After residency

[directdoc]

So after you're done with residency, are you just expected to be able to find jobs on your own?

I've shadowed at a few hospitals, and one of the hospitals helped (to an extent) their residents find a job after they were done and the other hospital just kind of let them go.

How do you find jobs after residency? Is there a period of time where you're just sitting at home looking for a job (like many other careers do)? If you're going into primary care, do recruiters contact you?

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[Winged Scapula]

So after you're done with residency, are you just expected to be able to find jobs on your own?

I've shadowed at a few hospitals, and one of the hospitals helped (to an extent) their residents find a job after they were done and the other hospital just kind of let them go.

How do you find jobs after residency? Is there a period of time where you're just sitting at home looking for a job (like many other careers do)? If you're going into primary care, do recruiters contact you?

The help most programs give is rather perfunctory so residents/fellows are left to do most of the job hunting on their own.

You can expect as a senior resident to get lots of phone calls from recruiters; there must be some database they mine for your information.

Your PD will have letters of recruitment from potential employers in your field and should post them in an area accessible to residents. You will also get mail from potential employers yourself. Lots of glossy ads with "lifestyle" pictures...always used to make me laugh because these were invariably some guy in a canoe fishing...a scenario which doesn't appeal to me in the least.

Trade journals will have ads for jobs available and conferences often have new jobs listed as well.

You can contact recruiters yourself or even call hospitals/medical groups in an area you are interested in working and see if they will sponsor you. My new partner did this...she wanted to work in a certain area (where she had done residency), so before fellowship was over, she called a bunch of local hospitals there and found one that would help set her up in practice. Pretty gutsy but it does work.

National organizations will often list jobs on their web sites.

You should not wait until the end of training to start looking for a job. The process of licensing, credentialing, etc. can take months. Even if you are already licensed in the state in which you have taken a job, contract negotiations, credentialing, etc. can take much longer than expected. Residents aren't often told this and if you don't have a job and are ready to legally start working on July 1, you'd better have another income source or a spouse/SO/family willing to support you. I likely will not be ready to work until November 1 even with submitting my FCVS application in February (it took them 6 months to process, a little more than their 8-12 weeks quoted). Fortunately, I have saved a bit of money and have a decent moonlighting job.

Bottom line is that most of the work is up to you...there are multiple sources for jobs and you should start considering them at the start of your final year of training if not before.

 

[directdoc]

Very helpful. Thanks.

 

[Winged Scapula]

Very helpful. Thanks.

Sure. I'll also put a plug in for this book: http://www.amazon.com/Ultimate-Guid...5181655?ie=UTF8&s=books&qid=1187194578&sr=8-1

as I found it very helpful and in agreement with all my other sources.

 

[JMK2005]

[/QUOTE]You can contact recruiters yourself or even call hospitals/medical groups in an area you are interested in working and see if they will sponsor you. My new partner did this...she wanted to work in a certain area (where she had done residency), so before fellowship was over, she called a bunch of local hospitals there and found one that would help set her up in practice. Pretty gutsy but it does work.[/QUOTE]

Dr. Cox, can you expand on what being sponsored by a hospital means? Does it mean they lease office space for you, buy certain equipment, or give you a low interest loan?

 

[Winged Scapula]

You can contact recruiters yourself or even call hospitals/medical groups in an area you are interested in working and see if they will sponsor you. My new partner did this...she wanted to work in a certain area (where she had done residency), so before fellowship was over, she called a bunch of local hospitals there and found one that would help set her up in practice. Pretty gutsy but it does work.

Dr. Cox, can you expand on what being sponsored by a hospital means? Does it mean they lease office space for you, buy certain equipment, or give you a low interest loan?

In my partner's case, they gave her a guaranteed salary for a certain period of time, paid her other expenses (ie, malpractice), gave her money to hire staff, rent an office, buy supplies, etc.

She thought they would give her a bit more help with the day to day things - that is, she was suprised that they essentially gave her a check and she had to go out and buy the office chairs, prints for the walls, etc.

In return, she promised to stay in the area for a certain amount of time, and the loan the hospital gave her (for all of the above) was forgiven after a few years. For all intents and purposes, it was a loan but since she was able to pay it back before the interest kicked in (ie, after 3 years), it was a freebie.

I mentioned it because its an option often seen in books about finding a job but not one often mentioned during residency; probably because most academic physicians don't know much about private practice. It takes guts to go into private practice but with the financial support of a sponsoring hospital, it can be much easier. She's done so well that she needed a partner after two years in practice. In her case, she knew the area, and did her research as to where her services were needed and where she was most likely to be able to "sell" those services to hospitals. You can't really move into an unknown area without doing your homework and investigating the need for your services.

 

[Blade28]

I likely will not be ready to work until November 1 even with submitting my FCVS application in February (it took them 6 months to process, a little more than their 8-12 weeks quoted). Fortunately, I have saved a bit of money and have a decent moonlighting job.

