second-year MD/Ph.D. student at McMaster, who has been an MMI applicant twice and an interviewer once. He stressed that how applicants communicate is just as important as what they say. “[The MMI] shows the person that you are, instead of the person you can practise to be,” he says.
Door No. 2
The buzzer sounds. Scenario: “Your company needs both you and a co-worker (Sara, a colleague from another branch of the company) to attend a critical business meeting in San Diego. You have just arrived to drive Sara to the airport.”
“Sara” (an actor) is debilitated by fear of flying. No matter what approach the applicant takes to urge her to get on the plane, the actor challenges the applicant. The hysterical and irrational Sara may accuse the applicant of patronizing her or, if the applicant is aggressive, Sara may start crying. The interviewer silently observes how the applicant reacts.
“I personally found it very difficult since it involved interacting with the actor as though they were my friend, relative or co-worker,” Hernandez recalled of the acting stations. “In the back of my mind, I knew that the situation was not real.” Almost every applicant interviewed for this article agreed that acting stations are the most challenging. “You could be a horrible actor, but does that mean you will be a bad doctor?” one applicant asked.
What mistakes do applicants make in acting stations? Some broke down crying or responded angrily when they got frustrated. But according to Rosenfeld, one of the most serious errors an applicant can do is to look at the interviewer instead of exclusively dealing with the actor.
