Medical Interview Preparation

Now that interview invite season has arrived, I thought it would be a good time to advise on some tips for preparing for these interviews. While these tips are specific for medical school interviews, some of the overlying advice and structure can be utilized in other types of interview as well.

The first thing you need to do before you can start preparing for interviews is know what type of interview you are taking part in. There are many types of interviews, but I will briefly discuss the three main types, panel interview, multiple mini-interview (MMI) and modified personal interview (MPI). I participated in all three of these different types and will give you tips based on both how I prepared and with some thoughts on how one could prepare after having experienced the interview.

Interview Types

Panel Interview

Panel interview is the most basic form of interview and is the modality that most people think about when they think of interviews. This format involves one or more people evaluating you sitting together in the same room and asking you a series of questions. The questions they ask you can vary based on who they are interviewing. In contrast to the other formats, which tend to be one-on-one, in a panel format, all interviewers are in the same room and interview you simultaneously. An example of a school that uses this format is the University of Ottawa, and they have forty-five minutes with a panel of, typically three different interviewers for your entire interview.

MMI

The MMI is a format that involves multiple stations where you are provided with a prompt or asked a specific question before you begin the station. The question/prompt is identical for all individuals taking part in the same interview circuit, and everyone in your circuit will answer the prompt to an identical interviewer. You have time to prepare for the question before you enter the room, and you are then allotted time to answer the prompt to the best of your abilities to a single interviewer in a one-on-one fashion. If there is leftover time, typically the interviewer will have follow-up questions for you to answer, or they can ask for expansion or clarification on your points. The time allotment and number of questions per interview varies, but an example of a school that uses this modality is McMaster University. McMaster medicine interview has a total of ten interview stations where they provide two minutes to read and prepare for the prompt, and eight minutes with the interviewer. There are also two rest stations for water and decompression.

MPI

The MPI is a hybrid of the panel interview and the MMI. It involves multiple stations, but you are not provided the prompt beforehand to prepare an answer for. You are still interviewing in a one-on-one fashion, and each station has a known theme. They typically will ask the same types of questions, but there is still an uncertainty factor, since they tend to be quite variable. An example of a school that uses this is the University of Toronto, as they were the school that established the MPI format and began using it in the 2013-2014 cycle.

General Preparation

As mentioned, the first thing you need to do is determine which interview type you are preparing for. Preparation will vary significantly with each modality, and identifying the modality to maximize your preparation efficiency is key. I will get into the specifics of preparing for each, but to begin I will talk about some tips that will help you across the board.

The first thing I would recommend you do is to organize all your activities and personal life experiences. List out all the activities you did and reflect on various aspects of your experiences. What was your role in each activity, why did you take on that activity, what motivated you to continue and what did you learn from the activity? Then brainstorm any specific anecdotes or experiences you can remember from the activity which you can use for potential interview prompts. Thinking of the anecdotes can be difficult before you encounter specific interview prompts, so you can leave that as a blank for now. As interview questions prompt you to recall specific scenarios in your life, you can come back and fill this in, and I would highly recommend this activity, it is extremely high yield. Having the anecdote handy allows you to use it without much thought during the interview and allows for the best response. You had time to contemplate it, process it and critique it without the adrenaline rush in the interview combined with the pressure of the ticking clock. There are many activities or experiences you may have had in the past that you completely forgot about, or do not remember the specifics of. Some of these activities can reveal a lot about you or assist you tremendously in answering specific scenarios. By organizing your experiences clearly, you have them primed and ready to call upon when needed.

With each activity you brainstorm and come up with anecdotes for, think about how each of them relates to one of the seven CanMEDS roles of a physician. The CanMEDS are a framework created by the Royal College of Physicians and Surgeons of Canada, and they essential outline what specific roles a physician has in the community. I highly recommend you read up on them even before you apply. They can be beneficial for essay writing as well as how you explain the activities you performed in your OMSAS, although I actually did not know about them until interview season unfortunately. It would have been beneficial to know about them as I was preparing my application, however, as long as you are aware of them by interviews, that is what matters most. I also think it is a good exercise to really think about what each of the CanMEDS roles means to you and why you believe they are essential roles for a physician.

