How to Ace The Multiple Mini Interview (MMI) Acting Stations

What Are MMI Acting Stations?

Many people recognize that the MMI is a medical school requirement, but it’s also common in other disciplines such as pharmacy, social work, and nursing. The multiple mini interview (MMI Interview) acting stations (aka role-play scenarios) are designed to make you uncomfortable to see how you perform under pressure. They force you to suspend disbelief to give you an opportunity to demonstrate your own values, empathy, and communication skills in a totally artificial situation. The actor will be bringing the scene to life and it’s your job to respond and interact with them in a professional manner.

Even the easiest medical schools to get into, the easiest pharmacy schools to get into, and the easiest nursing schools to get into will put applicants into these acting scenarios. This means that medical school acceptance rates, nursing school acceptance rates, and pharmacy school acceptance rates aren’t an indication of what you can expect in the interview. Fortunately, you don’t have to sign up for acting lessons to succeed. If you have acting experience, save that for your AMCAS most meaningful experiences or your PA personal statement!

How Do Admissions Committees Evaluate Acting Stations?

–The key to a strong performance in the acting stations is to be cognizant of the gravity of the situation you’re in. You need to be able to recognize that the interactions you’re having will reflect real conversations you will have as a prospective doctor. You will need to be professional, empathetic, knowledgeable, and a strong communicator. You need to treat these situations as if they’re real. If you don’t take them seriously, the admissions committee can tell. Your attitude, tone, and body language will all be taken into account in the aggregate score, which will include your performance in other stations.

The reason candidates often dread acting stations is that you can’t review for them the same way you can, for example, medical school secondary essays, AMCAS Work and Activities, or the dental school manual dexterity question. For any discipline, the acting stations entail a sort of dual preparation. While you’re practicing for this station, you will also be preparing for scenario questions as well. The difference is that for scenario questions, you are telling the interviewer what you would do, while for acting stations, you will be performing those actions.

So, not like the secret to writing an excellent secondary diversity essay, the secret to succeeding in the acting scenarios is a unique sort of preparation, which we will outline below.

How Do I Prepare for Acting Stations?

You don’t need to be a trained actor to succeed in the acting stations, but your MMI prep must be as realistic as possible to help you navigate these situations appropriately. You might be wondering, “when do you hear back from medical schools for interviews or from other institutions?” You can start preparing before you receive an invitation, but it can help to put your mind at ease if you have a date planned out. While your prep might not be as rigorous as your MCAT study schedule, you should still stick to a plan. Because MMI questions can also be quite similar to CASPer questions, some of the strategies you’ve used to from your CASPer test prep will apply here. Also, don’t forget that the same principles you use to prepare for acting stations will apply to scenario ones. The difference is that scenario questions ask you to describe what you would do if you were in a particular scenario, whereas acting stations you will perform those actions as if the scenario were real.

The best performers in these stations buy into the scenario without making the scenario all about them. It is always about the patient. It is ALWAYS about the patient (or those under your care, depending on the acting station that could mean your patients, your students, your employees, etc.). Consider how situations differ between MD vs DO. The setting and your approach to patients can be different depending on the program; you’ll want to consider osteopathic principles in patient care, for example.

Doctors (dentists, pharmacists and other healthcare professionals) are involved in an untold number of these situations in their lives. And that’s the entire point of the MMI Interview. We can’t try everyone out at medical school. We can’t have you in clinic with us for a few months to see how it goes. We only have the MMI to simulate real enough situations that hopefully serve to tell us something about you as a person. And this is crucial. Even if the scenario asks you to break bad news to a friend or to fire an employee or debate the quality of science education, it is really all about you as a potential doctor. If you’re trying to figure out how to act in a situation, ask yourself what a doctor would do because that’s the standard the evaluators are interested in.

The SPIKES Protocol

When breaking bad news in an acting station, the SPIKES Protocol developed by Dr. Walter Baile is the go-to for a guiding light. The SPIKES acronym stands for Setting up, Perception, Invitation, Knowledge, Emotions with Empathy, and Strategy or Summary. This is approach is designed to help physicians deliver news or communicate effectively with patients. You can use this approach for MMI acting stations to help achieve the following objectives: gather critical information from the patient; transmit medical information; provide support for the patient; and elicit the patient’s help in determining a treatment strategy. Check out what each letter represents in more detail:

Want to see how to ace the MMI acting stations? Watch this video:

MMI Acting Station/Scenario Example #1

In this first scenario, the candidate, Ashley, must deliver some unfortunate test results to the actor, Beth.

Ashley knocks on the door and enters the room with a clipboard in hand.

Ashley

Hi, my name is Ashley. How are you today?

Ashley makes eye contact and shakes the patient’s hand. She gestures to the chair, encouraging the patient to take a seat.

Beth

I feel great thanks. I would love to know my test results.

Ashley

Absolutely. How have you been feeling since we last met?

Beth

I feel quite well. Life is stressful. There’s a lot going on at home. One of my children is struggling at school and my partner is travelling for work a lot. I feel overwhelmed sometimes.

