What to do when you can't get a job?

[Pathoguru]

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So what can you do if you have completed a 4 year path residency with a year of fellowship and still are struggling to find a job? Any other options other than switching to another residency?

Pathoguru

 

[coroner]

The most common route taken by fellows without any prospects is to do multiple fellowships. This doesn't necessarily enhance their job prospects, but keeps a paycheck coming. Few people switch to another residency, although after three or four fellowships it would add up to the same amount of time. Plus, they wouldn't get the appropriate funding to re-start a brand new residency from scratch.

 

[bdunwood]

Hey Pathoguru.

I thought I might be able to help you with your situation. Others have helped me as there are many on here who are in a similar boat.

I decided to do my 3rd fellowship this Spring after having difficulty on the interview trail. (Actually most of my difficulty was just to GET an interview!!! so that is techinically not correct.)

Since reimbursement typically does not cover moving expenses and board expenses, I have found odd jobs to do to cover these things. Some on here find things beneath them but I do not as I enjoy working outside after my days spent in the lab/office.

It is hard though to not see your family much and I also am not able to enjoy some of my hobbies that I once enjoyed. But when you have kids, you will literally sacrifice anything for them so it is still rewarding at night going home having felt like you are giving them your all. When my son tells my wife that he wishes his daddy were home more often, that cuts kind of deep though. But there are certainly many more people enduring far more than what we are going through if you look around the world so we try to stay positive!!!

👍👍👍

Here's to better luck on the interview trail next year!!! It sounds like pathologists are not retiring do to their financial situations (according to the CAP president). Obama tells us we are on the brink of recovery so I see a big retirement wave -- perhaps 3 years worth of retirements -- coming in the next year perhaps!!!!

 

[Patho2009]

This kind of posting scares me to death and ruins my days...but this is the bad reality and bitter truth that we cannot escape from...all what I can say is that I wish you all - and myself - the best in professional career and life.

Passing the Board is the first critical step toward securing a job. Employers now - in the light of fierce competition- disregard Board eligible status. Doing any kind of fellowship is better than staying home jobless. I can only imgaine how you feel now.

 

[mcfaddens]

This kind of posting scares me to death and ruins my days....

You can't let this stuff do that to you emotionally. Use that energy into actively looking for employment in advance, remember a decent job is not going to be handed to you. Also it's probably a good idea to begin working on your anxiety and coping skills because when you do get a job there is a whole new set of problems that you will encounter that could easily give you a MI.

 

[zao275]

Agree with mcfaddens. Worrying will do you no good at all. Do what you can now to enhance your ability to get a job later. Network, go to meetings, get involved in committees, etc. None of these things guarantee you a job but you might meet someone who is looking. Many of my faculty say that MOST jobs are obtained via word of mouth (i.e. - they are not advertised or posted on job boards, they are from a director calling another director and asking if they have a good resident or fellow graduating soon). That is anecdotal of course, but that is what I have heard from many people I trust.

 

[oldfatman]

http://blogs.bnet.com/career-advice/?p=937&tag=nl.e713

Sorry, couldn't resist.

 

[pathstudent]

So what can you do if you have completed a 4 year path residency with a year of fellowship and still are struggling to find a job? Any other options other than switching to another residency?

Pathoguru

community practice troll

 

[Parts Unknown]

community practice troll

Have you ever worked in a private practice setting?

 

[oldfatman]

Being a physician is sort of a dead end job anyways. Your earnings are controlled by the government. Unless you are in an artificial situation, like academics, and are trying to be promoted from assistant associate professor to associate assistant professor, you peak out rather quickly.

 

[Parts Unknown]

Being a physician is sort of a dead end job anyways. Your earnings are controlled by the government.

Yes, and the first thing we must do is get the government out of Medicare.

 

[KCShaw]

Hopefully you can identify a few controllable reasons why you might not be having success. (Worrying about things you can't control will just turn you bitter, or worse.) Someone suggested trying to get your boards out of the way if you haven't already, which is probably a good idea. I think as long as you're able to take any tiny forward step each year (or at least sell it as such if someone asks), at the least you're improving your chances. Then try to always be looking 1-2 years ahead at your options and keep going after them. But don't "suicide" on one location or possible opportunity and risk missing out on others.

