MMI and CASPer Consulting

What is the MMI?

MMI stands for multiple mini-interview and is a modern take on the medical school interview. Many medical schools have realized that a traditional interview has limited predictive value for how prospective students will actually perform in medical school, and have attempted to create scenarios that more actively evaluate how a medical school candidate might perform clinically. In addition, the MMI also gives schools more data points about each individual applicant. While a school might only be able to give each student 2-3 traditional interviews at best, an MMI with 10 different stations allow up to 30 different people to rate a single applicant.

The format varies slightly from school to school, but generally, the MMI is structured as follows:

  • 7-12 MMI stations
  • Each station lasts 7-10 minutes
  • Applicants are rated at each station by multiple raters, and receive a composite score at the completion of all stations

The content of the MMI stations also vary slightly from school to school, but in general, each station contains one of the following:

  • An encounter with an actor
  • A discussion of a hypothetical scenario with an interviewer
  • A teamwork activity with another applicant

The MMI intends to measure the applicant’s communication skills and problem evaluation. By placing students in scenarios both hypothetical and real, medical schools can better gauge those attributes than asking “Why do you want to be a doctor?”

What is CASPer and How Does it Differ From MMI?

CASPer stands for Computer-based Assessment for Sampling Personality characteristics, and it is an attempt to simulate MMI-style scenarios by computer. Schools that use CASPer will ask you to take the CASPer test from home in addition to a traditional interview. Schools do not typically use both MMI and CASPer in the selection process as they measure similar attributes.

The format for the CASPer test is as follows:

  • 12 sections each lasting 5 minutes
    • 8 video-based
    • 4 word-based
  • Each section has 3 questions associated with it
    • Some questions will ask you to respond to the scenario as outlined in the video
    • Some questions will ask you to reflect on an experience you have had in your life

CASPer attempts to measure attributes such as empathy, communication skills, ethical awareness, and professionalism. Each of your answers is scored by 12 different raters, who independently rate your responses in these domains. Again, this allows many more data points than a traditional interview might, and tests you in areas that are relevant to your medical training.

What Criteria Are Used To Evaluate and Score MMI Interviews?

Exact scoring rubrics vary from school to school, but they are similar in that they rate applicants in several domains: communication skills, empathy, ethics, problem-solving, and professionalism. This is based on the rater’s subjective evaluation of how you performed at that particular station. At the end of the MMI session, all of your scores from each station are compiled to create an overall MMI score that the admissions committee will use to evaluate your candidacy. Some schools use the median of your individual station scores (which helps minimize the effects of outliers), while others add up the scores from each station to give a final total composite score.

Prospective students that perform well on MMI typically communicate well to different types of people and respond well under pressure or when challenged. Candidates who are able to empathize with others typically score the best. People who score poorly are those who have difficulty showing empathy, have trouble communicating their ideas to others, or quickly freeze up or crumble under pressure.

While some of these qualities are innate, practicing MMI scenarios can help you hone these skills so you can put your best foot forward to the admissions committee. In particular, communication skills and being able to handle pressure-packed situations are learnable abilities that can be improved through practice. The easiest way to improve in these areas is to practice with someone who has rated an MMI before, so they can give you pointers on how you can improve. The medical school admissions consultants at Solomon Admissions Consulting have firsthand experience on admissions committees rating thousands of medical school applicants on MMI interviews.

Every school weights the MMI differently, so there is no exact “perfect score” you should aim for on the MMI. However, as a general rule, medical schools see the MMI as a very good “rule out” test for candidates they do not want. While a strong performance on the MMI is one of many factors medical schools take into account when deciding who gets admitted, a poor MMI performance is typically seen as a red flag and can easily take you out of the running even with an otherwise strong application. As such, learning the behaviors which might disqualify you and how to avoid them is an incredibly important factor in your application. All it takes is one misstep in the MMI and your entire candidacy can come crashing down.

What Types of Questions Might I See on the MMI or CASPer Exam, and How Should I Answer Them?

