Routes in Finding Jobs After Residency
How can a resident or fellow find great jobs after residency? I think of jobs as one of three routes. You have the money route, you have the training route, and then you have the lifestyle route. It’ll break down the three of those. And these are the three ways people can come out of training and find a great job.
Money Route
The money route means you find the job that pays you the most, including the ancillary benefits such as the signing bonus, student loan repayment, moving expenses, base salary, and productivity incentives.
All these things could add up to making the most money possible in the shortest time. It is the most crucial thing for some people coming out of training. I want to get out of training. I want to make the most amount of money I can. I want to pay off my loans. And then, after however long that takes, 3, 4, 5 years, I may move on to a better geographic location or a place that provides a better lifestyle. So, that’s the money route.
Training Route
The training route is more important for some specialties than others. Some people want to be in a position where they’ll be around the best physicians in their specialty and get the best training environment. Now, for some specialties, this isn’t going to matter. But for some surgical specialties, this is the absolute number one thing. So, for those types of people, finding an environment where they will learn as much as possible and be around brilliant physicians is significant to them.
Usually, that would be in an academic environment or one of the more well-known hospitals like Johns Hopkins Hospital or Mayo Clinic. And that could be a place where you go, learn as much as you can, soak it all up, and then after, once again, 3, 4, 5 years, you decide to go out on your own and start doing your own thing or maybe move on to a different hospital where they will pay you more. That’s the training route.
Lifestyle Route
And then the last route is the lifestyle route. You want to find a place where they’ll not always slam you. So, the call requirements are reasonable, and the hours spent will not kill you. Once again, this is specialty-dependent. But how many patients will the hospital expect you to see daily, even in primary care or pediatrics? Is it 20, which is a reasonable amount? Or is it 35 or 40, which is crazy? That’s another consideration. So, lifestyle is how much time you will have outside of work.
How to Find Great Jobs for All Three Routes
Now, let’s discuss how to find great jobs for all three.
First, the money route. If you are a physician who wants to make the most money possible, moving into a community that’s very difficult to recruit to in a rural environment will make you the most money, and it’s just a reality.
If you want to move to San Diego, Phoenix, Miami, or any warm weather location where everybody wants to live and work, you will not make the most money. If you go into rural Idaho, Alaska, or a small farm town in eastern Ohio, these communities are in dire need of physicians, which is specialty-dependent as well. These communities are grappling with the problem of how to solve the physician shortage.
They can do this through substantial signing bonuses, student loan repayment, enormous salaries, and higher productivity incentives. So, if you’re looking to make the most money possible, that’s where you need to look—in these smaller communities that are difficult to recruit, that can’t get physicians to come in. Maybe they must pay for locums, which are extraordinarily expensive for hospitals. That’s where you want to look if you want to make the most money possible.
It is also important to remember that the conventional clinical path is not the only option for physicians. There are numerous non-clinical physician jobs out there that can offer different rewards and challenges. Regardless of your route, the aim should be to find a job that fulfills your professional ambitions and fits your lifestyle and personal goals.
Now, the training route. And this is self-explanatory. Just look for any big academic institutions, or if you know of specific physicians you want to work with, reach out to those places. These are difficult to get, obviously due to several reasons. Many people want to be around other brilliant physicians; they can teach you things you can’t learn anywhere else. And there’s a lot of competition for those positions.
So, you will likely make less money than you did if you went out into private practice. But this is probably the one I don’t need to explain, how to find these jobs. And they almost always require some relationship. So, if you have no touch, don’t know anyone in the program, and didn’t train with anyone where you’re looking, these are very difficult to find. Relationships are the most important thing when finding an excellent training environment.
And lastly, the lifestyle route. And this could be anywhere, so this is very job specific, but when you’re looking for a job that will provide a better lifestyle, you need to ask the questions I’ve already asked. What are my call responsibilities? How many patients will I see day-to-day if I’m an outpatient practice? How many PAs or NPS does the employer have? Can they make your job a lot easier? How many staff are there? Am I going to have an MA? Am I going to have a scribe? Does the RN always come in and do the H & P?
How much support you have from the practice with the ancillary providers or staff will make your job a lot easier. So, these are all the questions you need to ask. Very specifically, how many patients am I supposed to see? How many days am I supposed to work? Those types of things. If you drill down, you can determine whether an organization will have a good working environment.
Another Way to Look for a Job
And then the other way that you can find out is by asking the other physicians at the practice. When you go to an interview and talk to some of the other associates or maybe new partners, ask them how you would consider your lifestyle. Do you have a good balance? Would you consider yourself overworked? These are all things that I’m shocked about. Sometimes, when I talk to someone while reviewing their contract, I say, well, when you spoke to the other physicians at the practice, what did they say about this and this and this? And they say, “oh, I didn’t ask them anything. I didn’t even think about that.”
