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Light at the End of the Tunnel:
How to Find Your Dream Job

Allegheny General Hospital
Pittsburgh, Pennsylvania, USA

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Four years of medical school, 3 years of residency, 4 years of fellowship and about $8000 in exam fees later, you are poised to embark on a new journey. You expect to feel certain about your chosen career path, have your priorities lined up and feel confident about your future. You tell yourself that after putting yourself through the rigors of 80 hours workweeks on menial pay, someone owes you the 'perfect job'. This is all true—till you actually have to look for one!

Plunging into the job market is time consuming, confusing and—at times—plain frustrating. You postpone the process till after your exams or Christmas and, before you know it, it is March of the year of your graduation and you still don't know where you are headed.

You have to realize that job searching itself is a part-time job. You must understand the market, know your goals and have proper tools to see you through the process. Here are some key points to help you tread these waters:

Know what you want
Self-assessment is the first and most important step in any job search. Interviewers quickly eliminate candidates who are unsure of their direction. After your training, you should be cognizant of your key competencies as well as your personal concerns including family needs, community needs, education, and finally salary. These are the exact factors and objectives the people who will be looking to hire you are evaluating.

Curriculum Vitae and Cover Letter
Your CV is an extremely important and a highly personal document, which is a direct reflection of you. It should highlight your strengths and accomplishments as well as present a complete chronology of your training. It should not be so abbreviated that the reader gets too little information. Neither should it include irrelevant details, such as a list of journal clubs you presented in your own program. Including the volumes of the procedures performed to date and projected at the end of training can be very helpful. It is imperative to have the document proofread by another person, preferably a faculty member who is involved with hiring physicians (your program director may be a good option). The cover letter should be well thought out. It is your opportunity to give the reader a sense of you, and also the place to address any special requirements you might have, such as the need for sponsorship etc. You should include your clinical interests, activities and hobbies or any special training not reflected on your CV. It is also important to assemble a list of references that may accompany your CV or can be sent upon request.

According to a NEJM study, nearly nine in ten physicians quoted personal/professional referral as their main source for finding a job. Five in ten used subscribed online sources for job advertisements and about 65% found job-recruiting firms helpful.

Timing the process
If you want your choice of the best positions, start early, as most positions are filled 8-10 months prior to start date. Consider this: if a job opportunity is still available a month or so before it was meant to begin, there is a reason why no one wants that job.

If you are graduating in June 2014, here are some suggestions on how to approach your search:

  • July - August 2013 is the ideal time to start the search for the position of your choice and prepare/ update a CV. You are going to sort through many job options, many of which you will ultimately eliminate. Begin keeping a record of contacts, including the times and dates of any telephone interviews, especially if you are considering a number of opportunities concurrently. Request your faculty for letters of reference at this stage.
  • September - October 2013 is the time for telephone interviews, website postings and working with job recruiters. Telephone screening offers an introduction and poses an opportunity to assess what the job entails and what the expectations from the employer will be. Now would also be the time to remove any unprofessional entries or pictures from your Facebook page as potential employers may check these sites! When you post your CV on a website, you may lose control over its dissemination and get inundated with responses. You will need to review each carefully before responding. When considering working with a 'job-search firm', make sure they understand your specialty. If they don't, you have to assume their ability to represent you is limited.
  • November - December 2013: By this time interviews and site visits have begun in earnest. Remember, you are competing with people whose qualifications and accomplishments are very similar to yours and you need to distinguish yourself. During the interview process, it is helpful to learn as much about each individual in the group as possible because these will be the people that you will be spending a significant amount of time with during the day. You need to determine if the group is cohesive, what their practice styles are, and what their workload is. Try to determine how you will be expected to build and maintain a practice. It is appropriate to ask about your daily responsibilities, call schedule, as well as any administrative duties that may be asked of you. Be candid and direct, but do not ask about financial arrangements until the subject is raised by the group. The main goals during the first interview are for both sides to see if they are an adequate fit for each other. Salary is rarely discussed during the first interview, especially if the position is in an academic setting.
  • January - March 2014: A good percentage of your colleagues have signed contracts by now! If you have not identified any opportunities that meet your criteria, now is the time to reassess your priorities. If you have been offered a contract, it is prudent to have a lawyer or practice management consultant review your contract. If you have reservations, you may ask for extra time. Contract changes and negotiations are a normal part of the process. As a rule of thumb large groups, academic appointments and managed care providers have less room for flexibility. Prioritize a list of terms that you wish to negotiate on and keep it simple.

It is also important to remember that it is your first job and you will have additional opportunities to interview in the future. The challenges of your first interview and job are tools to learn from for the next time.

And last but not least - have faith in yourself and your decision!

oct links  Everybody ... I know you can believe in yourself!!

Disclosure Statement: Thanks to the input of friends and family, which I have summarized in the above article, I was able to land my 'dream job' in my final year of fellowship! No financial conflict of interest to disclose.

Acknowledgement: 'Candidate Information and Strategies' by Kate Lincoln with