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Acing The Multiple Mini Interview (MMI) Format For Medical School Admissions.    The Multiple Mini Interview (MMI) may be the wave of the future in medical school interviewing. The MMI is now utilized at over 50 medical schools around the world. I have been helping prospective medical students prepare for the MMI format for some time now. This article lists a set of 12 success strategies that have helped them do very well on it, and a checklist of 14 mistakes candidates make on the MMI. My clients have access to a list of hundreds of examples of MMI questions, scenarios and tasks, some of which are shared in this article.    2620 words.



Acing The Multiple Mini Interview (MMI) Format
For Medical School Admissions



Bill Cole, MS, MA
Founder and CEO
William B. Cole Consultants
Silicon Valley, California



The Multiple Mini Interview (MMI) may be the wave of the future in medical school interviewing. The MMI is now utilized at over 50 medical schools around the world. Once a school has adopted the MMI, they have retained it, and none have ever switched back to more traditional interview formats. So the MMI appears to be here to stay. Do you know how to prepare for the MMI? Do you know how to succeed with this format and get a high score?

I have been helping prospective medical students prepare for the MMI format for some time now, and I have discovered a set of 12 success strategies that have helped them do very well on it. I also have a checklist of 14 mistakes I have seen candidates make on the MMI and I have a list of hundreds of examples of MMI questions, scenarios and tasks. I'll share some of those with you later in this article.

First, let's discover what the MMI is all about.

The MMI assesses the "soft skills" of maturity, collaboration, communication, empathy, critical thinking, the ability to cope with ambiguity, ethical decision-making, attention to detail, cultural sensitivity, and current healthcare and societal issues. The MMI is not intended to test specific knowledge in the medical field or to assess prior academic, scientific or clinical knowledge. Applicants are not tested on mathematical or scientific formulas, not asked to solve scientific problems, not asked to complete true-false or multiple choice test questions, or asked to create diagrams or flow charts. The MMI allows the school to systematically assess the characteristics and attributes which are deemed to be important components in becoming a competent physician. The MMI tests how well an applicant can "think on their feet" and the degree of "emotional intelligence" they possess.

The MMI Process

The MMI is a series of seven to nine interview stations consisting of timed interview scenarios. Candidates rotate through the stations, each with its own interviewer and scenario, question or task. Each module or station is about eight minutes or less. There is usually a two-minute break between stations, with a total of nine applicants participating. The entire MMI process takes about two hours.

The applicant waits outside the examination room and reads, posted on the wall, a description of the next task, scenario or question they will need to face. They have two minutes to read and formulate their strategy. Then a bell rings, and all candidates enter their individual room to meet the interviewer. Some rooms will have an additional "actor" who will assist in a role-play of a scenario. The prompt is posted on the outside wall before going in to talk with the interviewer and it's also in the room, so at any point during the eight-minute interview the applicant can reference the question. Applicants are given a clipboard with paper and pencil, so they can make notes during the two minutes they have outside.

The MMI has three types of situations for the applicant to handle: a question, a scenario or a task. Instructions for tasks and scenarios given to applicants are vague by design. They are created that way as a sort of "medical Rorschach test", so applicants can go in multiple directions with their response. Interviewers may probe applicant's answers, disagree with them, interrupt them, or even debate them.

The interviewers will not discuss any aspects of the MMI process or of how the applicant is doing on the interview itself. Each station is graded on a scale from 1 to 10, with 1 being the best possible score. Applicants are given an aggregate interview score at the end of the MMI based on their performance in each individual station. If there is time, applicants may find themselves engaged in small talk with the interviewers.

The MMI interviewer may provide prompts designed to direct the applicant in each station. Applicants are urged to listen carefully to these cues so they can take advantage of any new information that may be introduced. Interviewers are a combination of school faculty, graduates, staff, and students who have been trained specifically for the MMI process at that institution. Each interviewer remains at the same station through the MMI while the applicants rotate. The MMI is a blind format. The interviewers do not have any background on the applicants.

The MMI: Psychometrically Sound

The MMI has demonstrated an ability to minimize unconscious interviewer bias (positive or negative) and to be more reliable than one-on-one interviews by using multiple "raters", or interviewers. Applicants who do poorly on one station (or who don't have favorable chemistry with one interviewer) have the immediate opportunity to perform better on another station.

The MMI test reliability is markedly higher compared to other interview formats. This gives the MMI higher predictive validity, which can predict future applicant performance much better than standard interview styles, including panel, group or behavioral interview formats. Traditional, one-on-one interview formats can be negatively influenced by inherent biases, expectations, and perspectives of an individual interviewer. The MMI overcomes these limitations. Harasym, et al. showed that interviewer variability accounted for up to 56% of the total variance in interview ratings.

Examples Of MMI Questions, Scenarios And Tasks

Remember, the MMI is not all scenario-based role-play, which many people tend to believe. The MMI can ask you a standard question, ask you to complete a task, or have you role-play a scenario. Here are some examples.

  1. Enter the room and speak to the "patient" about their drug addiction.

  2. Enter the room and respond to a picture, photograph or painting.

  3. Respond to the question, "Should doctors be allowed to go on strike?"

  4. Tell a patient that they have less than three months to live. Here you must actually role-play this scenario with an actor.