Some states are worse than others - one of the chiefs from last year said that Florida, where he was moving for fellowship, was terrible in this regard.

I submitted my FCVS back in April (as well as my paperwork for my state medical board), and finally got my license in the mail just last week.

 

[dutchman]

So after you're done with residency, are you just expected to be able to find jobs on your own?

I've shadowed at a few hospitals, and one of the hospitals helped (to an extent) their residents find a job after they were done and the other hospital just kind of let them go.

How do you find jobs after residency? Is there a period of time where you're just sitting at home looking for a job (like many other careers do)? If you're going into primary care, do recruiters contact you?

Some specialties do a lot more searching than others. Pathology and PM&R comes to mind.

 

[directdoc]

In my partner's case, they gave her a guaranteed salary for a certain period of time, paid her other expenses (ie, malpractice), gave her money to hire staff, rent an office, buy supplies, etc.

She thought they would give her a bit more help with the day to day things - that is, she was suprised that they essentially gave her a check and she had to go out and buy the office chairs, prints for the walls, etc.

In return, she promised to stay in the area for a certain amount of time, and the loan the hospital gave her (for all of the above) was forgiven after a few years. For all intents and purposes, it was a loan but since she was able to pay it back before the interest kicked in (ie, after 3 years), it was a freebie.

I mentioned it because its an option often seen in books about finding a job but not one often mentioned during residency; probably because most academic physicians don't know much about private practice. It takes guts to go into private practice but with the financial support of a sponsoring hospital, it can be much easier. She's done so well that she needed a partner after two years in practice. In her case, she knew the area, and did her research as to where her services were needed and where she was most likely to be able to "sell" those services to hospitals. You can't really move into an unknown area without doing your homework and investigating the need for your services.

Wow...that sounds like a good deal. But I'm sure its rare to see this...

 

[Winged Scapula]

Wow...that sounds like a good deal. But I'm sure its rare to see this...

Only rare because people don't investigate it. If you have a valuable service (ie, a skill which is in demand in an underserved area), the hospitals jump at the chance. Don't believe for a minute that she wasn't billing more than what they were paying her, even including all the other costs. Hospitals are not in the business to lose money.

I have no doubt that anyone else could do the same...find an area which is underserved (and she and I are in Phoenix...so its not some backwater) in yur specialty and market yourself. It CAN be done.

I have another friend who did the same in Michigan...she wanted to start a Breast Center in a certain underserved area of the state and approached the hospitals there, including those where she rotated as a resident and they took her up on the offer. These are BIG money makers for hospitals. But it can be done with other specialties, especially general surgery for which communities are going begging.

 

[Winged Scapula]

Some states are worse than others - one of the chiefs from last year said that Florida, where he was moving for fellowship, was terrible in this regard.

I submitted my FCVS back in April (as well as my paperwork for my state medical board), and finally got my license in the mail just last week.

Yeah, don't get me started on FCVS and how "well" they follow up on missing data or why they decide to mail verification requests to hospitals not even listed on my application!

I had a friend who took 13 months to get her license in Georgia...because FCVS was REVERIFYING everything even though they had done it 3 years prior (and despite what they say on their website that it only has to be done once).

Congrats on getting your license ...seems like you were just a bit over their 12 week estimate.

 

[Blade28]

I had a friend who took 13 months to get her license in Georgia...because FCVS was REVERIFYING everything even though they had done it 3 years prior (and despite what they say on their website that it only has to be done once).

Congrats on getting your license ...seems like you were just a bit over their 12 week estimate.

I hope I don't have that problem in the future! The whole reason I shelled out the $400 was so I only had to go through this painful process once.

Now if only I can arrange my DEA number, CPR/ACLS and malpractice insurance...then I can finally start moonlighting!

(On a related note, you DO have to provide your own Professional Liability insurance policy, right? Don't these run in the thousands of dollars, annually?)

 

[Winged Scapula]

I hope I don't have that problem in the future! The whole reason I shelled out the $400 was so I only had to go through this painful process once.

Now if only I can arrange my DEA number, CPR/ACLS and malpractice insurance...then I can finally start moonlighting!

(On a related note, you DO have to provide your own Professional Liability insurance policy, right? Don't these run in the thousands of dollars, annually?)

What for moonlighting? No...the hospital I always worked for provides it for me. Otherwise, I would really be in trouble because I can barely pay my bills (ok, I'm exaggerating but in no way would I be able to pay for malpractice).

I am not aware of anyone paying for their own malpractice while moonlighting but I suppose it could happen.

 

[Blade28]

I am not aware of anyone paying for their own malpractice while moonlighting but I suppose it could happen.

Whew, OK, thanks!

 

[Winged Scapula]

Whew, OK, thanks!

Enjoy all that extra money and time! We'll expect you to be tanned and muscle bound at the next SDN reunion like any good lab rat!

 

[Blade28]

Enjoy all that extra money and time! We'll expect you to be tanned and muscle bound at the next SDN reunion like any good lab rat!

