Archive for March, 2010

Body language at medical interviews

Sunday, March 21st, 2010

Body language plays an important role in medical interviews because this is what helps members of the panel relate to you. An interview is as much  a test of confidence and maturity as it is a test of content, and your body language is crucial in ensuring that you come across well.

Following several requests, here is a summary of the key rules of body language:

  1. Maintain eye contact with the person who is talking to you. At your interview you will face between 2  interviewers (for ST interviews and some locum consultant interviews) and 8 interviewers (for some locum consultant interviews and for substantive consultant interviews). In some regions/trusts, you may have up to 14 people on a panel (not uncommon in Northern Ireland and Scotland). It is impossible to look at everyone all the time, and if you did you would soon get dizzy! Conversely, it is important to try to involve everyone whenever possible to avoid having a situation where the panel member at the end of the table has to wait for 45 minutes before you look at them. So, look principally at whomever is asking you the question and, occasionally, look around to ensure you connect with the others.
     
  2. Put your hands on the table. Most of the panel members will have their hand on the table, taking notes, playing with their pen , or simply being attentive. It is crucial that you place yourself at the same level as the panel by also having your hands on the table. If you don’t, the table will act as a barrier between you and them and you are more likely to end up looking like a schoolboy/girl waiting to be interrogated. If you are worried about fidgeting, slightly interlock your fingers to stop yourself from moving your hands too much.
     
  3. Do not place your elbows on the table. Elbows on the table not only are rude/familiar, they also make you invade the buffer zone between you and the panel, with the risk that you might come across as threatening. Leave your elbows slightly outside of the table. This is typically achieved by sitting approximately 20 cm from the table.
     
  4. Move your hands if you want, but only in front of you. No need for Shirley Bassey impressions. Arm movement outside of the area in front of you will take the attention away from your face. To ensure that the attention remains on you and not on your hands, do not go left or right of your body; and do not move your hands above chest level in order to avoid obscuring your chin or face.
     
  5. Dress conservatively. The interview is a business meeting. You must wear a suit, preferably of a dark colour (navy/black for men, any dark colour for women). Wear a lighter shirt/blouse/top so that it frames your face. Don’t forget: they want to look at you, not your clothes! Most colours are fine, though men should avoid wearing pink (tie or shirt) because this is a colour better fitted to mediation and team playing which does not convey a strong sense of leadership. As such, though it would be suitable if you were going to a meeting to resolve a conflict, it is less suitable for an interview setting.
     
  6. Avoid anything that can take the eye away from your face. This would include any big items of jewelery (small is okay), as well as items such as poppies, red/pink ribbons, daffodils.
  7. If there is no table, you may cross your legs, but with the crossed leg always facing in the direction of the person who is talking to you. This will enable you to turn your body towards them whilst at the same time being able to rotate to engage wit the other panel members.

If you want to discuss any of this or anything relating to a forthcoming interview, why not join us in one of our consultant interview courses. They run 3 to 6 times per week in London so that you have plenty of choice for dates.

Consultant interview questions on how to reduce costs

Monday, March 8th, 2010

In an era when the NHS is asked to demonstrate austerity, there is an array of questions asked at consultant interviews on the topic of cost reductions, of the type:

  1. How can we maintain quality of care whilst cutting costs at the same time?
  2. If I told you that we needed to cut costs in your department by 15%, where would you find the cost savings?

In giving answers to such questions, the majority of candidates are having trouble distinguishing between cost savings and cost efficiency. Some then picked on by interviewers or get feedback that they had a poor graps of basic business concepts. I thought it would be useful to deal with this topic in an article in an attempt to remove any ambiguities.

Cost efficiency means that for a given cost, you are making the best use of the resources available. So for example, if a nurse costs the department £35,000 p.a. then she is cost efficient by being made to see as many patients as possible. In other words, you are getting the most out of the cost.

Cost cutting however refers to the fact that the cost of employing the nurse in the first place would be lowered. In other words, this would involve demoting her to a lower salary (tricky!) or making her redundant (tricky too, but far more feasible). 

Note that when you are making the nurse see more patients, you are actually cutting the cost of dealing with one patient (since her salary is spread over more patients than before but you are not cutting the cost of her employment.

When you get questions on cost-cuttings, they refer to cutting the overall cost and not the cost per patient. Overall, there are many ways in which costs can be cut in an NHS environment, which would include:

  1. Making staff redundant (salaries are the biggest expense).
  2. Using cheaper drugs (drugs are the second largest expense).
  3. Moving to day-case surgery, thus enabling a cut in the number of ITU beds, lowering the number of infections and readmissions (thus enabling redundancy of staff)
  4. Using cheaper staff to carry out tasks (e.g. replacing doctors by nurses, consultants by senior staff grades.
  5. Using permanent staff instead of locums
  6. Replacing one consultant by increased PAs for the other consultants in the team (the total cost to a Trust of paying 8 consultants £10,000 more is lower than paying one consultants £80,000)
  7. Encouraging follow-ups to be done by GPs (thus enabling redundancy of staff)

So for example, in anaesthesia, implementing pre-operative assessment clinics would lower the number of cancellations because patients would be better assessed and any risks identified. This would result in a fuller utilisation of the resources available and therefore greater efficiency, but not in cost savings because the trust would have to pay the salaries, theatre time, etc just the same.

Hope this helps! Good luck to everyone!