  5. A relatively healthy patient sees you and has a slight limp. They immediately ask for a handicap car placard. How do you proceed? This scenario could be answered verbally, as in "I would take the following approach...", or this could be a role-play with an actor.

  6. Enter the room and sit in a chair, back to back with the "actor". Describe to them the picture you have in your hand and guide them in drawing that picture, without using terms that actually describe what the object is.

  7. Enter the room and use the lite-bright machine to create what you believe to be the best representation of "health or medicine, or a doctor", in your mind. The interviewer will ask questions as you go.

  8. Write an essay on how you would go about reducing smoking and chewing tobacco use among teens at the national level.

There are generally no "wrong answers", but applicants are encouraged to be open-minded on matters such as abortion, euthanasia, and other common, yet controversial medical ethics issues. The goal is to look at all sides of an issue, pro and con, consider all stakeholders, and then take a stand on one aspect of that, and then to support that answer.

Once you begin coaching with me, I also have hundreds of specialized medical school questions I help you with around medical ethics, medical scenarios, traditional medical school questions, communication, current healthcare trends and societal issues and many other topic areas.

12 MMI Success Strategies

The MMI can be quite tricky and it can be intimidating. The only way to become confident and turn in a great performance is to prepare well, and to prepare early. Here is a sampling of strategies that can help you in an MMI situation.

  1. Read the posted task, scenario or question carefully. Make sure you understand it fully. Begin to formulate possible responses. Think broadly and creatively.

  2. Visualize how you'd like this station to play out. Picture yourself successfully navigating the situation.

  3. Organize your thoughts and have a mental checklist or outline of your process.

  4. Compose yourself before you enter the room. Take three very deep, slow breaths. Knock on the door briskly and enter with a smile. Walk right to the interviewer and shake the interviewer's hand, and introduce yourself, using your full name, not just your first.

  5. Be centered and calm and take your time when you move about, and when you leave the room.

  6. You do not need to utilize the entire time you have in the room. You will have two minutes to read and "game out" your response to the post while you are in the hallway. You can end your response early, as long as you've done and said everything you need. The sooner you enter the room the more time you have to respond. If you take too long in the hallway crafting your response, the interviewer may perceive you as indecisive, afraid, disorganized or sloppy.

  7. Have a formula for answering questions. Paraphrase the question back to the interviewer. Tell them how you will approach the answer. Give them an outline or roadmap so they can follow you. Discuss all sides of the issue. Conclude by taking a stand on one choice, and back up your decision with solid reasoning. Use stories and examples from your life if appropriate.

  8. Make sure you practice under timed circumstances. You must feel in advance the urgency to rapidly formulate your ideas and deliver cogent, thoughtful, reasoned, organized responses to each challenge. You may find that hiring a coach to help you craft these answers, role-play and prepare using mock interviews can be very helpful. This creates mental toughness and poise under pressure.

  9. You may decide to leave two minutes for the interviewer to ask you questions. If the interviewer doesn't have any questions, you can summarize your comments.

  10. Remember that the MMI tests emotional intelligence, so you want to use some rapport-building techniques in the room.

  11. While it is important to be "comfortable in silence", this is not the time or the place to be silent! Utilize small talk, get to know the interviewer and be personable and warm.

  12. Thank the interviewer and shake their hand one final time as you exit.

When you begin coaching with me, I give you a specialized 20-point medical scenario-answer checklist tool that helps you triage, organize and deliver potent scenarios.

14 Mistakes Candidates Make On The MMI

There is not a medical school applicant who is not nervous about undergoing an interview. Interviews put everyone on edge. When it comes to the MMI, an applicant's nerves are intensified, due to the ambiguous nature of the test, the requirement to actually act out responses, and the rapid pace of the entire day.

The worst mistake applicants make is to believe that the quality of their answers is without flaws. I receive calls and emails from students weekly who want last-minute coaching right before their interview. Some want this session the day before the interview! This is a disaster in the making. I have yet to encounter a student who has ideal answers, and ideal delivery of that content. Everyone needs to tweak and improve their material to some degree. If that is the case, how can this be accomplished mere days before such an important interview? It can't. How can these new answers be rehearsed? They can't. This adds huge stress to the applicant and can cause mental confusion. The remedy? Start early with coaching so you can practice, practice, practice. Correct practice and high-quality practice is what makes you feel confident going into the MMI. There is no substitute for practice.

Here are the most common mistakes applicants make when it comes to preparing for and performing at the MMI.

  1. Applicants guess about the quality of their body language and eye contact.

  2. Applicants practice only in their heads. The actual interview requires verbal responses.

  3. Applicants don't know how to structure their answers so they are logical, organized and understandable.

  4. Applicants don't time their practice sessions.

  5. Applicants don't understand how to use rapport techniques.

  6. Applicants don't know how to identify and handle "trick" questions.

  7. Applicants don't know how to tell a story properly.

  8. Applicants don't know how to gracefully "control the clock" so they feel more in control.

  9. Applicants don't understand the method called "active listening", so they can deal with behavioral, hostile, personal, or baiting questions.

