A Resident’s Guide to Finding Your First Position

Elisa Zenni, MD, recalls the process of completing her fellowship training in Boston, while at the same time, trying to land her first job in academic pediatric medicine. The Navy had stationed her husband, also a doctor, in Bay Area, California. Some professional couples are willing to live apart, but Zenni and her husband were not. So, finding an academic job in Northern California became her utmost priority.

In 1992, the internet wasn’t a big thing, so Zenni wrote “cold” letters to the three main academic pediatric institutions in the area. A department representative from Stanford University, Stanford, California, responded to her that they were interested and asked her to meet with the associate chair of the department. Ultimately, Zenni landed a job as an assistant professor of pediatrics at the university.

“I was very lucky,” she told Medscape Medical News.

If you’re a resident searching for a full-time job, sending a “cold” letter or email to a desired program may not be a bad idea.

“It’s worth a shot, absolutely,” Zenni said. The practice group may not have an open position at the time, but they may remember you later when they do, she said. Zenni now works as the associate dean for graduate medical education in the Department of Pediatrics at University of Florida College of Medicine in Jacksonville, Florida.

For those who are not moving onto fellowship training, navigating one’s first job after residency takes time and patience, research, and perhaps a smidge of luck, too. We asked experts for their advice on the job-hunting process and what to do once you land the job. Here is what they said.

Start Early

Start the job searching about 12-24 months before graduating from residency, Zenni stressed. “Definitely don’t wait until the last minute.”

“The process can take a long time to find the right job,” she explained.

Residency is a busy and tiring time, so plan ahead, Zenni said, especially if you know you are facing rigorous training or clinical rotations that will make scheduling time for interviews challenging.

It also takes time to obtain a state medical license. In some states, it is a 6-month process. Before starting a position, a resident may also need to get hospital credentialing, which can take extra time.

Consider What’s Right for You

Next, consider your personal and professional priorities, Zenni said.

Do you want an academic position, a private practice, or a hospital-based one? Would you prefer to work in public health or industry? These are all questions residents should ask themselves, according to Zenni.

Then, consider what type of setting you prefer. Do you want to be the only physician in the office, or do you thrive as part of a larger provider group? Think about your personal goals, too. What type of schedule would you like to have? What does work-life balance look like for you?

“Are you open to following your dream job no matter where it is, or are you very specific about a certain geographic location?” Zenni asked. Would you like to be near family, or are you flexible regarding what location you work?

If a resident is willing to move anywhere in the country to take a job, the search likely will look different than, for example, someone who needs to go back to a rural part of Nebraska to care for aging parents, Zenni noted.

“If you know that’s where you’re going to be, then start early and make sure you get a job there because if you really want to go to Nebraska, there might not be many jobs,” she said.

Figuring everything out can be overwhelming, she acknowledged.

“I would encourage them [residents] to speak with trusted advisors — colleagues who’ve been through this,” like recent graduates, Zenni suggested.

“It’s easy to just ‘go with the flow’ and look for the job that your own attending and co-residents are looking for, but you have a chance to craft your career now and you need to be intentional about the kind of job you really want,” Miriam Knoll, MD, radiation oncologist at Northwell Health in New York, said in an email.

Getting Your Materials in Order

On the practical side, update your resume and ask trusted people to review it, Zenni advised. “Have someone look at your CV [curriculum vitae] and really make it professional and make sure it really represents some of the things you accomplished,” she said.

There are different places to look for job opportunities, including job boards for physicians and advertisements from specialty societies. If you can, also consider attending or presenting at a specialty society meeting, Zenni added. “That’s a great way to network and start to establish connections of people you can follow-up with later,” she said.

“The best way to find a job is to network,” said Knoll. “Tell everyone you know — physicians and nonphysicians — that you’re looking for your first position.”

Zenni also encouraged residents to practice interviewing with their teachers or program directors (which she has done with residents).

Do Your Research

Once a resident narrows down his or her job search, they should carefully research each of the opportunities. What does the practice size look like? What is the call volume like, asked Erin McKean, MD, assistant director for student affairs at the University of Michigan Medical School in Ann Arbor, Michigan.

What is the compensation package? One of the best resources for those who want to go into academic medicine is the Association of American Medical Colleges Faculty Salary Report, which most large medical schools have access to through a subscription, McKean said.

Next, research what other doctors in the region earn for the type of practice you are considering, said McKean. Knowing this information will help you ultimately negotiate for the best offer if you land the job.

Don’t forget to ask about time in the clinic vs time in the operating room, McKean added.

“Time matters, right? That’s a form of compensation,” she said. “People shouldn’t just go in and sign a contract blindly. They really need to understand what’s going into the work because there’s finding a job, and then there’s being happy in a job.”

Review the Contract

Once a resident lands a job, “I strongly, strongly, strongly encourage people to have a contracts attorney review the contract,” Zenni said. Doing so can be costly, and money is often tight for medical residents, “but it would be well worth it to make sure that they don’t get into a situation that will create problems for them later if they choose to leave,” she said.

Sometimes residency programs will have a relationship with a contracts attorney with whom residents can connect, Zenni noted.

Building Your Practice

Once in a new job, consider sitting down with the office manager to try to learn “the nitty gritty of how this is going to work,” McKean advised. For example, ask about how much medical assistant support you’ll have and how much time physicians in the practice general spend on documentation. Having this information can help set you up for success, McKean said.

Conflicts may arise, such as if your senior partners expect you to see 2src patients in a half-day clinic, but you are only comfortable seeing 15. Most doctors will have some “hiccups” in their onboarding, McKean acknowledged.

“It’s normal not to have the perfect setup,” McKean said. “Call your mentors. Call your friends. Call people you can trust to kind of have some peer coaching, and think through how to make it work.”

If there’s a local physicians’ group or regional specialty group in your area, “it’s good to get involved more locally, so the people who are referring to you just get to know you as a human and call you and share questions,” McKean said. “It’s a great way to build a practice,” she said of networking with other healthcare providers.

Overall, it may be a bit overwhelming to search for a job while also working as a busy medical resident, but it’s a chance to venture out and explore a lot of options — hopefully naili