Interviewing Forms

Candidate Visit Checklist

Candidate name: _____________________________________________
Spouse Name:_________________________ Attending?  Yes  No
Arrival Date ________________________ Departure Date __________
Other family members to visit? Yes    No
Key contact(s) during visit
Administrator Others____________________________________________
Physician(s) __________________________________________________
Preferred realtor _____________________Contacted Yes___ No___

Key physicians to attend during visit

__________________________________ Breakfast Lunch Dinner

__________________________________ Breakfast Lunch Dinner

__________________________________ Breakfast Lunch Dinner

__________________________________ Breakfast Lunch Dinner

Travel reservations

Confirmed scheduled - air/car/other
Plans confirmed Physicians notified
Special arrangements: babysitter needed, special diets confirmed
Rental car reservations confirmed 


Hotel confirmation # _____ Direct bill confirmation ___
Spouse’s interests/requests/needs
Gift basket orders/delivery instructions

Related Activities

Clinic/Hospital tours by?
Spouse to attend tours Yes ___ No ___
Physicians available to meet on tour
Staff notified for lunch meet and greet; who to attend?
Who to distribute candidate CV to before visit?
Wrap-up scheduled (who/when)?
Itinerary Development: Be sure to include names, titles of all candidate dinner/lunch companions physicians names as well as key telephone numbers in case of travel complications. Also a well structured itinerary will have scheduled rest times, event start and end times, a map of area should be sent with itinerary along with directions provided to functions.

Interview Process Step-by-Step

How To Make Interviews Productive

Plan ahead! A well thought out written itinerary and planned activities are necessary.

Begin with a good meet and greet session, tour of the town, medical facilities, industrial and recreational areas. Arrange a luncheon or dinner meeting and if possible, have some community leaders along with other physicians attend.

Individuals you should consider inviting to a luncheon or dinner are those who would be in positions to assist or advise in matters such as: financing for housing or equipment, office space and personnel (if applicable), banking, real estate, accounting and law. Allow down time for the candidate. Interviewing is exhausting. The physician and spouse/significant other need some time blocked out between the end of the interviews and any evening social event. Allow up to two hours, if possible, so that they still have time for a shower and brief rest if the schedule runs over.

Describe the Dress Code for the visit and any social function. Avoid vague terms such as “casual.” Describe what members of your committee typically would wear to that restaurant or function.
With prior knowledge of interests, hobbies, etc., you may do well by considering a little get-together with a few members of the community who have similar interests. Alcohol should only be consumed with candidates you are sure will not find it objectionable.

The physician's spouse/significant other is a VIP and her/his being sold on area is more than critical. Underestimating the spouse's/significant other’s importance usually means disaster. Plan activities for the spouse/significant other while the physician is in professional conferences, etc. Recruit the spouse the rest will follow.

There are dual objectives of critiquing candidates while selling them on the opportunity. Do your utmost to impress upon the physician, the friendliness and helpfulness of your community and it's need for his/her professional services while you are asking questions to make your recommendation on their candidacy.

A candidate physician also needs to have some free time, to gather together thoughts, independently and relax a little.

Individuals, whom the physician wants to meet need to schedule enough time to focus on the candidate. Rushed meetings or meetings interrupted with other business do more harm than good.
Get your Hospital board and its physician recruitment committee involved. If your board does not have a physician recruitment committee, create one.

Schedule time during the interview to review and explain the contract. Take a straw poll and if appropriate, provide a sample contract for the candidate to take home. This is the perfect scenario to lay out your expectations to the candidate that if they are interested they need to get their legal review performed prior to receiving a formal offer.
Follow-up by telephone in five to seven days.

Upon receiving positive feedback and continuing interest from the physician, immediately schedule a 2nd visit.

Prior to 2nd visit insist that the candidate have the contract reviewed by their council. Get their questions and concerns ahead of visit and address them face to face during 2nd visit.  Formal offer should only be made with candidate’s contract issues already addressed and sent with a cover letter stating the length of time offer is good for.

