Soon to be PGY 3...don't know where to start when looking for a job

[otacon88]

Sorry if this is a repost, couldn't find any new and relevant info. Soon to be PGY 3 in EM, seems like all my co residents already know where they want to practice and in what kind of setting. My knowledge goes as far as academic, private, community setting, and options to do locums. After that, I have no clue what to look for in a job and what the different options are. Is there any compiled resources I can use or FAQs to get started? Or any tips/advices you guys can give? Thanks in advance.

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[Colbert]

EMRA has some decent resources. So does the AMA and ACEP. These are general guides but they're a decent place to get started.

In terms of actually finding a job, it all depends on what you're looking for. I'm a graduating PGY-3 so I can only speak from my experience last year. Going after academic vs community jobs are quite different. I went community. I started by first narrowing down a geographic area, finding all the hospitals in that area I'd be willing to work, and then doing quite a bit of hunting to find how who staffs them. Some of them were directly employed by the hospital, some are by the big corp grounds like Team Health, and some were private physician groups. It also helps a lot if you have alumni in the area you're looking for. They probably already know who staffs what ERs. You can also find out some of this info by checking hospital websites, calling the physician recruiter for the hospital, or calling the ER and asking to speak with the ER coordinator.

In terms of timeline, it's a good time to start working on your CV and cover letter. You can find good examples of these in the AMA resources. Then you'll want your program director or someone else to review them. I started making phone calls in September and that was still pretty early for most places and they weren't interested in hearing from me quite yet. If you're going to ACEP you'll have a chance to meet a bunch of people as well.

 

[The White Coat Investor]

If you're not sure what kind of practice you want, try to find something that gives you lots of options, like staying on at your program as part-time faculty and then moonlighting at a local community hospital. Only some of us really know what we want out of residency, that's why so many change jobs within a year or two. Better not to lock yourself into something until you're sure you like it.

 

[Groove]

Bingo. As AD said... if you are truly having this difficult of a time, stay at your home institution while you figure it out. Your biggest branch point needs to be academics vs private practice. Figure that out first. Geographics is another biggie. You didn't specify if you want a job close to family, a specific part of the country, a specific city, etc..? It's easier when you factor in geographic preferences. I wanted to be close to family, so that helped me narrow things down. If you really are all over the place, spend a lot of time at ACEP where everyone has the career booths set up. It's generally sectioned off geographically and you can mingle and talk to democratic groups vs all the major CMGs and talk about all sorts of gigs. I did a few interviews at ACEP a couple of years ago. It's a great way to see what's out there and network. As for locums, I've met quite a few new grads who are single and do locums for Weatherby or 100+ travel docs for Apollo, TeamHealth, etc.. and travel around. I can't say that I would want to do that, but the money is generally pretty good and it would give you a year with multiple settings to help you decide what type of environment you wanted to work at long term. One guy has been doing Weatherby for about 2+ years and lives in the Bahamas on a boat. He seems to be at new gigs every few months and seems to love it. I'm honestly a big jealous.

Other than that, spend countless hours on CareerMD or any of the other job sites. Good luck.

 

[daveyjwin]

I was always pretty sure I didn't want to do academics, so July of my final year, here's what I did:

1) figure out where you might want to live
- here's a google map I made, for reference - http://tinyurl.com/qywam9o
2) Find the hospitals in the area that you might want to work at, and consolidate info on them
- like this - http://tinyurl.com/lsj93tf
3) Find out who staffs each hospital (this is the hard part)
- a) Look through the hospital's website
- b) use ACEP's "findagroup" page (or google) to find group websites to hunt through: http://www.acep.org/findagroup/
- c) call the hospitals' "physician recruitment" department and ask
- d) call the ED at 5AM and ask the physician that's working for group and contact info (they're usually pretty nice)
4) Start emailing people. Wait a week or 2. If no response, call them on a weekday.
- a) some places just won't get back to you
- b) some places just aren't hiring yet (or at all) and will maybe get back to you later, or ask you to get back to them later
- c) some places don't hire fresh grads
- d) some places will be very interested (around half of my places were)

Some pearls:
- Most jobs aren't advertised
- It's okay to ask about "compensation and benefits." Keep track of it.
- Most people are really nice. You're like the pretty girl at the prom. Everyone wants you to like them.
- Schedule interviews in blocks, if possible, so you can do them all at once. I did 5 in a week around Florida, and then rest in three other, shorter but very busy, trips.
- if a place is offering to fly you out and put you up, ideally, have them front everything, instead of getting reimbursed, because getting reimbursed (especially from a place you're going to say no to) is stressful.
- Have a set list of questions to ask each place, so you know all the same information about each place, to help you keep informed. Keep a spreadsheet. Bring this info with you to interviews.
- Have more questions ready for interview day, and bring them with you to write down the answers to, because when you're interviewing at a bunch of places, it's hard to keep them straight.
- Take everything you hear to a grain of salt. They want you to come to them, so they're going to present everything a bit more favorable than it actually is.


I suppose that's all I have for now. If you have any specific questions, feel free to ask me. Good luck!

 

[otacon88]

Awesome responses! Thanks a ton everyone. Looks like I'm going to have to start the grueling process soon enough - I think the google info and making spreadsheets is an excellent idea, thanks daveyjwin. And I didn't specify where I was looking at because honestly I'm looking all over - mainly the west/east coast and TX as of now. Almost positive I don't want to do academics, unless it's part time and I have no other options, and interested in locums so I can get an idea for what I like and don't like in a hospital/system/group, but don't know if I want to travel all over the place every few weeks/months. Will definitely make use of my time at ACEP and talk to everyone I can to get a feel for it all.

