The Changing Face of Medical School Admissions

Featured in this expanded approach to screening and evaluation is the Multiple Mini-Interview (MMI) which is designed to assess candidates’ communication and problem-solving skills, ethical scaffolding and preparedness, and other personal traits that the SOM deems essential to becoming an effective and compassionate physician.

The Office of Admissions began using the MMI more than a decade ago, in 2012. Since the COVID-19 pandemic, it has been implementing the tool through a computer-based platform. Thus, instead of walking from room to room to meet with individual interviewers, candidates move virtually, explains Karen Murray, M.D. ’99, dean for admissions for the SOM, and assistant professor of obstetrics and gynecology. “Other than flipping to a virtual platform, the MMI process is still the same,” Dr. Murray says. “The things we are looking for in applicants are exactly the same, we are using similar scenarios, it is run the same way, and interviewers come from all walks of life,” she adds.

The MMI requires each applicant to interview with eight different individuals, all volunteers from the broader NYMC community, including SOM faculty and staff members, alumni, students, allied health professionals, hospital staff, community members, and patients. These volunteers do not sit on the admissions committee, although they do receive training from the Office of Admissions. “The admissions committee and the MMI team are two separate groups of people,” Dr. Murray says.

Holistic Review

The process begins by giving each candidate two minutes to read a scenario that is posted on the door of a virtual interview room. Then a signal sounds, and the candidate enters the room with an interviewer and engages in a focused, six-minute discussion about the scenario. Interviewers rely on this process to evaluate candidates’ life experiences and accomplishments, communication skills, aptitude for understanding medical scenarios, and overall presentation. After six minutes, an automated voice prompts them to change rooms, where they will discuss a new scenario with a different interviewer. Unlike admissions committee members, interviewers do not view candidates’ interview results or applications. “They just assess each candidate according to the six minutes they each have,” Dr. Murray says.

She considers the composite MMI score an essential component of each candidate’s well-rounded application, which also includes GPA, MCAT scores, a personal statement, letters of recommendation, and a compilation of research, employment, community service, and other volunteer experiences. “It is a more holistic way of analyzing applicants than having just one interviewer relying on undergraduate grades and an MCAT score,” she says. Most importantly, the MMI helps to mitigate interviewers’ unconscious bias because it gives candidates multiple opportunities to demonstrate their skills, she adds.

For instance, an applicant might have average scores but exceptional life or work experiences and tremendous compassion, which are the kind of qualities that patients seek in physicians. On the other hand, an applicant might have an excellent academic record but an impersonal or arrogant manner, qualities that do not promote good doctor-patient relationships or the SOM’s values or mission. “Just because you score well does not mean you have the attributes of a good doctor,” Dr. Murray says. “The MMI gives you an idea of who each applicant is and gives them the opportunity to showcase who they are and talk about what kind of medicine they want to do, and where they see themselves in the next five or 15 years. It is a wonderful process, and it works,” she says.

Diversity and Inclusion

Dr. Murray joined the SOM faculty in 2003 as an interviewer in the school’s then one-on-one interview process. Since taking the helm of the admissions office in 2018, her many goals have included making the admissions process more equitable for all applicants. The first step to do this effectively required diversifying the admissions committee which, at the time, had only two members from demographic groups underrepresented in medicine (URMs) and few women. “One of the first things I noticed when I came to the admissions committee was that lack of representation, which means that if you are a woman or URM, your voice is not heard,” she says. In addition to requiring yearly anti-bias and anti-racism training for everyone, Dr. Murray launched an effort to recruit men and women of color, increasing diversity on the committee by some 25 percent.

“It is important to have the admissions committee understand the strengths of diversity and why a medical school exists,” says Mill Etienne, M.D. ’02, M.P.H., vice chancellor of diversity and inclusion, associate dean of the SOM student affairs, and associate professor of neurology and of medicine. “We are here to improve the health of our communities and doing so requires that we have a plan to recruit future doctors who reflect the demographics of the communities they will serve,” he adds.