The next thing that is important is brainstorming about your answers to very general and obvious interview questions. While these questions specifically may not come up, they will almost certainly come up ingrained in other questions. These are your, “why do you want to be a doctor”, “what is your biggest strength/weakness”, “describe yourself to us” kind of questions. While they might not explicitly ask you, “why do you want to be a doctor”, the answer to this question should reveal itself in other questions. They might ask you “name a past experience that shaped you” and in that question you talk about your experience volunteering for an organization that works with underprivileged youth. Your experience involved you working with a diverse group and with the direct community which motivated or reinforced your interest in medicine because of the community role of a physician. That is just one example of many in which you can link your answers to other questions, and why it is so important to have these foundational questions answered.

Once you are done introspection and self-reflection, the next best thing in my opinion to do is to get more informed on the issues. Start reading the news regularly and reflect on articles. Think about how each article is relevant to today’s issues briefly and highlight a few that impacted or resonated with you the most. Having these handy can be useful because they can come up in your answer to other questions. Pulling a recent news article on many children dying from the H1N1 flu because of lack of public vaccination when answering the question on mandatory flu vaccines for health care workers is relevant. Being aware of current issues shows that you are up to date, which is an important aspect of being a physician.

I believe the next best thing you can do after organizing your introspection and reading the news would be preparing yourself for the ethical scenarios. The preparation for this is much like the preparation for the CASPer test, so I would highly recommend you read that if you have not read it yet, but there are some differences. CASPer does not exclusively test you on medical issues and can ask very general conflict resolution problems. These types of questions can also come up in an interview, but medical ethical dilemmas come up more often in medical school interviews, since they are directly relevant to the field. Being on top of most of the big medical ethical issues, and taking a firm stance on each issue, while understanding the other side is huge. The resources I would recommend would be the same as what I recommended in the CASPer post as the book Doing Right (at least read part of it, reading all of it is not necessary and not necessarily beneficial), and looking at the University of Washington Bioethics page. An important piece here is that many ethical dilemmas are a gray zone, and there is no “right answer” but there can be wrong answers. Regardless of your personal opinions on abortion, if a patient of yours requests an abortion, it is your duty to either agree or refer the patient to a physician that is comfortable performing the procedure, and it is unacceptable to judge or lecture the patient on the morality of having an abortion. As long as you are consistent with your ethics, you explain your rationale, and you demonstrate that you understand both sides, for the most part, you should not have an issue with this section.

Finally, another huge investment you can make as you start getting interviews is to read up on the programs themselves at the various universities. Think about some reasons why you would want to go there, and brainstorm some questions to ask faculty, physicians, and other students that might be interviewing you. Thinking of reasons why their program appeals to you can help with the “why [this school]?” question, and coming up with good questions for physicians and students can help you stand out during the “do you have any questions for me” part which may come at the end of a station or panel interview. Try to really brainstorm some good questions to ask, since the better the question, the better it appears on you, especially if it is unique and does not get asked by everyone.

When to Start Preparing

A common question is when do you start preparing for interviews. There is no right answer here, and as with anything there is a benefit to starting earlier, but starting too early can also lead to plateau, burn-out and degradation in performance, so there is definitely a sweet spot. For me personally, I started the process after getting my first invitation in early January. After receiving my first invite, I began doing the things I mentioned in the general preparation for a few weeks, and got the hang of organizing myself while still managing my third-year courses. I then started to reach out to upper years I knew that had interviewed and matriculated, asking for as much advice as possible. Getting a conglomeration of advice is vital since everyone has their own approach to interviews and no single person is necessarily correct but getting a good “average” among many people allows you to determine what is good advice and what is not so good advice.

