How to choose your referees/ staff members to fill out your assessment forms
We as IMGs need references at different stages of our careers.
1. When we are applying for our first post as non trainees - This is from our home countries
2. When we ask our consultants to fill out competency forms- ie foundation competencies, core competencies: Usually in the NHS
3. When we are applying for core training/ trainee SHO posts in the NHS - this is usually our consultants in the NHS we have worked under in our non training post.
4. When we are applying for higher specialty training- this is usually our consultants in the NHS we have worked under in our training post.
I am going to address this issue in the form of FAQs.
REFERENCE FORMS
As a rule, you should always inform the relevant consultants that you are putting their details down as your reference BEFORE you submit the application/fill out the form. An email/face to face discussion should suffice to take permission.
Why do we need references?
This is to ensure that a particular doctor has a good record.
From our home countries
How should I choose my references?
It is usually the consultants you have worked under during your one year internship ( also called house job). They usually say nice things however if you have been a victim of ward politics ( which can be quite common back home) then avoid that particular consultant. As we rotate in 4 different specialties, we have a few consultants to choose from - there are atleast 2 to 3 consultants in each specialty.
Can I ask registrars or assistant professors fill out a particular form?
It depends on what the form is about. It should be clearly mentioned in the forms guidance therefore read it carefully.
In the NHS:
How should I choose my references?
It is usually your supervisor (education and/or clinical) and any other consultant whom you have worked with. This may be an acute medical consultant, a consultant in a different specialty who was frequently on call with you and saw the patients you post taked or any consultant who knows you from the usual wards you have worked in.
How would I know if they would say something nice or negative?
Usually if consultants are happy with your progress, they usually ask you what your plans are. And then offer that they will be more than happy to be your references when you need any assistance. These are the people who will never say anything negative about you.
However, some people do not say nice things so always ask your colleagues ( trainee SHOs, registrars) if it would be reasonable to talk to that consultant if (s)he would be happy to sign any referee forms. Trainees are always getting their assessments signed off and therefore know which ones are good and which ones you should avoid. There are very few we need to avoid ( personally I have never come across any consultants like that but there have been instances when they have not been very supportive).
Can I see the reference form they fill?
No. It is supposed to be confidential.
I have got a bad reference from one of the consultants and my new employer has informed me about it.
Ask your employer if they will consider an alternative reference and find a consultant who knows you well and will say something positive.
Also take this opportunity to meet the consultant who gave a bad reference ( if you have been given any details) and ask politely what you did wrong and how you can improve yourself. Also, please do not ask that consultant to fill out any more forms for you.
ASSESSMENT FORMS
I have an e portfolio. Whom can I send assessments to?
In general,
MSF: Any healthcare professional from ward clerks, HCAs, OT, PT, FY1s, SHOs, registrars and consultants.
Mini CEX: clinical examination forms- Registrars and consultants.
DOPS - Procedure observation forms - Registrars and consultants. Some specialty nurses can sign it off as well, like cardiac nurses for elective cardioversions.
CBDs: Case based discussions - Registrars and consultants.
ACATs- acute assessment forms. You should have seen at least 5 patients who have then been seen by a consultant. This can be during one shift or over a span of a few shifts.
Consultants fill these forms.
Teaching assessment forms - Consultants or registrars who have observed you do a teaching session.
How do I know whom to send forms to?
You can judge this on the basis of the relationship a particular person has with you.
For example, you would not want to send a form to a ward clerk who hates you for taking her pens from her drawer. Or a consultant who did not like your management plan/ has suggested that you do not work efficiently face to face.
How should I ask people to fill out assessment forms?
By being human - Ie asking them nicely. Most will do them within a week.
I got a horrible assessment by a person. (S)he ticked unsatisfactory in all domains.
This is the worst part of e portfolios. The tick boxes can be confusing sometimes and if all of your other assessments are fine, ignore this one. Usually your consultant puts a note in like " this is an error as the other assessments are satisfactory"
I actually got a negative assessment from a person and his/her comments were quite negative.
It is best to talk to your supervisor about this first and see how to take things from there. These consultants usually know everyone can sometimes assure you by saying things like " Oh, I know that person. (S)he is always like that and other trainees have the same issue".
The person actually said horrible things in the comments section.