 

[Apollyon]

Oh my - Texas. I say that because someone stated a "rule" on SDN - if you are thinking of Texas, start applying for a license now, before you even need it. Now, someone is going to say that they applied for their TX license, and got it in 3 weeks, and I'll tell you that that person has a horseshoe up their butt. Also, don't forget the Texas Jurisprudence Exam. That's the one where, here on SDN, people who seem to barely speak English sign up to make one post, asking if anyone has the book to read for that exam for sale. And, as far as licenses go, get on that sooner than later, in general.

 

[WilcoWorld]

.

 

[Droperidol]

Oh my - Texas. I say that because someone stated a "rule" on SDN - if you are thinking of Texas, start applying for a license now, before you even need it. Now, someone is going to say that they applied for their TX license, and got it in 3 weeks, and I'll tell you that that person has a horseshoe up their butt. Also, don't forget the Texas Jurisprudence Exam. That's the one where, here on SDN, people who seem to barely speak English sign up to make one post, asking if anyone has the book to read for that exam for sale. And, as far as licenses go, get on that sooner than later, in general.

This is pretty hilarious and accurate. Takes in total 3-4 months roughly. The JP exam is really easy. You can read the book or use texasjurisprudenceprep.com

 

[gman33]

Thanks for the posts. I'm in the same position as the OP.
I have a geographic area picked out due to family reasons.

There have been other threads on this, but any more tips on what to look out for in a contract or group.
I'm fine with being the low man, and working more than my share of bad shifts etc.
That being said I don't want to sign up for a job where I'm always getting screwed.
I know of one group in my area where the pre-partners all start out working exculsively weekend overnights. thur-sun overnight.
This type of job would be torture to me, could maybe deal with for 1-2 years if I really had to.
Would hate to get a job and then find out that's the way the schedule worked out.

Is the schedule the type of thing that should be in my contract?
How do you ask about these kind of things without coming off like the guy who never wants to work nights, weekends and holidays?

 

[BoardingDoc]

Is the schedule the type of thing that should be in my contract?
How do you ask about these kind of things without coming off like the guy who never wants to work nights, weekends and holidays?

I can't speak to attending jobs as I'm just about to start my residency, that said, I can say from a career before medical school that you should absolutely ask about the schedule during your interview. You don't need to sugar coat it, it is obviously an important question. Just ask them how scheduling shifts works among the group. Do some members have seniority over others in their choices? How are nights and weekends divided? Simple and straightforward. If anyone gets touchy about it I would see that as a red flag about them, not as though you had made a mistake.

 

[Groove]

Branch Point:

IC vs Hospital Employee vs Ind/Dem Group - Research pros and cons of each. I won't rehash since we have plenty of old threads on this topic. We could start another one in here if people so desired. Personally, I prefer IC "now". I fully admit that there will most likely be a time when I would prefer another model.

Criteria when evaluating your job: Hospital (Resources, management, administration, colleagues, location, reputation, medmal environment (get your contract lawyer to do due diligence in regards to this... most can find out if there have been any large outstanding lawsuits in the last few years), nursing, ED environment, ED coverage, pt acuity, do they use MLPs and in what capacity, etc.. You know the drill.

Does the gig outweigh your desired employee model? You decide.

Always get a contract lawyer to at least review your contract and perform a little bit of due diligence. CMG contracts are very cookie cutter and easier to read, but there are virtually always modifications that can be added such as sign on bonus vesting language, conflict resolution provision or removal of indemnification clauses, etc.. You will NOT be the first physician to request changes to your contract. You have to be somewhat skilled at identifying the "important" parts of the contract and what you want to focus on such as termination clauses, compensation, malpractice, conflict resolution, indemnification, etc.. Lawyers will tear these things up and have an unreasonable number of demands, so I've found that you have to reign them in a bit so that your contract doesn't take forever to get modified and so you don't come across at the physician prima donna that is going to be extremely difficult to work with... That being said, you don't want to ever pen your John Hancock on a poorly written contract. I've found that the democratic group contracts are much less predictable and seem to contain a morass of nebulous language in various parts such as the termination clauses, profit sharing, etc.. that make it inherently more difficult to read. Essentially, they want to be able to fire you if they all wake up one Saturday and decide that they don't like you anymore because you farted on the senior partner's kid at last night's Christmas party causing Johnny to promptly vagal out and bust his head on the coffee table. Either way, you can't blame them. I wouldn't want to keep you either if all of us had been working together for 10-20 years and we suddenly hired someone that was most definitely not a good fit after several months or was farting on all our kids at every group event.

Schedule is usually not included other than clear statements about how many minimum shifts you are required to work each month vs hours/year, etc..

If you are going to do democratic partnership track with a nice group, then it's a little unreasonable not to expect to "do your time" during the partnership track which is likely going to include some crappy schedules. If you are looking to be treated equally from the get go with no strings then IC is a better fit. That's a long discussion on another topic though. Again, I prefer IC "now", but my dream job would probably be a private democratic group somewhere in the future. Who knows.

However, yes... it's unreasonable in almost any job to upon joining... ask not to work nights, weekends or holidays. Good luck with that! lol