How to Practice

After doing some general preparation and getting advice, the best thing for interview preparation, period, is to practice. Find a group of friends and do regular practice sessions after class. Even doing an hour or so every few days can be beneficial and increasing the intensity as it gets closer to your interview date. Make sure you simulate the interview type that you are practicing for. If it is a panel interview make sure that the entire time you demonstrate good posture, professionalism, and answer in the same manner you would to a medical school interviewer. If it is an MMI, time the individual to read the question, do not give them paper to write on and do the exact time frame allotted for the school. While some schools I know allow you to use paper to organize your thoughts, it is a good habit, especially early in the preparation, to practice not using paper. This builds on your ability to think on your feet and organize thoughts properly, which can help you in all facets of interviews, including follow-up questions. If you are only interviewing for a school that allows paper for interviews, then you could make the argument that you are practicing better for the school by optimizing the use of your resources, and that would be a valid argument, but I still believe there is a benefit to building the skill of just having your mind to work with. If you are in that situation perhaps it would be best to start without paper and switch to using paper closer to your interview date. When practicing with friends, have them write down points of improvement for you and reflect on it immediately after the interview is complete.

The key for practicing is to not always practice with the same person. Getting a diverse group of people to interview you is ideal. This allows you to be comfortable answering questions to all different individuals and not just your friends. This also gives you the benefit of getting the advice and opinion of a variety of individuals in terms of your answers, which can provide you with a fresh perspective. Consulting individuals in fields unrelated to health care also has its benefits. I asked my wrestling coaches to practice interviewing with me, and it was some of the best practice I received. They are not involved in health care, but their unique backgrounds provided another angle and perspective, and at the end of the day they have had to interview for their own jobs and practiced for those in their own unique ways. I asked strangers to practice interviewing with me too. I browsed reddit and found an interview preparation group and reached out to one individual that provided me with a practice MMI along with their feedback. I also reached out to some of my professors that have been involved in admissions committees in the past and got their perspectives. You do not have to agree with all perspectives provided, and I definitely had my disagreements with some of the advice provided, but you can learn from everyone. Even if someone gives you what you believe to be a “bogus” response, you can learn from their perspective and bring it up as you understanding the other side. It is always important to hear all forms of opinions and broaden your own perspective.

Interview Specific Practice Styles

As aforementioned, need to practice the modality of interview which you were given. If you have the privilege of multiple interviews with different modalities, then you need to strategically time the type of practice with your interview dates.

Let’s start with MMI practice. This is in my opinion the most important modality to practice. It is the most “unnatural” since it is a pretty unique form of interviewing that doesn’t typically present itself in many situations outside of professional school interviews. Getting use to speaking for a set amount of time without hearing a response and answering the question that was asked directly in the process, with a set structure can be difficult. I will break it down for you the best I can.

The first thing you need to do for MMI practice is getting the timing down. Practice some questions with the focus being talking for an allotted amount of time without stopping. For a typical McMaster MMI, you have 8 minutes total, but you want to reserve about 2-3 minutes for follow-up questions, so you ideally will speak for 4-6 minutes. You should aim in practice to hit about 5 minutes with variation based on the question, but you should never hit anywhere above 6 minutes and 30 seconds in practice. This leaves you with a very limited amount of time for follow-up and while in a real interview situation this might happen to you for one or maybe two stations that you are extremely passionate about, for most questions it should not happen. At that point you are probably dragging on and losing the interest of the listener. You also should almost never speak for less than 4 minutes since that means you are most likely not answering the question sufficiently. Getting the timing right is one of the most difficult hurdles to overcome and requires practice. Combined with the timing, ensure that your pace of speaking is also comprehensible and natural. Try not to speak too quickly to jam in more content since it is harder to follow, but at the same time do not speak too slowly either. There are many ways to improve speaking pace, but one huge tip is to actually leave gaps between sentences to breath. This makes you flow more naturally, makes it easier to follow, and is easier for you than speaking consistently without rest. You can actually practice the timing and pacing on your own with a webcam and a timer at home. Just record yourself speaking and answering a question, and at a designated time, cut yourself off if you are still speaking or try to think of more content to add if you are under a reasonable timeframe.

