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Give me a good reference
  1. D Taylor
  1. Correspondence to: D Taylor Institute of Child Health, London WC1N 3EH, UK;

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It is the duty of the referee to be honest, regardless of whether the candidate will see the reference or not

A young and rather inexperienced ophthalmologist was asked to provide a hospital, where he had applied for a 40 month registrar/senior registrar training post, with two references, one confidential and another open. As luck would have it, an administrative slip-up led to the open reference, which was glowing, being used as the definitive, confidential, reference that contributed to the appointment of the unlikely candidate. He was shocked to read the returned reference that was the confidential one, which was by the same author as the open one: it began “I cannot in all honesty say that Mr X is the most enthusiastic trainee that I have had, but...” and went downhill from there. The incident shows how luck is important in a career, and how little attention is usually paid to open references. It emphasises the value of different types of references and with the changes in human resources management in recent years it should suggest to us that we might do well to better understand the uses of references today.

Ophthalmology is a bit special where career assessment and references are concerned because it is where doctors need a combination of surgical and medical skills that is not seen to the same extent elsewhere. It is also very difficult for a potential employer at interview to judge whether or not a trainee is potentially a good surgeon, or for that a matter a good physician, except by the reference.

There are three main types of references: verbal, open, and confidential. Verbal references are usually given over the telephone or when people meet, and should only be used as a means of obtaining information quickly and should be followed up in writing. Often they are given because the human resources office does not appreciate how long it takes to receive the invitation to give a reference and how long it takes in many hospitals to get the reference prepared as an extra duty in an already crowded week. To assume a verbal reference is safe and offer a job on the merit of that reference alone is dangerous: often a written reference (which may be written by someone else) will not correspond to the verbal reference. It used to be quite acceptable to canvas by telephone on behalf of a candidate: the “old boy network” seemed to work well but it was unfair, bred inequality, and is not adequate now in most circumstances.

Open references are quite common in some countries and many visitors or fellows from overseas ask for an open reference. Realistically, it is difficult for referees to be completely honest when writing open references and often they are not considered worth the paper they are written on. None the less, it is still the duty of the referee to be honest, regardless of whether the candidate will see the reference or not. Open references may confine themselves to specific statements about the nature of the work carried out, how long the candidate had worked for the organisation, the department or unit the candidate had worked in, and tangible comments as to their capabilities.

A confidential reference can only be given adequately if it is focused on the position for which the candidate is applying. For job references, the author should be provided with the job description and the person specification and must consider the ways in which the candidate fits the job or otherwise for which s/he is applying. Under the Freedom of Information and Data Protection acts, the candidate has a legal right to see a confidential reference, although many health authorities have destroyed confidential references once considered at the committee meeting following conclusion of the recruitment process. They should therefore only contain factual statements that can, if required, be backed up with evidence, especially if the statements may be detrimental to a candidate. However, if there are known problems with a candidate’s performance or if there are negative perceptions about their performance, true or false, they must be dealt with honestly. They must be clear and concise, not contain innuendoes, tittle tattle, or second hand information. The confidential reference should never be disclosed outside the interviewing panel or its value is negated. Many employers abide by the rule that a reference should not be used to form an opinion but to confirm a decision, so references are not read until the decision to appoint is all but made.

Organisations have a duty to each other and to their employees to demonstrate good performance management but all too often it is seen as the easy option to provide a good reference and let the employee move on, sometimes with disastrous consequences.

No one is all good or all bad and if there are negative things to be brought out, they must firstly have be made known to the candidate and should have been addressed within the performance management process set down by the previous organisation. It is unfair and illegal to provide a reference based on previous performance issues that were not addressed with the individual during their employment and to which they did not have the opportunity to put right during their employment.

The following may be a helpful checklist for both questions on a reference request and considerations in the interviewing process:

  • Is the candidate appropriately qualified for the job? Qualifications do not just refer to diplomas, higher degrees, or fellowships of colleges, etc. Experience in the required field is as valuable.

  • Has the reference writer appraised him/herself of the job description and person specification?

  • Is his/her personality appropriate for the job?

  • Is s/he a team player (if, of course, the skill is required)?

  • Does s/he display appropriate collegiality?

  • Does s/he have an appropriate emotional intelligence/maturity?

  • Does s/he have a good sense of fairness?

  • Even temperedness?

  • Does s/he demonstrate an ability to work with staff at all levels and are they appropriately affable.

  • Does s/he show innovative skills?

  • Does the candidate show common sense?

  • Does the candidate show honesty to other staff members and patients?

  • Does the candidate have a criminal record? If so, you must consider the implications of the crime and if its relevance to the working environment. Those with a criminal record must not be discriminated against.

  • Does the candidate have a good health/sickness record? It is important to follow up previous reasons and periods for absence. A candidate should not be penalised for what may be perceived as an unacceptable record.

  • Does the candidate have good communication skills?

  • Does s/he have good medical skills, including basic knowledge, diagnostic skill, and medical common sense?

  • Is the candidate self motivated?

  • Is the candidate a potential leader (should the skill be required)?

  • Does s/he have any difficulties in taking or giving orders or leadership?

It is important to remember that all the above are only guidelines and no one factor should determine the fate of an individual’s career. Completion of any application form, format and content of the curriculum vitae, the interview, any psychological/ability testing, and references form the process and must be considered in totality, not in isolation.

Note in Proof

It is the duty of the referee to be honest, regardless of whether the candidate will see the reference or not


  • Any views expressed in the article are those of the author and do not necessarily reflect the views or policies of any institution at which the author works.

  • Series editor: David Taylor