I know it sucks to have non-medical real-life responsibilities and limitations on top of what you're trying to achieve in a medical career. It's a lot harder to move, lot harder to keep everyone in your family positive, and so on -- I get that, and so do a lot of people. Unfortunately, understanding the difficulties doesn't make them go away or land you a job -- it does, however, hopefully make focusing on what you -can- do slightly easier.

 

[2121115]

As someone beginning a job search right now I find this thread quite disheartening and discouraging. It seems like there is no way to predict whether or not one will be able to find a job and you only know after it is too late. After reading many of these threads I have to say that I have no idea what makes a trainee a strong or weak candidate for getting a job. People who find jobs seem to imply that those who can't must have "red flags" while those unable to find a job do not perceive themselves this way. This instills a certain amount of self doubt for someone entering the job search. Do I have "red flags"? I don't know. Apparently if you do you can't see them. I have missed cases in residency. Does that make me incompetent? I think I work well with people. Maybe they don't think so? Obviously everyone without a job perceives themselves as being competent and easy to work with, maybe that is me??? I don't know. Maybe I won't know until I ask for job references from faculty and they tell me to get lost.

I do know that my program has kicked my ass and I have worked hard. I feel like I shouldn't be this worried, but oh well. I am half a decade in now and if it doesn't work out I guess it is too late to go back now.

 

[KCShaw]

I think your honesty is both revealing and understandable. I guess it's easy to forget that sometimes people don't always offer a lot of hints as to why you don't get an interview or don't get a job (or they, frankly, lie to you to save the grief of being honest).

But, I still think attacking the things you can control is a good way to go -- it just may mean going out of your way to figure out what employers think those things are. It can be networking, the program(s) you've been at, recommendations (even just by phone), language, dress style, teaching experience, sign-out time, board certification, med school...lots of things play a role, some bigger than others, and some more fair than others, depending on the employer. Most programs have at least one hardass on faculty who will tell you straight. It might not be pleasant, but it might also give you something specific to try to address. The hard part is if all they do is talk about things you -can't- address, or not easily.

And there will be times when you do everything right and the stars just aren't aligning. Either employers have an "in" with some other applicant, you can't move in a certain time to a certain place, you called when they were having a bad day, and so on. It's hard, but you've got to try to scratch some positives out of any swirling black hole and avoid getting sucked in.

Good luck, everybody.

 

[deleted314957]

As someone beginning a job search right now I find this thread quite disheartening and discouraging. It seems like there is no way to predict whether or not one will be able to find a job and you only know after it is too late. After reading many of these threads I have to say that I have no idea what makes a trainee a strong or weak candidate for getting a job. People who find jobs seem to imply that those who can't must have "red flags" while those unable to find a job do not perceive themselves this way. This instills a certain amount of self doubt for someone entering the job search. Do I have "red flags"? I don't know. Apparently if you do you can't see them. I have missed cases in residency. Does that make me incompetent? I think I work well with people. Maybe they don't think so? Obviously everyone without a job perceives themselves as being competent and easy to work with, maybe that is me??? I don't know. Maybe I won't know until I ask for job references from faculty and they tell me to get lost.

I do know that my program has kicked my ass and I have worked hard. I feel like I shouldn't be this worried, but oh well. I am half a decade in now and if it doesn't work out I guess it is too late to go back now.

I got "hired" (out of the navy) in 1988 and it was thru contacts from Navy buddies who were ahead of me. Over the next 4 years we hired 3 associates who were navy contacts of mine who I turned on to the group.
When I was an interviewing partner involved in hiring from 1992 to 1996 everyone was a personal contact of someone in the group, several of them from the army nexus.
TO SUMMARIZE, IT WAS ALMOST ALWAYS PERSONAL CONTACTS. I don't know of anyone who got a job thru an ad. And if you check, you will see that a whole s*** load of folks in the Virginia Tidewater area are former military---all due to networking. I think the same happens in the "civilian" world but it is not as inbread ( or as easy). NETWORK until you are blue in the face!

