Residents and Fellows Job Search Stress: Preparation is Key

There's a lot to like about being a resident or fellow looking for a job—starting with, unemployment is so low in health care, you don't have to do much "looking." Also, physicians or dental practitioners comprise 14 of the top 20 highest-paying occupations noted by the Bureau of Labor Statistics. Health care is also the fastest-growing sector in the United States, representing 21 percent of the gross national product.

That said, getting from A to Z can still be stressful. You must do exhaustive homework, craft that killer resume, sharpen your interviewing skills to a fine point, and take time out to visit prospective employers. Then you'll weigh Job A compared to Job B, compared to Job C and Job D. It's a learn-by-doing process and you didn't take courses in job search during medical school—did you?

True, residents and fellows may not experience all the typical stressors that "other people" have, but they have their own. Let's start with the good news, and let's start with residents, as chronicled by Merritt Hawkins' 2017 Survey of Final-Year Medical Residents.

• 70 percent of medical residents said they received 51 or more job solicitations from recruiters during their training, up from 63 percent in 2014 when the last survey was completed.
• 50 percent of residents said they received 100 or more job solicitations during their training, up from 46 percent in 2014.

Stress may inevitably cause a new physician to cut and run. Surprisingly, 22 percent of residents indicated that they would choose a field other than medicine if they had their education to do over again.

Head Stress Off at the Pass

If you stress about changing jobs, that's really kind of natural, says Steve McMahan, president of the permanent placement division at CHG Healthcare. "After all, as a physician, you've likely worked more hours, gotten more education, and spent more money to position yourself where you are [than most other people]," he says. "You have more 'skin in the game.'"

Just as society and business have evolved over the past couple of decades, so, too, has the job search for physicians. "Back then the employment field for physicians was much less complex, when you worked either in private practice or a hospital and you might have a couple of opportunities," he says. "Now hospitals are being bought and sold, there's outsourcing, and lots of different employment arrangements."

As you weigh the pros and cons of your next opportunity, think long and hard about what you need and want, especially when it comes to quality of life. Employ the following strategies on your way to more lucrative and satisfying physician employment.

Steel Yourself for "Too Much of a Good Thing"

"There are many more opportunities than there are doctors available to take them," says Michael Belkin, JD, FACHE, CMPE, and divisional vice president for Merritt Hawkins / AMN Healthcare. "There are enough to go around tenfold, and someone coming out of training may get so many solicitations that it becomes overwhelming. It's similar to what I imagine a top high school quarterback goes through—it's that competitive."

Start Early

Don't wait or procrastinate, says Koushik Shaw, MD, founder of the Austin Urology Institute in Texas.

"Starting your search process a year before graduation will lessen the stress," he says. He urges job seekers to ask themselves the hard questions and be as prepared as they can possibly be.

In fact, the Merritt Hawkins survey found that the majority of residents (72 percent), begin a serious job search either within one year of completing their training or more than one year before. The firm found that 28 percent wait until six months before completing their training to start a serious job search—not recommended.

Weigh Location, Location, Location

Where you work is a big piece of the consideration pie, says Shaw. For example, do you want a big city or small city? Or does that really make a difference? 

"Consider the role of economics, because working in San Francisco pays less than in rural California," he says. "In 'competitive' zones, there will be benchmarks for pay."

"There's much less of a demand in major metropolitan areas because lots of candidates would like to go there," adds Belkin. "The smaller the community, the more challenging it is to find providers to go there."

So one way to reduce stress off the bat is to decide that you're not wedded to a top ten U.S. city and maybe, just maybe, you can find the right job at the right salary in a place that has as many amenities—just different kinds.

"By the way, clients looking for doctors in non-metropolitan cities can also get stressed," Belkin says.

Remember It's About More Than Just You

"Before it gets too late, be very clear about what your priorities are," says Belkin.

Those may involve more than you, says Shaw. You may know where you want to go, but if you have a spouse or partner, or children, your first choice may not be theirs.

"Now you have to think about their needs, too," he says. "Maybe your spouse or partner also has career goals, so take those into consideration. Maybe you want your kids to be in good private versus public schools, so that's a factor."

One location choice may involve more "red tape" than others. "I live in Texas," Shaw says. "If you want to live in, say Florida or California, they have the most stringent rules to obtain licensure." And that can take more time.

Keep All Your Options Open

Look seriously at, and interview with, at least a half-dozen employers, says Shaw. You'll get better educated along the way, and better at evaluating pros and cons.

"You'll also figure out pretty quickly that there's no standard template for physician jobs, and that can initially add to your confusion," he says.

You have choices. Do you want a partnership versus being an employee, and are you on a one-, three-, or five-year track? How's the cultural fit and are you aligned philosophically with the providers? Do you want a small practice, hospital group, community health center, or something else?

Options like paid time off or an hourly or yearly rate are pretty straightforward, but the rest of a "job description" can be much more opaque, Shaw says.

Know You Can Change Jobs Later

It's not such a big deal now when you change jobs, says Belkin. "Fifteen to twenty years ago, a physician who had multiple jobs was considered someone who maybe couldn't get along—a red flag," he says. "Today, that's not the case and in fact, 80 percent of residents make changes within three-to-five years of their first job. I think it's because they took a first job from the wrong category, maybe money, or location, and further down the road, priorities can change."

Beware of "Too Good To Be True"

Because employers know the physician shortage is more acute, physicians may be in a position to make more bad choices, McMahan says. "Employers are under pressure to get staffed, and may tell prospective candidates what they want to hear—overselling them."

He's all for candidates reducing stress by "controlling the 'controllables,'" he says. That means setting priorities and objectives, but understanding that every job involves a tradeoff. "A fabulous opportunity for one physician could be terrible for someone with the exact same set of qualifications."

Get Help to Lighten the Load

You have plenty on your plate, no matter what point you're at in your career. Looking for a job is like having another full-time job, and McMahan understands that doctors may not want to scour job boards and respond. That's where a firm like his can help, he says.

"The right firm takes the long-term view, has expertise and relationships to create something special for the physician," he says. "There's nobody you work with who can't find you a job. We have to find a better opportunity than someone can on their own—to make it easier. Remember that for you, it's not about just getting the job. It's about getting the right job."

Article Originally Published on ACOG Career Connection