Common Recruitment Pitfalls

For the past 25 years I have frequently been called upon to critically review transplant programs, many of which have become dysfunctional, with acrimonious interpersonal dynamics. More often than not, I find decent people are simply in the wrong place. They either made a mistake in accepting a position, or their current employment circumstances have taken a turn for the worse.

I began informally recruiting transplant professionals in relationship to the aforementioned transplant program reviews. I now formally recruit transplant professionals full-time as Founder, President, and Chief Executive Officer of the United Network for the Recruitment of Transplantation Professionals (UNRTP). I'm not a commercial recruiter. I am an intermediary who provides unbiased recruitment assistance to institutions, as well as job seekers. My goal is to maximize the professional and cultural fit between institutions and potential candidates. Together, we want to avoid miscues.

In this first installment in a series of articles, I will comment on some common pitfalls of which one should be aware of when looking for a position.

A lot of recruiting is done by word-of-mouth. People simply ask or refer friends. This is a straightforward, low-cost strategy with a significant downside. The process is usually non-competitive which, in turn, begets entitlement. This sets the stage for what can later become unreasonable demands. Every recruitment effort should be competitive. No one should be handed a position. Beware of institutions that build programs based on non-competitive recruitment. Chances are they're inbred and stagnant.

Sham recruiting is a common but meaningless exercise. This occurs when an institution posts a position that is, for all intents and purposes, filled. They know who they're going to hire, and are merely meeting various legal requirements, such as Equal Employment Opportunity (EEO). Even the finest institutions resort to this dismal practice when they want to promote someone from within. Don't dignify sham recruitment by applying. You're only demonstrating your ignorance.

Applying "on-line" with no identifiable contact person is nonsense. In fact, on-line application procedures are typically indicative of a sham recruitment effort. Always identify a contact person, even if it means reaching out to a member of the transplant team at the relevant institution. If people are uncooperative or seem distant, don't bother. You're wasting your time. Give them the middle finger.

Moribund positions should be avoided. If a recruitment effort has gone on for months and there is no substantially visible activity, you can assume one of two things: (1) the position is one no one wants, or (2) the institution has no idea what they're looking for. I know of positions that have been continuously posted for over three years. In virtually every case I would advise people to steer clear. These programs, and the people associated with them, are inept, and should be blacklisted.

The recruitment process can be legitimately protracted. People sometimes turn down offers at the last minute. Currently it is taking between 8 to 12 months to fill a credible position. Often five or more candidates may be subjected to multiple interviews. Some candidates are interviewing to leverage their present position. In other words, they're intent on using a competing offer to negotiate a promotion or a salary increase at their current institution. These people selfishly prolong the agony of a search. They should be acknowledged for what they are - disingenuous.

Too many candidates can be worse than too few. The best searches are those that yield no more than three excellent candidates. The worst searches are those that identify ten or more average or marginal candidates. Inevitably, when search committees are faced with too many questionable candidates, they procrastinate in hopes that the ideal candidate will eventually "turn up." This rarely happens, unless the search is both continuously and aggressively pursued. The focus should be on quality not quantity.

"Churning" is always a concern. This occurs when an institution has frequent turnover. Thus, it is important to get a good sense of how many people associated with a given program have left over the past 5-10 years. In particular, you want to know why people have left. Churning is the strongest indicator of a dysfunctional program. Believe me, one bad character with excessive power can not only destroy a program, they can forever tarnish the reputation of an institution. Through an independent programmatic review, bad apples should be identified, labeled, discarded, and banned from the profession. No one wants the liability these fools represent.

Increasingly institutions rely on "internal" recruiters, many of which are exceptional, provided they recognize their limitations. Internal recruiters represent the institution for which they work. I routinely work with internal recruiters, serving as an intermediary between them and the candidates we jointly identify. What a candidate needs, as well as the recruiting institution, is a balanced perspective. In this regard, a knowledgeable recruitment intermediary, providing unbiased assistance, can best meet the needs of both parties in hopes of achieving the most appropriate professional and cultural fit. The consensus goal for both parties must be the assurance of a mutually satisfying long-term relationship.

Make sure your credentials are in order. Positions are often posted indicating that potential candidates should be "BE/BC." In other words, candidates should be Board-Eligible or Board-Certified in the appropriate specialty. This can be misleading. More often than not, the employer's expectation is Board-Certification. Technically, any physician or surgeon is board eligible. They simply have to take the required exam. To address this issue, the American Board of Medical Specialties (ABMS) is requiring all member boards, including American Board of Internal Medicine (ABIM), to establish a Board Eligibility Policy to define a time period for candidates to achieve certification. Clearly, credentials matter, and the earlier they're obtained, the better. Never underestimate the importance of credentials.

If you're not a U.S. citizen, your visa status should be clearly indicated on your curriculum vitae. For permanent positions in the U.S., a J-1 Temporary Visitor Exchange Visa is an unequivocal liability, and even an H-1B Visa can be problematic. A green card, known as the permanent resident card, is the real issue. Green card holders can legally live and work in the U.S. They can travel in and out of the United States more freely as well. The U.S. green card is also the first step to U.S. citizenship, as one must generally secure a green card before applying for naturalization. Employers may sponsor an H-1B holder for a green card.