Career Focus

Medical selection

BMJ 1999; 318 doi: (Published 19 June 1999) Cite this as: BMJ 1999;318:S2-7199
  1. Naomi Craft, general practitioner and freelance journalist
  1. London

    New selection practices from outside the world of medicine are proving influential. Naomi Craft considers what these recent developments mean for applicants for medical jobs

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    Most doctors will change jobs about half a dozen times in the course of their career. This may involve at least as many job applications, often many more more if you include the unsuccessful ones. In Britain doctors are still selected on the basis of an application form (including a curriculum vitae), references, and interview, although these methods have been criticised..1.2

    Current problems

    Because the first thing selectors do is look at the application form and curriculum vitae, it is worth spending some time on preparing these. Some candidates falter at the start if their name doesn't fit: research on admission to medical schools.3 and applications for junior hospital posts.4 in Britain showed that candidates with non-European surnames were more likely to be rejected at this stage.

    Plainly this is both unjust and illegal. To tackle this, candidates and selectors need to be aware of best practice in this area, and to change their behaviour accordingly. The essence of good selection practice is to use procedures that focus on determining relevant objective criteria for the job in question and using fair procedures to assess each candidate according to them.

    The curriculum vitae

    Your curriculum vitae has one purpose: to get you an interview. A poorly organised curriculum vitae may be interpreted as evidence of poor communication skills and could constitute sufficient grounds for rejecting a candidate. Medicine has much to learn from the wider professional world, which has begun to abandon the traditional curriculum vitae that presents achievements in chronological order. The new style curriculum vitae presents prospective applicants in a more relevant and accessible way, by focusing on concrete skills and achievements.

    Read the specification

    Good employment practice demands that employers prepare a job description and a person specification. The job description will describe the duties of the post, and the person specification outlines the skills that the person who is appointed to the post should have. This should allow for objective differentiation between candidates at the shortlisting stage..5

    It is possible to be fully qualified for a post but to be rejected because the selector, who may have to skim through hundreds of curricula vitae during longlisting,6 missed essential detail buried in a poorly organised curriculum vitae. So how do you make sure your curriculum vitae gets on to the longlist? Some argue that longlisting is superfluous if communication skills are considered an essential part of an advertised post6: curricula vitae that are hard to analyse demonstrate poor communication skills and therefore constitute grounds for rejection.

    Ideally, you should tailor your curriculum vitae for each application. Identify important information in the advertisement and the person specification and related materials (such as the “Orange Book” for specialist registrars or model documents from the relevant royal college) and ensure that the relevant information is prominently presented in your application.

    The person specification is likely to include specific criteria, and selectors may use numerical scoring systems to rate them. Qualities include clinical experience, involvement in audit, teaching experience, team working, effective communication skills, and research (including how much research you have done, whether it is published in peer reviewed journals, and what subject it covers).

    Centre on the concrete

    The best curricula vitae illustrate ability and motivation by reference to concrete achievements such as medical school prizes or elective studies, which illustrate commitment to a specialty. Particular jobs may highlight your ability to deal with responsibility and stress, such as deputising for a senior colleague or working in the busiest unit in the country.

    It is traditional to present this information in reverse chronological order, but applications for jobs in business are increasingly making use of competency based curriculum vitae, many of which are “simple, concise, and elegant, and would save a lot of midnight oil.”.6 A competency based curricula vitae orders the information to show how your career so far has led you to gain the skills you are required to have for the present job. For example, if a job requires good written communication skills you might discuss how your school qualifications in English and your contributions to the medical school magazines, and latterly to learned journals, have combined to increase your competence in written English. You might then describe how you have put this skill into practice by writing patient information leaflets and audit protocols.

    Playing it safe

    This approach is new in medicine, and you may be reluctant to present yourself in this way in a profession that holds on dearly to its traditions. A compromise, and possibly a safer option, might be to summarise the information relating to the key skills for the job (obtained from the person specification) on the first page and to present a traditional reverse chronological order curriculum vitae on subsequent pages.

    How much of your personal life to include in a curriculum vitae is a moot point, and a matter of personal taste. A curriculum vitae that contains no information about life outside medicine may seem flat and without character, which may worry some selectors. There is no compulsion to include information about your marital status, family, or sexual orientation, and, indeed, to discriminate between candidates on this basis is illegal.

    You should spend most of your time preparing the content and order of your curriculum vitae, but presentation is also important. Check your spelling and punctuation carefully. Keep the design simple, clear, and consistent. Use headings and the white space on the page to guide the reader's eye. More than two different fonts on any page are an abomination. Print out a draft and get a colleague to proof read it. Use slightly heavier paper (100 g/m 2 ) when you finally print the version to send off.

    If the application requires a form rather than a curriculum vitae (and this can be to your advantage), don't ignore it: transfer the details across. This may be the one use left in the world for a typewriter: it's probably best to persuade a secretary to do this unless you are an expert typist. You may decide to include your curriculum vitae with the application form. Electronic forms are used for applications for some research posts, and this trend is likely to spread.

    Keep an electronic copy of your curriculum vitae on a computer, keep it up to date, and use this as a basis for each application. Back it up on floppy disk, too. You may also consider making it available on the web.

    Preparing for interviews

    Most serious shortlisted applicants will have spoken to the present incumbent of the post and to relevant staff in the department. More senior jobs can be likened to a courtship, with informal visits before the formal interviews. Remember that an interview is a negotiation between adults: essentially, you want to judge if you want them, and they want to judge if they want you. The relative strength of each party in the negotiations is determined in part by the prevailing labour market conditions, but, whatever these may be, a clear idea of what you want from the post and of what compromises you may be willing to make will help you present yourself well. Clarify the issues on paper beforehand.

    Appearance matters: tailor your presentation to the likely prejudices of the interviewers. For most jobs in medicine, this means a suit and tie for men and their equivalents for women.

    Allow plenty of time for travel. If you drive, allow time for congestion and difficulties with parking. Aim to be relaxed and patient in the interview waiting room. Take some suitable reading material.

    In the interview itself remember that, as you have been shortlisted, you are a serious contender for the post. This is not a viva: although the interviewers want to make objective judgments about your clarity of verbal presentation and your ability to think on your feet, they also want to judge whether your personality and attitude will fit in with the team or department. A sense of humour is generally a welcome attribute.

    Good interviewing practice generally means that each candidate will be asked similar questions, and there may be some kind of structured or numerical evaluation of your responses. The interviewers are likely to present difficult scenarios, often ones that are active concerns for the department. The best candidates will answer from experience and also show that they have used that experience as part of their ongoing personal development. Be prepared to debate and defend a point of view, having presented a balanced appraisal of the options. Don't pretend to know something that you don't; it's better to admit your ignorance and say how you would go about finding out.

    The references

    The main reason for providing references is to ensure that there is objective confirmation of a candidate's history. Most competent interviewers are aware that a reference says more about the referee than the referent and use the references to confirm what they already know from the shortlisting and interviewing process.1While the qualitative information within a reference may shade a fine decision, it is the least important part of the application process.

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