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While accumulating predictive validity evidence shows that multiple mini-interviews (MMI) are related to subsequent program performance, there are relatively few studies that compared MMI performance with academic difficulty. This study assessed the relationship between MMI performance and the likelihood of experiencing academic difficulty in a paramedic program. Data consisted of MMI scores and program performance of 37 students enrolled in a paramedic program in Winnipeg, Canada. Logistic regression analyses found that students who obtained lower MMI scores were much more likely to experience academic difficulty compared to students who obtained higher MMI scores. Future research could explore the relation between MMI performance and alternative measures of academic difficulty.