If your other assessments are nice, I would ignore that if I were you. However if you feel like you need to find more about this in order to improve yourself and the solution/problem identified is not clearly mentioned in the assessment form then you could talk to that person directly in a non confrontational way.
Have you ever got bad assessments?
Yes. And I chose to ignore them as overall, my assessments were fine and I worked on the negative points mentioned in the assessment form.
Is this a fair way?
No, not at all. I honestly believe that if you are struggling, the assessor meets you face to face and informs you that you need to work on certain things and also assures you that you are doing well and many doctors like you have had the same struggles. Then (s)he suggests that you should work on these and then send him/her an assessment form.
This way, you are:
1. Fedback in a non official way about the things you need to work on .
2. You are given a chance to work on them.
3. You are given the opportunity of sending an assessment form again.
I have been asked to fill an assessment form. Should I say negative comments?
No. Always be nice. If you do not have anything nice to say, just tick " satisfactory" rather than "below average" or "outstanding".
Remember these e-assessments remain with us throughout our lives and that person may be having one bad day when you were an unfortunate witness/victim of his/her behavior.
There is a registrar who is a bully. He has asked me to fill out his assessment form.
Forget the assessment form - sort out the bullying.
Unfortunately, not a lot of people are aware of systems which have been put in place to speak up.
One such system is "Freedom to Speak up".
This is what this is about:
https://improvement.nhs.uk/resources/freedom-to-speak-up-whistleblowing-policy-for-the-nhs/
Read about it in detail.
Find out who your Freedom to Speak up Guardian is (Talk to your HR if you do not know). If you have any concerns, raise them with that Guardian so that the bully is fed back about what (s)he has done (anonymously).
If anyone else has been through any issues (and resolved them successfully), please mention them here (without mentioning the trusts or the professionals involved) so that people who are struggling know what to do.
People who can support you are:
1. Your supervisor
2. Your colleagues ( The doctors mess is an amazing place to vent out- just be careful whom you vent out to. That SHO may be in a relationship with the consultant/registrar you are moaning about )
3. Freedom to speak up Guardian
4. Chief registrar (if your trust has one).
5. Occupational health if you feel you are going through a lot of stress - they can direct you to the right professionals if you need any help.
Also ask HR - usually they inform the new doctors about whom to contact in induction. They can be very supportive in directing you to the right people.
Here are some more links:
https://www.nhsemployers.org/retention-and-staff-experience/tackling-bullying-in-the-nhs
https://www.nhs.uk/conditions/stress-anxiety-depression/bullying-at-work/
https://bmjopen.bmj.com/content/3/6/e002628?
I have done all of this. This registrar is still a bully. And it is not just me, but my other colleagues who are affected.
You all should write assessments of the event, what that registrar did and then feed this back to the registrars supervisor. They are usually very good.
You can also try to talk to them face to face. However be careful and they can quickly get very angry and this can turn out to be very ugly.
I know a bully. Should I report him/her to the GMC?
No! This is a major thing. That person may have had a few difficult days at work and if (s)he is reported to the GMC, you will be asked to explain why you think this is the case. That person may even lose his/her license. This is not a small thing. This could be taken to a tribunal and you may have to be present there and then defend yourself. It can go horribly wrong.
I have issues in my ward. My fellow colleagues have the same issues. It is not just one person, it is the whole team of consultants. We have been through the Freedom to Speak up Guardian, discussed this with our supervisors who say that these consultants have caused them grief as well.
This can be very tricky. You can either "wait it out" and try to avoid any confrontation. Or consider mentioning this in a work staff survey - ie like a trainees survey, etc.
Have you ever done this?
Yes. I did this for a particular person the whole trust was sick and tired of. Later on, I found out that it not just me who did this but everyone from nurses to other consultant colleagues who did it as well. He underwent a lot of investigations and had to leave certain roles.
However I did it only because I was well supported by everyone, including my supervisors, colleagues and consultant friends.
Remember- avoid negative comments in assessment forms. I am sure you know how it feels when someone says the same about you in a typed message on a portfolio you want to be as positive as possible for your upcoming annual appraisals.
1. When we are applying for our first post as non trainees - This is from our home countries
2. When we ask our consultants to fill out competency forms- ie foundation competencies, core competencies: Usually in the NHS
3. When we are applying for core training/ trainee SHO posts in the NHS - this is usually our consultants in the NHS we have worked under in our non training post.
