Volume 8, No. 2: Section 7

THE PHYSICIAN EXECUTIVE’S COACH ON
Acing The Interview: The Hourglass Is a Clue To The Five Parts To a Well-Framed Answer

I have found that applicants can often anticipate many of the questions that they will get when interviewing for leadership positions in Academic Medical Centers. A good way to prepare is to construct a list of these questions (build your list by inviting a colleague, other ELUMs or your coach to ‘submit’ their questions to you) and then prepare bulleted answers to each. Rehearsing responses with a spouse, colleague or coach will make you more comfortable with the process.

But here’s an additional strategy to consider. Most interview questions (at least the opening ones) are rather broad in scope. You have an opportunity with broad questions to ‘take control’ of the process and feel more comfortable about your answers. That is, reframe the question in such a way that you are able to include in your answer topics about which you are knowledgeable or experienced and examples that highlight your successful performance. I am not talking about giving a ‘politician’s answer’, one that does not address the question. I am talking about capitalizing on your strengths and taking control.

There are five parts to the process. I think of it as an hourglass … broad at the top (start) and bottom (end) and narrow in the middle.

• First , restate the question in light of what is happening across the field.
• Second , reframe the question to narrow it to your own institution.
• Third , narrow it further with an example of something you have personally done in the area. If you have not personally handled this area, speak about what was done at your own institution and make a responsible attempt to connect yourself to the process or the outcome.
• Fourth , broaden it out further in the context of what is/may be needed at the institution at which you are interviewing.
• Fifth , broaden it still further by speaking to its global importance and then close by looking for (and even asking for) affirmation that your answer was responsive to the question.

Example

Question: We’re very concerned about the status of our Medical Student Curriculum, which hasn’t changed substantially in 20 years. What would you do about this if you were to come here as Dean?

Answer:

Part One (Broad Response – what is happening across the field): All medical schools are confronted with the challenge to make their curriculum relevant and competitive. We are all faced with ever increasing amounts of information competing for a finite amount of student contact time. Our students today expect universal access to the content, often in multiple media formats that are accessible 24/7. Not only must we all invest in an expanded and up-to-date content, but also in the technology to deliver it.

Part Two : (Reframe and apply the question to your own institution): Early in my career I was very involved in the curriculum process, but it has been some time since I took on additional responsibilities and passed this curricular responsibility on to others.

At my current institution we have a team of faculty assembled to address ‘The Next Curriculum”. Though not on this committee, I am aware of its activities and have attended a number of their briefing sessions. I have worked with others in my discipline on the content for our courses. Further, I am on the Capital Planning Committee at our school and have been involved in discussions concerning the considerable investment required in hardware and software to mount and deliver the New Curriculum.

Part Three: (Narrow the response further with a specific example of your work or effort which connects to the question):  I served on the site visit committee for two LCME accreditations, and I took a particular interest in this issue. LCME takes this subject very seriously. One of the schools we visited was cited for not having a plan to revamp its out-of-date curriculum in a timely fashion. The other school was well along in its development.

From this experience I learned a great deal about how the LCME looks at issues … not only what to do, but also what not to do. I returned to my own institution and shared with the Dean and the Chair of our Curriculum Committee the need for a well-developed plan of action and a demonstration of real progress … our own LCME re-accreditation is coming up in another 18 months. I think that my comments got our Committee moving at a more deliberate pace and we are going to be OK.

Part Four : (Start broadening answer out to what may work at this institution): In preparation for my first interviews here, I spent considerable time looking at the materials that were provided to me and also at your website. I came to these interviews with some questions about where you are in developing the next generation curriculum. It appeared to me that this is something that is going to need considerable attention.

