​Interviewing With Skill

Planning and Preparation for Interviewing

Before responding to a job posting, prepare your curriculum vitae or portfolio. For everyone, standard information will be required regarding your legal name, social security number, current contact information, educational background, professional activities, publications, and presentations. As part of the credentialing procedures, you will later be asked to send (or to have others send) materials such as birth certificate, passport (and visas if appropriate), transcripts from educational institutions, graduation certificates, and letters of recommendation. For materials of an official nature, such as birth certificate, citizenship papers, social security information, and diplomas, be sure to have certified copies made and retain the originals yourself. Expect that any employer interested in your initial contact will do a preliminary background check, and with further interest will pursue an in-depth verification of your identity, education, licensure(s), credit profile, court records, previous employment history, DEA registration, information in the National Practitioner Data Bank, and professional profile (AMA, AOA). Be prepared to discuss any irregularities among these data, such as lapses in employment or education or involvement in liability actions as part of the interviewing process. ​

Your initial communication with a practice may be personal, by email or regular mail, or indirect through a recruiting company. At this first level of contact, your interest is an exploration of whether this practice has potential for you. If regular mail is used or you are contacting a recruiting agency, a cover letter expressing interest with a succinct summary of your qualifications and interests may be sent along with a curriculum vitae (CV). In some instances, forwarding a CV may follow a response indicating the practice's interest in further information. The CV should be carefully prepared using a standard format (see CV outline, or "Preparing a Curriculum Vitae and Cover Letter" on the AAP's Practice Management Online website.) and updated so as to account for all time and professional activities up to the present. Gaps in the CV's timeline are a red flag to practices and to credentials committees. CVs unaccompanied by a letter of inquiry are unlikely to garner a positive response.

In most instances, a contact individual within the practice or an individual from the agency will respond to initial inquiries. Remember, recruiting company employees are agents of the potential employers and may or may not be able to answer your questions. The first contact with the practice may be personal (by phone or face-to-face meeting, as at a national meeting) or indirect, as through email. Early contact permits exploration of the important "deal makers" in your job search and allows the practice representative to assess your potential fitness for the position being filled. In this discussion, feel free to explore questions about the practice's history, the reasons behind the practice's need for a new or additional member, the overall mission of the practice, and personal goals of the interviewer. Expect to be asked why their practice attracted you, what career goals are most important to you, and when you can be available. If you are already in practice and looking for a new position, expect to explain your desire to seek a new position. This explanation should be forward-looking and based on advancing your career goals; avoid put-downs directed against your current associates or toward your current hospital, ,university, or practice group. Such contact allows both parties an opportunity to opt in or opt out before embarking on more formal steps. If there is mutual interest in further exploration, expect to be asked to send a letter of interest along with your CV/profile if it had not been a part of the initial contact. It is reasonable to define a timeline for next contact for the convenience of both parties.

If there is potential mutual interest after the first level contact, you will want to proceed with the next, more in-depth level interaction. For those positions appearing to fulfill your criteria, find out as much as you can in advance of a formal interview. Most hospitals have websites which provide much information about the history, mission, and vision of the hospital. Many universities, national practice organizations, and individual practices may have websites. This is certainly true for large national practices, but websites may also provide very useful information about hospital systems, university academic departments, and surrounding communities. Review the publications and presentations of the practice associates. Search the Directory published by the Section on Perinatal Pediatrics for the hospital(s) and physicians in the practice. The Directory can also give a sense of near-by perinatal services, maternal-fetal medicine support, and number of hospitals attended by members of the practice.

This document as a whole explores a wide-spectrum of practice-related issues important to finding a suitable career-starting position. Before an actual visit, it is helpful to organize your thinking and establish a means to retain information you're given and your impressions of the interview. Many interviewees see several sites, and after a while some important (to you) details may fade. The "Practice Evaluation Workbook" can be used to retain information and impressions of various aspects of each practice you evaluate. Make a list of questions and topics you plan to explore at the practice.

