By: David Kashmer MD MBA (@DavidKashmer)
Finding your first job as a doctor is a major life decision. The choices you make now are going to have impacts, both in the short and long run, on the rest of your life. You’re at a very busy time in your life—you’re wrapping up a residency or fellowship and you’re getting ready for your boards, and on top of that, you’re about to start job hunting. Busy as you are, put some serious thought into what you want your first job to be. The more you know what you want from that job, the more efficient your hunt will be and the more likely you are to end up with the job that’s right for you.
Timing Your Job Hunt
Chances are that as you approach the end of your training, your inbox is starting to fill up with mail from recruiters and matching agencies. Some recruiters work for employment companies—they’re medical headhunters. Others work in-house for a specific hospital or group of hospitals.
It’s fun and even flattering to suddenly be getting email from people who say they want you, but don’t jump on an opportunity just because it has arrived in front of you. Save the offers that seem interesting but you don’t need to rush into interviews. Most jobs stay open for a fairly long time while the search committee looks around. Unless a job seems so perfect that you want to try to grab it right away, take your time. Don’t dawdle, however. You’ll be done in July and you’ll want to have your job lined up well before then.
If you’re finishing your residency or fellowship, you’ll start job hunting in the last three months to four months. Sometimes, if you’re a fellow in an academic Mecca, the hospital will try to retain you. You’re already there, you’re credentialed, you know the system, you’re ready to go on day one. When a physician goes to a new hospital and has to learn their coding and billing system, there’s a cost associated with that. The hospital won’t be reimbursed all it could be as that physician learns the system—it could be six months before you start bringing in significant income. That delay usually translates into several hundred thousand dollars.
Academic Centers & Salaries
However, benchmark salaries for fellows who stay on are usually much lower than what they could get in a different practice venue. At academic centers, people work very hard and their take-home revenue isn’t as high as what they’d make in another system. But because academic centers also have a lot of positives, many fellows do stay on. They’re familiar with the environment, it’s comfortable, they’re already living there, the kids are in school, their partner has a good job in the area, and so on. If you have a particular research interest that the center is supporting, that’s a good reason to stay.
If you decide to look beyond your current hospital, give yourself plenty of time to develop meaningful options before July comes around. I recommend getting started (seriously) by April or May at the latest. After all, remember that you may need four to six months of lead-time in order to get a license (and be able to work) at this new job. Do a little math: if it takes six months…
Interested in more advice about your first job hunt? Look here for more from The Hidden Curriculum: What They Don’t Teach You At Medical School.