There are SDN reunions?!

 

[Winged Scapula]

There are SDN reunions?!

Just joking....but there should be (there are get togethers here and there I see announced in the Pre-Med and The Lounge forums).

 

[deleted87716]

Just joking....but there should be.

Alright!!! Party at Kim's place. I'll bring the beer.

 

[Winged Scapula]

Alright!!! Party at Kim's place. I'll bring the beer.

I'll get the folding chairs and table out and supply the dip and chips!

Anyone for Canasta? (I really have no idea what that is except that I remember my parents saying that)

 

[Blade28]

Anyone for Canasta? (I really have no idea what that is except that I remember my parents saying that)

That, or whist.

 

[angel80]

Only rare because people don't investigate it. If you have a valuable service (ie, a skill which is in demand in an underserved area), the hospitals jump at the chance. Don't believe for a minute that she wasn't billing more than what they were paying her, even including all the other costs. Hospitals are not in the business to lose money.

I have no doubt that anyone else could do the same...find an area which is underserved (and she and I are in Phoenix...so its not some backwater) in yur specialty and market yourself. It CAN be done.

I have another friend who did the same in Michigan...she wanted to start a Breast Center in a certain underserved area of the state and approached the hospitals there, including those where she rotated as a resident and they took her up on the offer. These are BIG money makers for hospitals. But it can be done with other specialties, especially general surgery for which communities are going begging.

The hospital where I am currently doing IM residency has a great program like this if you go into primary care. It's not even in an underepresented area. It's in a major suburb in on one of the top 10 largest cities in the country. What they do is if you want to go into primary care, they will buy you a practice, pay for all the equipment, staff, etc. They will pay you a decent salary and give you benefits for 3-4 years. Then, you will have to buy the practice off of them. By that time, you will have an established patient base and will know more about the business of running a practice.

The hospital is very profitable and wants to make sure it stays that way in the future. Most of the primary care docs in the area are older and are retiring. Although primary care docs themselves don't make too much money for the hospital, they refer pt's to the hospital's surgeons, cardiologists, oncologists, etc. They also provide the patient base for most of the hospital's admissions. Since no one want to go into primary care anymore, the hospital is giving great incentives to those who do. They're even talking about adding medical loan forgiveness to sweeten the deal.

 

[Winged Scapula]

The hospital where I am currently doing IM residency has a great program like this if you go into primary care. It's not even in an underepresented area. It's in a major suburb in on one of the top 10 largest cities in the country. What they do is if you want to go into primary care, they will buy you a practice, pay for all the equipment, staff, etc. They will pay you a decent salary and give you benefits for 3-4 years. Then, you will have to buy the practice off of them. By that time, you will have an established patient base and will know more about the business of running a practice.

The hospital is very profitable and wants to make sure it stays that way in the future. Most of the primary care docs in the area are older and are retiring. Although primary care docs themselves don't make too much money for the hospital, they refer pt's to the hospital's surgeons, cardiologists, oncologists, etc. They also provide the patient base for most of the hospital's admissions. Since no one want to go into primary care anymore, the hospital is giving great incentives to those who do. They're even talking about adding medical loan forgiveness to sweeten the deal.

Sounds great and it echoes what I was saying...unlike some of the government programs, you don't have to go to a traditionally "underserved" (ie, rural) area, just one where your specialty services are needed or "underepresented".

 

[Pilot Doc]

One thing to keep in mind is that the hospital supported practices can really screw you in some circumstances.

Ideally, as it seems in the case mentioned by Dr. Cox, a hospital will sponsor a doc who can serve a previously unmet need and make a profitable go of it.

Another possibility is that a hospital, for its own political or financial reasons wants more docs in town. It may fully know that the market won't support another Xologist (that's why there's not one there to begin with), but they entice an unknowing new grad in. The "salary guarantee" as mentione, is a loan. Once the guarantee runs out, your salary drops precipitously and you are $500,000 in the hole to the hospital. You either have to pay the money back or stay in a bad financial situation for a few years.

Just something to keep in mind.

 

[Winged Scapula]

Good point by Pilot Doc.

I certainly saw many of these offers, especially in "undesirable" places (at least for me), for general surgery. HUGE guarantees, in the middle of no where, and no evidence that they had been able to attract anyone, in some cases, for years. Always a red flag.

You never want to put yourself into a position of having to owe a hospital tons of money and not be able to leave the position. You must clearly understand your contracts to prevent this from being the case. Although I was fairly certain I had weeded out all clauses which might work against me and had researched the market place, I still had an attorney adept at Recruitment Contracts and Health Care Law review them. Expensive, but worth it for the piece of mind.

 

[Pilot Doc]

I still had an attorney adept at Recruitment Contracts and Health Care Law review them. Expensive, but worth it for the piece of mind.

Very good advice.

On a separate issue, my belief is that that no good job is ever advertised or put out to a recruiter. Really desireable jobs go to those who look for them through contacts or word of mouth.