Looking for a job after residency and reviewing contracts

First Job After Residency

Half of new graduates leave their first job within 5 years, and half of those leave within the first 1-2 years. Prepare yourself to decrease your chances of adding to those statistics.

Look for positions (Summer, fall of final year)
 Word of mouth—let former residents, faculty, other physicians, family, and friends know that you are looking (people in other specialties or outside the medical field may still have connections to physicians in your area)
 Network—go to local medical society meetings, pharmaceutical dinners, or any other gathering of health care professionals
 Attend career fairs
 You can use a recruiter or a placement service, especially if you are looking outside of your immediate geographical area

Prioritize practice characteristics (Fall, winter)
 Practice type: hospital based, community based, multispecialty group, independent contractor, private practice, academia
 Family: local schools, culture, nearby relatives
 Location
 Financial: salary vs production, partnership potential, cost of living

Interview (Winter)
 Just like residency, you are interviewing them at the same time they are interviewing you
 Sell yourself! Be confident in your strengths without sounding arrogant
 Look the part—invest in a well fitting suit, have conservative hair and make-up, avoid revealing clothes
 Be open to interview at places that you may not immediately love, as you may be surprised when you see the practice up close
 Have your CV and references ready to distribute at the interview, even if it has previously been emailed out
 Talk to current employees (and former employees if available)
 Ask important questions to multiple people, to ensure that you get a complete answer
 Remember to write thank you notes, and follow up 1-2 weeks after the interview to let them know you are interested

Review the contract (Winter/Spring)
 Read it! In its entirety!
 Have a lawyer review (preferable one knowledgeable in medical contracts); it is well work the cost
 Have residency faculty or physician mentors review the contract
 Know your benefits: health/disability/life insurance, malpractice insurance, retirement account (+/- matching by the employer), CME allowance and time, professional association fees, vacation time, maternity/paternity leave
 Is moonlighting allowed?
 Call duties and frequency
 Salary vs production, bonuses
 Ensure oral promises are written in the contract explicitly
 Are relocation expenses included?

Negotiate (Spring)
 Most contracts have some (although not a lot) of wiggle room
 Do not expect to get everything in a contract; prioritize your needs
 Sell yourself during negotiations, so that they will want to invest in you
 If you don’t ask, you won’t receive; they are looking out for their bottom line, not yours
 Only use another job offer for leverage if you have another position, as you do not want them to call your bluff if you don’t actually have a back up plan
Youtube contract video: http://www.youtube.com/watch?v=qT2QO5VI67Y


Licensing requirements
Every state has individual requirements for being licensed. In general, you must have completed either USMLE or COMLEX Steps 1-3, and completed a minimum of 1 year of residency (more if you are a foreign medical graduate). If you know which state you will be practicing in, get your license before you finish your senior year. The process can take up to 9 months. Initial licensing requirements: http://www.fsmb.org/usmle_eliinitial.html

If you are applying to jobs in multiple states, or want a depository for your documents for ease with future credentialing or licensure, you may consider the FCVS service, which keeps copies of all of your documentation and sends them for you. There is an extra cost, but it may be convenient if you are strapped for time. http://www.fsmb.org/fcvs.html

Board certification
In your final year, or after completing residency, you are “board eligible.” You then may sit for your specialty board exam. Upon passing, you will be “board certified” for 7-10 years (depending on your specialty). Maintenance of your board certification requires annual CME (continuing medical education), maintenance of a valid medical license, passing the board exam at required intervals, as well as maintaining a level of ethics. See your individual specialty board for more specifics. American Board of Medical Specialties: http://www.abms.org/