All posts by dwdm2024

Doctors, time to roll up your sleeves and sign on the dotted line!

Doctor jobs, , ,

Doctor: Wow, almost February already?! Where did the time go? And already a physician in your last year of residency/fellowship. Some of your colleagues have already chosen jobs and signed contracts. Most are in the throngs of the job search.  A few stragglers haven’t begun looking.  This is peak season, and time to make your final choice is in the next couple of months.  If you are one of the fortunate doctors who has more than one contract before you, count your blessings, and pat yourself on the back for putting yourself out there and obtaining those offers.

Some people know just what they want in a job, find it, scrutinize the contract, negotiate, sign and are on their way.  Kudos to the physicians who may find themselves in that category.

In my case, I was so eager to have the job and location issue resolved, I signed a contract in the spring of my fourth year of a five year residency.  Turned out not to be the best long term job choice for me, but I did enjoy peace of mind during my last year of residency, was able to focus on details of the move that year rather than on finding a job, and enjoyed a great learning experience as a solo radiologist (thankfully, within the year I was able to add two more rads to the practice) in a beautiful location.  Ultimately, it was a great experience living and working in coastal Maine. Another potential benefit of an early decision is enjoying a signing bonus and/or stipend when you most need it: during residency.

Most doctors proceed with the job search during the last year of residency. Some proceed with hesitancy, a bit uncertain, or maybe the offers they have aren’t exactly what they anticipated.  If you find yourself in this predicament, what should you do?  Keep looking? and risk losing the offers you have? and at what point are the good jobs all taken?

At this stage in the game, if you haven’t found the ideal job on your own, this may be a good time to talk with a diligent trustworthy recruiter (make a careful choice), and find out about other options. Perhaps expand your search, geographically or otherwise.  It is not too late to find job(s) of interest, submit your CV, interview, obtain and negotiate a contract and sign, if you move swiftly to get interviews underway.  Keep in mind that if a job specifies that you have a license in a certain state, and you don’t have one there, as long as you are in good standing without any problems in your record, you should have no trouble getting a license in any state. So don’t let that deter you from applying.

On the other hand, if a job offer has been extended to you in the form of a contract, and you risk losing that offer in order to pursue other possible options, do think twice before walking away from a bird in the hand, so to speak.  Consider the current job market in your specialty.  How likely are you to receive additional offers if you let this one go?  How close to ideal is this position? Weigh all the factors that are important to you, and strongly consider all of the pros and cons before letting an offer slip away.

Keep in mind that the credentialing process can be long and laborious.  The sooner you accept a job, the sooner you can move on to the stacks of credentialing paperwork that await you, and for many, begin preparing for a big move. For some, a significant other is waiting to begin a job search in the chosen location, childcare and school applications await, not to mention finding a place to live.

Comments about your experience and how the job search process is going are welcomed!

Big City Doctors Face Most Income Pressure.

Doctor jobs, Guest Post from Doctor Employment Attorney Jim Barna, ,

Guest post from Attorney Jim Barna, specializing in physician contract negotiations and other physician related employment matters.

http://medicalemploymentlaw.com

At a recent talk I gave to radiology residents at a prominent teaching hospital in New York City, I was reminded that doctors in big cities face surprising income pressures.

You would think that for most professions, moving to a world-class city would allow you to maximize your potential income.  However, this is not the case for physicians in cities like New York City, Boston, and Washington D.C.  Here starting doctors’ salaries are $50,000-$100,000 lower than the salaries outside the urban areas.

Large cities are the places where most doctors complete their training.  Physicians may begin their education in smaller communities, but by the time their residencies are finished, they have often lived in major metropolitan areas, where they may have met their spouses, and started families.  This feeds a desire to stay in major metropolitan  cities after residency, in addition to the obvious attraction of a large city.  However, this also leads to a glut of physicians competing for a limited number of positions each year.