The following are two examples of scenarios you might encounter on the MMI or CASPer, and how you might be prepared for them. The examples were put together by our consultants at Solomon Admissions Consulting who have personally evaluated thousands of medical school applicants during MMI interviews and CASPer exams while on the admissions committee.

Example MMI Scenario I: Joey the Ph.D. Student

This is a scenario involving an actor. You will read the prompt on the door, then enter the room and interact with the actor. The prompt reads as follows:

“You are a college student in the midst of studying for finals in the library. After a long night of studying you get up to go home, but your backpack knocks over your neighbor Joey’s coffee- which spills all over his laptop, destroying it. You have no money in your bank account to pay for a new laptop. Joey is in the room.”

At this point, you enter the room and encounter Joey. Joey will be extremely upset with you, and demand that you pay for the new laptop, despite the fact that you have no money to pay for it. He will further inform you that his Ph.D. dissertation was on the laptop, and grow increasingly upset with your inability to fix it. He will make increasingly large demands of you, including asking you to rewrite part of his dissertation. This scenario is testing several important qualities in a physician: communication, empathy, ability to stay calm under pressure, and ability to keep yourself from making promises you cannot keep.

Prospective students who score best on this scenario will perform as such in the following domains:

Communication skills

The best candidates will calmly apologize and explain that they did not mean to cause harm. The best students will resist the tendency to become defensive and take full responsibility for the harm that they caused.


The best candidates will clearly and explicitly express their understanding of the irreparable harm their actions have caused. They will communicate that they understand the impact that their carelessness has caused.

Calm Under Pressure

The actor will be instructed not to accept any apology, and to continue to attempt to escalate the situation into an argument. The best students will not take the bait and continue to have a calm discussion. The actor is purposefully attempting to rattle the candidate.


The scenario specifically states that you do not have money to pay for a new laptop. Promising to pay for a new laptop is seen as an attempt to get out of the conflict with a false promise. Promising to help rewrite the dissertation is also an unrealistic promise. The best candidates will avoid making any promises to avoid the conflict, and instead, own the fact that their mistake caused Joey harm and apologize without making promises they cannot keep.

Example CASPer Scenario I: Text-Based Question

This is a scenario involving a short test-based prompt, followed by questions. The prompt reads as follows:

“Think of a time when you had a conflict with a peer, superior, or subordinate.”

You are then prompted with 3 questions. You have 5 minutes to answer the 3 questions.

  • Briefly describe the conflict and how you resolved it.
  • If you could go back and change anything about how you handled the situation, what might it be?
  • How will you apply the lessons learned from this conflict to your future career?

The best responses are as follows:

1. Briefly describe the conflict and how you resolved it.
The most important thing here is that you choose a real conflict where you were able to help diffuse it. Everyone has had a conflict before. Surprisingly, many students will say that they cannot think of one; this is a sign of poor insight and judgment and invariably leads to a poor score. The important part is to focus on the resolution, since that is where the graders will be evaluating your problem-solving abilities as well as your interpersonal awareness.

2. If you could go back and change anything about how you handled the situation, what might it be?
“I handled the situation perfectly and would change nothing,” is ALWAYS the wrong answer. While it might feel strange to acknowledge in a testing situation that you handled it imperfectly, this scenario is testing your ability to reflect and self-evaluate and your ability for self-improvement. Medicine is a field where you’ll be reflecting on your skills often, and the ability to objectively look at your own abilities and note where you can improve is an incredibly important trait. Concrete ideas are always better than vague ones. “I could be less angry” is a poor response, while “I recognize that my emotions sometimes get the better of me and I could do a better job of noticing when my emotions begin to spiral out of control so that I can take active steps to diffuse them, such as walking away or taking deep breaths,” is much more concrete.

3. How will you apply the lessons learned from this conflict to your future career?
The highest-scoring students will either give a real-life scenario in which they applied the changes in Question 2 to another conflict, or give a hypothetical scenario where they apply the ideas they reflected upon in Question 2, and show how they could do a better job at conflict resolution next time. Again, reviewers are looking for concrete ideas for self-improvement, and your ability to apply them to future scenarios.