When both parties share a mutual interest after reviewing the above, an on-site visit and interview process usually follows. Strategic scheduling involves timely scheduling (undue delay suggests disinterest) and avoidance of inconvenient time periods (Mondays are often difficult, as are late afternoons or weekends). If your spouse or partner will accompany you, be certain that the interviewers are aware. If present during the actual interviews, spouses should be good listeners and let you respond to questions. If the interviewers prefer one-to-one conversations, their awareness of the spouse's presence allows them to facilitate community visits, tours with real estate agents, or contacts with potential employers for the spouse.

The visit schedule should be discussed in advance. Express your interest to meet prospective colleagues in neonatology, perinatology and obstetrics, pediatrics, pediatric subspecialties, and medical administration. In addition, an opportunity to meet with leaders and staff in pediatric nursing, respiratory care, social work, developmental care, and parent support can give added insight about inter-professional relationships and expectations. An interview with hospital administration is helpful in addressing the role of neonatology in the institution as a whole. A look at the community should follow. This full range of interviews may be conducted during one visit, as is often the case if interviewees are traveling considerable distances. If time requires or proximity allows multiple visits, the agenda for the first and subsequesnt sessions should be worked out in advance. Your interest in exploring these discussions reflects your interest and enthusiasm about the position. Record details of the practice visit and your subjective impressions in the Practice Evaluation Workbook. If multiple sites are considered, having your own documentation will ease the selection process.

If the interview leads to continued interest, the next level of exploration serves to confirm mutual goals, expand on specific practice components, define expectations, and delineate details of a potential contract. This may be accomplished through added visits, phone discussions,or email or other means to afford you of a more explicit understanding of the clinical, administrative, educational, research and business aspects of the practice. At this level, if you are considering a new community, time can be spent in an in-depth exploration of the community. If you have interests not previously discussed as being within the scope of current practice activities, be sure to bring them to the table. This may be an academic interest, eg. public health, ethics, teaching outside of the practice venue, authoring or editing material for publication. Or, it could be a citizenship activity, such as international volunteerism, active participation in organized medicine, etc. There should be explicit agreements as to whether these interests can or should be pursued as part of the practice, or if they need to be relegated to one's personal (non-practice) times.

Practice

There are several questions that in one form or another will be included in many, if not most, interviews. (See Appendix: TEN QUESTIONS and CUES TO THEIR ANSWERS). Be prepared to respond to these in a comfortable, informed manner. Rather than encountering the loosely-structured process of traditional interviews, behavior-based interviews address previous practice or professional events, action(s) taken, and resultant outcome(s). It often helps to have a colleague, spouse, or significant other work through these questions with you. Although you should practice responding to the questions verbally, do not memorize exact answers or your responses will sound rote.

Punctuality

Whether getting to the visit involves a short car ride or cross-country travel, being late is not fashionable! Make your travel arrangements so as to allow for unexpected delays and the time needed to find parking.

Professionalism

Dress professionally. Although you may be familiar with coming to the hospital in recreational clothing and changing into "scrubs" for work, more formal clothing is best for first impressions! This holds true for both interviewers and interviewees. Many data exist demonstrating more patient trust and confidence in clean and well-dressed professionals. Physician appearance in many professional settings affects performance, especially in those areas demanding cooperation. Recruiting is one of those activities.

Personable

You really can't be anyone but yourself. That said, there are pointers that help us all as we interact with newly met individuals, especially those with whom we ultimately may wish to associate. If you don't have a genuine interest in the position you shouldn't be wasting your or their time; but playing hard-to-get about a position you do seek is foolish. Demonstrate your enthusiasm and interest in their position and orient your comments toward your strengths in building the practice. Don't assume that the interviewer has reviewed your CV, so feel free to emphasize your accomplishments and how you see them becoming an asset in practice. Remember, interviewers seek to determine what kind of person you are, what you care about, what your interests are, and from that surmise what it would be like to work with you. Although being confident in yourself is reasonable, never go into an interview confident that you have the job—such an attitude usually results in a non-offer!