Once you have the timing and speaking pace down, the next difficult aspect is organizing your thoughts properly and having a proper structure to your answers. I treated MMIs like essays. I would introduce the topic by reiterating the question and ask the interviewer if I understood what they were asking correctly. By reiterating and confirming you understood correctly, if you did misread a portion of it or misunderstand part of it, you can catch it early and do not waste time answering the wrong question. Following confirmation of my understanding I would provide my introduction to the issue at hand. If it is an ethical scenario, I would produce the ethical dilemma at hand and why it is a difficult situation. If it is a conflict question, I would introduce the conflict and speak about the potential reasons and feelings of parties involved for the conflict. I would then start by providing my “body paragraphs”. This is where I bring in my arguments or points for the scenario in question. I would almost always start with the opposite perspective that I hold and present that side of the coin. This allows me the opportunity to not only show that I understand the other side but allows me to then rebuttal the issues later as I bring in my perspective. After providing the bulk of both sides, aiming to hit 2-3 points on each side, I would then conclude by reiterating the points to sum it all together. I would start by saying “while I can understand the other side since individuals may believe X, Y or Z, I think given A, B C and D, it is evident that this should not be done” or something along those lines. Once again, very difficult to give advice without a concrete example, but I hope you are getting the gist of what I am saying. The structure is very important and tends to be where people fall through. If you are not organized in your speech and do not have a clear organized path that is easy to follow, the interviewer may miss what you are trying to say. They are listening to many other people interviewing all day and they can zone in and out. By being clear, and reiterating points to drive home a key message, it makes it easier to follow if the interviewer misses out on part of it, and prevents them from getting lost in a sea of jargon. Remember, however, that everyone has a different interview style, and this is just one example of how to structure your content. For some people a different style works differently, and my general advice is always to go for whatever feels most natural for you.

Organizing your thoughts can be difficult, especially since you only have about two minutes to read the prompt and have a structure going into the room, but the method I took for this was to read the prompt two times. The first time I would read it relatively quickly to allow my brain to start brainstorming ideas, and then read it again but much slower to catch any potential misreads I had on the first read. Then during this time, I would speak out-loud VERY QUIETLY, so quietly that the people at the doors next to me most definitely could not hear me, what the main issue is, my stance, and the main points I will be bringing up. I try not to delve into the details during the two minutes, but instead I develop a framework to build off of when I am speaking. By having the skeleton structure, I can fill in details and I have a clear direction to take as I speak.

A tip is if you get a question that immediately makes you think “WTF I HAVE NO IDEA”, take a deep breath it will be OK. If you panic, you waste your time and it will be worse. My first station at my McMaster interview threw me in a spiral since it asked me a question that I could not quickly recall anything for, and I spent about one minute of the two minutes panicking. Then I took a deep breath, let myself relax and with a sound mind I thought of something. Ironically, it was probably my best station that day. This set me off on the correct trajectory and I was able to use that momentum to answer the rest of the stations very confidently, and I believe that because of that one station’s positive response downstream effect, I got my acceptance to McMaster. The situation would have been very different if I had continued to panic and did not calm my mind, I would have sabotaged myself. While it is difficult, just remember that if you are panicking you will do worse than if you are calm and level-headed, so just come up with strategies if you come across a question you are blanking on completely.

So now you have practiced for MMIs, and are very well versed in being able to handle an MMI question. You are now setup with the skill sets that can come back to you when you need them and can apply them to other modalities as well, so congratulations. After MMI preparation, if you also got panel interviews you should practice those, if you only have panel interviews, I would still recommend you do some MMI preparation, just don’t delegate as much time to it. The reason is that I believe MMI practice provides you with the skills to do well in many different interview situations, including panel when they give you ethical scenarios and such, since the organization that is needed is translatable. With panel interview the difference is you do not have the questions before you start to speak, and you are speaking with the same group of individuals for the whole interview, so you can be asked more personal questions, especially since the interviewers tend to have your application in front of them.

A tip for panel interviews is to know when to not speak. When you are asked a question, first confirm your understanding of the question to the interviewer, then it is good to ask for a few moments to collect your thoughts. Think of this as an express version of the two minutes in the MMI preparation. You can take as long as you want but aim to be around 30 seconds although there is no gold standard time to take. It is better to ask for time before you start talking than to ramble or contradict yourself while speaking. Organize yourself in the same way you would an MMI, you just tend to speak a little bit less on each panel question compared to MMI questions with a range of 2-4 minutes with three minutes being pretty standard. In a panel situation it is also very important that you make a very good first impression. Unlike an MMI, in a panel, a set group of individuals who listen to you for a set amount of time together will be deciding if you are on the path to becoming a doctor or not. In an MMI if you mess up one station for instance, you have more to make up for it, and they are completely independent of each other. In a panel, however, if you make a mistake, especially early in the interview, they can implicitly judge you for it for the rest of the interview, and this is not necessarily a fault of the interviewer, it is just human nature. Unfortunately, first impressions matter a lot, and numerous psychological studies have shown that individuals continue to judge people based on their first impressions of them, and it takes a lot of effort and time to break out of that first impression that you do not necessarily have in an interview setting. This is not to say that if you make a mistake early in the interview you are doomed, but it is something to be cognisant of.