4. When we are applying for higher specialty training- this is usually our consultants in the NHS we have worked under in our training post.
I am going to address this issue in the form of FAQs.
REFERENCE FORMS
As a rule, you should always inform the relevant consultants that you are putting their details down as your reference BEFORE you submit the application/fill out the form. An email/face to face discussion should suffice to take permission.
Why do we need references?
This is to ensure that a particular doctor has a good record.
From our home countries
How should I choose my references?
It is usually the consultants you have worked under during your one year internship ( also called house job). They usually say nice things however if you have been a victim of ward politics ( which can be quite common back home) then avoid that particular consultant. As we rotate in 4 different specialties, we have a few consultants to choose from - there are atleast 2 to 3 consultants in each specialty.
Can I ask registrars or assistant professors fill out a particular form?
It depends on what the form is about. It should be clearly mentioned in the forms guidance therefore read it carefully.
In the NHS:
How should I choose my references?
It is usually your supervisor (education and/or clinical) and any other consultant whom you have worked with. This may be an acute medical consultant, a consultant in a different specialty who was frequently on call with you and saw the patients you post taked or any consultant who knows you from the usual wards you have worked in.
How would I know if they would say something nice or negative?
Usually if consultants are happy with your progress, they usually ask you what your plans are. And then offer that they will be more than happy to be your references when you need any assistance. These are the people who will never say anything negative about you.
However, some people do not say nice things so always ask your colleagues ( trainee SHOs, registrars) if it would be reasonable to talk to that consultant if (s)he would be happy to sign any referee forms. Trainees are always getting their assessments signed off and therefore know which ones are good and which ones you should avoid. There are very few we need to avoid ( personally I have never come across any consultants like that but there have been instances when they have not been very supportive).
Can I see the reference form they fill?
No. It is supposed to be confidential.
I have got a bad reference from one of the consultants and my new employer has informed me about it.
Ask your employer if they will consider an alternative reference and find a consultant who knows you well and will say something positive.
Also take this opportunity to meet the consultant who gave a bad reference ( if you have been given any details) and ask politely what you did wrong and how you can improve yourself. Also, please do not ask that consultant to fill out any more forms for you.
ASSESSMENT FORMS
I have an e portfolio. Whom can I send assessments to?
In general,
MSF: Any healthcare professional from ward clerks, HCAs, OT, PT, FY1s, SHOs, registrars and consultants.
Mini CEX: clinical examination forms- Registrars and consultants.
DOPS - Procedure observation forms - Registrars and consultants. Some specialty nurses can sign it off as well, like cardiac nurses for elective cardioversions.
CBDs: Case based discussions - Registrars and consultants.
ACATs- acute assessment forms. You should have seen at least 5 patients who have then been seen by a consultant. This can be during one shift or over a span of a few shifts.
Consultants fill these forms.
Teaching assessment forms - Consultants or registrars who have observed you do a teaching session.
How do I know whom to send forms to?
You can judge this on the basis of the relationship a particular person has with you.
For example, you would not want to send a form to a ward clerk who hates you for taking her pens from her drawer. Or a consultant who did not like your management plan/ has suggested that you do not work efficiently face to face.
How should I ask people to fill out assessment forms?
By being human - Ie asking them nicely. Most will do them within a week.
I got a horrible assessment by a person. (S)he ticked unsatisfactory in all domains.
This is the worst part of e portfolios. The tick boxes can be confusing sometimes and if all of your other assessments are fine, ignore this one. Usually your consultant puts a note in like " this is an error as the other assessments are satisfactory"
I actually got a negative assessment from a person and his/her comments were quite negative.
It is best to talk to your supervisor about this first and see how to take things from there. These consultants usually know everyone can sometimes assure you by saying things like " Oh, I know that person. (S)he is always like that and other trainees have the same issue".
I had a word with my supervisor and this is not the case. That person always gives nice comments.
Usually they all say nice things but in order to balance things out, they might say " I would want this doctor to work more on his/her leadership skills/ go down to resus more" which is not negative in a way, but actually genuine feedback you should work on.
Usually they all say nice things but in order to balance things out, they might say " I would want this doctor to work more on his/her leadership skills/ go down to resus more" which is not negative in a way, but actually genuine feedback you should work on.
The person actually said horrible things in the comments section.