  10. Applicants don't know how to "sell themselves".

  11. Applicants don't know how to artfully recover if they lose their place or go blank.

  12. Applicants don't know how to ask questions to create a conversation, or how to find unusual questions that make them stand out from other applicants.

  13. Applicants don't know how to use mental training techniques to help them remain calm and focused throughout the entire MMI ordeal.

  14. Applicants don't know how to prepare to get in the "zone" so they can give a great interview.

History Of The MMI

The MMI began at McMaster University Medical School near Toronto Canada in 2004, and since then, has been used by many medical, dental and pharmacy programs, and in other schools around the world. The MMI was developed from the Objective Structured Clinical Examination (OSCE). The OSCE is used by many health and medical programs to assess a student's application of clinical skills and knowledge. Reference: https://en.wikipedia.org/wiki/Objective_structured_clinical_examination

The MMI is being used as a medical school program admissions test by the majority of schools in Canada, and Australia since 2008.

The University of Cincinnati College of Medicine initiated an MMI pilot program in 2008, and launched their official MMI testing program that same year. This was the first use of the MMI at any medical program in the United States.

The MMI is also utilized in schools for chiropody, dental hygiene, medical laboratory technology, nuclear medicine technology, pharmacy, physiotherapy and occupational therapy, veterinary medicine, ultrasound technology, and X-ray technology.

Medical Schools Using The Multiple Mini Interview

In The United States:

  1. Albany Medical College

  2. Central Michigan University College of Medicine

  3. Cooper/Rowan School of Medicine

  4. Duke University School of Medicine

  5. Michigan State University College of Human Medicine

  6. New York Medical College

  7. Oregon Health and Science University

  8. Robert Wood Johnson Medical School, at Rutgers University

  9. Stanford Medical School

  10. David Geffen School of Medicine at UCLA

  11. New York University School of Medicine

  12. Universidad Central del Caribe School of Medicine, in Puerto Rico

  13. University of Arizona College of Medicine

  14. University of California Davis School of Medicine

  15. University of California Riverside School of Medicine

  16. University of Cincinnati College of Medicine

  17. University of Massachusetts Medical School

  18. University of Mississippi School of Medicine

  19. University of Missouri-Kansas City School of Medicine

  20. Virginia Tech Carilion School of Medicine

  21. Western Michigan University School of Medicine

In Canada:

  1. McMaster University Medical School

  2. Queens University

  3. McGill University

  4. UBC Faculty of Medicine (British Columbia)

  5. Northern Ontario School of Medicine

  6. University of Alberta

  7. University of Calgary

  8. University of Montreal

  9. Dalhousie University

  10. University of Sherbrooke

  11. University of Laval

  12. University of Manitoba

Prepare Well, And Prepare Early For MMI Success

Navigating the MMI so you can arrive at a high score is a major accomplishment. When you can do that, you are well on your way to a satisfying career in medicine. You have just spent many years as an undergraduate, and studied long hours. You have spent a lot of time on medical school applications. When it comes to preparing for the MMI, don't sell yourself short. Prepare fully, and prepare well. Do that and you'll walk into the MMI and actually look forward to showing the interviewers "what you have", and how you can become a wonderful medical professional. Good luck!

  
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To learn more about how interview coaching can help you improve your abilities in media situations, oral test and exam situations, and job interviews visit Bill Cole, MS, MA, the Mental Game Coach™, at: www.mentalgamecoach.com/Services/InterviewCoaching.html.

Copyright © 2011- Bill Cole, MS, MA. All rights reserved.


Bill Cole, MS, MA, a leading authority on peak performance, mental toughness and coaching, is founder and CEO of William B. Cole Consultants, a consulting firm that helps organizations and professionals achieve more success in business, life and sports. He is also the Founder and President of the International Mental Game Coaching Association (www.mentalgamecoaching.com), an organization dedicated to advancing the research, development, professionalism and growth of mental game coaching worldwide. He is a multiple Hall-Of-Fame honoree as an athlete, coach and school alumnus, an award-winning scholar-athlete, published book author and articles author, and has coached at the highest levels of major-league pro sports, big-time college athletics and corporate America. For a free, extensive article archive, or for questions and comments visit him at www.MentalGameCoach.com.

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Practice MMI Questions Bank

Who is this for? 

The following is for students applying to any health related professional program that requires the multiple mini interview as part of their admissions process. The sample MMI questions below are relevant to medicine, dentistry, pharmacy, physical therapy, nursing,  etc.

First Things First!

Before we jump into the sample questions, it is important to mention that sample questions are only effective if you: 

1) Time yourself and utilize the questions in a realistic multiple mini interview simulation (MMI SIM), and, 

2) You get expert feedback on your performance so you can identify your mistakes and learn from them way before your actual interview.

With that said, you are now ready to get started. Good luck on your multiple mini interview!

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Note: The following is a compilation of 100 sample MMI questions. Some of the questions are from BeMo’s database of questions and some are from official universities and colleges that administer the MMI as part of their admissions process. A link to each source is provided, whenever an outside source is used. Please note that BeMo does not endorse nor affiliate with any of the mentioned universities and colleges. Each respective source is the copyright owner and the material is shared here under the fair use clause of Copyright Act. 

