Job Hunting Tips for Medical Residents
by Tony Stajduhar
For Medical Residents, Start the Job Hunt Early, Set Realistic Priorities
It is ironic that medical residents and fellows often are the least equipped to make smart choices about their first job. Intelligent, driven, compassionate people following one of the highest callings in life, many of them put the nitty-gritty details of a job search off until the last few months of their residency.
As a result, many first jobs don’t have the staying power they should. Conventional wisdom holds that more than half of young doctors are dissatisfied with the first position they take after their medical residency and look to relocate within two years. A recent survey by our firm found a slightly lower percentage—but a significant one, nonetheless. Our survey of more than 500 physicians found that over half of them left their first job after five years, and more than half of those stayed only for one or two years. The percentages were somewhat higher for female physicians over males in each category.
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Interestingly, too, our study confirmed that, as a basis for making a decision about a first job opportunity, location is shaky ground. Physicians who spent fewer than five years at their first practice were more likely to cite location as the top priority driving their choice. In contrast, those who stayed more than 10 years at their first practice said the most important driver for their decision was not location, but the quality of the practice. There is an important lesson here for any resident on a job search.
Clearly, some approaches are better than others in bringing success to that first job choice. By incorporating a bit of forethought into the decision-making process—and by setting priorities carefully—medical residents can make great choices that last.
The best tip: Start early.
As a recruiter who has helped hundreds of young doctors find the jobs they really want, I think the best advice is to start early. Granted, medical residencies are all-consuming undertakings, leaving little time for students to consider the specifics about their first job. Here’s a tip: Invest the time in yourself and in your future.
The old saying is true: Time can be your friend or your enemy. Too often, residents wait until their final year of residency to start looking for a job. By then, confusion and panic often set in, and residents accept jobs out of necessity rather than choice. If you’re scheduled to complete your program in summer 2014, March 2013 is the ideal time to start the job hunt. Many organizations looking to hire physicians begin their search 12-18 months out. Of course, it varies by specialty and sub-specialty—some hospitals and practices start several years ahead—but 12-18 months is an industry average.
So be proactive. Smart time managers make appointments with themselves to complete critical tasks; it’s an excellent practice. Understand that you have worked hard for 28-30 years to get where you are today, and it’s a disservice to yourself to make a haphazard decision about something so important in your life.
With the number of opportunities available today, how do you keep the choices from being overwhelming? How do you rate the possibilities and narrow them down to a short list that makes the most sense for you and your family? Here are five tips to make the process easier—and to help ensure that your first job is a match that will last.
1. Step out of your comfort zone.
One reason first-position turnover is so high is that residents and fellows often make decisions based on emotional comfort. You may think you want to return to the town where you grew up or where your parents or your spouse’s parents live. Or you might be completing your residency at the University of Michigan and be thinking to yourself: “Why not stay right here in Ann Arbor and not have to relocate?”
This frame of mind might sound reasonable on the surface, but it can be full of blind spots, causing you to overlook some of the best opportunities available. You might also find that being close to immediate family sounded good at first, but over time can become claustrophobic. I call it the “Everybody Loves Raymond” syndrome, where family members become a little too close for comfort. In addition, physician jobs in university hospital towns like Ann Arbor typically fill very quickly. These communities don’t offer the safety net one might expect in terms of attractive contracts and a wide variety of choices.
2. Remove geography from the equation.
Location is often the first factor residents consider when starting a job search. As our survey confirms, it should be the last. Don’t get hung up on wanting to go someplace because it’s cool. Sure, it sounds good to think about working in a dream location—what we call a “destination job” in our business. Lake Tahoe, for example, or Denver if you love skiing. The Florida coast for sun and surf. The problem with destination jobs is that everybody else wants them, too. There are typically many physicians practicing at these locations and the cost of living can be high.
Managed care programs might be prevalent in these locations, as well, meaning contracts can be onerous and pay lower than other areas. I’m not saying you have to live in Tinytown, USA your first time out. But be cautious about spending your prime money-making years in heavily populated areas where the pay isn’t as good and the cost of living higher than many other desirable spots in the U.S. With nearly 30 years as a recruiter under my belt, I’ve traveled extensively and have seen many attractive places to live. They might not have the cache of a Denver, a Miami or other “hot” spots, but they offer many benefits. So be practical. Don’t rule out a location just because your perceptions or fear of the unknown make it seem like an unattractive choice at first glance. And be aware that a destination job away from friends and family isn’t the only way to step outside your comfort zone.