It wouldn’t be appropriate at this time for me to critique the curriculum per se or the process you are using to review and renew it. Based on your question, this is something that I, as Dean, will look at very closely and address appropriately. [Time for your answer up to this point: 3.5 minutes]

Maybe it would be appropriate for me to comment on how I would go about organizing and conducting such a review? (Looks for consent to proceed … gets it … continues)

• I am going to make some assumptions here, which is always risky when one doesn’t have the full picture. Please be assured that first I would assemble the curriculum leaders … I’d invite student input as well as involvement of our IT team  … to brief me on how the curriculum is viewed as well as the status of the current curriculum change process. I’d have our LCME liaison/coordinator … You do have someone on staff who is an expert in the LCME’s requirements and coordinates the preparation of materials for your submission and site visit, don’t you? … address the new standards so we are sure that we are working toward a known benchmark. After all, LCME accreditation is not only an essential ingredient in documenting our excellence … without it there is no medical school!  
• With our assessment in hand… where we are and where we need to be… we’d:
• Develop an Action Plan that will produce the intended outcome in the prescribed timeframe;
• I’d assign leadership responsibility and authority to those qualified and capable of handling this important task … and I’d free them of other responsibilities sufficient to assure that they have the time and energy to do a credible job on this project … I’ve found too often that we give tasks like this to people whose plate is already full and expect them to take it on and let nothing else be impacted … that just isn’t reasonable.
• We need to create a timeline for execution …  working backwards from our planned implementation date to the present, with periods of time in there for evaluation and as a contingency for slippage. If we have a LCME accreditation survey scheduled before we can reasonably complete and implement the new curriculum, I’d make sure that we demonstrate that we have not only a well developed plan but that we’ve made real progress toward its implementation.
• I’d expect my leadership team to develop and present to me a list of resources that are needed to execute the plan in the timeframe … I, as Dean, am responsible to assemble and provide the resources needed.
• And finally, I’d ask the team to propose interim review dates so that I can be assured that as things progress we are on schedule and on track. These interim reviews serve as opportunities for us to reset our compass, verify the sufficiency of resources and affirm our commitment to a successful execution of our plan.

This is just a brief overview of how I would go about addressing this very real concern. If I am the designated candidate for Dean, I will go into more depth in my discussions with the Provost. Before I do that, I would need to have a better understanding of the current state of affairs and the current plan of action. To do that I would ask to meet with the curriculum leaders as I do not wish to prejudge what has or has not yet been planned and accomplished.

Part Five : (Broaden further by linking to global importance and close by checking if the question was answered):  Curriculum is just one part of what makes an excellent academic program that will attract the caliber of medical student that we seek. We’ve got to address other issues that are also likely to be of concern here at the ABC Medical School. I would expect that you, like most medical schools, are also challenged by related issues, such as faculty participation in the teaching process and medical student admissions, balancing competing demands of faculty concerning academic productivity and clinical service, honoring commitments of protected time in order to allow for preparation of research grants and of manuscripts for publication …. I could go on but maybe I’ve sufficiently covered your question and we should move to another topic … unless you want to pursue this further, which I’d be happy to do. [Time for your answer up to this point: A total of 7 minutes]

Conclusion

This example reflects one of many ways to respond and is intended to give you something to think about as you prepare for interviews. Each individual will adapt this ‘hourglass’ concept to fit her or his own style. Managing the process is important so that you are able to:

• Frame the question in a way that your answer responds to it;
• Show you understand the breadth and importance of the subject, and your knowledge about it and closely related areas;
• Demonstrate how you organize not only your thoughts but also your process of responsively dealing with and acting on complex issues, including the involvement of others and the need to hold them accountable, the establishment of meaningful timelines, the assignment of resources sufficient to get the job done, etc.
• Deliver your answer in a timely fashion …3.5 minutes for the first part and another 3.5 minutes for the second part (if permitted or encouraged to expand further) is about the right amount of time for such a question in a 60-90 minute interview session.

In the next SELAM newsletter I will ‘dissect’ our candidate’s response and demonstrate how her words and phrases communicate much more about herself then a simple answer to the question would convey.

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