UBC Center for Student Involvement and Careers:

1. A 14-year-old patient requests birth control pills from you and asks that you not tell her parents. What would you do?

2. A member of your family decides to depend solely on alternative medicine for treatment of his or her significant illness. What would you do?

3. If you have the choice of giving a transplant to a successful elderly member of the community and a 20-year-old drug addict – how do you choose?

4. An eighteen year-old female arrives in the emergency room with a profound nosebleed. You are the physician, and you have stopped the bleeding. She is now in a coma from blood loss and will die without a transfusion. A nurse finds a recent signed card from Jehovah's Witnesses Church in the patient's purse refusing blood transfusions under any circumstance. What would you do?

5. Your local Paediatric Association has recommended that circumcisions 'not be routinely performed'. They base this recommendation on their determination that 'the benefits have not been shown to clearly outweigh the risks and costs'. Doctors have no obligation to refer for, or provide, a circumcision, but many do, even when they are clearly not medically necessary. BC Medicare no longer pays for unnecessary circumcisions. Consider the ethical problems that exist in this case. Discuss these issues with the interviewer.

6. A biotech company was hired by the Military to develop a cure for Ebola. They successfully developed a vaccine to treat the symptoms of the virus and lowered the mortality rate for infected patients. Discuss the implications of this on a global scale.

7. Your mother calls you and asks you to help with a major family decision. Your maternal grandfather is 70 years old and has been diagnosed with a condition that will kill him some time in the next five years. He can have a procedure that will correct the disease and not leave him with any long-term problems, but the procedure has a 10% mortality rate. He wants to have the procedure, but your mother does not want him to. How would you help mediate this issue?

8. You are a genetic counselor. One of your clients, Linda, had a boy with a genetic defect that may have a high recurrence risk, meaning her subsequent pregnancies has a high chance of being affected by the same defect. You offered genetic testing of Linda, her husband, and their son to find out more about their disease, to which everyone agreed. The result showed that neither Linda nor her husband carry the mutation, while the boy inherited the mutation on a paternal chromosome that did not come from Linda's husband. In other words, the boy's biological father is someone else, who is unaware that he carries the mutation. You suspect that Linda nor her husband are aware of this non-paternity. How would you disclose the results of this genetic analysis to Linda and her family? What principles and who do you have to take into consideration in this case?

9. A woman enters the emergency room with stomach pain. She undergoes a CT scan and is diagnosed with an abdominal aortic aneurysm. The physicians inform her that the only way to fix the problem is surgically, and that the chances of survival are about 50/50. They also inform her that time is of the essence, and that should the aneurysm burst, she would be dead in a few short minutes. The woman is an exotic dancer; she worries that the surgery will leave a scar that will negatively affect her work; therefore, she refuses any surgical treatment. Even after much pressuring from the physicians, she adamantly refuses surgery. Feeling that the woman is not in her correct state of mind and knowing that time is of the essence, the surgeons decide to perform the procedure without consent. They anesthetize her and surgically repair the aneurysm. She survives, and sues the hospital for millions of dollars. Do you believe that the physician's actions can be justified in any way? Is it ever right to take away someone's autonomy?

10. You are a general practitioner and a mother comes into your office with her child who is complaining of flu-like symptoms. Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of bruises on the boy's torso. You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as "cao gio," which is also known as "coining." The procedure involves rubbing warm oils or gels on a person's skin with a coin or other flat metal object. The mother explains that cao gio is used to raise out bad blood, and improve circulation and healing. When you touch the boy's back with your stethoscope, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother. When should a physician step in to stop a cultural practice? Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine?

11. A patient with Downs Syndrome became pregnant. The patient does not want an abortion. Her mother and husband want the patient to have an abortion. What should a physician do in this situation?

12. A 12-year old boy is diagnosed with a terminal illness (e.g., malignancy). He asked the doctor about his prognosis. His parents requested the doctor not to tell him the bad news. What should the doctor do in this situation?

13. A couple has decided to have a child through artificial insemination. They asked the physician for sex selection of the child. What should a physician advise in this situation?

14. A physician became sexually involved with a current patient who initiated or consented to the contact. Is it ethical for a physician to become sexually involved?

15. A 17-year old boy lives independently. He is married and has one child. He wants to participate in a medical research study. Does he need his parents’ permission?

16. A physician went to vacation for 2 weeks. He did not find another physician to cover him. One of his patients with hypertension developed severe headache. The patient has an appointment with the doctor as soon as he comes back from vacation. The patient did not look for another physician and decided to wait. The patient suddenly collapses and was diagnosed to have intracranial haemorrhage. Is the physician responsible for this patient?

17. A 40-year old schizophrenic patient needs hernia repair. Surgeon discussed the procedure with the patient who understood the procedure. Can the patient give consent?

18. A physician picked up a car accident victim from the street and brought him to the ER in his car. He did not want to wait for an ambulance because the patient’s condition was critical. Physical examination in the ER reveals quadriplegia. Is the physician liable for this consequence?

