You’re on track for fantastic grades, you’ve prepared for the UKCAT and/or BMAT, you play sport and music, you’ve volunteered in your local hospice and practised interview questions – but there’s more! What’s all this about practical tests in medical school interviews and MMIs?
Medical schools look to their interviews to help them choose the most promising candidates for medical school – that is the people with the right skills to make good doctors. This is why they include practical tests. These practical tests are intended to examine some of the same skills that are required in a medical career. Clearly you will have specific training and experience and the chance to develop these skills further before you make it on to the wards – that is what medical school is for – but you must be able to show that you have at least the basics during your medical school interview.
What do medical schools want and how do they test? Junior doctors (and senior doctors) are often required to meet total strangers (patients!), speak to them briefly and gain their trust quickly, before performing some practical task to help them (taking blood, etc.) and then leaving to move to the next patient. Is it any surprise that medical schools want to see potential medical students doing something similar before accepting them on to the course?
Practical stations in Multiple Mini-Interviews (MMIs) are very common and are increasing in popularity at medical school interviews. The medical schools know that you don’t have any clinical knowledge or experience, so they won’t be asking you how to assess and treat real patients, but you are likely to be faced with an actor or a volunteer who you will have to help. Most MMI stations will involve just you and an examiner (or two) but the practical stations willl involve an actor as well.
The idea is that, once you have read the instructions, or been given them by the examiner, you will interact with the actor to help them in some practical way and TALK TO THEM whilst doing so. Having spent time in general hospitals watching junior doctors in action shortly after acting as an examiner for medical school entrance interviews, the similarities between the practical stations and the real world work of junior doctors is striking – and reassuring.
What sort of things can you be asked during a practical station in MMIs? Junior doctors are asked about diagnosis and treatment of medical problems, but you don’t know this yet, so this will NOT be part of the assessment. You will be asked to help people with what seem like trivial practical tasks – perhaps opening a jar and measuring a specific amount of various ingredients into a measuring bowl. You may be asked to help someone understand a bus timetable or instructions about medication. The task may be more practical – helping someone with mobility problems move from a chair to a bed, or write a letter, or put shoes on, or take shoes off, or brush their hair, or one of a hundred other things.
It is impossible to “revise” all the conceivable scenarios, but you can prepare by spending time talking to people and helping them. Ideal opportunities for this would be regular paid employment in a shop, or, ideally, volunteering in a local hospital or hospice. If you spend enough time doing something like this, you will fin that you develop a reasonably comfortable interpersonal style, get over the embarrassment that many people feel when talking to total strangers and develop resistance to becoming flustered when facing new and slightly awkward situations.
If you have thought about it and prepared, you will be wearing the right clothes for all of this and will feel comfortable, if not too relaxed.
The keys to success in the practical stations are to lay the foundations be getting some life experience (shop work, volunteering, charity work, community work, healthcare support worker experience, supervising of children, babysitting, etc.) and by reading the instructions at the time of the medical school interview. The practical station is likely to involve you touching the actor, to help them out of a chair, help them put their socks on or similar. The instructions will make this clear:
“You are a support worker on a ward for elderly people with memory loss. You should enter this station and help Gladys to find the correct pair of glasses. You should provide her with practical help and should interact with her by talking to her appropriately.”
An easy way to fail this station would be to say to Gladys that you are not sure if you are allowed to touch her glasses, or that you cannot help her to put her glasses on as a result of legal concerns. This indicates that you have not read or understood the instructions and that you are not aware of the purpose of the practical stations of the MMI. If you haven’t made time to understand this, and come across as unhelpful and obstructive towards the lovely Gladys, will you make a good doctor? No – the examiners will spot this immediately and your glorious medical career will be over before it has started.
The way to success at these stations is to smile, introduce yourself by name warmly, shake hands if appropriate (the “patient” may have their arm in a sling or a plaster or may have mobility problems – don’t allow this to fluster you in the first few seconds). You should then talk to the patient, not to the examiner (unless the instructions say otherwise) and speak to them in calm, reassuring and friendly tones but avoiding any suggestion of arrogance or ordering them around. The instructions will have told you what is required and the patient may well add to this by providing more information. Have a look around the area to see if there are any props or aids available. The presence of a walking frame, surgical gloves, a hat or any other items might suggest that these should be used.
Once you have worked out what you should be doing and how, explain to the patient what you intend to do and ask if that is alright. Do ask them to tell you if they are uncomfortable at any point.
You are then required to lead the process (whatever it is) but you should ask the patient for prompts “Do they normally do it this way?”, “Do let me know if this is uncomfortable” and so on.
The tasks are often trivial, and although you will only have a few minutes (typically between 5 and 10) for the station, you are likely to be able to finish the task in this time. Don’t rush! You are marked largely on your “bedside manner” and the quality of your interaction with the actor, rather than your ability to open jars, weigh Coco Pops or similar. Make sure that, whilst doing the task, you take time to talk to the actor in a calm, conversational and reassuring way. If you have elderly grandparents, it may help to bring them to mind. The actor will often prompt conversation by mentioning topics for discussion, such as the weather, bingo, going for a walk, etc. and you should follow up these prompts with gentle, pleasant and non-intrusive conversation, remembering to smile throughout. Try to keep up the pretence required by the station. If you are a volunteer in a hospice, say so when the patient/actor asks you what you do – don’t tell them that you’re coming for interview for entry to medical school.
Above all, expect the unexpected at these stations and do not allow yourself to become flustered. The actor may deliberately wear smelly socks if your task is to help them put their shoes on – this is to test you. If you don’t want to have to deal with people with personal hygiene problems, should you really be applying to be a doctor?
The examiner will usually only intervene if you are straying from the subject, have misunderstood the instructions or are heading fr other problems. Listen to anything they say and follow any instructions carefully. Good luck!