Perspective on EP job search

[coloredcrayons]

I thought it might be helpful to give an update/some perspective on the EP job market.

When I was deciding to go into EP, this was something I was curious about, so I wanted to pass on some info in case others might find it helpful.

Overall, I was pleasantly surprised at the job market and job offers available this year (looked in 2021 for a position starting summer 2022). I wasn’t expecting to be able to find a job in the state I was looking, but ended up with a few offers in the county and found a job that I'm very happy with in the city I wanted to be in

edit: regarding the ability to be selective about the area you live in, overall, it seemed that people who looked outside of the city/county they were initially interested in did so because they specifically wanted very academic positions or wanted EP only jobs (i.e. no general cardiology call or gen cards clinical responsibilities). I'm not sure if covid affected the job market, but it seemed very good this year and everyone I know was happy with the job they got.

How to search:
-I found the internet to be the most helpful overall, different job search sites let me know what jobs were available and what groups were hiring. This is especially helpful if you’re looking to practice in a different area than you trained
-mapping and device reps, some of the companies keep lists of available job postings. Groups may let their reps know about a job opportunity and the listings gets updated every couple months or so. That being said, different companies have different listings and neither are comprehensive.
-local connections you may know at different hospitals, sending emails to groups you know of. Talking to fellows in areas you’re interested in. There’s a potpourri of ways to listen for positions. I felt like the sooner you found out about a position and applied the higher likelihood you’d be of getting an offer
-I also felt like talking to reps and fellows in the area was helpful to understand the reputation of the groups in the area

When to start looking:
-I started late spring of my first year, every opening I contacted then though said they were looking for someone to start that summer. I still felt it was helpful to start to see the job opportunities for the area I was looking in. With that being said, if the fit is right then some groups will hold the position for you until you graduate
-I feel like at the mid to end of summer (around August) is when groups start looking for people for the next academic year
-About 50% of people seemed to have signed somewhere by January of their second year
-New jobs pop up throughout the fall and winter, it seems around late January is when new listings stopped popping up. This may vary year by year, and I’m not sure how COVID changed things this year. A comment someone made during my search was some groups wait for their financial standing to be clear near the end of the year before posting a job.

Compensation:
-Varies greatly by geographic area. Jobs can be anywhere from low 3K to 7K starting. In general, if you’re an hour away from one of the top 3-4 cities “downtown” or not in an exceedingly desirable area, salaries start around 4’s-5’s
- In general, private practice can start lower than hospital employed, but once you become partner in 2-3 years then salaries go up. Academics overall has the lowest compensation

(part 1)

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[coloredcrayons]

(part 2)

Types of positions:
Private practice
Can be broken down into:

• A group has gotten big enough that they want to hire an EP and stop referring their cases out. You’ll be their only EP until the group grows big enough for a second EP. They may start you with some general cardiology until your practice is big enough that you can be 100% EP
• An EP is retiring or changing practices and you’re taking their position
• A group is looking at a new area to expand its reach and you’ll be their EP in this new expanded area (may involve outreach clinics and driving time)

Academic
-Generally, you’re joining at least one other EP. In these situations (especially if it’s a larger group) the group may be looking for a specific skillset like extractions or VT
Hospital employed
Working for a hospital system, highest starting salaries but less room to grow
*Private practice with teaching opportunities: groups that are private practice but either EP or general cardiology fellows rotate through and who you can teach

EP vs Cards/EP
In general, the closer you are to a more desirable area the more likely you are to have some general cardiology in your practice

Interviews
-When interviewing with a group, it was a full day process starting around 8 and ending around 6, can go later if there’s a dinner. Expect to meet everyone in the group and conversations can go from 30 mins to 2 hours.
-You may meet some of the higher ups in the hospital(s) you’d be working at
-Some groups have you come for a second day either the next day or at a later time
-Interestingly, some groups did not pay for the travel and lodging but instead had me interview when I would be in the area for other reasons. This was not limited to one group but instead seemed to be the practice for specific areas of the country

 

[coloredcrayons]

(part 3)

Offers
I found a pretty broad range of times given to reply to an offer. There were some groups that gave 2 weeks to respond to an offer and some that were able to wait months. Because new positions open up throughout the fall/early winter, it was difficult to decide on offers when you weren’t sure if something new was going to come up, this is the nature of finding a job outside of the match though

Contract
-I had a lawyer look at my contract to make sure there wasn’t anything unexpected in it. There was a lot of jargon and I wasn’t sure what should and shouldn’t be in a standard EP contract.
-Negotiating for a better contract is possible, there are lots of different things to ask for (e.g. higher sign on bonus, guaranteed CME time, only EP call, etc). Some lawyers will do the negotiating for you.
-For me it was less stressful to just have a setup where I paid one sum at the beginning of the process to the attorney rather than do an hourly rate as I heard stories of fellows that ended up with a pretty expensive bill
-Contract negotiations can take a while, can take 2 months or longer to have everything settled
-Most contracts seemed to be for 3 years

What groups look for:
In general, I felt that unless I was interviewing with another EP, groups were looking to see if I could do procedures safely and competently and if would I fit with the personality of the group. I think they also looked at the name of the institutions I trained at. Surprising to me was that the name of the people I trained with and my competencies at things like extraction and VT were less important unless it was a large academic institution

-I'll update this if I think of any more helpful information, this is what's come to mind so far

 

[epeepsLI]

(part 3)

Offers
I found a pretty broad range of times given to reply to an offer. There were some groups that gave 2 weeks to respond to an offer and some that were able to wait months. Because new positions open up throughout the fall/early winter, it was difficult to decide on offers when you weren’t sure if something new was going to come up, this is the nature of finding a job outside of the match though

Contract
-I had a lawyer look at my contract to make sure there wasn’t anything unexpected in it. There was a lot of jargon and I wasn’t sure what should and shouldn’t be in a standard EP contract.
-Negotiating for a better contract is possible, there are lots of different things to ask for (e.g. higher sign on bonus, guaranteed CME time, only EP call, etc). Some lawyers will do the negotiating for you.
-For me it was less stressful to just have a setup where I paid one sum at the beginning of the process to the attorney rather than do an hourly rate as I heard stories of fellows that ended up with a pretty expensive bill
-Contract negotiations can take a while, can take 2 months or longer to have everything settled
-Most contracts seemed to be for 3 years

What groups look for:
In general, I felt that unless I was interviewing with another EP, groups were looking to see if I could do procedures safely and competently and if would I fit with the personality of the group. I think they also looked at the name of the institutions I trained at. Surprising to me was that the name of the people I trained with and my competencies at things like extraction and VT were less important unless it was a large academic institution

-I'll update this if I think of any more helpful information, this is what's come to mind so far

What was the differential between hospital employed and private practice partner track when one were to reach partner?

 

[MaxPlancker]

Very helpful, thanks for sharing!

 

[coloredcrayons]

What was the differential between hospital employed and private practice partner track when one were to reach partner?

I think depends on how productive you are in private practice, hospital employed can increase based on productivity as well, but I didn't see pure productivity models at hospital employed positions.

I would venture to guess that the higher numbers you see for EPs are mostly private practice partners, maybe a rough guess would be 25% higher when comparing a very productive partner to someone same years in practice but hospital employed? Again, that's a rough guess based on the few numbers I know of