Professional Goals

Prior to an interview and site visit, you have prepared a career plan (See: CAREER PLANNING PERSONAL WORKBOOK). The purpose of this visit for you is to see if this practice position is a reasonable first-step toward your professional goals. The practice colleagues want to hear of your qualifications, areas of special interest or expertise, and strengths. These need to be presented with confidence without being pompous or obnoxious. Explore with practice associates how the practice facilitates their special interests and how it could advance your career goals. The practice needs to present itself to you in an attractive manner, as there are many positions from which fellows may select. The practice with a mission statement and a vision for its future can convincingly discuss attainment of mutual goals. On the other hand, if all you hear pertains to call schedules, time off, local recreational activity, and money, be wary.

Patient Care

It is likely that your fellowship has prepared you well for the clinical patient problems you would confront. The interview likely will include rounds, but don't expect those rounds to be a quiz! Rounds generally occur in the most intensive care setting covered by the practice, giving you a sense of that aspect of practice. Remember, most practices have considerable time commitments to lower levels of care which may not be included among rounds but need to be discussed as you review the clinical area(s) of the practice. On rounds, look for evidence of continuity of care, communication among associates and with nurses or other health professionals, shared-decision making, parental presence and involvement, and interrelationship between clinical care and teaching. You may see approaches unfamiliar to you, which present opportunities to see practice members consider alternatives, and for you to explore the practice's approach to variations or innovation. Rounding may give a glimpse of the interprofessional communications among practice colleagues, nursing staff, or consultants. Your analysis of team-functioning (when practice associates and others are on their best behavior) should be a major goal. The practice will be interested in your reactions to patient-based questions, but they will not expect bed-side lectures. Rounding is an opportunity for you to observe the degree to which specific approaches to care result from individual preferences or group consensus. After observing on rounds, a discussion with the interviewer can address communication, call distribution, process of coding and billing, approach to clinical or ethical dilemmas, and use of collaborative data for outcomes analysis, benchmarking, and monitoring change.

Prohibitions

Practice members, as employers, should not request or require that you discuss matters such as religious preference, political affiliation, personal health, sexual preference, and the like. Although many close colleagues and friends discuss many of these matters, they have no place in the interviewing process. If lighter conversation is desired, stick to sports (maybe), personal recreational interests, or the weather.

Practice Particulars

Common interests in medicine, pediatrics, and neonatal-perinatal medicine brought you and the practice together. The discussions above address some of the professional issues important in a new job. But, understanding the practice structure, its organization, and its funding are essential components as you consider the potential site. In your discussions, questions pertinent to your potential role regarding the each of following may be useful [these topics are addressed in detail in other chapters]:

• Spectrum of practice-related responsibilities, especially those beyond patient care, including education, administration and directorships, scholarly activities, and citizenship
• Patient demographics and capabilities (levels of care) at site(s) covered by the practice, especially those you'd be covering, and the relative time spent at each
• Personal performance expectations, follow-up & feedback, reward structure
• Practice outcome evaluations (collaboratives)
• Participation in organized medical organizations, such as the Section on Perinatal Pediatrics, American Academy of Pediatrics
• International medicine (if that is an interest of yours)