 

[zao275]

I have not started looking for a job, so I have no personal experience. But I watched many of the residents and fellows that I know go through the job application process over the past 2-3 years, and my understanding was that the vast majority of them found jobs via networking/personal contacts/an attending calling up an old friend/etc. My attendings have always told me that was the very best way to get a fellowship or job, by knowing people and/or by knowing people who know people. Obviously you have to be a good pathologist, but you can be amazing and still not get hired if you don't have some help getting your foot in the door (that is how I got my fellowships!). So my observations agree with mikesheree's advice very strongly.

The good news is that networking is cheap, easy, and usually fun (depending upon your personality, I guess).

 

[oldfatman]

I have heard the usual bs about networking a thousand times, without it being explained or described. It's kind of loose buzzward that means you get a job by blind luck. It's how I got my first job, but I've had a lot of opportunity to sit and think about what I could have done differently. Residents are already in a underdog/social leper position, and you may find it difficult to go around begging for a job.

There is something you can learn, which has a lot on unambigious material out there--it's called SELLING. And the product you will be selling will be yourself. And no one can do that for you. And if you can SELL yourself to the group, you can SELL your competence to the surgeons, gi docs, ob/gyns, urologists, derms, and so on.

I would start will the Zig Ziglar material, but there is so much material on SELLING that anywhere would be a better start than doing nothing.

 

[deleted314957]

I have heard the usual bs about networking a thousand times, without it being explained or described. It's kind of loose buzzward that means you get a job by blind luck. It's how I got my first job, but I've had a lot of opportunity to sit and think about what I could have done differently. Residents are already in a underdog/social leper position, and you may find it difficult to go around begging for a job.

There is something you can learn, which has a lot on unambigious material out there--it's called SELLING. And the product you will be selling will be yourself. And no one can do that for you. And if you can SELL yourself to the group, you can SELL your competence to the surgeons, gi docs, ob/gyns, urologists, derms, and so on.

I would start will the Zig Ziglar material, but there is so much material on SELLING that anywhere would be a better start than doing nothing.

Networking is knowing and having a "Zig Ziglar" in the group you aspire to join who is pulling for you with the others in the group.

 

[zao275]

I have heard the usual bs about networking a thousand times, without it being explained or described.

Good point. I guess that many people use the term without explanation. To me, networking means getting to know people in the field that might be able to offer you a job, or that will put in a good word on your behalf when you are applying for a job (similar to what mikesheree said). Examples of how I have tried to do this include:

-

• Attending national pathology meetings, and going to social functions at those meetings.
• Introducing myself to as many people as I can when at meetings.
• Introducing the people I know to each other...it expands your network of connections.
• Attending local pathology society meetings (state or city), if available in your area.
• Making a point to keep in touch with people you meet at meetings (via email, facebook, or in person).
• And of course, behaving professionally and competently with the people you currently work with or train with (that's obvious, I guess). They can put in a good word for you if needed one day.

None of these things guarantee you anything, but I think they have the potential to help. Maybe some of them make us reach beyond our comfort zones (e.g. - introducing ourselves to well known people), but it might be worth it. At a recent meeting, I introduced myself to Juan Rosai (I am a resident). I felt a bit nervous, but I wanted to meet him, so I walked up and told him thanks for contributing his collection of slides to be digitally scanned by Aperio. Now I am not suggesting that he will remember me or help me get a job or anything, but I make the point that you can walk up to anyone and introduce yourself. He didn't seem annoyed with me for talking to him (how could anyone be angry for someone saying "Thanks for your hard work, I am a huge fan"?)

I am a very social person, so this stuff is easy for me (but it might not be for others). I suppose the downside is that some of these things might make me look like a suck up or something, but as people get to know me, I think most of them realize that I just like to meet and get to know people.

The key to networking is doing these things BEFORE you need a job or fellowship, so that you can build relationships over time. People that know you and trust you on a personal level are much more likely to choose you over some random applicant on a piece of paper that they don't know (in my opinion). Plus, I have met some really cool people this way!

