The Health August 2021 | Page 22

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THE HEALTH | AUGUST , 2021

| Column |

Let ’ s try to do it right

The process of writing recommendation letters has legal consequences and ramifications in a variety of fields

function together .
For me , I threw this behind and moved forward simply because I believe that God chooses the best for us and our decree in life was written before our birth . I just relax and try to enjoy my life .
BY DR WAEL MY MOHAMED

NONE of us in academia will be where we are now without the assistance of recommendation letters . As a result , most of us in turn feel obligated to write letters for students who need them .

We do so with the understanding that exaggeration of the content of such letters is standard practise . However , we are not obliged to write letters merely because they are requested of us .
Without going into too much detail , the process of writing recommendation letters has legal consequences and ramifications in a variety of fields . It is important to note , that if a pushy student or colleague attempts to dominate the process , the main decision is yours to make .
This includes whether or not to write the letter , the dual responsibilities to the student and the letter evaluators , and whether or not to show the letter to the student .
I once prepared a letter for a student who applied to graduate school under my own school programme , but only after the student continuously refused to accept no for an answer . The decisive aspect in my choice to write a negative remark is my loyalty to our programme .
Gatekeeping is always far less serious than transmitting clear , legitimate queries , but it always involves some sort of a mental boxing fight while you make up your allegiance most .
The deeper one ’ s relationship with people receiving the assessment , the more compelled the writer will feel to serve as gatekeeper . Perhaps the most ethical principle is this : If you criticise with the purpose of elevating the profession ’ s expectations , you should make that goal clear in the message while also refraining from criticising in an irrelevant or overblown manner .
For me , the ideal technique for producing recommendation letters is :
“ Ask me if it ’ s time for me to write the letter and if I would be happy to write a positive letter to encourage you . I ’ d rather not write a letter of recommendation rather than a vague one .”
The need to bow out
Sometimes , the most responsible and kind thing we can do for a classmate or co-worker is to decline to write a letter of reference . Most professors tend to soften the student ’ s opposition to this idea by implying that they are too distracted , that they don ’ t know what to say , that someone else may have sent a more constructive message , or that they simply don ’ t know anything about the student .
Savvy students will recognise those responses as faculty code for a “ NO ,” but the more observant will provide you with a resume and a meeting or an e-mail to aid you in creating positive details for a letter ( a few have won me over by doing so ).
Furthermore , the most obnoxious and histrionic kids may feel that you are the best recommender they have and that your letter is critical to their survival . I once listed my colleague Prof X in my recommenders list during my application for an associate professor position in a private university in Egypt .
He agreed and welcomed this . We had a very good relationship , and we had a strong brotherhood bond .
Unfortunately , I was rejected from the job , and it turned out after few months he was hired for the same position in the same university . I was shocked and talked to him , but he said irrelevant things .
My best guess was he presented himself as a possible substitute for me and he betrayed me and hijacked the position for himself . This was a delicate ethical issue with a deep conflict of interest .
Emotional balance and insight
So the question is what will you do if you are in the shoes of Prof X ? If he had wanted the position , he could have declined to give me the recommendation letter to avoid losing me as a loyal colleague and a collaborator . He could then have applied for the same position and we would have had a fair game with best candidate winning . However , he played dirty and hit under the belt .
I believe that having a co-worker mate has been shown to improve interaction and efficiency . But what if you and a collaborator / colleague are both up for a promotion – or in some other competitive situation in which one of you stands to “ win ” while the other stands to “ lose ”?
First and foremost , emotional balance and insight are important . Remind yourself that this is only one of the promotions / academic positions that will come your way throughout your career . Perspective would also assist you in realising that your relationship is likely more valuable than the promotion / position .
Second , maintain a healthy sense of self-worth . In this case , our partnership has always been mutually beneficial rather than competitive . And we both had valid reasons for pursuing this job . Prof X introduced himself to the boss instead of me , and he was hired .
I was disappointed . Although I was delighted for him , my self-esteem had suffered as a result . My closest co-worker was now in a position that I desired , which meant a new awkwardness between the two of us that eventually affected our ability to
BY DR WAEL MY MOHAMED
Ask me if it ’ s time for me to write the letter and if I would be happy to write a positive letter to encourage you . I ’ d rather not write a letter of recommendation rather than a vague one .”
Ideal recommendation letter
Anyone participating in the recommendation process does not have to suffer through it . Following the ethical criteria will assist the requestor in obtaining a favourable letter of recommendation , as well as assist the writer of the letter in fulfilling his or her ethical commitments to both the requestor and the evaluator .
A recommendation letter should be : 1 ) authentic ( based on enough first-hand knowledge of the candidate ’ s talents ); 2 ) genuine ( exact ; avoid distortion or exaggeration ); and 3 ) brief . ( transparent with no omissions ); 4 ) fair ( taking into account all strengths and weaknesses ); 5 ) discrete ( avoiding unwanted or unexpected exposure ); and 6 ) have adequate information and duration ( material tailored to administrative or individual needs ); and 7 ) theoretically simple ( avoidance of unnecessary abbreviations and jargon ).
Medical referral letter
Similarly , let ’ s look at a medical referral letter which involves the transfer of a patient ’ s care from one physician or clinician to another in the course of medical practice . It entails one physician realising that a patient under his / her care requires certain knowledge or talents that another physician possesses .
An appropriate referral is an essential component of comprehensive quality health care management and should be based on a patient ’ s specific requirements . It is considered that the referring physician has the necessary diagnostic and therapeutic abilities and expertise to determine whether a referral is warranted .
The question here is whether a true medical recommendation from one medical staff to another constitutes a criminal or unethical behaviour ? When is it immoral to recommend a patient to another physician and what factors influence whether a recommendation is ethical or unethical ?
It is anticipated that a practising physician understands his / her limitations and , as a result , knows when to seek support and aid in the care of his / her patients .
This is especially true when a physician realises that such individuals rely on him / her to make the right judgments about their health issues . Also , accepting money for a patient referral is unlawful in general , and finally , no doctor should intentionally write bad referral .
In closing , I prefer to name this particular behaviour of Prof X as “ Ethical Cheating ” and this raises a significant dilemma in academia : Is it possible to be both ethical and cheat ? — The Health
Dr Wael MY Mohamed is with the Department of Basic Medical Science , Kulliyyah of Medicine , International Islamic University Malaysia ( IIUM ).