Ashley

That does sound overwhelming. What kind of support system do you have at home?

Beth

I have my mother and my eldest daughter is a huge help. But she’s leaving for college soon and I will be so sad to see her go, but so proud of her at the same time, you know?

Ashley

Absolutely. Congratulations to your daughter. Well, we have a lot to discuss today. Would you like to have your daughter or mother or partner here before we get started?

Beth

No, I don’t want to burden them with coming all the way down here. It’ll be fine.

Ashley

Okay, great. So let’s get back to why we ran these tests in the first place. What’s your understanding of why we ordered the last scan?

Beth

Well, I have had this headache for a long time, and you just wanted to make sure it was nothing serious.

Ashley

Right, that’s right. So how would you like to hear the results? Would you like to go over it line by line or do you just want the important stuff?

Beth

Oh no, that sounds scary. Should I be scared?

Ashley

(In a calm, pacifying tone) The scan revealed some information I wasn’t expecting. We found something serious and that’s why we are going to take the time to review today. How does that sound?

Beth

Okay, fine, but tell me: do I have cancer?

Ashley takes a deep breath and makes eye contact with Beth. Her expression is neutral, her posture forward.

Ashley

Unfortunately, the scan shows that there is a growth on the right side of your brain. I cannot tell you right now for sure that it’s cancer, but that is what we will figure out today when we arrange follow up.

There is a silence. Ashley allows it, doesn’t interrupt.

Ashley

This is really difficult to hear. I’m sorry this is happening.

Beth starts crying.

Beth

I can’t believe it. I have a brain tumor?

Ashley

Let’s go through the results together and I can answer your questions. Yes, you have a brain tumor. However, what that means for you and your health is not yet clear.

Beth’s crying intensifies. She’s shaking and burying her face in her hands.

Ashley

I know this isn’t what you were expecting today. And I am sure it isn’t what you wanted to hear.

Beth

What do I do now?

Ashley

First, I think the next hard thing will be sharing with your family. I am happy to have them come in so we can do that together. I know that some people have lots of questions in these situations but the moment I say the word “tumor” they can’t think straight anymore. It can be so helpful to have a loved one in the room going over the details.

Beth

Yes, I think that’s a good idea. My husband is home tomorrow and so is my daughter. I think we should come back. I feel so awful all of a sudden - what are they going to do without me?

Ashley

I think there is a lot to talk about with your family, and I am happy to facilitate.

Beth

Okay, oh my god, this is so strange…It feels unreal…I have a brain tumor!

Ashley

This is news I don’t like giving but it doesn’t mean there isn’t hope.

Beth

So what do I have to do now?

Ashley

I think it’s best if we could sit down with you and your family tomorrow to talk through everything. But in the meantime, are you comfortable if we go over some of the options for treatment? And next steps?

Beth

Yeah, I think so. I might forget everything, this feels so weird, so you might have to repeat yourself tomorrow.

Ashley

That’s no problem at all, I am here for you. You’re going to have a team of people helping and we will do whatever you feel you’re up to in terms of approaching this problem.

MMI Acting Station/Scenario Example #2

In this scenario, the candidate, James, is being asked to break the bad news to a patient, Cynthia.

The patient is sitting inside the room in the chair with their hands together, looking forebodingly at the bright, tiled floor.

James knocks on the door and enters. He reaches out to shake Cynthia’s hand, which is cold and trembling. She’s hunched over slightly in a timid posture. James’s expression is warm, but he avoids a tone of enthusiasm or excessive delight. He pulls up a chair and sits across from Cynthia at a comfortable distance.

James

Hello, my name is James. Am I talking with Cynthia?

Cynthia

Yes, that’s me.

James

Cynthia, thank you for seeing me today, especially on such short notice. I wanted to ask, what do you understand of why we’re meeting today?

Cynthia glances off to the side, tapping nervously on arm of the chair.

Cynthia

I have an idea why. I’ve been experiencing a lot of discomfort. And the bleeding has been persistent, and we’ve ruled out other explanations. I’m at the point where I just want to know what’s going on.

James puts his hands together and makes eye contact with Cynthia. He allows a moment of pause.

James

I’m afraid I have some bad news. Would now be a good time to discuss the results of the tests with you?

Cynthia

(With embittered inflection) Please. Just get on with it, I’m tired of waiting. I know I’m dying. I just want it to be as painless as possible.

Cynthia’s anger evolves into tears. She’s holding her face in her hands. James allows the tears and doesn’t interrupt. He has a box of tissues ready to hand to her. He proceeds a minute or two later, when she’s slightly calmer.

James

Maybe you would like to discuss the results in presence of a loved one, or a friend?

Cynthia

That won’t be necessary. Rip it off like a Band-Aid! (She giggles nervously)

James

The results of the tests have confirmed that you have colon cancer. I’m sorry.

Cynthia

How bad is it? Am I as good as done? Is there any hope?