 

[zao275]

I also posted the above suggestions on the "How to Get a Fellowship" page on the Pathology Resident Wiki. Please feel free to edit that page and any thoughts that you may have. I think some of the same principles apply to both fellowship and job application process.

http://pathinfo.wikia.com/wiki/How_to_Get_a_Fellowship#Networking

 

[KCShaw]

<snip> <snip>
The key to networking is doing these things BEFORE you need a job or fellowship, so that you can build relationships over time. <snip>

I think this is an important point, though admittedly less helpful to people facing a current job crunch. Still, start when you can. If you're out there enough, even merely showing up to some of the meetings, you're at least more familiar when applications start flying. Not everyone is a natural at socially squirming into the life of someone who could help them, and successful approaches will be different.

Something I don't think has been said yet, but I'll note -- when possible, make personal contact with whatever group you're interested in joining. In most cases phone calls are much more effective in the long run than emails or sending a blind application because of an advertisement on the internet.
</snip></snip></snip>

 

[lipomas]

I think people confuse "networking" with "showing up at conferences, introducing yourself to people, and hoping that things happen." It doesn't work that way. You are very unlikely to introduce yourself to someone well known and have them call you up 6 months later and offer you a great job. The purpose of doing all of this is to introduce yourself, start to make connections, etc. You never know what comes up when you start talking to people. This person knows someone who you know peripherally, this person knows of someone in the area you're from who they are still close to, things like that.

Luck plays a role in everything. But getting a job is not based on blind luck. Luck plays a role in timing, quite often. You might be perfectly suited for a job in a particular group, only you are finishing residency one year too late. That sucks when that happens. But luck is playing much less of a role when you meet someone at a conference and they put you in touch with the chairperson of a group near you who is looking for someone with your qualifications.

Networking also includes making it known that you are competent pathologist and someone who people want to work with. I received a couple of unsolicited recruitment-type contacts towards the end of my residency because attendings in my program were contacted by their friends who were looking for someone to hire, and the attending thought of me.

 

[zao275]

I think people confuse "networking" with "showing up at conferences, introducing yourself to people, and hoping that things happen." It doesn't work that way.

I agree. I was not intending to say "If you just show up, it will all work out for you." Sorry if I made it sound that way. I think that you should actively work to build relationships with people, have conversations about what they do and where they trained and who they know, talk about your career plans and interests, give the other person a chance to get to know you and your qualifications (as lipomas rightly said). Basically, follow every lead and be actively involved in getting to know people. Introduce people to each other and also let them introduce you to other people. If you lack the qualifications, it won't really help that much. But if you have what someone is looking for, then you are "marketing yourself" by getting to know a lot of people. I hate to make it sound so crass, but I guess that is what it is. It is not that you can't appreciate people and be friends with them for who they are, but by letting them know your skills and interests, they just might know someone who needs a person just like you.

 

[yaah]

Networking also includes making it known that you are competent pathologist and someone who people want to work with. I received a couple of unsolicited recruitment-type contacts towards the end of my residency because attendings in my program were contacted by their friends who were looking for someone to hire, and the attending thought of me.

This is a key point, often neglected.

I hear lots of people say they are "trying to network" but all they are really doing is going to conferences, maybe with a poster, and standing around hoping someone notices them. Others just keep introducing themselves to famous people I guess in the hope that something will happen. Neither of those is generally effective (the exception being if you have major hawtness). There is no real perfect way to network - it's a matter of keeping your options open and being a good advocate for yourself, without being a jackass. Local/state path societies can be good places, as they often have lunches or snacks where you can sit with private practice paths. What often happens with residents is that they all end up sitting together at their own table. Then they wonder why nothing good came out of their "networking."

 

[zao275]

What often happens with residents is that they all end up sitting together at their own table. Then they wonder why nothing good came out of their "networking."

