American College of Physicians: Internal Medicine — Doctors for Adults ®

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How to find a job after training that you really want

Tips for finding job leads and evaluating opportunities

By Christine Kuehn Kelly

Web resources to aid your job search

When she was an internal medicine resident at the University of Maryland last year, Mysheika LeMaile-Williams, ACP-ASIM Member, thought long and hard about her future. Dr. LeMaile-Williams, who holds a degree in public health, decided she wanted a position that provided care to an underserved segment of the community yet did not involve the stress of inpatient care. After hearing about an opening from her residency director, she successfully interviewed for a position as medical director of the Eastern Health District STD Clinic in Baltimore.

Talk to program directors, attendings and new physicians, and you'll hear that research and networking are the keys to finding your first job. But first of all, they say, you need to do some self-examination to determine what you really want to accomplish in your career.

Job LeadsRobert DuPont, a St. Louis-based consultant who helps physicians with interviewing skills and other job searching skills, said that new physicians need to identify the type of job they want in terms of compensation, practice style and philosophy, type of practice (solo vs. group) and quality-of-life-issues. "The top three reasons physicians leave a position within the first three years are compensation, interpersonal clashes with other doctors and not fitting into the community," he explained.

To avoid pursuing opportunities that will be a bad fit, Mr. DuPont suggested asking yourself the following key questions: What do you value most about practicing medicine? What kind of a work environment do you prefer? Will the practice and the community support your professional and financial goals? What type of community will mesh with your personal and work interests? Will the community suit your family?

With those questions in mind, here are some tips to help you find the right job:

  • Network. Recruiters estimate that more than 80% of physicians find a job through networking. One of the easiest ways to make contacts is to tap into the resources within your own program.

    Let your program director, program chairs and attendings know the geographic areas that interest you, suggested Patrick C. Alguire, FACP, the College's Director of Education and Career Development. Ask your program's administrative staff for a list of recent graduates and get in touch with people practicing in locations that interest you.

    If you want to stay close to where you're training, Dr. Alguire said, talk to the community-based physicians who participate in your program. They often volunteer for rotations primarily as a means of recruiting and would like to hear from you. Finally, don't forget to tell your peers about your geographic or practice interests.

  • Think creatively. Greg Buford, MD, a plastic surgeon who recently began practicing in Denver, took an unusual approach and focused much of his networking efforts on physicians who were in practice five years or less. The reason? He felt they would be more knowledgeable about the job market.

    "I also talked to my local pharmaceutical representative, who gave me some leads," Dr. Buford said. "Contact with the reps was helpful in fleshing out the practice environment and generally getting a more honest impression of the local docs."

    And because he was competing in a competitive market, Dr. Buford decided to take an aggressive approach. He sent a mass mailing to Denver physicians and targeted older doctors who he figured were likely to be considering retirement. The direct mailing approach led to his current position.

  • Use the Internet selectively. You can find extensive background information on physician recruiters, hospital-based physician recruiters, hospitals, practices and communities on the Web. Residents who have recently been through a job search, however, caution against relying too much on Internet job listings.

    Some said that Internet job listings are sometimes out-of-date or pitching not-so-desirable positions. If you decide to research a job or geographic area online, experts say, stick with reliable sources like the College (www.acponline.org) and the American Board of Medical Specialties (www.abms.org).

    (For more information on how to get help from the Internet, see "Job searching on the Web," below.)

  • Understand the strengths-and limits-of recruiters. The big advantage of working with recruiters is that they may have leads on jobs that are not publicized or are available in less familiar geographic areas. The downside is that most recruiters don't view new physicians as a large segment of their business because of their lower earning levels and less advanced careers. As a result, some recruiters may not be as interested in working with new physicians or give them much attention.

    Recruiters do, however, depend on word-of-mouth and repeat placements for long-term business. Top-notch recruiters will take time to understand your skills and needs and the kind of position you want.

    Beware that in most cases, recruiters work for physician practices or institutions and represent their interests, not yours. Some recruiters, however, work on a contingency basis and bring together available physicians and open positions. (You should not have to pay recruiters yourself.)

    Experts say that because in-house hospital recruiters rarely work on commission, they typically will spend more time working with you. Christine Bourbeau, physician services liaison at Bristol Hospital and Saint Francis Medical Center in Bristol, Conn., said she works with a physician throughout the process, from arranging dinner meetings with hospital staff to transporting the physician to and from the airport.

    Because anyone can claim to be a recruiter, ask about physician placement rates and retention to help weed out the less competent or inexperienced. (For more on selecting a search firm, go to ACP-ASIM Online at www.acponline.org/counseling/search.htm.)

  • Look beyond compensation. "Many residents are overly focused on salary and end up calling us a year later to make a job change," said Mark E. Smith, executive vice president of Merritt, Hawkins & Associates, a recruiting firm. "There are other important variables to keep in mind when you job hunt."

    Along with benefits such as health and life insurance, residents may be able to negotiate for pagers, cell phones and autos, particularly when more than one institution is involved.

    Be sure to look beyond salary to quality-of-life and practice-style issues. Are you willing to accept lower pay to work in a smaller community? Do you prefer a dynamic urban setting to a less stressful rural one? Does the practice or institution mesh with your practice style and career goals?

  • Scrutinize part-time opportunities. Part-time work may seem like an ideal option for residents trying to juggle careers and young families. Many part-timers, however, end up seeing patients or doing paperwork during their off hours, and they must often take a full call schedule.

    Before you decide that part-time employment is right for you, examine the financial aspects of a lower paying part-time position. Be sure to look at how the practice's overhead costs are apportioned, how salary incentives apply to part-timers and whether you'll be offered any opportunities to advance to partnership.

  • Consider a trial run. One way to get a sense of the available practice opportunities is to work as a locum tenens. Several firms specialize in temporary placements, which let you check out a practice or institution and the surrounding community. Locum tenens assignments provide flexibility, a chance to travel and the opportunity to preview practice environments. Assignments run an average of six to eight weeks, but they can be as short as two days or as long as two years.

    Dustin Koger of Staff Care Inc., an interim physician staffing agency, said that it is sometimes possible to arrange locum tenens positions in a practice where you are considering a permanent position. He pointed out, however, that you're more likely to find these positions in a larger health care delivery network that has a budget for temporary staffing.

    Another consideration with locum tenens positions: You must be licensed in the state where you want to practice, and you must take care of any necessary DEA and controlled substances registrations.

Christine Kuehn Kelly is a Philadelphia-based freelance writer specializing in health care.

Web resources to aid your job search

  • ResidentWeb (residentweb.com/default.asp?specId=112) bills itself as a one-stop source of information for residents. Users can search its jobs database by specialty and location.
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  • The American Board of Medical Specialties Web site (www.abms.org/Statistics.asp) offers statistics on the geographic distribution of physicians to help you gauge market needs and avoid internist-saturated areas.
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  • National Association of Physician Recruiters (www.napr.org) offers job listings by specialty and location, as well as information from salary surveys.
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  • The ACP-ASIM Career Resource Center (www.acponline.org/careers/) offers listings from College publications including Annals of Internal Medicine, as well as information on residency programs for contacts and articles on how to navigate the job search.
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  • The Association of Staff Physician Recruiters (www.aspr.org) offers a membership directory of recruiters and a database of open jobs.

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