“Be careful what you say:” Advice on appropriate evaluations, references and interviews.

1. “Be careful what you say:”Advice on appropriate evaluations, references and interviews. The Association of Human and Medical Genetics2014 Conference Ellen M. Rothstein, Esq. Associate General Counsel Boston Children’s Hospital

2. Outline Part One: The Hiring Process: Best practices for hiring the best people Part Two: Evaluations and Letters of Recommendation: Managing Risk Questions and Answers

3. What was the best hiring decision you ever made? What was the worst?

4. Hiring Basics – Develop a Hiring Plan • Clearly define the position • Establish the reporting structure • Identify determinative hiring criteria • Define the process • Interviews • Decision-makers • Timeline

5. Developing a Hiring Plan • Regulatory considerations • Academic considerations • Compensation • How will comp be structured? • Bonus and Incentives • Benefits • Identify resources

6. Case Study 1 You have two advanced clinical fellowships in your program. Six months before the start of the fellowship, one of the fellows withdraws. Fellows are critical to clinic coverage and you are worried about finding a replacement. To help speed up the process, you e-mail your colleagues around the country for potential candidates. One of your colleagues from afar calls you and recommends Martha, whose husband recently got a position as an attending at your institution and needs to move. He gives Martha a superlative recommendation - brilliant, dedicated, hard-working. You review her CV, which is stellar, and conduct a phone interview. She is a finalist for the position, and so you invite her for a round of interviews with the rest of the staff. She says it would be difficult for her to make a long trip now due to work and distance and asks if the interviews can be conducted via Skype. She also asks what the program’s policy is on work-life balance. Should you agree to the Skype request? How would you respond to the questions about work-life balance? What other questions can you ask Martha?

7. Interview Questions Not Okay to Ask Okay to Ask How many years of experience do you have? What is your long-term career goal? Are you available to work occasional nights and weekends? Can you work the following schedule? Can you take call? Do you need any reasonable accommodations in order to do the job? Is there anything you would like to share with us about yourself that relates to your skills and qualifications for this position? • How old are you? What year did you graduate? Do you plan to retire soon? • Are you married? Are you a single parent? Do you have children? Do you have adequate childcare or daycare coverage? • Are you disabled? Is your health okay? Do you have any disabled family members? Is your family’s health okay? • Have you ever been to this hospital for treatment? What for? • Do you have any significant financial problems? • Do you have a criminal record? • Have you ever been sued for malpractice?

8. Case Study 1…Continued You conduct the interviews via Skype. The staff is split, but you push for her and in the end decide to make Martha an offer. You email her that you are offering her a two year fellowship beginning July 1. She e-mails back accepting the fellowship. She also informs you that she is pregnant and would like to delay her start date until October 1. Your program administrator, who has been copied on the emails, goes on Facebook and discovers that Martha has a 3 year old child with developmental delay. She forwards the Facebook site to you. How do you respond to Martha? What factors can you consider in your decision?

9. Hiring Best Practices • Create a set of job-related questions for all candidates. • Be clear about schedules, start dates and expectations during the interview process, not post-offer. • Communicate the same information to all candidates • Conduct final interviews in person. • Limit e-mail to logistical matters. • Offers should be made in a letter and reviewed by appropriate individuals beforehand. • Follow your institution’s policy on references. • Make offers contingent on references (or check references before making an offer.) • Be wary of social media. Avoid social media to vet candidates.

10. Hiring Criteria • Objective, job related • Uniform and consistent for all individuals in the same or similar position • Cannot be based upon group affiliation or other legally protected classifications: • Race, ancestry, ethnicity or color; gender, sexual orientation, gender identity, or pregnancy; religion; age; disability and disability association; veteran or military status.

11. Effective Reference Checks“Red Flags” • Frequent or large gaps in the CV. • Unusually large number of training positions. • Unexplained jumping from one scientific field to the next. • References from peers. • No reference from current director/supervisor/PI. • References from family members or individuals with a vested interest in seeing the person get hired. • Reference letters with lots of adjectives and few accomplishments. • General answers given to specific questions. • Reluctance to give a phone reference. • Reluctance to answer any of these questions: • What is it like to work with this person? • Does this person get along well with support staff? • Is this person respectful of others? • How are his/her communication skills?

12. Part Two:Evaluations and Letters of Recommendation To say or not to say…..

13. Case Study 2 You hire Martha and agree to adjust the start date of the fellowship. She has a slow start at the beginning and often requests to work from home or leaves early without informing other people. She occasionally calls out for clinic, leaving the clinic short-staffed and causing disruptions in coverage. The other fellow in the program is unhappy and has complained to you. In the research arena, she is a bright and enthusiastic researcher. Right before her first year evaluation is due, she asks to reduce her clinical responsibilities so that she can focus more on research. She also asks for a part-time schedule. How would you handle the request? What would you include in her evaluation? Would you call her prior program director for guidance?

14. Navigating High Risk Situations • Apply a single standard to everyone who is similarly situated. • Consider how you or colleagues have handled other individuals with similar requests and issues. • Bring in other decision-makers and those with expertise to assist. • Stay objective and be truthful; avoid the tendency to “sugarcoat” real concerns. • Avoid acting out of anger and frustration.

15. Case Study 3 Bob is an MD, Ph.D in your department. He trained at your institution and has been a faculty member for a number of years. He is not especially popular or likeable. He frequently gets impatient with nurses and other staff when in clinic; Human Resources was involved recently due to staff complaints. Several years ago, he got into a fight in the parking lot with another physician which resulted in security being called. He supposedly had an affair with a colleague and is now going through a nasty and public divorce from his wife who is a PI in another department. Nonetheless, he is a prolific and brilliant physician-scientist, has many important papers as first author, plenty of funding, and is generally well-liked by patients. Bob asks to meet with you. He tells you that his therapist thinks he would benefit from a new setting with less stress, and that he has applied for a position at another institution. He asks you to write a letter of recommendation to the Department chair, a close colleague of yours. Would you provide a letter of recommendation? If so, what would you include?

16. When should you decline to provide a letter of recommendation? • When it would be damaging to the person’s career. • When it would be damaging to your career. • When you cannot be objective. • When you don’t know the person well enough to provide a meaningful reference. • When you are aware that the individual has been asked to leave the institution due to misconduct.

17. Letters of Recommendation • Meet with the individual and discuss the letter contents in advance. • Review what you would or would not say. • Agree on the handling of leaves and similar issues. • Be certain you’ve checked with all appropriate individuals before agreeing to provide a reference. • Avoid requests for “personal” references.

18. Best Practices for Writing Letters of Recommendation • Letters should be tailored to the position and addressed to an individual. • Describe yourself. • Describe your relationship with the individual. • Identify achievements • Describe assets. • Be honest and direct. • Be aware of what’s not included. • Be thorough and thoughtful. • Be conscious of potential gender bias.

19. Case Study 4 A year passes. It’s a Friday afternoon in summer and you are at your desk getting caught up on administrative work, including writing evaluations and recommendations for Martha and other fellows and residents. The phone rings. It’s your Chief calling from her lakeside vacation home. She’s not happy. She tells you that she just got off the phone with the General Counsel’s office. The Hospital, the University and Bob (who is still in your Department) have all been named in a harassment suit brought by two nurses and two doctors, including Martha. The media have called to inquire about the case. Do you still give Martha a recommendation? What do you say?

20. Questions and Answers

21. Appendix • Effective Reference Check Questions • Writing a Letter of Recommendation • Ellen Rothstein Bio