Let me see those recommendations

By C. Douglas Phillips, MD, FACR, Weill Cornell Medical College, NewYork–Presbyterian Hospital, New York, NY
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 Dr. Phillips is a Professor of Radiology, Director of Head and Neck Imaging, at Weill Cornell Medical College, NewYork–Presbyterian Hospital, New York, NY. He is a member of the Applied Radiology Editorial Advisory Board.

He who praises everybody, praises nobody.

—Samuel Johnson

There is a term that has been thrown around a lot in the last few years, which I both understand and really hate, and which I want to throw a few barbs at. It’s called “grade inflation.” It has gone way past just grades in middle school, high school, or through college. It has ascended and poisoned (my opinion) the evaluations we need to do about residents and fellows, and also about colleagues. Here’s my current opinion—if you come to my program with a CV and supporting documentation, and every SINGLE letter doesn’t say you can walk on water, light fires with your finger tips, call forth the winds, and read my mind, I’m not sure I want you.

This is an odd predicament we’ve placed ourselves in. Now, when you read applications and letters, you have to read for “red flags,” or little secret codes. “I overwhelmingly support this candidate’s application” vs. “I can wholeheartedly support this candidate’s application.” One, from the right source, could mean if you hire this person, don’t be surprised if you wake up some morning with him or her in your reading room sacrificing a goat and carving a nice little design in a chosen clinician’s forehead. I’m serious. I’ve seen it. The hidden meaning letters, not the goat sacrifice… .

We have now all gained an incredible respect for the occasional person who can write the truth. “Do NOT hire this person.” “Completely untrustworthy.” Well, I WOULD have respect for that person if they existed. That, my friends, will never happen. That is what lawyers are for. Also, people get to choose who writes their letters, and they are selective. If you’re likely to blow a whistle, you won’t be writing too many letters, particularly those that require the person to sign away their right to see it.

I don’t know if there is a way to get rid of this sticky little problem. It starts early (preschool), and becomes only more entrenched. That’s one reason I love interviews. Although, even a real sociopath/psychopath could likely hold it together for 15 to 20 minutes to get through an interview. All the while, they could be contemplating carving that design in your forehead, AFTER they have the job. Do you smell roast goat? Mahalo.

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Let me see those recommendations.  Appl Radiol. 

February 01, 2013

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