All About Interviews

Back in the old days, interviews were just a formality. They already knew which men they wanted because they simply sorted MCAT and GPA and invited the highest numbers. Then two men would get into a room, talk about sports or traveling or a good book, shake hands, and a new member of the Old Boy's Club was welcomed.

After a few decades of that behavior, people started to notice that there were some problems in American healthcare. Certain groups had worse health outcomes than others, we have higher mortality rates than other nations, the costs were off the charts, and yet the quality just wasn't there. People don't like going to the doctor and they avoid it all costs. Why?

Turns out that selecting people based only on metrics and meritocracy doesn't produce good doctors. Surprise! In response to that realization, the AAMC created the Holistic Review, which aimed to diversify the physician work force. By de-emphasizing metrics and adding value to attributes, medical schools were empowered to select anyone they wanted. With very little transparency or justification for why, they chose people based solely on "fit". Well, that too feels a little icky, if we don't trust that they'll do the right thing.

Fast forward a few years, and here comes the 15 Core Competencies. These competencies are supposed to guide med schools to screen applicants based on an agreed upon set of values and skills. That's where we are today: Competency Based Admissions.

So, about interviews.

Traditional one-on-one interviews carry a lot of bias. You can either get lucky and have a very engaging, meaningful conversation where the physician does not talk too much and simply learns about you. Or you can be unlucky and get a narcissistic interviewer who talks 80% of the time, doesn't ask you anything, and is only on the committee for political reasons. If you're unlucky and don't build a strong connection with your interviewer, that's just too bad. Luck as a measure doesn't feel very good when it comes to selection, so many med schools have opted for a less biased approach: MMI.

MMI stands for Multiple Mini Interview. The idea is it reduces bias because you have multiple encounters with different people. Each station gives you a stand alone score. Scores are averaged, and Boom! You have an unbiased measure! Right? Well, if you can think on your feet quickly, adapt to changing environments, have no aversion to bell ringing and do not need human connection, it's perfect. For neurodivergent applicants, it might cause some issues, but hey, at least for most of the applicants, it's a better approach.

What I love about MMIs is it screens out the sociopaths. MMIs stations are super creative these days. Simple questions like "Tell me about yourself" are rarely used, and instead you walk into a room where you may face a crying patient or an angry customer, and you've got to talk them down. People who struggle with empathy would suffer in a station designed to measure their ability to care for others in a state of conflict. The uncontrolled nature of the experience is designed to catch someone in their natural element. In other words, if you get flustered easily in the face of conflict or rudeness, they want to know that. If your natural reaction to someone crying is consoling, that is good stuff to know! Scenarios are like CASPer LIVE.

MMIs also force you to demonstrate your thought process. The timed questions force you to explain yourself. The more you talk, the more insight they gain about you. The questions won't be predictable, so you can't practice them and deliver a perfect answer. Again, people who need to be perfect may not flourish in an MMI setting.

When it comes to one-on-one interviews, there are two kinds: conversational and measured. Conversational interviews are what they sound like. They may start with "Tell me about yourself" and they'll take something you said in that and ask you a follow up question. If you notice after a couple questions that they are just chit chatting with you, it is essential that you relax and move a little outside of interview mode. If you remain super formal and cannot shift to just talking, you will fail because normal people do not communicate in interview mode. They want to see that chit chatty side of you.

If the interview questions sound behavioral in nature: "Tell me about a time when you...." that is a measured interview. They have goals and attributes they are measuring. The questions are pre-planned and they are looking for certain elements in your answer. Those can be prepared for. There is a method. I'll post about that next.

Group interviews are the most simple. They aren't going to get super personal in a group, and so the questions tend to be safe. They are typically the ones you probably prepared for. The goal in a group interview is to keep your blinders on. Don't get distracted by what others are saying. Focus on your answer and be confident.

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