Now we can move onto MPI. This is specific to the University of Toronto, as I am not aware of any other school using this method for interviewing at the moment. The best thing about MPI preparation is that you are essentially ready for it if you have done MMI and panel preparation, and you just need some fine tuning. If UofT is the only school you got an interview at, I would still suggest you do MMI preparation early, and then get a little bit of panel preparation in as well, then move exclusively to MPI format preparation. The structure works such that you have four 12-minute stations with 3-minute breaks between them. There is actually a paper that was published by several members of the University of Toronto on the MPI style. I highly recommend you give it a read as it outlines the structure as well as some of the merits of the MPI, giving you more of a sense of the entire interview. I provide a citation to the article below.

Other than the general structure, the only modification you need to make with the MPI is think more specifically about the school itself. As I mentioned in the general preparation you need to think about why UofT is a medical school you want to attend. One of the stations is also open file review where they go through your essays and ask you questions about it, so know all your essays inside and out, and try to get friends/family to read over the essays and get them to probe you with interview questions related to the essays and your answers to them. As mentioned about with the CanMEDS, I would continue to think about them but more specifically, think about the 4 roles that UofT has posted on their website on non-academic criteria. They describe the type of person they want as a medical student and they are based off the CanMEDS. Highlighting these roles subtly in your interview can be quite helpful.

Closing Remarks

The interview is the most important aspect of your medical school admissions process. It can be difficult and requires good preparation. Practice practice practice. I cannot stress this enough. Some students get flustered and ask, “how do I do well”, and I have provided you with some sound tips on how to structure your preparation so that you can optimize your results. What you may not have noticed is that I have never explicitly told you how to ace your interview. This is a skill that I believe cannot necessarily be taught properly over a blog. Everyone is different, and depending on the type of person you are, your social strengths and weaknesses, and your personal story, the optimal approach you take will differ. You can hone this through interview practice with different individuals and find what is more natural to you, and what does not work as well through trial and error. Practicing with friends also gives you the benefit to see how they tackle a certain question, giving you the opportunity to learn from them as well. I have a personal problem with some approaches many interview preparation courses are taking. They tell students to answer questions in a certain way. While this might work in some interview settings, especially if you practice it, but it is not you. I truly believe that if you are passionate about what you are doing, and you are being honest, that will project itself in most interviews, especially ones that involve more stations. The passion you project will be detected by most interviewers and that is exactly what they are looking for. So instead of telling you how to answer different questions, I focused instead on the process of preparation. I want you to think of the personal impact of each question. Try to relate to how the question impacts you personally if you have any experience with it, and if you do not, just stick to objective facts. Also please do not lie on the interview. Nothing irks me more than people who “play the system” and lie about their best friends dying at a young age or having a major medical crisis in their family. I know if you are set on lying on your interview you probably will anyways and I will not be able to dissuade you, but just stop and think to yourself, do you have nothing else to offer?

I thank you for reading my post, it was long and if you made it this far, that means you must be serious about wanting as much preparation guidance as possible. Interview preparation is complicated, and I cannot possibly hit on every point, but I hope I hit most of the major points on how to prepare, giving you a framework to expand on yourself and ace the interviews. Best of luck and hope to see some of you as colleagues in the upcoming year!


Citations

Hanson, M. D., Woods, N. N., Martimianakis, M. A., Rasasingham, R., & Kulasegaram, K. (2016). Multiple independent sampling within medical school admission interviewing: an “intermediate approach”. Perspectives on medical education, 5(5), 292-9.

 

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