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Politically correct references

BMJ 2000; 320 doi: (Published 10 June 2000) Cite this as: BMJ 2000;320:1613
  1. Peter V Scott, consultant anaesthetist
  1. Redditch

    In my day we were not stupid enough to suppose that references were the key to getting a hospital consultant job. They were just one more worry. Given a fair wind at interview we knew perfectly well that telephone calls would long ago have been made, discussions at the 19th hole would have taken place, and the chosen candidate's on-call roster would be into the third draft. We knew, too, that references for the also rans would have been taken up, made available to the advisory appointments committee, and read out, or better still read—all of them—after the interviews but before crunch time.

    References do not seem to mean what they used to mean

    References (and the choice of referees) were important. Without them the appointments committee could rely only on candidates' opinions of themselves from self serving curricula vitae or from self confident interviews. Some doctors who excel at their job do not always excel at interview; a referee can say that. References gave honest views from independent arbiters with nothing to lose and nothing to gain: honest because, in law, the arbiters were responsible for them. Although you could, and did, read between the lines, it probably told you as much about the arbiter as about the candidate. With a cruel or stupid or covertly racist reference you might hint to an unsuccessful candidate a change in referees.

    Even in these politically correct days consultants still have to write references. If a senior house officer is looking for a specialist registrar job I spend about an hour or so at the word processor; two to three hours if a specialist registrar is looking for a consultant job. Having given trainees a promise to do my best, they trust me to do my best. But why bother? I ask the question since references do not seem to mean what they used to mean, what I think they mean, what trainees think they mean, or what they ought to mean. And they are not read. There has been a subversive sea change driven by the positive discrimination lobby of the equal opportunities industry.

    I did not realise the full implications in all their horror until I rang medical staffing about a new consultant appointment. “When do we see the references?” I asked.

    “See them?” she replied.

    “Watch my lips,” I said. “Do we see the references, all of them, before the appointments committee meets, as it meets, or after it meets—that is, when the interviews are done but before we have made up our minds?”

    “No,” she said. “You may see the references for the putative favoured candidate, Doctor, after, and only after, you have made up your minds.”

    “Not before?”

    “Before? Are you mad? References are a joke. How many times have you yourself seen the rubric ‘Dr X claims that he used to work for me’? We in medical staffing have no remit to confuse the minds of fuddy duddies on an interview panel. If we got an honest reference like that what on earth would happen to our equal opportunity policy?”

    “Equal opportunity, you mean, as between the good and the bad?” I suggested helpfully, and I meant it to sting.

    “Quite,” she said.

    You have but to scan the columns of the BMJ's advertisement supplement: “Working towards equal opportunities”—Aintree Hospitals NHS Trust; “Committed to equal opportunities”—Royal Hull Hospitals; “We are committed to employing a workforce which reflects the diversity of the local community”—The Whittington Hospital (they employ deadbeats and dropouts, do they?); and my own institution “The Trust operates an Equal Opportunities Policy and encourages applications from disabled people and those with an ethnic minority background.” Euphemisms for colour and race are weasel words, racist in themselves. We want the best man or woman we can get.

    On references a trust may technically have no written policy. Technically, perhaps; but in the current climate its personnel department, from the need to protect the trust from dark suspicion, would think itself foolish to have no policy at all on what you might call “good practice.” So it has become customary to share the contents of references with the interview panel following a discussion about the favoured candidate only. The panel is unlikely to see references from unfavoured candidates. “The government is looking closely at race relations and sex discrimination. Any failure of NHS trusts to adopt good practice may result in attendance at an employment tribunal.”

    When a trust feels under pressure to set its own standards of political correctness from fear of an employment tribunal (self censorship) it is a bad lookout for medicine. It is unfair to the individual. What is more, it has a questionable legality. To put it bluntly, it's cobblers. If you must read my references read them. No one can stop you.


    • If you would like to submit a personal view please send no more than 850 words to the Editor, BMJ, BMA House, Tavistock Square, London WC1H 9JR or e-mail editor{at}

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