Being open to consider a variety of locations is a great quality for residents to possess when starting that all-important first job search. I’ve worked with many residents who initially wanted to focus their search only on New Jersey, for example, but were pleasantly surprised at the options they found in Pennsylvania, and ended up being extremely pleased with the position they chose there.
3. Consider your personality/practice type.
Of course, the next question to ask yourself is what type of practice is right for you. Being a hospital employee, an independent contractor, part of a multispecialty group—which do you think will be the best fit for you not just today, but two years from now? Additional questions might relate to the number of patients seen per day. What type of call will you have and what does that entail? How many days per week in the office? Are there any remote locations you need to visit? Basically, you want to know exactly what your days, nights, weeks, etc. will look like so there are no surprises. Then compare that with what you believe you will want in your practice.
Personality profiling is key here, and can make the difference between choosing a position that you think is right for you and choosing the one that really fits. First, are you more of an entrepreneur who wants to run your own practice, or do you prefer to be employed and just see patients? Do you consider yourself a people person who likes to spend more time with patients as an Internist for example, or would you be better off as a Hospitalist and taking care of what is acute in the hospital? These are all questions that can help determine your working environment. To start the ball rolling, ask family, friends and colleagues what they think your key strengths are. Above all, be honest with them and with yourself.
4. Evaluate what makes your family tick.
As a physician recruiting company, we focus 60-70% of our work on a candidate’s family needs. When you’re going about your workday and are happy in your working environment, does it really make a difference to you whether your practice or hospital is located in Florida or New Jersey? Probably not, but it does matter to your family, and that’s why their needs are an important part of the decision you ultimately make.
Let’s face it—if you come home and your spouse or significant other isn’t happy, it’s not going to be an enjoyable day no matter how much you like your work. If you can, take your spouse with you when you go to an out-of-town interview. While you’re interviewing, he or she can check out the area’s schools, services, churches or synagogues, recreation facilities and cultural life. If his or her enthusiasm matches yours at the end of your day, it’s a good sign the move should be a good fit for everyone.
5. Be realistic about money.
Contract negotiations alone are a separate article topic, but for starters, you should realistically consider your financial needs. 1) What do you actually need to get yourself going and to make sure that you and your family are comfortable (definitions vary from family to family), and 2) What would you like to make once your practice is established? If someone tells me he or she wants to make X amount their first year, and I know it’s an unrealistic amount for the market they want to work in, I help them gain a better understanding of what’s really important—for the physician and for their family.
Be sure to evaluate the practice’s growth potential, too. It might be wise to accept a lower starting salary as a trade-off for a job that holds considerable opportunities for expansion into new specialties or areas of practice. Or, you might find a practice with a great track record that indicates the need exists and should allow you to grow your practice quickly.
Also consider the local cost of living and view your salary expectations accordingly. For example, $200K in a small Midwestern town will go a lot further than the same amount in New York City. There are other perks that are offered based on the need and difficulty of recruitment that could be beneficial, such as medical school loan repayment.
6. The challenge of today’s demand
With a high demand for physicians today, and with a historical average of 6% of U.S. physicians moving annually, good job opportunities are plentiful. The downside is that the choices can be overwhelming. As a resident, you can hear of literally thousands of opportunities you might be willing to consider. How do you narrow them down to a reasonable scope? Starting early is vital, but so is being crystal clear about your own professional needs, as well as the needs of your family.
You might want to consider professional help, too. Our research shows that using a recruiter to find a first job is on the rise, and that those who do use one are likely to receive incentive bonuses much higher than those offered to physicians who find their first job by networking or word of mouth.
Above all, it’s important to remember that Utopia doesn’t exist. One rarely hears of a perfect life, perfect job, perfect marriage and perfect children. It’s best to have that fact firmly in mind when you began the job search. What is possible are great matches between physicians and opportunities that last a lifetime. Whether or not you choose to work with a recruiting firm, you can find the right match if you keep an open mind to all opportunities, ask the right questions and answer them realistically.
||Tony Stajduhar is President of the Permanent Recruitment Division of Jackson & Coker, a healthcare recruiting firm representing clients throughout the U.S. With more than 25 years at Jackson & Coker, he is a sought-after speaker for national medical associations and residency programs.
For full report statistics please click here.