Tips on Approaching a Sample Multi Mini Interview (MMI) Question

Here you will find a quick but efficient summary of a method in which I would approach a sample Multi Mini Interview (MMI) question:

Sample MMI Question 1:

There is a man that has been responsible for taking care of his wife that has been in a vegetative state for the last year following a car accident. The extent of her abilities involves being able to breathe on her own. The husband asks that her feeding tube be removed. What as a physician would you do?

Firstly, I would summarize the question to the interviewer to make sure that we both understood the stem in the same way.

I would then explore all sides of the issue I would have to tackle. Here we have the perspectives of: the husband, the wife who is in a vegetative state, her other family members, the current law, the hospital resources, and yourself as a physician.

As a physician you would want to see if you can glean more information…is there any possibility of neurologic recovery, have we had a second opinion, did the patient express wishes in this kind of situation before they were rendered incompetent?

You can explain the different possible courses of action to take and what the consequences could be. You may not remove the tube and go against the husband’s wishes but is that in the benefit of the patient and her family? Or ultimately you could comply with the husband and remove the feeding tube which would end the life of that patient, could end the suffering of the family, and free up resources for other patients.

Ultimately, you must choose what you will do and support it. In this case, after exploring the patient’s prior wishes with her family, as well as taking their opinion into account, I would consult with my ethics and legal team to see if there was already a substitute decision maker in place for her in which case I would have to follow their wishes. If there wasn’t one, we would need to have one chosen for her. I would consult with the substitute decision maker about the situation of the patient explaining to them the potential outcomes of taking her off or leaving her on life support and counsel them about the likelihood of recovery in this patient. Together with the family and other support from hospital staff, a decision can be made where each step of future actions will be thoroughly communicated to ensure that everyone is on the same page.

Again, you can then conclude by reinstating your actions and the positive outcomes that are associated with that.

Overall, remember that most questions will not have a right answer! Have a way in which you will remember to look at all perspectives of a situation and show your ability to communicate them in a professional manner and you will find that the Multi Mini Interview format is a lot less stressful than you may have originally thought!