19. As a physician at a local hospital you notice that there is a man with an alcohol dependency who keeps on consuming the hand sanitizer offered at the hand sanitizer stands throughout the hospital. He is not a patient at the hospital at present but has been many times in the past. Consequently, there is often no hand sanitizer for public use. What do you do? Do you remove/change location of hand sanitizer stands? Do you approach him?

20. A 18-year old man is diagnosed to have suspected bacterial meningitis. He refuses therapy and returns to the college dormitory. What should a physician do in this situation?

21. Is it ethical for doctors to strike? If so, under what conditions?

22. There is an outbreak of an incredibly contagious life-threatening disease. The disease is spreading across the country at a rapid rate and the survival rate is less than 50%. You are a senior health care administrator, and when the vaccine is developed, you have priority to receive the drug. Do you take the vaccine yourself or give it to another person? Why or why not?

23. You are a health researcher at an academic institution. You have been asked to work on a top-secret vaccine that would treat biomedical weapons or other communicable diseases. Before your break through, you are instructed by the government to stop all research and turn over all materials and copies of your work to be destroyed. You know you are very close to finding a cure. What do you do?

24. A patient requests needles and syringes at his/her local pharmacy. They do not present with a prescription, and based on the records you can access, they are not receiving treatment for diabetes. Do you sell the syringes or not?

25. Dr. Blair recommends homeopathic medicines to his patients. There is no scientific evidence or widely accepted theory to suggest that homeopathic medicines work, and Dr. Blair doesn't believe them to. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle aches, because he believes that it will do no harm, but will give them reassurance. Consider the ethical problems that Dr. Blair’s behaviour might pose. Discuss.

26. The City of Vancouver has taken great measures to increase accessibility to alternative forms of transportation (Canada Line, Hornby and Dunsmuir Bike Lanes, Proposed Evergreen Line, and Burrard Street Bridge closures). Discuss the impacts (both positive and negative) of these decisions?

27. If the Prime Minister/President were to ask your advice on one change that could be applied to the healthcare system that would improve it enormously and have the greatest positive effect, how would you answer?

28. The man who lives next door to you often rides his bicycle in the company of his two young children but without a helmet. In fact, on several occasions you have seen him riding with his helmet hanging by its straps from the handlebars. His young children sometimes wear a helmet, sometimes not. If the man fell off his bicycle and hurt his head in a way that would have been prevented if he had worn a helmet, would it be reasonable to ask him to contribute towards the treatment costs for his injury?

29. Due to a shortage of physicians in rural communities, some policy-makers have suggested that medical programs preferentially admit students who are willing to commit to a 2 or 3 year tenure in rural areas after graduation. Consider the broad implications of this policy for health care and the costs associated. Will this policy be effective?

30. Recently, certain hospitals have been charging patients $29/day for their hospital fee on top of the fees charged to MSP. What are the implications of this policy? Discuss both positive and negative impacts with the interviewer.

31. Do you think general practitioners have an obligation to report their patients' health status to a public health agency, if their patients have active infectious diseases?

32. Statistics have shown that effects of advanced age such as changes in vision and response time may adversely affect elderly drivers' ability to drive safely. As a matter of fact, many doctors discuss the issue of stopping driving with their older patients as a precaution for the safety of theirs as well as the public's. Do you think older drivers have to give up driving when they reach a certain age?

33. In recent years, there has been an increase in popularity of full contact sports, such as Ultimate Fighting Championship (UFC) and boxing. Should doctors have a role in regulating such sports?

34. Do you think medicine should be more about changing behaviour to prevent disease or treating existing disease?

35. Discuss the pros and cons of legalizing marijuana. How does this impact a physician’s present ability to write out prescription for ‘medical marijuana’? Would legalization cost the health care system more or less after it was passed?

36. Imagine your friend’s father is 70 years old and has lived in major North American City his whole life. He is taken to the emergency department at the local General Hospital. He has had good health until now and this is the first time he has been to hospital of any kind since he was 20 years old. What changes in the healthcare system and environment in the hospital do you think he would notice?

37. Discuss any topical health care issue that is unique to the region for Med School you are applying to?

38. Discuss one of these health care issues: human genome project, AIDS, abortion, the right to die, the cost of health care, and genetic engineering

39. How does Canadian health care system compare to that of Britain’s system vs. the American system?

40. What is the difference between Medicare and Medicaid? (American Question)

41. Recently, the Prime Minister suggested the idea 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

42. What is your opinion about stem cell research using fetal tissue?

43. How would you advise patients who are interested in visiting an acupuncturist or a chiropractor?

44. When is it appropriate to participate in assisted suicide of a patient? Why or why not?

45. A Kootenay town runs a health-collective that provides various alternative and traditional forms of medicine. The physicians there encourage parents of small children not to vaccinate their children. Discuss the positive and negative impacts of this opinion.

46. In June 2011, the Vancouver Canucks lost the Stanley Cup and riots broke out in Downtown Vancouver. Discuss the impact on the community and the range of health care professionals at St. Paul’s Hospital.

