Challenges facing university career centres in effectively preparing students for medical school multi-mini interviews

By Kimberley Rawes and Barbara A. Smith

The working world has valued reductionist and analytical approaches, and the medical profession is a classic example of this “left brain” emphasis (Pink, 2006). Globalization and the use of technology to outsource medical procedures that depend on rule-based logic, like diagnosis which often involves decision trees, have transformed the need for local talent with different skill sets . For instance, patients using technology can now access the same information as doctors and arrive at the same diagnostic conclusions. Consequently, the following questions have arisen at some university career centres across Canada, and UBC Career Services thinks about them in particular: What is the role of the physician in the globalized era, and what are necessary skills and attitudes for success in medicine? The challenge is that historically, pre-med and medical students have been rewarded academically for “left brain” thinking. When we are preparing students for the Multiple Mini Interview (MMIs), how can university career centres support pre-med students to develop the emerging skills required by this evolving profession?

Medical professionals and globalization experts recognize that divergent thinking and empathic approaches by doctors will shape the future of the profession, because these skills cannot be computerized and are difficult to outsource. Therefore, the traditional emphasis on analytical and convergent thinking skills is necessary but insufficient. Doctor and bioethicist Jodi Halpern calls for a shift from “detached concern to empathy” in order to work effectively with patients (2011). Current research shows that doctors rated as more empathic see greater improvements in patient health than those who remain objective and detached (Hojat et al., 2011). However, research suggests that the Millennial generation is less empathetic than previous generations (Konrath et al, 2011; Westerman et al, 2011). These skill deficits may impede students’ ability to succeed in their goal to enter medical school, but also their ability to thrive as the profession changes.

UBC runs the largest medical school in North America, and Career Services supports students preparing for MMIs using principles of active engaged learning. Although interview content is a closely guarded secret and applicants sign confidentiality agreements, standard MMIs require students to respond to questions regarding health care policy, ethics, current events and their reasons for pursuing medicine. We lead a large lecture that explains the MMI format and expectations of strong answers. Small breakout groups follow where students practice prompts using the strategies described and receive feedback. Afterwards, students may seek additional support at Career Services. Students take turns leading small group discussions and providing feedback to their peers. Advisors encourage students to utilize divergent thinking by calling attention to alternate considerations.

Although medical school applicants excel in traditional, logic-based academics (UBC, 2011), we have observed that, for a generation with unprecedented access to information, a significant number seeking assistance have limited knowledge of current events that affect health care policy or the role of empathy in effective care. Students often focus on getting the “right answer” quickly, but they lack the necessary divergent thinking and decision-making skills to comprehend “big picture” issues and anticipate the implications and consequences of their decisions. Coaching some students can be particularly challenging because they have been rewarded for being task focused rather than being process oriented. It is difficult to undo years of rewards in two coaching sessions.

Some of our best students are not adequately prepared for the demands of the globalized professional world. Universities like UBC are trying to implement enriched educational experiences to better prepare students with necessary skills; however, further research is needed to explore the types of learning experiences pre-med students need most to succeed in their chosen profession.

Author Bios

Kimberley Rawes, B.A. is a Career Educator at UBC Career Services who designed the MMI preparation services and coordinates the Career Advisor graduate student staff.

Barbara A. Smith, B.A., M.Ed. is a Senior Career Advisor at UBC and has taught healthcare ethics.

References
Halpern, J. (2011). From Detached Concern to Empathy Humanizing Medical Practice. Oxford UP.

Hojat, M., Louis, D.Z., Markham, F.W., Wender, R., Rabinowitz, C. & Gonnella, J.S. (2011). Physicians’ empathy and clinical outcomes for diabetic patients. Academic Medicine, 86, 359–364.

Konrath, S.H., O’Brien, E.H. & Hsing, C. (2011). Changes in dispositional empathy in American college students over time: A meta-analysis. Personality and Social Psychology Review, 15(2) 180–198.

Pink, D. (1996). A Whole New Mind: Why Right Brainers Will Inherit the Future. New York, NY: Riverhead Books.

Westerman, J.W., Bergman, J.Z., Bergman, S.M. & Daly, J.P. (2011). Are universities creating millennial narcissistic employees? An empirical examination of narcissism in business students and its implications. Journal of Management Education, 20(10), 1–28.