Getting a Job
At some point in residency or fellowship, every physician needs to confront the issue of landing the first job. While it may not be your only job in medicine — indeed, the odds are against it — every position is important in a developing career. That’s why physicians in training should approach this assignment with a mission: to get the best interviews.
Where are the Jobs?
Your first pass through the advertising should be to find those listed opportunities that meet your "type of practice" criteria. This would include the size of practice (number of physicians), style of practice (academic, multispecialty group, etc.), and the geographic location of preference. A telephone call (or letter to a blind ad) should help you determine if the opportunity is worth your application.
The bromide in recruiting is that the best jobs aren’t advertised. We don’t know if it’s true, but it doesn’t hurt to proceed as if it is. This means enlisting the word-of-mouth network to spot good target opportunities. One technique is to let everyone you’ve ever met in the field of medicine (or even remotely connected with it) know you are looking and ask for their help in spotting opportunities for you. It would certainly include hospital administrators in your target communities, leaders of organized medicine, outstanding figures in your specialty and related fields. Asking for help is a great way to make a friend and the logical targets are people who will be helpful to you later as well.
A mass mailing to everyone in your specialty in your target areas, asking for their help in spotting opportunities for you may yield several leads. It is hard to say who will be able help or who might have an opening for you, but it does get your name in front of a lot of people — something that can only help in the long run. The letter should be short and direct, telling people of your upcoming availability, and asking for help in identifying opportunities. Put in a paragraph describing your credentials and experience but don’t bother with the CV at this point.
Your mission is to get leads on possible openings. If you have identified specific practices that you would like to join, solicit them. It costs very little, and, if you are persistent, they may take you on even though they don’t have plans to expand their practice. We are continually amazed at the number of practices that hire doctors because they apply. Most physicians do precious-little planning so they may be ripe for your doing it for them.
First Impressions
All of your contacts with the outside world should telegraph the message of professionalism and quality. Your letters requesting help in the job search, application letters, and CV all need to be professionally prepared and letter perfect.
When you go for your interview, get a haircut, shine your shoes, and dress like the majority of doctors in the area. If in doubt, hang around the hospital for a while to see how they dress. Appropriate physician attire differs tremendously by area, but for men a natural shoulder, natural fiber, traditional look is probably the safest. For women, a conservative dress or suit are appropriate. Avoid dramatic or fussy looks. Show up on time and smile. Be friendly to everyone. Receptionists, medical assistants, techs, and managers may be just as important to your success as your potential colleagues.
Listen carefully and take notes. You will forget what people tell you. Ask plenty of questions and display a knowledge of the medical community if you can. It is a good idea to do some homework about the hospitals, the demographics of the area, and the major employers, too. In most towns, the chamber of commerce or convention and visitors bureau will have a brief demographic description to provide you with the background to ask some reasonable questions. Knowledge of the dominant employers, insurance plans, and HMOs, and so forth will help you get the most from your interview.
Some of the questions you may want or need to ask may seem awkward at first. Give the other party permission not to answer: “I hope you won’t think I am prying or being rude when I ask you these questions. And if you would prefer not to answer some of them, I hope you will just say so. But since my time here is short and this is an important step for everyone involved, I feel obligated to ask.”
First Interview Questions
The interview process can be stressful to both the employer and the candidate. Both are often inexperienced in the professional hiring process. Employers are often seductive in the process, trying to entice the candidate by putting on a good front. And job candidates may be doing the same thing. But your desire to impress them with your credentials and winning personality should be balanced by the need to uncover important facts about the target employer. Here are some good questions to ask of the doctors, clinic administrator, or office manager of your prospective employer’s practice:
- Why am I here? Why are you looking for another physician? What need will I be filling?
- Could you describe your marketing plans for adding me to your practice? Where do your patients come from? What will I be permitted (or required) to do to build a practice?
- Would you describe the philosophy of the practice for me? What are you trying to do here? What kind of cross-consultation mechanisms do you have? What is the general internal medicine component of the practice? May I review some charts?
- Is the medical community facing any unusual problems here? What about the hospital? Are there any tough new competitors on the horizon?
- How long have you been looking for a physician?
- What are the names of physicians who have worked here in the last three years who are not here now? Do you mind if I call them? What will they tell me?
- What is the mechanism for making management decisions? What management roles do each of the doctors take? May I see your personnel policies? How about the job descriptions?
- May I see a sample employment contract?
Having a short list of questions shows you are serious and interested in the opportunity. And, an organized set of valid and thoughtful questions to cover in the interview reflects positively on you, too.
Ask for the Order
If things are going well and the answers you got seem straight and reasonable, then tell them you are interested in pursuing the opportunity further. You should also ask if they are interested enough to talk about the specifics. “I am impressed with what you have done here. I think this might be a good place to consider developing a practice, and I would be very interested to go into the specifics of what that might mean. Are you?”
We think it is a good idea to get to a discussion of the deal as early as possible, provided one party isn’t wasting the time of the other. (If either you or your prospective employer feels the situation doesn’t hold much promise, why waste a lot of effort on the negotiation process?) But, if things do look good, it is usually the least awkward to get some specifics out on the table early.
If they have no specifics to offer, as is often the case, you should be prepared with yours. Give plenty of advance thought to what you are looking for in terms of salary, benefits and working conditions. Generally it is better to let them make an offer first, since it may be higher than what you would be willing to accept. After the interview, send a personal thank-you note to each principal, regardless of the outcome.
Most physicians recruiting associates are inexperienced at it and lack interviewing skills. They may actually be naive about what how to proceed or only appear that way out of sheer caginess. Either way, if you are prepared and conduct yourself well your odds of success go up.
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