After all references are checked...

Just because they have called your references doesn't mean they have completed a reference check. A full reference check usually involves a background check and possibly a credit report. If HR outsources their background checks then it likely takes some time to get the full report back. Since the hospital has to pay for this service, it's possible that they call the references of all applicants, but only do background checks on those they are seriously considering.

Things can change in a minute in these situations. The manager may have thought they were done interviewing, but then had a few more applicants surface that looked really promising. There might have been an internal applicant or an applicant related to someone at the hospital that had to be interviewed. There's no set rule that references are only checked after interviewing is done, so the person from HR might have been mistaken about how the hiring manager likes to operate.

It wouldn't hurt to send a polite follow-up email to the manager reiterating your interest and asking when you should expect a final decision. But there's no reason for HR to be misleading, and if they said interviews are still being conducted, that's likely the reply you'll get from the manager as well.

It wouldn't hurt to send a polite follow-up email to the manager reiterating your interest and asking when you should expect a final decision. But there's no reason for HR to be misleading, and if they said interviews are still being conducted, that's likely the reply you'll get from the manager as well.

Thanks, I actually did email the manager, she says she is still working on the positions. There is some hangup with the positions, because only one is approved thus far, and I know she was working on making two positions. I actually have a friend that works in HR (at a different place), and she says it isn't uncommon to give a canned response like that when they aren't at liberty to say anything else. But still I am not holding my breath, as much as I'd like to, because obviously its not a sure thing in any way. thanks for the input.