47. What is the difference between HMOs and PPOs? (American Question)

48. “Liberation Therapy” (LT), a vascular operation developed to potentially cure multiple sclerosis (MS) in certain patients, has recently come under very serious criticism – delaying its widespread use. Among other experimental flaws, critics cite a small sample size in the original evidence used to support LT. As a healthcare policy maker, your job is to weigh the pros and cons in approving novel drugs and therapies. Please discuss the issues you would consider during an approval process for LT.

49. 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?

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50. You are a family physician. One of your patients, Mark, did not attend one of his classes and missed an important exam. He told you that his teacher would like a doctor's note explaining his absence from class; otherwise, he will receive zero, and all hell will break loose. He wants to you write a note for him, indicating that he was not feeling well enough to write the exam. Not able to find any physical symptoms, explain how you would deal with this. Enter the room and talk to Mark.

51. You are a 3rd year medical student doing hospital rotations. A fellow medical student who is doing rounds with you often show up to these sessions tired, messy, hung over, or even drunk. One day you found him in the lunchroom unaccompanied, so you decided to talk to him. Please enter the lunchroom.

52. Your friend Jason hasn't come to class for a few days. Being a hardworking pre-med student, he very seldom skips classes. You know that he is applying to medical school in the past several weeks. You called his house and he said you could visit him. You decided to pay him a visit after your classes. Enter the room and talk to Jason.

53. You are a cardiologist at a local hospital, who just finished a shift and has a tight run to your daughter's high school graduation ceremony. As you headed off to the door, Jennifer, a patient who knew you well, saw you from the waiting room and grabbed your attention. "Doctor! I have a bad chest pain. Please stay for a bit. I'll feel much better if you were here." Enter the waiting room and talk to Jennifer.

54. You are a current undergraduate student. During the week of graduation, you attend a number of parties around the Lower Mainland with your best friend, Kelly. The last party is held at a campground in Squamish. The morning after the party, you receive a call from Kelly. She asks that you come over and talk. Kelly reveals that she left early and drove home despite drinking that night. Enter the room and talk to Kelly.

55. You are an emergency room physician at a local hospital. A patient comes in requesting painkillers for his back. Upon reviewing his file, you realize that he frequently comes to the hospital requesting painkillers and he has already capped his prescription for the month. Upon examination, you notice no new injuries to indicate an increase in painkillers. You politely tell patient that you will not increase his dosage or re-fill out another prescription for him. He tells you that he will go and inject himself with heroin right now if he does not get the painkillers. What do you say next? What do you do?

56. Your 5 year old nephew asks you, "Why is the sky blue?” How would you answer him using a series of simple scientific experiments?

57. Your company needs both you and a co-worker (Sara, a colleague from another branch of the company, who is gripped by fear of flying since one of her friends narrowly escaped being at the World Trade Centre when it was destroyed) to attend a critical business meeting in San Diego. You have just arrived to drive Sara to the airport. Sara is in the room.

58. Nursing workload is a significant problem that needs to be addressed. Often nurses find they do not have adequate time to complete the tasks that are required of them in the time given each shift. How does this impact patient care? What are the implications for the nurses and the work culture and environment? What are the potential policy changes that can help alleviate some of this workload pressure?

59. As a physiotherapist, you are referred a 16 year-old for treatment of severe burns that limit function on the patient's arms and hands. Upon examination, you notice other burn marks and unexplained bruises on the patient. After working with the patient for a few weeks, you ask about the other marks on the patient's body. The patient admits to being abused by their parents but begs you not to tell anyone. What do you do?

60. As an occupational therapist, you work with clients of all ages. One of your younger clients begins searching you on the Internet and contacts you through social media sites. In this age, it is common for people to have many various personal and professional web profiles through sites like Facebook, LinkedIn, Twitter, Instagram, etc. What measures would you take if this happened? What would you do if the client would not stop?

61. You are an occupational therapist that works with a population with complex psychiatric histories. One of your older clients has been recently diagnosed with neurodegenerative disease, and she has schizophrenia. There is a history of the client’s children neglecting her needs and taking advantage of the client financially. Nevertheless, the client has a relationship with her family and they want to be named the primary decision maker for the client. How do you work with the client and her family knowing the past history of neglect and present needs of your client?

University of Alberta – School of Dentistry 

62. In 2007 the Journal of Dental Education surveyed over 1000 dental students and found that 74.7% admitted to some form of cheating during their undergraduate career. The university has asked you to be part of a student focus group to determine how to reduce the incidence of cheating. You are well aware of this behavior as you have observed the reusing of old assignments on many occasions. What suggestions would you make to help reduce the incidence of cheating and improve the academic integrity of students?

63. The apartment next door is for rent. The previous tenants were nothing but trouble and have been evicted. Your landlord tells you about a new tenant he has found with more promising credentials. As he tells you about him, you realize that he is one of the drug addicts who was in treatment at a halfway house you volunteer at. You know that this person has a history of relapsing and may not have been completely honest on the application form. Do you warn your landlord about the person's history or do you keep your knowledge confidential?

64. Your neighbor has a five-year-old child who has many decayed teeth. The mother asks you for advice because she knows you volunteer for a dental professional and her child is in pain. The mother needs a dentist who will accept monthly payment for treatment. You provide her with different options and coach her on how to seek dental care for a child. One week later you see the mother and ask if she was able to acquire care for the child. She says no. What do you do?