James

Because we caught the cancer early, we think surgery will be the optimal treatment at this point. The cancer is localized, and we will recommend chemotherapy after the operation is complete. How do you feel about that?

Cynthia takes a deep breath and contemplates. She seems accepting, or perhaps oddly apathetic.

Cynthia

It sounds painful. Difficult. I don’t know if I can do all that. I’ve never had surgery. And what if it’s all for nothing and I die anyway?

James

I understand that the path ahead seems scary. We will be here to support you the whole way. With the right treatment, we are optimistic about the prospect of recovering. You can always take some time to think things through. Do you have any questions or concerns about the treatment?

Cynthia

I need to call my parents. My dad had colon cancer. Twice. The second time, we didn’t think he’d survive. It was brutal. I can’t believe now I have to go through what he did.

James

Having a support system during this time will be much needed. And as I said, I will be here to answer any questions; even if you just want someone to chat things over with, I can gladly do that. Is there anything else I can do for you right now?

Cynthia reaches for her purse and zips up her jacket, heading for the door.

Cynthia

No, thank you though. I will let you know if anything else changes.

James

I’ll be in contact then. Thank you, Cynthia.

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MMI Acting Station/Scenario Example #3

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.

Jennifer places a warm cup of coffee in front of you at the table and sits next to you. She sighs loudly and shakes her head in frustration.

Jennifer

I just don’t know what to do anymore. I’ve tried three times now and it hasn’t worked out. I truly am at a loss.

The candidate gently puts her hand over Jennifer’s. They’re best friends, after all.

Candidate

I totally get it. It hurts when you put in so much effort and passion into something and it doesn’t work out.

Jennifer

I know, I know. And it’s worse because I don’t know what I’m going to tell my parents and boyfriend. They were counting on me. My parents have been collecting savings to put me through med school since I was a kid.

Candidate

Give yourself some credit. You worked really hard and no one can take that away from you. And besides, if you decide that you want to continue to pursue medical school, you still can. There are plenty of stories of triumph and persistence that show what medical doctors went through to get where they are now. You could be one of them.

Jennifer

That’s easy for you to say (she snaps) You got in on your first try. Not everyone is as lucky as you are.

The candidate takes a moment to pause. She sips on the cup of coffee and waits for the tension to diffuse.

Candidate

I understand your frustration completely. I remember feeling similar when I got rejected at one of my top choices for undergraduate programs. I think the important thing to remember is that it’s a process. There will be good times and tough times along the way. I’m just glad I have you to be there through both.

Jennifer

Thanks for saying that. I think I’m just stressed about the future. Like I said, I don’t know what I’m going to do at this point. What do you think I should do?

Candidate

Maybe now is a good time to take some time off and reflect. Figure out your priorities and do what’s best for you. You could apply again next cycle, or maybe there’s something else you would want to do?

Jennifer

Trust me, there’s nothing else I’d rather do. My boyfriend will break up with me if I tell him I got rejected. And my parents will disown me.

Jennifer fans herself – she’s on the verge of tears. The candidate avoids physical contact and doesn’t interfere with Jennifer’s emotions. After a moment, she continues.

Candidate

I don’t know how your boyfriend or parents are going to react when you tell them. But I can tell you that no matter what happens, I’ll be here for you.

Jennifer interrupts, raising her voice.

Jennifer

You just don’t get it, do you? What does any of that matter if at the end of the day I have nothing?

Candidate

I’m so sorry you’re going through this. How do you think I can help you right now?

Jennifer

You can help by leaving me alone.

The candidate takes a pause before standing to see if Jennifer changes her mind, but it’s clear that she definitely wants to be alone.

Candidate

Okay, Jennifer. I’m really sorry you’re going through this right now. I’d be happy to talk to you again when you’re ready. If there’s anything I can do, please let me know. I’ll talk to you soon.

Conclusion

Often, in the stem of the MMI question in an acting scenario, you won’t be given details about the particular diagnosis. In the above sample acting station, I made up some general details about the scenarios to make them feel more real. I wouldn’t recommend getting too specific because you’re not a doctor and some of the specifics won’t make sense. You risk annoying your evaluator if you make up fake medicine. Remember, acting stations are designed to elicit the behavioral traits of a good doctor, physician assistant, nurse, dentist, or whichever profession you’re interested in. This makes the acting station a valuable evaluative adjunct to the interview question “why do you want to be a doctor?” , “why do you want to be a PA?”, and so on.

The entire point of this station is to let the actor’s emotional presentation lead the interview. When someone is upset, don’t just ramble on and on because you’re uncomfortable. Don’t talk about how this is similar to something that happened to you, thereby making the scenario all about you. Try to do what you can to comfort the person. Often, this means introducing some safe silence into the situation. It means putting yourself in their shoes and thinking through what you might need if the situation were reversed.

MMI acting stations are about being a decent human being. There is no real trick to them. If you spend the whole station in your head trying to figure out the perfect thing to say at the perfect time, you will seem cold to the actor and the evaluator. Get into the situation and try to experience it authentically and you will do well.

Best of luck!

FAQs

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