Best Practices: Pay Attention to Every Detail during Site Visit

Personal greeting at airport (if feasible)
Best possible hotel or bed & breakfast
Hotel room amenities: - flowers - coffee, tea, soft drinks, juice - gourmet food basket, snacks for Children - Inexpensive, appropriate gift wrapped toys to occupy young children during visit
Comfortable rental car to make most of free time to explore community
Provision of professional babysitter for day/evening functions

Physician Interview Questions

Can you tell me a little about yourself?
Why did you choose to become a Physician?
What is your current Board Certification Status?
What is your plan regarding future Certification?
Why did you choose to specialize in ______________?
What do you like most about being a ______________?
What do you like least about being a _______________?
Would you tell me about a particularly difficult case and how you were able to handle it successfully?
What do you think your strengths as a physician are?
What areas do you think you need to improve on?
How important is money to you?
How important is academia?
What is your ideal practice situation?
What are your hobbies or areas of interest outside of medicine?
What do you think your peers would say about you?
What do you think the ancillary support staff would say about you?
Why should someone hire you?
Ideally how many hours per week do you see yourself wanting to work?
If you joined my practice what would your goal be within the first year?
What would your goal be in five years?
When would you like to retire?

Reference Statement

Candidate Name:_______________________
Reference Source: ______________________
How long have you known Dr. ______________
What has been your association with him/her?
How closely have you worked with him/her?
Do you directly observe him/her?
Do you know him/her on a personal or social level?


What is your assessment of Dr. _________________’s medical knowledge?
How would you evaluate his/her general clinical skills?
How would you assess Dr. _______________’s level of self confidence?
In what surgical/procedural skills is the doctor proficient?
How would you describe his/her work ethic or habits?
How does s/he respond to constructive criticism?
Have you noticed any weaknesses in him/her?
Overall, what are Dr. __________’s greatest strengths?
How solid is his/her knowledge base?
Has s/he experienced any problems or delays in academic testing?
Does s/he keep up-to-date through journals and other current sources?
Does s/he participate in CME courses?
What is her/her ability to apply theoretical knowledge?
How would you assess his/her diagnostic abilities?
Are his/her treatment plans appropriate?
Have you seen an increase in his/her confidence during residency?
Is his/her confidence now at an appropriate level?
Have you known him/her to attempt any procedures beyond what is warranted at this training stage?
Do they refer appropriately?
Are they realistic about his/her limitations?
What volume of high-risk work does he/she do?
What type of cases do they usually refer out?
What surgical procedures have you observed him/her perform?
What volume of surgeries/procedures has s/he done?
What is his/her demeanor in the OR/ER? How does s/he treat the OR/ER staff?
Does s/he have “good hands”?
Have his/her surgical outcomes been satisfactory?
Are his/her OR.ER reports completed in a timely manner?
Are they punctual?
How are his/her time management skills?
Of what volume of work is s/he capable?
Does s/he stay until the work is done?
Is his/her charting complete and timely?
Do you ever have difficulty finding/reaching him/her?
Is s/he defensive or antagonistic?
Is s/he responsive to suggestions? Does s/he apply what s/he has heard?

Or for practicing physician

How would you evaluate the quality of medicine they practices?
Are they respected in the medical community?
How successful is his/her current practice?
Has s/he been counseled about this?
Have they shown improvement?
What are his/her greatest professional strengths?
What are his/her greatest personal strengths?


How does s/he interact/communicate with other physicians?
How is his/her relationship with ancillary staff?
Is s/he a team player?
What kind of rapport is Dr._____________ able to establish with patients?
How would you describe Dr. _____________’s personality?
How appropriate is his/her professional appearance?
Are there any circumstances in his/her personal life that will have an adverse effect on his/her ability to concentrate on a practice?
How are his/her relationships with faculty and /or attendings? With fellows, residents, and interns? With medical students?
Are they responsive to physicians who refer to them?
Is she/he respected by the nurses?
Is she/he respectful toward others?
Have there been any problems between Dr. ____________ and any other staff members?
How well does she/he handle stressful situations?
Is she/he cooperative? Is she/he flexible?
Have you directly observed him/her with patients?
What kind of feedback have you received from your patients when they haven been seen
Is she/he sensitive to the needs and concerns of patients’ families?
Do you see him/her as a practice builder?
Apart from being a physician, what kind of person is s/he?
Are they well-rounded? Does s/he have interests outside of medicine?
Does s/he have sense of humor? Is s/he an enjoyable associate?
What kind of impression do you think s/he will make on an interview?
What kind of professional image does s/he project?
Is there anything surprising in his/her appearance?
Have you ever been present at a social event which s/he attended? Was his/her dress and behavior acceptable?
Does s/he have a stable home life? A supportive family environment?