65. In healthcare professions like dental care, you will be required to establish good working relationships with people from all walks of life. Talk about what you think will be your strengths and challenges in establishing these relationships with your future clients. Will you have more success or challenges in relation to:

  • young versus old clients
  • clients from different cultures
  • clients at different levels of health

66. A YouTube video of a group of junior high-school boys verbally abusing bus monitor Karen Klein went viral this July. The abuse included taunts, profanity, physical ridicule, and even threats to Karen’s person and home, ultimately resulting in her breaking down and crying. The video prompted an investigation on the part of school officials and local police. They were suspended from school and given 50 hours of community service. Klein stated that she would not press charges, partly because of the flood of criticism aimed at the boys. Do you believe the boys’ punishments were just, or what could have been done differently?

University of Victoria – Co-operative Education Program and Career Services 

67. You are working alone in a convenience store as a cashier late at night. An older man comes in and buys a coffee. He is staggering, seems disoriented, and you smell alcohol on his breath. On the way out, he bumps into a shelf and knocks some cereal boxes off. He tries to put the boxes back, but cannot manage this task. What actions might you take in this situation? Provide reasons for your responses.

68. You are on holiday at a Mexican beach resort with some friends who are staying one floor down from you. In the middle of the night, a large earthquake takes place, and the building you are in is severely damaged. You have injured your leg, suspect it might be fractured, and you hear someone yelling for help near by. What would you do?

Tuft University - An Admissions OSCE: the multiple mini-interview

69. A message that recently appeared on the Web warned readers of the dangers of aspartame (artificial sweetener – Nutrasweet, Equal) as a cause of an epidemic of multiple sclerosis (a progressive chronic disease of the nervous system) and systemic lupus (a multisystem auto-immune disease). The biological explanation provided was that, at body temperature, aspartame releases wood alcohol (methanol), which turns into formic acid, which is in the same class of drugs as cyanide and arsenic." Formic acid, they argued, causes metabolic acidosis. Clinically, aspartame poisoning was argued to be a cause of joint pain, numbness, cramps, vertigo, headaches, depression, anxiety, slurred speech and blurred vision. The authors claimed that aspartame remains on the market because the food and drug industries have powerful lobbies in Congress. They quoted Dr. Russell Blaylock, who said, “The ingredients stimulate the neurons of the brain to death, causing brain damage of varying degrees." Critique this message, in terms of the strength of the arguments presented and their logical consistency. Your critique might include an indication of the issues that you would like to delve into further before assessing the validity of these claims.

70. Why do you want to be a physician? Discuss this question with the interviewer.

71. Universities are commonly faced with the complicated task of balancing the educational needs of their students and the cost required to provide learning resources to a large number of individuals. As a result of this tension, there has been much debate regarding the optimal size of classes. One side argues that smaller classes provide a more educationally effective setting for students, while others argue that it makes no difference, so larger classes should be used to minimise the number of instructors required. Discuss your opinion on this issue with the examiner.

72. The parking garage at your place of work has assigned parking spots. On leaving your spot, you are observed by the garage attendant as you back into a neighbouring car, a BMW, knocking out its left front headlight and denting the left front fender. The garage attendant gives you the name and office number of the owner of the neighbouring car, telling you that he is calling ahead to the car owner, Tim. The garage attendant tells you that Tim is expecting your visit. Enter Tim’s office.

73. What experiences have you had (and what insights have you gained from these experiences) that lead you to believe you would be a good physician? Discuss this question with the interviewer

74. Robert Collier stated: "Success is the sum of small efforts, repeated day in and day out." Consider the quote you have just read. What does this quote mean to you in terms of how you live your life and how you will pursue your career?

University of Calgary 

75. In 2007, the American Family Physician Journal published an article exploring the issue of physicians as role models, using a scenario in which an obese physician is offering nutrition and exercise counselling to his obese patient. According to the author’s research, patients have more confidence in health-counseling advice from non-obese versus obese physicians, and physicians with poor personal lifestyle habits are less likely to counsel patients about a healthy lifestyle. Based on these research findings do physicians have a responsibility to act as healthy role models to their patients? Please elaborate.

76. A proposed bill would require all individuals to vote in federal elections or face a $100 fine. What do you think about this bill?

77. You are the director of a financially struggling hospital. You have been unable to generate enough revenues to implement some very important initiatives at the hospital and are at risk of inevitable service cuts, if more funding is not secured immediately. The only secure source of funds that is being offered is by a cigarette company. They are willing to provide your hospital with all the resources required in exchange for advertisement at your facility. What will you and should you do as the hospital director?

78. You are a specialist who has just received lab results with regard to one of your patients. The results indicate that your patient, a single mother of two young boys, has been diagnosed with a terminal cancer and that she will only have 4-6 months to live. There are not many treatment options aside from a few experimental procedures that are still under study. There are some alternative treatments available in Europe; however, they have not been validated by scientific studies in North America. What would you say to your patient once they are in the office? If an alternative treatment, without scientific evidence for its efficacy, existed for a terminal illness would you recommend it to a patient?