Compensations and Benefits

Financial discussions are among the hardest for interviewees. In early discussions, practices should be able to present their basic financial structure, and thereafter disclose sources of practice income (e.g., all patient-based billings; grants; contacted stipends from institutions/universities/hospital) and the degree to which individuals are responsible for generating added income. For employees of the practice (a common first-year arrangement), benefits are generally straight-forward and easily discussed. Beyond salary, some of these include moving expenses; payment of professionally-related expenses such as application fees for licensure, privileges, certification; liability insurance; leave (vacation, health or pregnancy related); and educational support. Once greater interest is mutually expressed, financial offers follow. It is useful to review existing data (e.g., the AAP's PedsJobs) to get an idea of the prevailing salary range. After a period of employment, some practice types lead to shareholder status or partnership. From these practices, an idea of potential remuneration with full partner status, the related benefit structure, and time it takes to get there should be discussed. Hospital-employed physicians need to understand the policies affecting institutionally employed physicians' salary and benefit schedules. For practice types requiring academic achievement, tenure-tracks, and the like, recruited physicians should seek a detailed understanding of the expectations, support provided for members of the practice to meet those expectations (time, research funding, etc), and time allotted. Many practices are allowing for more flexibility and for extended time to full partnership, promotion, or tenure to allow for family growth, part-time practices, job-sharing, and other innovations directed toward work/life balance. Some of these arise from generational or gender based priorites, especially considering the majority of fellows who are women, many of whom have or are starting to have children. Many of these innovations arise from changes in work/life balance requested by senior physicians as they wish to "cut back" in time, intensity of clinical care, or both. Understanding the practice's approach to generational issues and to its senior members may reflect its flexibility, response to change, and collegiality.

Questions

As noted above, having a list of questions important to your understanding of the position can help organize your visit. To the degree possible, integrating these questions into various parts of the interview/visit is more comfortable than using your list to interrogate the interviewer. If possible, seek a short interval toward the end of the interview/visit day to privately go over your question list and to enter your impressions on the practice evaluation worksheet. This will bring out areas missed in earlier sessions and give you a response to the inevitable "Do you have any other questions about our practice?" that will be part of the conclusion of the day. An added question or two demonstrates interest in the practice to the interviewer and makes it unnecessary for you to make an "I forgot to ask about…." return call.

At the close of the interview, it can be useful to learn from the interviewer(s) the expected time-line for follow-up communication and ultimately for filling the position. Likewise, you may wish to discuss your personal timeline and indicate when you would be in a position to make a commitment. Interviewers are aware that you are likely evaluating other positions and it is often useful to know when you have completed your interviewing schedule. Should you get an on-the-spot offer, feel free to ask for time to make your decision. A take-it-or-leave-it offer often is best left!

Post-interview Planning

As soon as practicable, send a brief, preferably hand-written thank-you note to your interviewer(s) for sharing their practice information with you. Email is becoming pervasive, but the added formality of a letter is appreciated. Offer to provide any additional information they desire and indicate interest in hearing back from them. Be sure that names are correctly spelled and titles are accurate.

Review and Decision-making

First, regarding the job you do not want. Once you decide that a site is not for you, regardless of whether you have been offered a position, get back to the practice contact person, employer, or recruiter as soon as possible. You need not explain the details affecting your decision; "Other opportunities I am pursuing better match my personal and professional expectations" is sufficient. Remember that some of the disclosures made by the practice to allow for your serious job evaluation involve sensitive or confidential issues. These confidences should be protected. Even if you choose a different practice, maintaining good will is wise.

Job offers often come verbally, followed by a letter or email, and then by a contract. If you receive a job offer, expect to make your decision and communicate it within two weeks. If you have already decided to accept a given position, if offered, no delay is needed. But, if you are in an approach-approach conflict or have potentially attractive sites yet to visit, contacting the practice and honestly disclosing your expected timeline will be appreciated. Considering the costs associated with recruiting and incorporating new associates, practices have it in their interest to be sure that your decision follows a complete assessment of your options. This situation sometimes can be avoided through disclosure of your timeline during the interviewing process (as noted above).

Accepting a Position

Letter of commitment: Should you accept an offered position, expect that the practice then will cease its further recruiting for that position and notify any other applicant(s) of its having been filled. It is not appropriate to accept two or more offers with the intent to make the ultimate choice at a later date. Letters of commitment can be a useful means for both parties to express the terms of employment in common language and allow for ambiguities to be worked out before the terms are entered into formal contracts. Letters of commitment should never be used as a means to hold open an option while seriously considering others.