Has s/he ever had privileges revoked or suspended, either voluntarily or involuntarily?
Has s/he ever been called before a disciplinary committee or a peer review group?
Has s/he had any malpractice suits?
Does s/he have any current problems with illegal substance abuse?


Would you feel comfortable having him/her treat a member of your family?
In theory. Is this a physician with whom you would want tot be associate?
How does s/he compare with other you have trained?
What kind of practice would best suit Dr.______________?
Would you want your name on the same door as his/hers?


Reference taken by: ________________________Date: ____________________

Sample Itinerary

TO: Dr. and Mrs. Smith

FROM: Roger Jones, MD

Practice Name: Outstanding Practice Name

SUBJECT: Site Visit: Saturday, Sept 6, 20XX to Monday, Sept 8, 20XX

Following is the proposed itinerary for your visit to (facility name & town).

Sunday, September 6, 20XX

Fly into XXX on XX Airline, departing XXX at ____ and arriving in ____ at XXX.

DIRECTIONS: Your hotel reservation is at the XXX (name of hotel). Address: of hotel. Directions to hotel: (Example: Take I-76 East from airport. You will exit from the interstate at Exit #80. At bottom of exit ramp, drive south (right-hand turn) onto Main Street.  You will drive one block. Hotel will be on your left and is to the south of McDonald’s). I have made reservations for you as our guest Sunday, Monday, and Tuesday evenings. Please feel free to relax as tomorrow will be a busy day. I would be happy to send you movie tickets or passes to the local health club, if you wish. Just let me know by calling and leaving a message.

Saturday, September 7, 20XX

9:00 a.m. Meet with XXX for a hospital tour. From hotel, drive east on XXX Avenue
for approximately three blocks. The hospital parking lot will be on your right. Park where you wish and enter through the main doors of the hospital. The hospital’s main entrance is adjacent to the parking lot. Have the receptionist page me and I will come down and greet you.

10:00 a.m. Community tour with XXX of YYY Realty.

12:00 p.m. Lunch at XXX, with administration and medical staff.

2:00 p.m. – 4:00 p.m. Meet with XXX, CEO, to answer your questions and review the physician relocation package.

4:00 p.m. – 6:00 p.m. Time to relax and unwind after a busy day!

6:00 p.m. – 8:00 p.m. Reception at the Country Club. I will meet you at your hotel and lead you to the facility.


Free time to explore area with your family.


Fly back to XXX on XXX Airlines, leaving at XXX a.m./p.m.

** We have reserved a car through XXX Car Rental in your name. They will need to see your driver’s license and credit card but will direct bill the hospital.

Note: I have included maps of the area as well as other community information. If you have any questions, please call me at XXX-XXX-XXXX. We look forward to your visit to our hospital and community.


Spouse Questionnaire

We are delighted that you will be visiting our area. In order for us to prepare for your visit, please complete this brief survey and return to my attention. Again, we look forward to seeing you soon!

1. Do you have career/job objectives or requirements?
2. Would you be interested in continuing your education?
3. Would you like information sent by our area schools, colleges, and universities? If yes, please explain your area of interest.
4. During your visit, would you like to tour local campuses?
5. Is children’s daycare of interest to you?
6. Are you interested in touring local or private schools? If so, what age levels?
7. Do you need further information on the following:-advanced placement YES NO-gifted student programs YES NO-special education classes YES NO-other school programs YES NO
8. Which of the following is your housing preference regarding the setting?___ subdivision ___ apartment___ rental home ___ country
9. Which of the following style of home do you prefer?___ modern ___ traditional ___
both other ___________________________________________
10. Would you like information on any particular places of worship or to tour a specific one while visiting?
11. Would you like to tour or receive additional information about our theaters and cultural activities?
12. What recreational activities or hobbies do you enjoy?
13. Please tell us about other areas of interest or concerns you may have such as: the cost of living, taxes, drive time to larger cities, quality of life, community organizations, or any other areas.