How to interview: Some pointers towards better hiring

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Interviews are an inherent part of the job-seeker. The board/panel wants to know if the candidate “fits” in their requirements. Who gets chosen depends on a combination of luck, hubris, familiarity of the candidate with the board and “past successes”. However, I haven’t come across an interview board that assesses the candidate’s actual merits and “suitability” for the organisation.

The first obvious question is why the candidate wants to join the said organisation. Is it the salary? Compensation structure? Organisational ethos? Recruitment specialists pushing through the process? Or is it the “vision and mission” statements that attract people? Is there any specific past record of the institution that speaks for itself? Is it the ex-employees, who have had to move on and speak highly about the organisation? Or is the TINA factor? (There Is No Alternative). Knowing this for the panel will also serve as a reality check about the kind of projection they have done to attract and retain talent. I can well imagine that big-tech in “silicon–valley” will always attract people (whether it’s Google despite the cut-back in employee perks) or Meta, despite the privacy snafus. I am trying to address a different problem, though: How does a hospital attract talent? Specifically, doctors? Medicine is highly regulated (in the interests of “public safety”), but it doesn’t stop technology companies from pushing out “wellness-products” or “alternative-therapies” that clog the supermarkets. Doctors migrate because of perceived benefits in “compensation structures” (ability to milk insurance companies), become “key-opinion-leaders” (an euphemism for “influencers”) or “research” (more on that later).

For the past couple of years, I have been pursuing extensive reading, writing and collating activities by trawling the web and attempting to understand the gradual creep of technology disruption of healthcare. I started a blog to document my thought process and use it to funnel it for “big-ideas”. There is a massive spate of interdisciplinary research happening on the sidelines that will alter the practice of medicine beyond recognition. I can foresee surgical specialities relatively immune (for the time being), but eventually all branches of medicine will get impacted in the next decade. While robotics and AI/ML appear to be futuristic (and a few of my illustrious colleagues allaying fears of joblessness), those in administrative managerial roles will evolve, while doctors will eventually become glorified machine operators like forklift technicians. This is subject to regulations that require someone to “pin-the-blame” if things go south, or algorithms being given more responsibility and ownership cadence.

In this scenario, I am pained to see that interview panellists persist with inane questions related to career trajectories shaped by choices and circumstances; sometimes beyond control. I find it amusing if the average past scholastic performance is given an importance for “cut-off”, because if a candidate has become a specialist, he/she has already demonstrated grit and determination to see it through. Scholastic performance plays little role in determining approaches to practical problems. I doubt if you require straight A’s to counsel a patient for end-of-life care. That requires a specific set of skills, empathy and ability to give hope (and counselling to patients for undergoing highly toxic treatments for radical approaches). A certification process only ensures the candidate knows what to say in a formal clinical setting. Beyond that, success is only relative.

An interview not designed to understand the candidate’s role in fostering interpersonal relationships with colleagues and subordinates also falls short of expectations. These can be judged by giving practical problems and understanding the approaches taken by them. It can’t be distilled for actual on-ground scenarios, but is only a bellwether to grasp the candidate’s “instincts”. For example, asking the top three things to do if a building catches fire should include triaging patients first for evacuation, then the women and children, and then fighting fire to douse it. Besides, I have also faced typical questions around “leadership”, which often begs the typical managerial response of “equity, diversity and people-frameworks”; in effect blowing up fancy smoke rings to tick the confirmation biases. These are more prominent in those places invested in “academic-gatekeeping” to ensure “continuity of academic excellence”, but remain glorified academic citation rings and hubs of political nitpicking. I have seen some of them from the ringside (while working there) – as they perpetuate nepotism and favouritism, often shutting out fresh ideas (and approaches) for excellence in patient care. These are pronounced in public institutions, where government provides maternal care from cradle-to-grave, with the only chance of getting fired if you have committed a felony.

Hiring a “perfect candidate” remains a statistical venture, and those in power to effect it would rather tick the confirmation biases than see fail themselves publicly. Humans congregate around power structures and “hierarchies”, which negatively impacts the institutions. You may have the best selection procedures, but if you lack the institutional capacity to absorb the best you have chosen, it is an abject failure. I am realistic enough to understand that everyone can’t be absorbed but those who are asked to stay back should push the envelope further by developing innovation and bringing in specific skills that enrich everyone involved. Any organisation that fails to innovate (or demonstrate its ability to hire exceptional candidates based on the dint of their idea matrices) and interpersonal capabilities to work as a team, atrophies, despite the funding or exceptional credentials of the board running it.

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