79. You are the father of a 12-year-old boy. Your son’s friend, who is also your neighbour, is playing with your son in the backyard. As you approach them to ask them about lunch, you notice some severe bruises on the friend’s arm and upper neck. You are worried about these obvious signs and decide to approach your neighbour (the young boy’s father).

How would you approach this situation? What would you say to the father of the young boy? What are some potential concerns that you may have?

80. You enter the cafeteria at work. You sit down to eat with a group of male colleagues who are having a conversation about a female colleague of yours. The comments they make are not very professional and can be deemed rude and offensive. You feel very uncomfortable. What do you do? What do you say to your male colleagues? If this became a regular occurrence, even after you speaking to your colleagues, what other steps would you take to resolve the situation?

81. Your best friend, Jennifer, calls you to tell you that she has been rejected for the 3rd time from all medical schools that she had applied to during the previous application cycle. She invites you over to her house to have a chat about her future plans. Go inside the room and speak with Jennifer.

82. "Education is the kindling of a flame, not the filling of a vessel." - Socrates What does this quote mean to you? Go inside the room and discuss your thoughts with the interviewer.

83. Every week, your classmates gather at the local coffee house to review the lessons from that week. In the last month, everyone has been working on a major paper on Roman history, which accounts for 40% of the course grade. One of your classmates has copies of two of the papers that last years’ students wrote for the same course. Your classmate has e-mailed copies of the paper to you and the other people in the group. What would you do in this situation and explain why? Discuss what values and choices are relevant in this situation? What are the implications if you decide to read the paper from last year?

84. Please describe the object presented to you to the interviewer. The interviewer has never seen the image. Note you are only allowed to use your words to describe the image. (The image could be any abstract image that you may have never seen before)

85. You are the team leader of a group assignment and two of your group mates inform you that one of the group members, Tim, has a very strong body odor and they are unwilling to take part in any further group meetings until Tim addresses this issue and takes care of his personal hygiene. Tim is waiting inside the room, go inside and discuss this issue with him.

86. Some medical schools have a preference for selecting medical candidates from certain geographical locations. What are your views about such selection policies? Please discuss your answer with the interviewer inside the room.

87. In a class of 78 students 41 are taking French, 22 are taking German. Of the students taking French or German, 9 are taking both courses. How many students are not enrolled in either course?

88. If you could have any superpowers, what would it be and why?

89. You are a PhD student and your supervisor Prof. Harry, has recently published the results of his publicly funded research project with the intention to commercialize his discovery. What are your views about university professors that use public funding to create for-profit solo ventures?

90. You are the emergency doctor on duty when two patients are rushed in within 7 seconds of each other and both desperately need a heart transplant. You only have one donor organ available. And both patients are a match and both are equally medically fit for the operation. One patient is a 35-year old single dad with 3 children, while the other is a 35 year old single male, who’s an Olympic Gold medalist. Who would you give the heart to and why?

91. You are a research supervisor and you notice that one of your graduate students has been sleeping in the lounge area within the research facility, because your student is recent international student she cannot afford to rent a place of her own with her student stipend. You are aware that the facilities safety policies prohibit overnight stays. How do you approach the student about this?

92. You are the executive director of a law firm. You find out that your articling student has accidentally destroyed an important piece of evidence that would have cleared a wrongfully accused person. If you reveal this to the authorities, your student will not only lose her job, but will face jail time for destroying court evidence. What will you do in this situation? What if you had information that the accused person is indeed guilty of other unrelated but more serious crimes for which you do not have any evidence that would hold up in the court?

93. Regardless of what we do in life, there will be times when we will come into disagreement with an authority figure or a superior. Describe a time when you came into conflict with an authority figure and how you dealt with it.

94. What is your favorite quote? Discuss the quote and what it means to you with the interviewer inside the room.

95. You are the Dean of Admissions at a very competitive medical school. One day as you are leaving your office at the end of the day, you are approached by the mother of a student who was recently rejected from your school. The mother explains that her son has a 4.0 GPA, scored 98th percentile on the MCAT, and has numerous awards and many relevant accomplishments. She wants answers right now and she demands to see every applicants’ file. Go inside the room and talk to the parent.

96. A friend of yours has a cat named Jingles. One day your friend calls you and tells you that Jingles is very ill and in need of a vet. Unfortunately, Jingles does not have insurance and the cost of seeing a vet will be around $1500, which your friend has to pay out of pocket. She cannot afford the cost and asking you for help. What would you do and say in this situation?

97. What do you do for hobbies and on your spare time?

98. Tell me about yourself.

99. “The first task of the doctor is political: the struggle against disease must begin with a war against bad government. Man will be totally and definitively cured only if he is first liberated...” What are your thoughts about this quote by Michel Foucault?

100. It is well known that big Pharmaceutical companies along with their expansive lobby have a huge influence on the medical profession and its education. In your opinion what are the positives and negatives of having the Pharmaceutical companies play a role, if any, within medical educational institutions? If you do not think that Pharmaceutical companies should have any role within medical schools, what steps would you take to remove big interest groups such as Big Pharma out of the education system if given the opportunity?

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