Employment contract: Some suggest that the particulars of the employment agreement are best worked out in the common language format of the letter of commitment, and then converted to legal language by attorneys. This can save expensive lawyer time. Others prefer to have the attorneys do the final negotiations, which can become more expensive and time-consuming. In either case, disclosure of the process and of who pays for the necessary legal fees is part of the finalization process. The job offer should be followed by a contract, which is generally prepared by the practice's counsel. In some cases, your contract will be described as "the same one we all sign" and negotiation is discouraged. Regardless, and although you have discussed contract issues in the recruiting process, the document should be reviewed in detail with legal counsel familiar with physician employment contracts in the jurisdiction where the practice is located. For objectivity and lack of potential conflicts of interest, you should seek and hire the attorney, even if fees are reimbursed to you by the practice. Be sure that the contract's provisions are consistent with the discussions held at the interview(s) and written in letters of commitment and that you understand each element of the contract. In the discussion with your attorney, special attention should be given to identification of the parties (who actually will be your employer and who represents the employer), contract term and termination criteria, completion of board certification, delineation of duties, restrictive covenants, indemnification, listing of compensation and benefits, and provisions for mediation or arbitration, After resolving any conflicts or ambiguities, return the signed contract. Once a contract has been signed, both parties are bound by its provisions and breach may be associated with significant damages. [For more detail on legal issues, see "Legal issues on entering practice"]

Transition

After the recruiting process is completed and a position is confirmed, important actions must follow to allow you to begin working at the time desired in the contract. The most time-consuming of these are securing state licensure and acquiring privileges at each hospital and with each health insurance plan (so your efforts can be billed). These processes can take several months. Often practices will provide a sponsor within the group and references or contacts in the community regarding housing, schools, and other relocation activities.

Ten Questions and Cues to Their Answers 

Using these examples, work with a friend or family member to prepare a confident, but not rehearsed or rote, response to each. Note, suggested ideas combine factual data and behavioral responses to prepare you for both types of questioning.​

1. Tell me about yourself.

• Focus on yourself as a professional, no need to go into recreational interests.
• Interviewer may or may not have reviewed your portfolio (CV)
• In short statement, "I am the best candidate for this position because ………."
• Indicate examples of clinical skills and specific preparations that support your candidacy
• Consider an example where you found or introduced a new or better way of doing a significant practice activity

2. Why should I hire you?

• Indicate how you see the "fit" with their job needs
• Cite items in your portfolio (CV) that fit with job requirements or practice interests
• Enthusiasm is good; cocky is not
• Illlustrate an example of how you process decision making in the world of insufficient data

3. What are your long-term career objectives?

• Review your Personal Career Workbook as you think out this answer.
• Envision your ideal practice 5 years hence
• Describe how you see the practice as a good first step in your career plan, or be prepared to elucidate what you'll need from them to generate your interest.

4. How has your training to date prepared you for these goals?

• How have you engineered your fellowship experience specifically toward your career expectations?
• Describe preparatory activities outside of the fellowship curriculum.
• Highlight items in your portfolio (curriculum vitae) directed toward long-term goals.
• Indicate future plans for education, especially if course-work is involved.

5. How is teamwork important in neonatology?

• Address inter- and intra-professional understanding and communication
• Relate teamwork to problem solving and outcomes analysis and maintenance of certification
• Discuss an idea you forwarded and how you fostered its success

6. Tell me about a conflict and how you worked to resolve it?

• We all have had conflicts, so be sure you are prepared for this discussion.
• Think about patient priority, root-cause analysis, systems thinking, and personal respect in discussing conflict among professionals
• Describe your experience with a difficult patient or family.

7. What is your greatest challenge or weakness in your professional life?

• In what endeavors do you feel least confident and what are you doing to improve in those areas?
• Examples: public speaking; giving/receiving feedback; time management; work/life balance

8. What will your colleagues and teachers will say about you?

• Emphasize strengths and relationships
• Interviewer will likely compare your answer to reference letters

9. What are the qualities of the successful career neonatologist?

• Think about professionalism, collegiality, growth in practice
• Think about work/life balance
• Discuss your approach to unforeseen circumstances that disrupt your plans

10. Is there anything you'd change if you had to do it over?

On Becoming a Colleague »​​​​