Should I Walk Into the MMI or CASPer Cold?

Absolutely not! Poor performance on the MMI or CASPer could jeopardize an otherwise strong application. Preparation is key.

Familiarity with the format of the test will help you improve your scores by helping you hone your skills in advance, allow you to remain calm in the face of the high-pressure testing environment, and be acquainted with many different types of scenarios so that you are not caught off guard on testing day.

Ultimately, while the format may feel very different than the SAT or the MCAT, the MMI and CASPer are both standardized tests, and extensive practice with the format can always improve your performance.

How Can Solomon Admissions Help You Prepare for the MMI and/or CASPer?

Many of our medical admissions consultants at Solomon Admissions have served in the past as raters for the MMI on medical school admissions committees. Our consultants have experience evaluating and rating thousands of medical school applicants on MMI and CASPer, and we pool this knowledge and experience together to best prepare you for the interview.

Through their experience, we have crafted a series of practice MMI and CASPer scenarios that can help you practice for the test in a format that closely resembles the real thing, including written scenarios, discussion-based scenarios, and detailed feedback on the strengths and weaknesses of your performance. With this data, you can complete a second practice exam so that you can incorporate our consultants’ feedback and evaluation for improvement.

Consultants focus in particular on improving your:

  • Communication skills
  • Performance under pressure
  • Expression of empathy
  • Ethical awareness

From the first to the second practice exam, we typically see dramatic improvement as our students learn what is expected from them on the exam.

MMI and/or CASPer preparation typically takes 1-2 hours of the total medical school admissions package. It is critical to get feedback on your MMI and CASPer performance from former medical school admissions committee members like the ones at Solomon Admissions who evaluated applicants under this interview format.

What Specific Medical Schools Use the MMI and/or CASPer format?

Here is a list of medical schools that use the MMI format:

  • Albany Medical College
  • California Northstate University
  • California University of Science and Medicine
  • Central Michigan University
  • Duke University
  • Hofstra University
  • Michigan State University College of Human Medicine
  • New York Medical College
  • New York University
  • Nova Southeastern University Patel College of Allopathic Medicine
  • Oregon Health and Science University
  • Rosalind Franklin University of Medicine and Science
  • Rutgers Robert Wood Johnson Medical School-New Brunswick
  • Stanford University
  • SUNY Upstate Medical University
  • University of Alabama
  • University of Arizona–Phoenix
  • University of Arizona–Tucson
  • University of California-Davis
  • University of California-Los Angeles
  • University of California-Riverside
  • University of California-San Diego
  • University of Cincinnati
  • University of Colorado
  • University of Massachusetts
  • University of Michigan
  • University of Minnesota-Twin Cities
  • University of Mississippi
  • University of Missouri-Kansas City
  • University of Nevada–Reno
  • University of North Carolina-Chapel Hill
  • University of South Carolina-Greenville
  • University of Texas-Austin
  • University of Toledo
  • University of Utah
  • University of Vermont
  • Virginia Commonwealth University
  • Wake Forest University
  • Washington State University
  • Wayne State University
  • Western Michigan University

Here is a list of medical schools that use the CASPer format:

  • Albany Medical College
  • Central Michigan University
  • Drexel University
  • East Tennessee State University
  • Florida Atlantic University
  • Medical College of Wisconsin
  • Mercer University
  • New York Medical College
  • Rosalind Franklin University of Medicine and Science
  • Rutgers Robert Wood Johnson Medical School-New Brunswick
  • SUNY Upstate University
  • Temple University
  • Texas A&M Health Science Center
  • Texas Tech University Health Sciences Center
  • Tulane University
  • University of Colorado
  • University of Illinois
  • University of Miami
  • University of Michigan
  • University of North Carolina-Chapel Hill
  • University of Texas Medical Branch-Galveston
  • University of Vermont
  • University of Washington
  • Virginia Commonwealth University
  • West Virginia University

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