How does one's reputation precedes them?

[SpoiledMilk]

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They say that medicine is a small community and that one's reputation precedes them.

How does the small community of medicine "hear" or find out about one's reputation? e.g. lack of reference letters from faculty or PD of the residency, speaking with alumni of the residency who have had exposure with said job applicant, job recruiters "spreading the word," clinicians at prospective job speaking with other clinicians, etc

Are there actual instances where a resident has a had a difficult time getting a job for after graduation due their misbehavior or reputation for being "toxic" during residency?

Or does the shortage of physicians mean that resident will get a job no matter what even if they have a reputation for toxicity during residency?

 

[ThoracicGuy]

Maybe someone at the job knows someone from your training program and reaches out to them to hear about what's said behind closed doors. That could help or hurt you depending on what is said.

 

[DrMetal]

They say that medicine is a small community and that one's reputation precedes them.

How does the small community of medicine "hear" or find out about one's reputation? e.g. lack of reference letters from faculty or PD of the residency, speaking with alumni of the residency who have had exposure with said job applicant, job recruiters "spreading the word," clinicians at prospective job speaking with other clinicians, etc

Are there actual instances where a resident has a had a difficult time getting a job for after graduation due their misbehavior or reputation for being "toxic" during residency?

Or does the shortage of physicians mean that resident will get a job no matter what even if they have a reputation for toxicity during residency?

Your question is too general. If you can be more specific about your particular circumstance, you might get better advice.

In general, you look for a job, you apply, you get it, you start working, make money. Who cares about what anybody said about you in the past???
You quickly realize how high schoolish medical education and training was. Best to forget it and move forward.

And for God's sake: scan everyone and everything. The physical exam is useless

 

[Smurfette]

usually if we know someone who may have a connection to the applicant, we will ask them.

I've also received a phone call to discuss someone applying for a job because someone there had raised concerns based on prior experience in residency and they wanted a more updated assessment as I worked with the applicant more recently. I had no connections there; they reached out to me.

 

[Apollyon]

When I got near the end of residency, our PD told us to make an appt with the medical director of the ED. It was a 15 minute sit down to make sure we could be "normal" for that long, or, if he knew us (because, although a small group, there was always someone who, somehow, didn't get to know anyone), just fill in any gaps. Then, he told us (or, at least me) that I could use him as a reference for my first job.

 

[DrMetal]

When I got near the end of residency, our PD told us to make an appt with the medical director of the ED. It was a 15 minute sit down to make sure we could be "normal"

That's pretty deuchey. If you've been a resident in said program for 4 years, you've likely worked several shifts in that ED for that medical director. Based on that alone, he should give you a professional reference. And if you're graduating from the program, it's likely you performed well (or at least adequately).

If they feel negatively about you---to the extent that they would deny you a reference---then they shouldn't graduate you, or at least they should bring up their concerns with you, and make you remediate.

You shouldn't have to 'interview' for a reference.

I wonder if said ED medical director is as deuchey with the army of NPs he just hired to replace his physicians in the ER.

 

[Apollyon]

That's pretty deuchey. If you've been a resident in said program for 4 years, you've likely worked several shifts in that ED for that medical director. Based on that alone, he should give you a professional reference. And if you're graduating from the program, it's likely you performed well (or at least adequately).

If they feel negatively about you---to the extent that they would deny you a reference---then they shouldn't graduate you, or at least they should bring up their concerns with you, and make you remediate.

You shouldn't have to 'interview' for a reference.

I wonder if said ED medical director is as deuchey with the army of NPs he just hired to replace his physicians in the ER.

I probably described it poorly. For me, it was like being in the physician lounge - just being professional (that is, not casual or cursing).

Also, it was about 19.5 years ago, so, my recollection might be, of course, off.

 

[eyeeye_captain]

If you’re in a niche field like mine (~3k of us in the US), there’s maybe 2-3 degrees of separation from everybody. So if I don’t know who trained you, I know someone who knows someone who trained you.

The last time we were hiring, 2 of the applicants - one trained with my friend, another at a program I trained at. I reached out to my contacts, and *gasp* spoke to them on the phone. One had their CV thrown in the trash based on the feedback. Sadly the glowing review one joined a crappy private equity job for location reasons. Still got a good one, and wouldn’t you know it, I randomly ran into the big name at their program at a conference talking with one of my friends.

I doubt administrators care as much in larger fields, especially if you move out of region, but you’re still going to need some references to tell people you’re not a serial killer.

But come on, spill the tea. Something interesting is going on to prompt this post.

 

[mistafab]

You have to understand the idea of shrinking pools of people in local careers.

There may be tens of thousands of hospitalists... But what about hospitalists who staff ICU's in a single city? Now we are in a smaller pool. What about pure nocturnists that do that? Now we are less than a dozen. What about nocturnists who do great work, so the daytime folks who pick up the patients say "thank goodness it was Dr. X..." Now we're talking 1-2 people. All of a sudden everyone wants to hire Dr. X. Job is going to open? Let me shoot Dr. X a text and see if they're looking....

Reputation is extremely important. It opens and closes doors. The less mobile you are, the more reputation matters. I absolutely know psychiatrists who couldn't get jobs due to reputation alone. I absolutely know residents who raised stink and then no one wanted to touch them for employment. People in those buckets will have to move to a new area (i.e. find new victims) to get a shot if they have been black balled in an area. Word of mouth and reputation matters far more for being hired than your CV does. Everyone graduates basically and everyone is board certified. Nothing on your CV really matters except in academia (where reputation has more reach than non-academia).

Most specialties get very small very quick, even in a big city. Within a year or two you start to recognize everyone's name and start to know about the kind of work they do and how they get along with others. In academia, the circle is small enough that you know everyone in your field (academic specialty / subspecialty conference) essentially and by reputation alone could become untouchable (halo or outcast).

 

[Saddleshoes]

If you understand how the gossip mill works you can use it to your favor.
-- I don't know about others but I know I cultivate a certain kind of reputation.