Dr. Murray also felt the importance of increasing the number of female members, who comprise more than half of the admissions committee today. She is dedicating the same effort toward encouraging female medical school applicants. “When I started medical school in the early 1990s, women in white uniforms were still assumed to be nurses, since doctors traditionally had been male,” she says. “NYMC was one of the first medical schools to admit a Black woman,” she says. Indeed, more women are entering medicine than ever before, as demonstrated by last year’s class, which was 55 percent female, she says. “NYMC has always led the trends.”

In the years since Dr. Murray arrived, the SOM has doubled its number of underrepresented minorities from eight to 16 percent. In addition, the number of applicants of Korean, Chinese, East Indian, or Vietnamese descent has increased, as has the number of Jewish applicants. “We have a lot more Jewish applicants, because the school is now under the auspices of Touro University, which observes all the Jewish holidays, removing a previous challenge to observant Jewish students,” she says. “Our commitment to diversity and inclusion encompasses our accommodation for Jewish observance and culture,” says Dr. Etienne.

Yet, despite significant advances in the SOM’s URM enrollment, which has exceeded 20 percent in recent years, there have been some declines. For example, last year’s URM enrollment was only 18 percent, a dip that Dr. Murray attributes to “a lot of moving parts in the world.”

Balancing Costs and Scholarships

Among these moving parts is the cost of medical school tuition. Tuition at NYMC is typical of private medical schools in the U.S. but students often choose a school based on the amount of financial aid they are offered. “We accept a lot of qualified applicants, but it is difficult to hold onto them,” she explains. “We try to offer as many scholarships as we can but it is hard to compete with other schools that have more money than we do. We have had students to whom we would give a half tuition scholarship and they would come back asking for more, saying that another institution had given them a full ride, and they end up going elsewhere,” she says.

Also challenging the SOM’s efforts to increase or at least maintain URM enrollment is the recent U.S. Supreme Court ruling ending affirmative action. “That is another challenge that has gotten thrown at us this year,” Dr. Murray says. “We can no longer screen by ethnicity or race.” As a result, the school must screen according to other parameters. “As we screen for diversity, we have to make sure we come up with ways to help students come to school and support them while they’re here,” she says.

The good news is that SOM is finding other ways to welcome racially, ethnically, and socioeconomically diverse students. One way includes identifying those who qualify for the MCAT fee assessment program; represent the first generation in their family to apply to medical school; or, fit the Association of American Medical College’s definition of ‘socioeconomically disadvantaged,’ she says.

Support System

Another way in which Dr. Murray is working to increase diversity is by collaborating closely with the Student National Medical Association to encourage undergraduate college students of color to consider medical school by inviting them to attend medical school for a day. “College students of color need to see medical students who look like them,” she says. She is also backing the SOM’s efforts to provide steady student support in the form of mental health and wellness, and academic support services. “We also have a robust pre-matriculation program through which we get students well acclimated in the campus environment so they can have a greater sense of belonging. This has had a positive impact on academic outcomes for our students,” says Dr. Etienne.

In the years to come, maintaining its commitment to racial and ethnic, gender as well as socioeconomic diversity will likely be an ongoing challenge for the SOM. “Despite these challenges, we must not give up on our goal of doing all we can to make our communities healthier,” says Dr. Etienne. “We must make eliminating health disparities in the U.S. our next moonshot. NYMC is well positioned to lead the way in that endeavor.”

For an institution that takes credit for more than its share of firsts among medical schools, Dr. Murray says, “Nothing is impossible.”

School of Medicine Office of Admissions Seeks MMI Interviewers

The SOM Office of Admissions seeks volunteers to serve as interviewers for the Multiple Mini-Interview. Volunteers include faculty, staff, alumni, medical students and residents, nurses and other allied health professionals, public health experts, social workers, legal professionals, education experts, patient advocates, former patients, leaders of community organizations, as well as community members at large. The interview season runs from mid-September through March, with interviews taking place Mondays, Tuesdays, and Thursdays. Interviews take place on the Valhalla campus or virtually. Interviewers are asked to sign up to interview one afternoon per month and training is provided. Learn more on the MMI webpage.