Multiple choice questions (MCQs) which assess an ability to understand interpersonal situations and to reason about human motivations have become an increasingly important consideration in the medical selection process. Interpersonal MCQs are currently being used in Australia as part of a battery of instruments to discriminate between large numbers of academically qualified candidates applying for limited places in university medical courses. These MCQs form a component of the Australian Undergraduate Medicine and Health Sciences Admission Test (UMAT), constructed by the Australian Council for Educational Research for the UMAT consortium of universities. This paper will outline the function and purpose of interpersonal MCQs, including their relationship to other tests such as self-report personality tests and other English comprehension or critical thinking tests. Using examples, the paper will describe the process of constructing interpersonal MCQs, outlining the main issues and difficulties encountered when selecting material and creating questions. Such issues include the extent of verbal loading, the subjective opinions of the reader, the intentions of the author, the plausibility of incorrect answers (distracters) and the defensible correctness of answers (keys). Item panelling, in-test trialling, and the psychometric properties of successful questions will also be discussed.