The multiple mini-interview for selection of international medical graduates into family medicine residency education

Abstract

The multiple mini-interview (MMI) was used to measure professionalism in international medical graduate (IMG) applicants for family medicine residency in Alberta for positions accessed through the Alberta International Medical Graduate (AIMG) Program. This paper assesses the evidence for the MMI's reliability and validity in this context. A group of 71 IMGs participated in our 12-station MMI designed to assess professionalism competency. A 10-point scale evaluated applicants on ability to address the objectives of the situation, interpersonal skills, suitability for a residency and for family medicine, and overall performance. We conducted generalisability and decision studies to assess the reliability of MMI scores. We assessed the validity by examining the differences in MMI scores associated with session, track and socio-demographic characteristics of applicants and by measuring the correlations between MMI scores and scores on compulsory examinations, including the AIMG objective structured clinical examination, the Medical Council of Canada Evaluating Examination (MCCEE) and the Medical Council of Canada Qualifying Examination Part I (MCCQE I). We measured the correlation between MMI and non-requisite MCCQE Part II (MCCQE II) scores that were provided. The reliability as indicated by the generalisability coefficient associated with average station scores was 0.70 with one interviewer per station. There were no statistically significant differences in total MMI scores or mean station sum scores based on session, track, applicant age, gender, years since medical school completion, or language of medical school. There were low, non-significant correlations with OSCE overall (r = 0.15), MCCEE (r = 0.01) and MCCQE I (r = 0.06) scores and a higher non-significant correlation with MCCQE II scores (r = 0.33). There is evidence that the MMI offers a reliable and valid assessment of professionalism in IMG doctors applying for Canadian family medicine residencies and that this clinically situated MMI assessed facets of competency other than those assessed by the OSCE.