When there are too many physicians in a given market, it drives salaries down for the physicians in that market in a way that often appears unsustainable.  What is a new doctor to do?  One possibility is to simply accept lower salary expectations with the hope of making up the pay deficit in the future.  However, for most doctors the best answer is to widen your expectations in terms of what types of communities might be acceptable.  There are good high paying job for doctors across the United States so long as you can look beyond the largest cities on the east and west coasts; and the quality of life in these communities can rival what large cities can provide.

The Road to Becoming a Doctor: Is it worth it?

Doctor jobs,

I recall when I was an undergraduate student thinking about applying to medical school, asking a medical student, “Is it worth it?,” referring to the long hours and personal sacrifice required to succeed.  It seems a little comical to me now, knowing that the medical student really would have had very little perspective with which to answer that question.  After all, she still had years of medical school, residency, and fellowship training ahead of her before she would even have her first job in her specialty, which turned out to be ear, nose and throat surgery.

Since then, though, I have heard that question many times, as have my physician colleagues.  One fellow radiologist said he answers that question with this reply:   “In order to become a physician, you have to be willing to give up a decade of your life at a time that is in the prime of your life, typically in your 20′s.”  This is a fairly accurate statement.

Although there have been limits on hours worked put into place, limiting resident and fellows’ hours to 80 hours/week, which definitely makes a difference, that does not take into consideration countless hours of time spent at home reading, preparing for conferences, lectures, rotations and exams.  These hours are tagged onto your daily work hours, and certainly can put severe limits on your social life, especially if you start a family during the course of your training.  Working in a male dominated specialty, I admit to some jealousy at my fellow residents’ having stay-at-home wives who took care of their children and homes, so that they had only to concern themselves with work.  They were all great dads, so were very involved with their kids during their time off.  No question, though, a doctor mom married to a husband who works full time has a lot of juggling to do, during training and afterwards.  And this must be done in such a way that is not perceived by male colleagues as having any effect on availability to work. Certainly now there are a lot of men with wives working full time who find themselves in similar circumstances.

So, back to the question, is the personal sacrifice worth the end result?  The question ties into other advise that I received and have since given, and that is, don’t choose medicine for the money.  If making a lot of money and living large is your goal, business is the way to go, or law, professional sports, or a very successful acting/singing career… Although medicine can provide a good living, too, reimbursements are going down year by year.  On the other hand, there will always be a demand for doctors.

Another factor that hugely contributes to the answer to this question for each individual is the job that you choose after training and your satisfaction with that. Regardless of how much you love your specialty, thinking about extrinsic factors when choosing a job can make all the difference in terms of your long term happiness. Factors to be sure to consider, in addition to monetary compensation, benefits and long term potential, are the people with whom you will be working and the patient population you will be serving.  Will you be able to bond with your patients in some way that will make you feel appreciated? Will you look forward to joining your staff and colleagues for work each day? If you are passionate about serving patients as a physician, and enjoy studying (definitely a nerd factor here), then it is indeed likely to be worth it, and (most of) the sacrifice and learning can be enjoyable in its own right.  Whatever job you choose, dedicating yourself to being the best that you can be in that career can be a very satisfying endeavor, and in medicine, it is both satisfying and a necessary coping mechanism. If you do choose to pursue a career in medicine, probably the best advice for success, especially during the years of training, is arrive early and stay late!

Finding the right job- Doctor priorities in finding the right job

Doctor jobs, ,

You’ve spent a decade or more in the trenches learning the basics of medicine, learning your specialty, your subspecialty. You have devoted long hours to mastering your area of expertise. Looming on the horizon is the end of your formal training, the beginning of your career, the light at the end of the tunnel: your first job.

This is the goal you have been working toward since you first envisioned yourself as a doctor.  Maybe you’ve known since preschool that you wanted to be a doctor. Maybe you figured it out during your first career as an artist or a stockbroker. Regardless, you have been focused and worked hard to get to this point, and you deserve a pat on the back for making it this far.   Will the next step put you closer to your dream, or will you jump from the frying pan into the fire?

Hopefully, you are viewing this exciting turning point from some distance, perhaps a year or two from finishing your residency or fellowship. If so, you have plenty of time to consider your options, see what is out there, make choices, interview, negotiate contract(s), sign, and perhaps even enjoy a stipend and/or signing bonus during your last year of training.

