Getting the real scoop on your first job in medicine
By Edward Doyle
SAN FRANCISCO—For residents trying to find and evaluate jobs in medicine, the advice from the experts is simple: Be aggressive—and skeptical—to find the position that is right for you.
At an Annual Session presentation, the top question on the minds of many residents—how to choose the geographic location where you want to work—was the most difficult to answer. A resident who is not ready to commit to one community and wants to explore different settings could work as a locum tenens, said Robert D. Ficalora, FACP, director of medical residency programs and assistant professor of medicine at Tufts University School of Medicine. However, expect placement agencies to take a cut of your pay.
Panelists at the session offered another warning: If a location seems too good to be true, it probably is. Jack D. McCue, FACP, from Baystate Medical Center in Springfield, Mass., recalled how he visited a vacation town in Maine during the summer when he was looking for his first job, and loved it so much that he took a job with a hospital there. But when the tourist season ended, the town's character changed drastically. Only one of the many restaurants remained open, he said, and most social activities disappeared. "The vacation appeal lasts about three months," Dr. McCue said.
Residents shopping for location should watch what they include in their curriculum vitae. "If you list one of your hobbies as skiing and you're applying for a job in Tennessee, they'll find a picture of the town with snow in it and send it to you," Dr. Ficalora said. "If you send a CV, they may know too much about you."
If you have identified the area where you want to work, start to look for a position by using any personal contacts you have in the area, Dr. Ficalora said. If you have none, he said, try talking to the local hospital's chairman of medicine or administrator.
When it comes time to evaluate a job offer, beware who you talk to, Dr. Ficalora warned. For example, a physician from the town where you are considering a job may stand to benefit financially from a young physician coming to town, or the hospital nurse who tells you the opportunity is a good one may simply be looking for someone to relieve her of patient care duties.
To get the real scoop on a potential practice opportunity, Dr. Ficalora suggested pursuing some unlikely sources—like the local pharmacist. "You'd be surprised how willing most pharmacists are to talk to a doctor," he said. Drug company representatives—who want you to trust them and to buy their products—are another potential source of information about practice opportunities. "A drug rep who has worked in the community for years can be a wealth of information," he said.
Dr. Ficalora said new physicians should be wary of a new trend: hospitals that are increasingly trying to recruit young physicians to work in offices on the fringe of their geographic area to woo patients from other hospitals. Because these practices are outside the hospitals' immediate communities, making them successful can be difficult.
Most important, young physicians looking for work need to remember that if their first job doesn't work out, they can always find something else—and probably will. As Dr. Ficalora pointed out, only half of new physicians remain in their first job after two years, and only 20% after five years. "You're almost guaranteed that you're going to be in another job in five years," he said.
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