Final-year residents: Are you up to speed with your job search?

It's been a life-changing journey through medical school and graduate medical education. Now in your final year of residency or fellowship, you can see the light of full-time practice around the corner. Here is some expert advice on how to approach the physician job search process.

Eileen Curl is principal for physician search at Avoca Search, a recruiting firm headquartered in St. Louis. In an interview with the AMA, she offered insight on what residents and fellows entering the physician job market for the first time should expect. Although the timing of a job search is going to vary by physician specialty and other factors, the actual process essentially breaks down to four steps. 

You should be doing this throughout your training, particularly if you have a narrow or specific geographical preference. Curl said she is working with residents and fellows who are reaching out to practices years before they enter the job market to determine the setting—private practice, academic, etc.—that might best suit their professional interests. 

You’re going to want to do some of your own research. The AMA offers a number of tools and resources that can help you map your future as a physician, including offering insight on employment contracts and a list of positions from employers around the U.S. and beyond. Your peers and attending physicians can also provide some insight as you begin to plan your career path.

When you know the specifics of your career plan, Curl recommends exploring networking opportunities within your specialty for possible job leads. 

“Specialty societies and associations  typically have a career center or job board. This is the best place to start your search, as most organizations will post openings on the respective  specialty society,” she said. “You will also find excellent networking opportunities at the society and association conventions. Whether through formal career fairs or informal meetings, many prospective employers are available to connect with you.” 

You may also need to submit an employment application online, though this is more common for academic institutions  and a prerequisite in order to be considered. Not all health care organizations require it.

Also, don’t be shy about using social media to locate and then inquire about job opportunities.

“Physicians have historically been less likely to use social media in their job search, but I believe this trend is changing,” Curl noted.

Dive deeper:

• Should you expect a signing bonus in your first job after residency?
• 4 keys for a physician’s first employment contract
• What I wish I knew in residency about being an employed physician
• In transition to practice, know these 8 steps for evaluating jobs

Once you’ve identified an opportunity of interest, you’ll likely go through a number of phone or videoconference interviews. Typically, you will first speak with a representative of the hiring organization. After that, if there’s mutual interest, a call with a lead physician or primary decision-maker will often be arranged. These conversations precede the in-person interview.

But don’t be lulled into complacency by early interviews, Curl warned.

“I do think the younger generation of candidates view the interview process a little too informally,” she said. “When you go on an onsite interview, you're going to wear a suit. The same etiquette needs to be observed during any video interview. Many resources are available offering candidates preparation tips for video conferencing.”

The number of health care organizations you may choose to visit for on-site meetings will vary based on how specific you are with respect to your geographic preference and practice setting. 

“On-site interviews typically span multiple days,” Curl said. “We try to schedule them over a long weekend to allow for travel time, time spent seeing the facility and clinic in operation, meeting prospective colleagues, talking with administration, and exploring the community. We strongly recommend bringing your significant other, as they play an important role in your final decision and will impact your decision to accept an offer or return for another visit.”

You will want to have your professional references lined up in advance, so that the process is not delayed in any way when you find that “right fit” and the organization of choice is considering extending an offer. 

Offers can come while you’re still interviewing, and they may have a deadline. For that reason, it makes sense to know what is most important to you in terms of practice setting and lifestyle, so the focus of any potential negotiations can revolve around compensation package and benefits. 

As far as the actual format of an offer, it can come in many forms. Some employers send offer letters or term sheets, while others send the full contract. Today, Curl said, most contracts are standard contracts signed by all physicians within the group or organization, so they are rarely amenable to significant edits or revisions. 

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“If you wish to have an attorney review the document to help you better understand the terms, I’d recommend you choose a health care attorney who is familiar with physician contracts,” Curl said.

This advice was echoed by Elizabeth A. Snelson, president of Legal Counsel for the Medical Staff PLLC, which specializes in working with medical staffs, medical societies and medical staff professionals.

“I can't tell you how many very smart, very well-read, highly educated physicians sign a contract that says horrible stuff, and they just don't understand that it's horrible,” Snelson said. “This is a new age in the practice of medicine.”

Snelson is the author of the AMA Physicians’ Guide to Hospital Employment Contracts (PDF), free for AMA members, which provides expert guidance to physicians contemplating, entering into or working under employment contracts with hospitals or related entities.

“Or they think they talked about it with the employer and it will all work out. They don't understand that it doesn't matter what you talked about—the only thing that matters, legally, is the contract. A jury will look at this incredibly overeducated human and think, ‘How could you not know? It's right there on paper!’"

Attorneys may also have insights on the local market or a prospective employer’s negotiating style or workplace culture. They also might have access to costly salary surveys that aren’t practical for employment candidates to obtain. One way to find a specialist lawyer is to contact your state medical society.

Once you find the right lawyer, remember to remain hands-on, Curl recommended.

“Make sure to give that attorney a deadline and keep an open dialogue with your prospective employer,” she said. “An employer  wants to negotiate with you, not your attorney.”