Yes, it is a hard habit to break. I try to encourage my junior residents to go sit at tables with practicing pathologists that they don't know and talk to them at meetings. At the last CAP Residents Forum meeting, we had a joint session with both the Residents Forum and the CAP House of Delegates together in one room. We also had a joint lunch. Even the House of Delegates had to be coaxed to mingle with the residents (and vice versa), but overall it was a great success and we plan to do our meetings like this in the future. Residents can learn a lot about the "real world" from practicing pathologists. I suppose that some practicing pathologists can also learn some enthusiasm and idealism from the residents. 😉

 

[BU Pathology]

Medical school in general does not train physicians how to sell themselves. There are times in your career when you need to be an advocate for yourself, such as getting a residency, fellowship, and then job. Part of this is learning how to network, but as this discussion shows even a description of networking is not uniform. One needs to have confidence but not arrogance that you are a good fit for the next position. At times, this also includes recognizing that you may not the best candidate because the job does not match your skills or desires. In some ways, recognizing your own limitations increases your confidence.

For specific advice, be pro-active throughout your career. Seize opportunities and work to create new ones. Show the people who are considering hiring you that you can deliver even when times are difficult.

 

[zao275]

One needs to have confidence but not arrogance that you are a good fit for the next position.

Well said. A difficult but important balance to find!

I wish that med schools and residencies taught more of the social/intangible skills that are needed for any professional (the stuff I like to call "meta-pathology"). I read an old book that was really great and explained a lot of useful things in regards to this topic: "How to Win Friends and Influence People" by Dale Carnegie. Short and sweet, but I highly recommend it.

 

[oldfatman]

Networking will not get you a job. Personal contacts will get a job. The stronger these contacts are and the more of them you have, the more likely you are to get a job.

People want to help their friends, not random strangers with business cards. Pathologists included.

 

[Parts Unknown]

People want to help their friends, not random strangers with business cards.

Couldn't agree more. The grinning Tracy Flick clones who lurk around meetings trying to network with everyone and everything really give me the creeps. I actually have a primordial impulse to sabotage these people, if given the opportunity.

 

[lipomas]

Networking will not get you a job. Personal contacts will get a job. The stronger these contacts are and the more of them you have, the more likely you are to get a job.

People want to help their friends, not random strangers with business cards. Pathologists included.

Acquiring personal contacts (and cultivating them) IS networking. At least, it's a huge part of networking. I think part of your objection to the terminology is simply definitional.

BU Pathology makes a great point - there is far too much arrogance in medicine. Arrogance can be put up with when you are in charge and well established (even if people all hate you!). But when you are just starting out or looking for a job, it does not help you at all. Unfortunately, but not surprisingly, the arrogant among us are generally the last to figure this out.

Early in their careers, the arrogant tend to do a lot of blaming other people for keeping them down. Later in their careers, they are still blaming people, but they are blaming people for doing an inferior job or something like that.

 

[zao275]

Acquiring personal contacts (and cultivating them) IS networking.

That is what I have always thought that networking was, too. I am very sorry if I have conveyed the wrong idea or not made my definitions more clear. I guess I always thought of networking as a good thing and didn't realize that it has negative connotations for some.

I actually enjoy getting to meet people and developing relationships with them over time. If people just know your name, that doesn't do much good and there is not much fun in that. Actually talking to people and keeping in touch with them and getting to know them is pretty enjoyable. But to do all of that you do have to start by breaking the ice and meeting people in the first place. I guess some people just stop there and never get to know anyone for real?

 

[oldfatman]

I would like to make the point that this is about intent, not semantics. If you want to call making friends with a lot of people "networking", that is fine with me. However, this implies that there is a value for value exchange. If you are meeting people with mostly the ulterior motive of getting a job, your desperation will show through, and you will not be as effective.

The same thing could be said for dating, or any other human relations.

 

[zao275]

I would like to make the point that this is about intent, not semantics. If you want to call making friends with a lot of people "networking", that is fine with me.

Good point. Motive is important. Yes, I do like to make a lot of friends. I think that one day some of these contacts might be useful/helpful for me (whether getting a job or otherwise), but that is just the icing on the cake. I certainly hope that I have the opportunity to be helpful to them regardless.