In finding jobs after residency, yes, you must use every resource when looking for new jobs, and talking to the people there is extraordinarily important. Now, it’s doubtful that you’ll find a bunch of physicians just completely badmouthing the employer, but if you do, it’s an enormous red flag, and you need to run away as soon as possible. But talk to the people there and find out how they like working there and their lifestyle. If you can identify where you want to go and then ask the right questions, you can find a terrific job that suits your needs.
Ideal Time for a Resident to Look for a New Position
When is the ideal time for a resident to start looking for a new position after training?
It depends on several reasons. You want to start looking before you’ve completed training. Most of the time, I would find people will start to think about, all right, where do I want to go? What are some opportunities in the areas I’m interested in moving to? Then usually, right before the last year of training, they start to get serious. I would say maybe July, August, or September of their previous year of training. And that way, they have close to 10 months, something like that, to find the job, negotiate the contract, sign the agreement, prepare to move, and all that stuff.
And this is specific. I had a contract review with a physician this week. He grew up in a small community and knew he wanted to return to that community. He had an agreement with the hospital for his last year of medical school, where they would pay a training stipend through his final year of the medical school internship.
And then, in return for that, he agreed to move back to the community and start providing care for the hospital. The hospital would then forgive that amount they paid over the next five years. Thus, he was required to stay there for five years, but it allowed him to have a little extra money during training, which is always lovely since most residents don’t get paid very much.
And it secured his spot at the hospital. He was interested in moving back to be near family. It is a rare scenario. But if you’re in a situation that’s similar to that, you’re okay. I know I want to go to a community and maybe have a relationship with some providers in that area. It’s not a terrible idea to reach the hospital and say, “I’m from this town,” or maybe, “I have family here, and I want to come here and work for you. Is there anything we can do to secure the relationship before getting out of training?”
Now, the only downside is that if something happens where you cannot move or start with that employer, you will pay back whatever training stipend they paid out. So, that’s the first thing.
Ways to Find Resident Physician Jobs
And the earliest way of looking for a job is either at the very end of med school or the beginning or middle of your training when you know the place where you want to go. Now, this is different for most residents. Most residents honestly have yet to decide where they want to go. There are a couple of good places to look for jobs.
One, there will be job fairs. Different facilities will come out to wherever you’re training, and they’ll try to entice the residents to come to their facility. One way of doing it is asking the attendings or any older physicians you’re working with if they know of any positions. It frequently happens for jobs not even in the city where you’re finishing your residency. So, that’s something to keep in mind.
The second way is just getting on the internet, doing a regular job search, and looking for postings.
Another way of doing it is to be completely proactive and specifically reach out to some practices in the area where you want to move. There will only be so many opportunities in the city if you’re in a specialty. And so, just identifying these places you might be interested in and just saying, “hey, I’m going to be out of training in a year or a year and a half.” Many practices are planning so far out that they may not need a physician but will have a need in a year and a half, which may be interesting.
So, that’s a great way of doing it. There’s no downside. And there are times when someone may say, “you know what? I’m not looking for anyone, but I have a friend in town who is.” Because all of them, or at least many, know of the different people in their specialties in the cities. And so, they may have some opportunities as well.
Lastly, it would be through a recruiter. There are physician recruiters nationwide, and they source people from training and place them in organizations looking for a new physician and your specialty. You will not have to pay for a recruiter. The employer will pay a fee to the recruiting agency once they place you there, and you usually have to stay for at least a year. There is no downside to you reaching out to a physician recruiter because you’re ultimately not the one that pays any of the fees. The employer hiring you would be the one that foots that bill.
Finding the Right Job
To summarize, we have one, reaching out to a hospital, specifically if you want to move back to the area or where you grew up.
Two, ask colleagues, attendings, or any older physicians where you’re training.
Three, precisely, reaching out to different practices in your specialty in the city where you want to move.
Four, get on the internet and look for open jobs.
And then five would be working with a physician recruiter.
There are a ton of different ways to find employment. I’m always surprised when a physician says, “Oh, well, this is the first thing I found on the internet, and so this is what I want to go with. Some extraordinary differences exist in compensation, signing bonuses, productivity incentives, malpractice, and non-competes. Going for the first job you find doesn’t make sense to me. You can find better potential employment packages if you spend a little time reaching out to different areas.
Now, it’s difficult for some with no specific geographical location. That certainly opens the opportunities for you, but it can also be an overload with, how the hell am I going to pair this down when I have a hundred potential options? It would help if you did the work. I mean, I know you’re tired. It is essential because you have little free time during your training. And putting the time in to find the ideal opportunity is worth undergoing.
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