My husband is completing his medical subspecialty fellowship this coming summer, a long awaited event. When this past June rolled around we started actively seeking his first “real” job. Just as I helped proofread his medical school entrance essays and helped him study for numerous board exams, naturally, I began actively seeking advice about how to find that first job. I turned to my trusted friend, Google, to learn more about the process and what we should know.
Unfortunately, my search yielded few results. It seemed the topic of the first post-training job is not well discussed online. I had my choice of unanswered threads from people like me, asking about how to proceed on Student Doctor Network or brief, shallow commentary written by physician recruiters touting the benefits of utilizing a recruiter. Both left us scratching our heads.
Many physicians enter the search with a small area in mind and that helps simplify their search. However, some are willing to include a larger search area to find the job that best fits their parameters. Finding ourselves in this boat, we were overwhelmed with where to begin and how to proceed. My husband signed a contract last week, almost six months after we began. I’ve learned a thing or two in the process that I think might be helpful to others.
Physician Family, Know Thyself
Help your spouse narrow down what practice setting is the most appealing. If he or she knows hospital employment is the way to go the field becomes smaller. Similarly, which state or region of the country do you prefer as a family? We were able to narrow it down to the southeast United States but my husband was unsure which practice type would best suit him, until he actually interviewed in small private practice and hospitals.
DIY or Full Service
We decided to look for the position ourselves instead of utilizing a physician recruiter. An independent physician recruiter is paid by the enlisting practice to find the physician. If you have the time to find the job yourselves, you can save the practice thousands of dollars, which can be reallocated to your future salary. For us, that meant cold calling and using network connections to find leads. Here’s where I became useful. I searched for every practice of our subspecialty, in every state we were willing to reside. I made a spreadsheet of practice names, size, address, phone and contact. My husband called them and once we got the go ahead to send a CV, I either emailed or direct mailed his CV. I sent followup emails and kept tabs, once we knew their interest.
Condense Your Interviews
Next, phone interviews began. I scheduled phone interviews for my husband around his schedule and made sure he remembered when they were and the details about the practice. He could have physically done all of this himself, but he is in the second year of a two year, clinical heavy, fellowship and time is not readily available. Once the phone interview was completed we decided if and when he would interview in person.
Once we began searching, it all started happening fast. The first interview was over and an offer was made almost three months before our last interview was over. In hindsight, I would have tried to condense interviews closer together since we had practices waiting around for an answer for a while. Many understood, but it increased our stress. Unfortunately, we were trying to schedule interviews around a very busy schedule and it wasn’t easily accomplished.
Stay Organized
Once we were talking to so many practices it became difficult to stay organized. I used a spreadsheet again with contact names, where in the process we were (phone interview, interview pending, etc.). Many practices were waiting for letters of recommendation, online applications and other credentialing info before scheduling interviews. If you can assist, this helps speed up the process. I had a very good understanding of my husband’s schedule and was able to book flights and hotels without talking to him. At the end of each day, I would update him on when and where he was going. If we’d had to wait for him to do this himself, it would have taken a lot longer or his search would have been much smaller.
Spouse Recruitment
Before we began the process, I read that spouse recruitment is common, as no practice wants to move a family with an unhappy spouse. Yet, I wasn’t sure what that would look like, exactly. This can vary, depending on specialty, but I was invited to attend every interview with paid expenses. I was offered a real estate tour, childcare, and given a tour of the practices. We attended dinner with the partners and all of the groups offered to help in any way they could. I found myself at the house of a partner with my three young children having lunch with his very hospitable wife. I silently prayed that my children would not turn into tiny Tasmanian devils or forget that we don’t use the bathroom outside, even though its fun. Be prepared to be included and ideally enlist help if you need childcare so you may attend. One practice would not interview any candidate without a spouse present, as they had frequent turnover due to unhappy spouses.
Deliberation
As offers come in, you’ll be forced to weigh their potential and your interest without knowing other offers. We were able to immediately rule out many groups after a phone interview. We asked for more information where it was necessary. We needed to learn more about potential partnership options. If the long-term goal is partnership, understanding their buy-in and buy-out parameters is extremely important. Once you know the best option for your family, graciously declining offers is crucial. It was our goal to sign a contract by the beginning of December. I am aware that credentialing for a new physician can take months and I have heard of physicians needing to push their start dates back if credentialing is not complete. As a nurse practitioner, I have credentialed myself so I know it is tedious and time consuming.
Contract Negotiation
I think it’s fair to assume everyone knows the absolute necessity of a healthcare contract attorney, but let me reiterate, their help is a must during negotiations. Ask all the questions you can, read articles on contract negotiations and go into them with a good working knowledge and a knowledgeable teammate on your side. Depending on the practice, this can be very slow or it can move quickly. We received one contract within a few days of interviewing; another told us it would take weeks.
Celebrate
If you’ve found the best practice for your spouse in a location that works great for your family and if you’ve negotiated to the point of signing, congratulations! It’s a great feeling and we are still riding that wave. Celebrate big and relax some. Training isn’t over but some of the unknowns are behind you. Now take a breather, momentarily, until you start receiving the credentialing paperwork and find yourselves looking for your spouse’s kindergarten finger paintings to present to the credentialing department.
The hardest work of all is to do nothing.