Peds Jobs

[Allerian1004]

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I was talking to some of my fellow residents, and it has taken some of them a year to get a job with licensing. Is this typical? I hoping to go out of state post graduation but unsure if I'm going to do a fellowship (rheum) or hospitalist. I'm the only income for my family (husband and daughter). We wouldn't be able to afford going months without income and saving that much money in residency would be difficult. Is this typical for getting a license, and then a job?

 

[umass rower]

I don't know what the job market is like in your area, but based on my experience with fellow residents, I think this is fairly atypical. One thing that might have been going on is that if graduates had some specific requirements for their job (certain call schedules, patient populations, office structure, locations), it can be harder to find that in the market. And I have certainly seen plenty of people take some part-time jobs or essentially frequent moonlighting by choice, if they had something else planned for later or weren't sure what they wanted to do. But from my program at least, everyone from the last two years has been able to secure a job without too much difficulty well in advance of graduation.

I'm not sure what your inclusion of licensing means for your question. Start your license application in the fall of your 3rd year, because there's a decent chance that something will get missed with the paperwork on the first run through. Nobody's going to hire you if you're unlicensed.

 

[BigRedBeta]

I'm not sure your question? Is it a question about the licensing process? Or about finding a job (or a fellowship), because those are two different processes.

There are some states (Texas comes to mind) where the licensing process is ridiculously long. The best advice is once you have an idea of where you're going to end up, you have to start the license process, even if that's in the middle of second year. If it's fellowship, you start the process the day after a successful match. If it's a hospitalist job...then I'd narrow down locations as quickly as possible (I think very few people though are doing national sorts of job searches - most people have an inkling of where they'd like to end up, based on family or weather or whatever).

Not all states are that difficult though...

 

[oldbearprofessor]

I was talking to some of my fellow residents, and it has taken some of them a year to get a job with licensing. Is this typical? I hoping to go out of state post graduation but unsure if I'm going to do a fellowship (rheum) or hospitalist. I'm the only income for my family (husband and daughter). We wouldn't be able to afford going months without income and saving that much money in residency would be difficult. Is this typical for getting a license, and then a job?

To clarify some of the responses you've been given a bit. First, if you choose to do a rheumatology fellowship, then you'll likely be covered under the institutional license although you should try to get a permanent license as soon as possible. As a hospitalist, you are functioning as an attending who bills and will need a license for most positions.

How long it takes to get a license depends on a number of factors most importantly being the efficiency of the state licensing system. US graduates with no red flags on their applications will go the fastest in general. In some situations, I believe reciprocity may be helpful but I don't really know how common that is now. Regardless, at best it is usually a 3 month process and at worst 9 to 12 months, although the longest times often relate to one or two states and non-US medical schools. Therefore, as noted, if you are going the hospitalist route, you need to begin working on this pronto. Depending on the state, the costs, etc, you can consider getting a license in your current state, but that may be more expensive than the time saved.

 

[oldbearprofessor]

Nobody's going to hire you if you're unlicensed.

I'm not sure what you mean by this. It is standard in academic medicine to hire someone before they have their license in the state they are going to. Now, no one is going to hire someone they know to be unlicenseable, but this isn't common. Private practice or strictly clinical jobs (e.g. hospitalist with no academic role) won't allow you to start before you get your license for obvious reasons, but many/most academic jobs will have faculty start/get paid in non-clinical roles for a few months before the license comes through.

 

[Allerian1004]

I haven't decided whether I want to do rheum or hospitalist. But I'm a first year, and can't take my step 3 til next year (for Illinois). So I can't start my application or looking for jobs.

 

[kristing]

I haven't decided whether I want to do rheum or hospitalist. But I'm a first year, and can't take my step 3 til next year (for Illinois). So I can't start my application or looking for jobs.

You can look for jobs without a license. I did it before taking my Step 3 in my 3rd year, private practice jobs as well as fellowships.

You apply for rheum fellowships and it's no biggie without the license - many other residents won't have it when the application cycle starts.

You can start looking for hospital jobs also. Many places don't expect interviewing soon to be grads (and by soon to be I mean in their 3rd year) to have their permanent licenses if they are interviewing out of state because that would be dumb. Why pay for a license unless for sure you are going there? When you get an offer, assuming it's a hospitalist sort of one, then you start the state licensing then. This is why you apply a year before you are going to graduate.

 

[Sweet Tea]

I am fresh out of residency and moved from VA to TN, and am currently working as a hospitalist.

It took me about 6 weeks to apply for and get a TN license. This included an inordinate amount of pestering the medical board when they repeatedly lost my application. I was licensed in June, right after I graduated.

I applied for hospital credentialling right after I got my license. Holy. Freakin. Hell. That was a painful experience and it took a ridiculous amount of time for someone who was straight out of residency and therefore had no nefarious background to check. I applied for credentialling in June. I was approved at 1 hospital in mid-September, and I just got on at the last hospital last week. It was a painful, painful process. Fortunately for me, I'm working for a private group and you do not need to be credentialled anywhere to work in their office so I was able to work in the outpatient setting and pay the bills while awaiting hospital privileges. I abhor outpatient medicine so this was less than ideal, but paychecks are helpful things so I did it. I've been told that the process here is much longer than getting credentialled in other locations, so at interviews I would definitely ask how long it takes and can you get the paperwork started if you hear that credentialling moves at a glacial speed.

If you decide to go the hospitalist route, I would start looking at the end of your second year or beginning of your third year. That will allow you plenty of time to narrow down where you want to be geographically, apply for your license, and then apply for credentials. That way the ball is in your court and you can pretty much pick your own start date and be ready to start work when you want. You don't want to be forced in to a 4-month unpaid vacation while your credentialling application waits to go to the next committee meeting. We're constantly interviewing for our hospitalist program and most of our applicants don't have a TN license much less credentials at any of our hospitals. They also usually have commitments (military, residency training, fellowship training, contracts with their current jobs) that push their start date pretty far in to the future. Employers are used to working on a distant time frame so applying over a year in advance will be nothing new.

Of course, none of what I just said applies to a rheumatology fellowship. So if you decide to go that route then just ignore my post. 😉

 

[The Masked Duck]

Of course, none of what I just said applies to a rheumatology fellowship. So if you decide to go that route then just ignore my post. 😉

Dumb question, but what is so special about rheumatology??? Is it because there is such a shortage?? I mean pretty much all the pediatric subspecialties are in shortage, not just rheumatology. Look at PICU, I think last year only a little over 60% of programs filled.

 

[Allerian1004]

I think rheumatology has less specialists than the vast majority of peds specialists. And, let's be honest the pathology is fascinating. But what I ultimately choose will be based on what type of life I want with my family.

 

[Sweet Tea]

Dumb question, but what is so special about rheumatology??? Is it because there is such a shortage?? I mean pretty much all the pediatric subspecialties are in shortage, not just rheumatology. Look at PICU, I think last year only a little over 60% of programs filled.

Nothing. I just mentioned rheumatology fellowship because that's what the OP is interested in. Nothing of my post applies to any fellowship.