Perhaps you are at the beginning of your training,  in medical school or early residency. Planning for your first job after training is like planning for retirement (and sometimes may seem about the same distance away !). The earlier you start to think about it, the better off you will be.

So, how do you begin? Where do you start? First, honestly ask yourself, “What are my priorities?”  There is no wrong answer to this question.  The answer, however, can definitely guide you in your search.  Is your top priority Location?  Academics versus private practice versus employed scenario? Schedule? Salary potential? Paying off student loans? Satisfying your significant other’s work or personal priorities? Do you want to be a big fish in a small pond (the only specialist of your kind in the area), or a small fish in a big pond (have many colleagues in your specialty in the area)?

Of course, your answer will be some combination of those.  Finding the right job is a lot like shopping for real estate.  You’ll have a wish list.  You are not likely to get everything on your list, but starting with such a list can be helpful.  Rank the categories above in terms of priority, and add a few of your own.  Feel free to be as specific as you need to be.  Then step back and look at your list.

How specific is your location? A specific city? An area within a state? A whole state? A group of states? A region (northeast, northwest, southeast, southwest)? Are you open to exploring locations? Do you want a certain size city or town? Do you prefer urban or rural living? The more specific your location requirement, the more limited you will be regarding all of the other choices.  It seems like many people start out with a specific location requirement, but may not succeed  in finding the job of their dreams in that location.  This is where compromise comes in.  If this happens, choices come down to choosing a job that may not be ideal but is in the right location, or choosing to venture out of the desired location in search of the ideal job.

What is fun and fascinating is how the ultimate decision you make may surprise you based on your initial priorities.  On the other hand, creating a priority list can help you stay focused, and keep you from being distracted by falling in love with a job/location that is kind of the opposite of what you said you wanted… (on the other hand, if you consider yourself to be a spontaneous person, you may actually enjoy musing at the morphing of your priorities through the process…).

Finally, just keep in mind how much time you will likely spend working.  There’s a good chance you’ll spend more time working than time off, so keep that in mind when prioritizing work characteristics that appeal to you. It is extremely important to consider personalities of colleagues, staff and administration at any work location. If you do venture out to explore various location options, keep in mind that you can always work in one location and travel to your favorite places when you’re off, especially if you choose a job where your specialty is in high demand.

DocWorking: Physician blog about finding doctor jobs

Doctor jobs

Working as a physician is both rewarding and challenging.  It is a long road to becoming a physician, and I remember asking people before embarking on that road whether it was worth the personal sacrifices required.  Since then, my colleagues and I hear that same question many times from people at all levels of training, and it remains an intriguing question, especially as I realize in retrospect how strongly influenced I was by the answers I received when asking it years ago.

Before becoming a physician, I worked as a physician recruiter at one of the first successful large physician recruiting firms in St. Louis, Hitchens & Foster.  My contacts from that period remain strong, and many of my fellow recruiters have gone on to create their own successful recruiting companies.  I am so thankful for this background, as it has served me well in navigating my own job searches (yes, for many physicians including myself, finding the ideal job requires figuring out what the ideal job is, and what is right for you.  You hate to think that the first, or even second, job that you take may not be where you’ll stay forever, but take the good with the bad, and you’ll always come out ahead…but that’s another post…)  The recruiting background has given me a  unique perspective among physicians on the topic of doctor job hunting.

My hope is that DocWorking will serve as a platform for initiating discussions among practicing physicians, residents and fellows, medical students, premed students, doctor moms, doctor dads and anyone else who may find the subjects at hand interesting. Topics for upcoming blog posts include:

The long road to becoming a doctor: Is it worth it?
Doctoring: Choosing the right career path
How physicians plan for the right job
How physicians find the right job
Finding doctor jobs in saturated markets
When is working with recruiters useful? and when is it not?
How to get work as a physician in the U.S.
MD Steps to practicing medicine in the U.S.
Physician life choices
Doctor Mom to Doctor Mom

I hope that these and other upcoming topics will spur some interesting discussions, and help some people with choices and decisions along the way!