If your other assessments are nice, I would ignore that if I were you. However if you feel like you need to find more about this in order to improve yourself and the solution/problem identified is not clearly mentioned in the assessment form then you could talk to that person directly in a non confrontational way.
Have you ever got bad assessments?
Yes. And I chose to ignore them as overall, my assessments were fine and I worked on the negative points mentioned in the assessment form.
Is this a fair way?
No, not at all. I honestly believe that if you are struggling, the assessor meets you face to face and informs you that you need to work on certain things and also assures you that you are doing well and many doctors like you have had the same struggles. Then (s)he suggests that you should work on these and then send him/her an assessment form.
This way, you are:
1. Fedback in a non official way about the things you need to work on .
2. You are given a chance to work on them.
3. You are given the opportunity of sending an assessment form again.
I have been asked to fill an assessment form. Should I say negative comments?
No. Always be nice. If you do not have anything nice to say, just tick " satisfactory" rather than "below average" or "outstanding".
Remember these e-assessments remain with us throughout our lives and that person may be having one bad day when you were an unfortunate witness/victim of his/her behavior.
There is a registrar who is a bully. He has asked me to fill out his assessment form.
Forget the assessment form - sort out the bullying.
Unfortunately, not a lot of people are aware of systems which have been put in place to speak up.
One such system is "Freedom to Speak up".
This is what this is about:
https://improvement.nhs.uk/resources/freedom-to-speak-up-whistleblowing-policy-for-the-nhs/
Read about it in detail.
Find out who your Freedom to Speak up Guardian is (Talk to your HR if you do not know). If you have any concerns, raise them with that Guardian so that the bully is fed back about what (s)he has done (anonymously).
If anyone else has been through any issues (and resolved them successfully), please mention them here (without mentioning the trusts or the professionals involved) so that people who are struggling know what to do.
People who can support you are:
1. Your supervisor
2. Your colleagues ( The doctors mess is an amazing place to vent out- just be careful whom you vent out to. That SHO may be in a relationship with the consultant/registrar you are moaning about )
3. Freedom to speak up Guardian
4. Chief registrar (if your trust has one).
5. Occupational health if you feel you are going through a lot of stress - they can direct you to the right professionals if you need any help.
Also ask HR - usually they inform the new doctors about whom to contact in induction. They can be very supportive in directing you to the right people.
Here are some more links:
https://www.nhsemployers.org/retention-and-staff-experience/tackling-bullying-in-the-nhs
https://www.nhs.uk/conditions/stress-anxiety-depression/bullying-at-work/
https://bmjopen.bmj.com/content/3/6/e002628?
I have done all of this. This registrar is still a bully. And it is not just me, but my other colleagues who are affected.
You all should write assessments of the event, what that registrar did and then feed this back to the registrars supervisor. They are usually very good.
You can also try to talk to them face to face. However be careful and they can quickly get very angry and this can turn out to be very ugly.
I know a bully. Should I report him/her to the GMC?
No! This is a major thing. That person may have had a few difficult days at work and if (s)he is reported to the GMC, you will be asked to explain why you think this is the case. That person may even lose his/her license. This is not a small thing. This could be taken to a tribunal and you may have to be present there and then defend yourself. It can go horribly wrong.
I have issues in my ward. My fellow colleagues have the same issues. It is not just one person, it is the whole team of consultants. We have been through the Freedom to Speak up Guardian, discussed this with our supervisors who say that these consultants have caused them grief as well.
This can be very tricky. You can either "wait it out" and try to avoid any confrontation. Or consider mentioning this in a work staff survey - ie like a trainees survey, etc.
Have you ever done this?
Yes. I did this for a particular person the whole trust was sick and tired of. Later on, I found out that it not just me who did this but everyone from nurses to other consultant colleagues who did it as well. He underwent a lot of investigations and had to leave certain roles.
However I did it only because I was well supported by everyone, including my supervisors, colleagues and consultant friends.
Remember- avoid negative comments in assessment forms. I am sure you know how it feels when someone says the same about you in a typed message on a portfolio you want to be as positive as possible for your upcoming annual appraisals.
Be human when it comes to giving feedback- do it face to face instead of behind a computer screen. However never ever compromise on patient safety. The aforementioned channels ( on the bullying post) are the best way to deal with such things. This is why they have been put in. However always talk to your supervisor when it doubt.
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