I have a confession to make – I trained at a time when getting a training position was nowhere as competitive as it is now. Even when I applied for my consultant job, I remember having a conversation with my boss that went something like this:
“So, I know there are two jobs on offer now and one job coming up in the next 12 months. I expect that the first two jobs will go to C. because she brings an incredible skill set with her paediatric qualifications, and to M. because he has three years more experience than I do. And then that third job will be mine”.
And that, in fact, was the outcome.
But I’m not completely unqualified to give direction about the referee process. In recent years, I have been a referee to countless junior (and senior) doctors, and I have sat on the ACEM Trainee Selection Committee for a time.
But for the purpose of this presentation, I have enlisted the help of generous colleagues. These include senior specialists, trainees, junior doctors and PHOs, and medical education officers who have shared their experience*.
The landscape of specialist training in medicine is completely different now than it was even 10 years ago. The approach to it requires strategy, being organised, and starting early.
The approach to cultivating your referees is the same – it requires strategy, being organised, and starting early.
Why bother with quality referees?
To put this process into context, recognise that the selectors’ dialogue with your referees is the final hoop in your application process.
Whether you are applying for a trainee position or a job, getting to this stage means that you’ve passed the previous tests, by virtues of your cover letter, your CV, and perhaps your interview.
This last part is to confirm that the impression that has been formed of you is accurate, and that no one who knows you thinks you may be a sociopath. In this competitive market, they are also likely looking to distinguish between candidates on their short list.
If the dialogue with your referee is verbal (rather than written), it provides a further opportunity for the selector to explore whether there is anything that could be said about you that one may not want to write down on paper!
While this dialogue is the final hoop, your own dialogue with your potential referees needs to be one of your first hoops.
This starts with a conversation.
This conversation needs to start early – while you’re still exploring your specialty direction. It’s the conversation you have with your supervising registrar or consultant. It may even be with a senior nurse or allied health colleague.
The conversation may be opportunistic or you may set up a formal meeting. Either way, it must be frank, open and honest.
Ask your supervisor if they’ve have enough time with you to form an opinion. And then you have to ask the question:
“Do you think I have the aptitude to be a …..?” (surgeon/dermatologist/emergency physician).
There is no point bypassing or pussy-footing around this step. If you just don’t possess the skills or attributes – and this a consistent message (not just bias or personality-based) – then it’s good to recognise this early, and you really have to think again.
Once you’ve found your path, gather up your guides.
Question two is:
“If you think I’m suited to this specialty, are you willing to fully back me?” (in my application and my journey)
Followed by:
“Do you feel you could give me a strong reference?”
Starting to ask these questions early builds your bank of referees. Keep a living document/database of these people, including their contact details.
If anyone ever says “Let me know if you need a reference down the track”, put a gold star next to their name on your database, and even consider asking them for a generic written reference at the time.
These people are your specialty-specific referees. What about rest of your Board of Referees?
The specialty you’re applying for will determine the diversity of your referees. Some are exclusive and only want to hear from peers. Some value a broader experience and a broader perspective.
Inform yourself with regards to this – ask the recruiting body, ask your colleagues, ask your friends, and ask the referees if they know.
Diversity may mean other people within the medical profession, or it may mean others within healthcare (nurse, allied health, paramedic). It may mean others within your life outside medicine (committee, charity, sport, military).
Include people who can speak to your clinical, education, research and administrative experience. Predictably, they also need to speak to your professionalism: your work ethic, your ability to be a team player, and your engagement and investment in the department and in the specialty. Finally, they need to help you to stand out in the crowd, by being able to describe your unique skills or your ability to overcome hurdles.
Now you have your board, and it’s time to submit your application and nominate your referees.
Here are four steps to managing your referees
1 Make your final choice (from your board of referees)
The ideal referee is valued, well known and well regarded in the field, known and respected in the place or by the people on the selection committee (college/department/hospital). Further, they are invested in your success and understand when you say, “It needs to be good”.
Hopefully, you’ve already primed them with the “Will you back me up?” conversation so that when you formally approach them with a specific application, their agreement will be likely.
Check the referee descriptors for the application. Often, a current/recent supervisor is required. If none of your referees have had direct contact with you for a couple of years, that will raise suspicion regarding why you haven’t chosen any more recent referees.
Depending on your relationship, you may contact your potential referee via phone, email, or in person. I find email to be my preferred communication mode as it allows flexibility.
It is important that you make it comfortable for them to say “No”. A referee under duress is unlikely to give you a good reference.
2 Prepare/coach your referee
You will need to handle your referee like a fragile, disorganised, time-poor (but well-intentioned) creature.
Set this process up for success by removing any foreseeable barriers.
Give them as much information as possible, without overwhelming them with stuff to read or sift through – give them bite-sized morsels (an executive summary) with options to read more if they want to.
Include:
– What you are applying for – a summary, with the job description attached
– Why you applying for this
– What the selector (college/course/job) is particularly looking for
– What will be required of them:
How will the reference be garnered – verbal vs written (is there a template?)
When are they likely to be approached and what time frame they will have
What kinds of things they may get asked
Without being presumptuous you might prompt them with examples eg “You could talk about that audit we did on hand washing in OT” or “You may want to mention the education session I ran on starting research as a junior doctor”.
– Additional information:
CV – up to date, comprehensive, “tight”; highlight any relevant bits eg publications, presentations, extracurricular professional activity
Your ‘personal statement’
Get their best contact details. For me, outlook is unreliably checked, and if you ask me, I’ll tell you to give out my gmail and mobile no. – because I won’t say yes and then be unable to be contacted.
3 Send reminders,
and each time you do, send all above information again so they don’t need to hunt through their inbox for the original documents.
4 Send a thank you note
It’s good manners.
It acknowledges their effort and time.
It develops your long-term professional relationships.
You never know when you may need them again!
Finally, here are some potential traps to be aware of.
1 Don’t go “too big”
Your referee should be someone who is valued and esteemed, but not too important and busy to spend time writing something thoughtful and good.
The Director of Department may be a compulsory requirement – in which case make sure they know you as well as possible, preferably via direct observation, but otherwise at least indirectly.
If this is not compulsory, then you’re better to choose the consultant who most knows you, and preferably knows the good bits…
Victoria Brazil often gets asked to be a referee (she hits many marks including being international, a full professor, and ultra-visible) but she is time-poor and often distant from the applicant, and so has to decline.
2 Make sure they will be around
Referees are sometimes uncontactable due to leave, illness, travel or being busy, or the contact details you’ve given are simply not current. This paints the picture that regarding the person you said would vouch for you (the BEST person!) – either you didn’t communicate with them effectively, or they couldn’t be bothered to follow through!
3 Conflict of interest
Avoid someone with a personal connection – unless maybe you had a professional connection first, and can be confident that you are asking with integrity, and explicitly give permission for them to say no, or at least to be objective.
4 Political strategy
Be aware of the bigger picture. If your referee has an agenda (or another preferred candidate), they will undermine your application, consciously or subconsciously. Keep your eyes and ears open – be aware, be astute, don’t be naïve. Seek advice from your peers, your trusted seniors.
In summary:
- Start early – collect a bank/board of referees
- Make you final selection based on specific considerations
- Coach/guide referees through process
- Say thank you
*I am extremely grateful for the input provided by my colleagues:
Victoria Brazil, Professor of Emergency Medicine
Alex Markwell, Senior Emergency Physician
Brooke Bullock, Medical Education Officer
Shema Haima, Surgical PHO
Kendall Sharpe, Dermatology Registrar
