While you must be understandably excited about this new chapter in your life, don’t let this excitement get in the way of optimizing your job search. Over half of physicians leave their first job within five years and, of those, a majority leave after 1 or 2 years. Your first job search is an important step in your career; make sure the search gets the time and energy it deserves.
Be clear about your wants
View your first job as a potential life partner and plan accordingly- you want a sense of contentment when you wake up knowing you will spend more time at this position than with your significant other. Viewing your job in this way, it is easy to understand why you must be clear about your likes, and dislikes as well.
I think it is vital to set pen to paper and write out the details of your “dream job.” While no such job exists, you want a position that considerably overlaps with this vision, remembering that your “dream job” may change throughout your career. Nevertheless, making your wishes and wants concrete by writing them down will give you a sense of purpose and direction as you start your journey.
A few months into the search, I began my “manifestation” book, listing all my non-negotiables. This included not only the concrete, such as healthcare setting, patient population, and work hours (including call) but also the intangibles such as the feelings I wanted to have when walking through the door of my office each day and the sense of accomplishment from caring for patients or educating the community.
Believe in your worth- and negotiate for it!
Many of us straight out of residency and fellowship have never negotiated a salary in any meaningful way. The offer letter provided by your residency clearly stated your income and likely set guidelines for the changes over the rest of your training, with no room for discussion. This system puts us far behind other professionals who may have learned this valuable skill up to a decade earlier.
The offer is a starting point; be confident in your worth, realizing this dollar amount signifies the hours, education and toil that you have put into your education as well as the tangible and not so tangible value you will provide for years to come to your future employer. Do not shortchange yourself. While it is helpful to look at average physician pay in your specialty and area, know that your skills are unique from your peers and the average wage includes physicians at all stages of their career. Whatever the starting offer is, don’t appear too eager to accept it; it may make it difficult to negotiate your needs later.
If there is pushback regarding salary, but the position is close to your ideal job, see if the offered benefits bring the two into greater alignment. Benefits include relocation costs, paid malpractice and CME and end-of-year bonuses. Remember, this is not “free money;” you may have to repay the bonuses if you break your contract or fall short of the productivity parameters outlined in your contract. Additionally, these benefits may be considered taxable income.
As physicians, we better than others, understand that health care does not come cheap. While you are caring for patients and your community, it is vital to have the peace of mind knowing that should your health- or the health of a family member- suffer, you have adequate health insurance. Ask probing questions about the health insurance packages and options. Don’t forget to consider the family and/or maternity leave available. A survey of academic centers shows that many do not live up to the recommended 12 weeks of maternity leave with some policies left purely to the discretion of the department.
Ask for advice early
From your residency director, colleagues, family members and anyone else whose opinion you trust. Don’t reinvent the wheel with your job search; countless physicians have walked this path and can help you on your journey. Senior physicians in your field are privy to information that may improve your job search, such as inside knowledge about the politics of a particular department or geographical region. Family and trusted friends provide another perspective by servicing as a sounding board that takes into account your personality and lifestyle factors that will complement the search. Don’t forget to ask to talk to current employees or, more importantly, any physician that has recently left the organization.
While I asked my program director early for advice, I did not speak candidly with current physicians until I accepted the position. When I did, I learned valuable information that would have affected my decision.
Two cautions:
- Don’t put too much trust in advice from physician recruiters. While a good resource, their interests don’t always align with yours, and they won’t always give objective information about the contract, benefits or drawbacks, or even a full picture of available jobs.
- Advice is just that- advice; do not let this advice sway you from your ideal job. You should be firm in your wants and wishes so that this advice complements your job search, rather than ruling it.
Get a lawyer to review your contract
This is a must. Never sign the dotted line until a contract lawyer has reviewed everything thoroughly. You will not regret the money spent, as they will guide you regarding certain loopholes that may seem insignificant at first glance. Whatever your familiarity with the law- read the contract yourself. While a lawyer’s guidance is invaluable, it is essential that you take the onus to understand what you are signing and why. Circle, outline, and question everything!
Personally, I have a friend who specialized in contract law, and while I asked for her advice, I still paid an independent lawyer to review the contract.
These are some things to consider during your first job search. Remember – think of your job as a life partner for as long as you have it. Spend adequate time to ensure that you won’t regret it!
References:
- Riano N, Linos E, Accurso E et al. Paid family and childbearing leave policies at top US medical schools. JAMA. 2018 Feb 13; 319(6):611-614
- Jackson & Coker. Physicians’ first jobs: an online research study. Retrieved at: https://www.prnewswire.com/news-releases/study-shows-first-job-after-medical-residency-often-doesnt-last-161949055.html. Accessed Oct 18, 2018.
