Starting the post-residency job search can be daunting. You’re working long hours, studying for boards and trying to have some semblance of a personal life. How are you supposed to add anything to your schedule, let alone a job search? The solution is to take things one step at a time. And if you’re married or in a committed relationship, the good news is that you’re not tackling this journey alone.
Just don’t forget to start early. "It depends on your specialty and where you would like to work, but most residents should start their search 12 to 18 months from their completion date," says Jen Kambies, FASPR, director of special initiatives at the Cleveland Clinic. It’s the one job-search mistake she sees most often. "Applicants can underestimate the time it takes to get licenses and complete the credentialing process," she explains.
Wendy Barr, M.D., MPH, residency program director of Lawrence Family Medicine Residency in Massachusetts, agrees. "I hear residents tell me they’re too busy to start their job search," she says. "But I remind them, the whole point of residency is to get a job. If the search is delayed, they can go a month or two without a paycheck while they wait for the paperwork to be done."
So here’s a rough roadmap to make getting a head start easy. Read on for the steps you should be taking - and how your spouse or significant other can help:
"Medical school and residency are so regimented. A job search marks the first time new physicians have the freedom to choose their path. It’s scary and exciting at the same time," says Barr.
Before you begin your search, sit down and decide what you’re looking for in a job. Do you want to stay where you are or move? And if you’re moving, what kinds of job opportunities does your spouse need to find in the area? What salary range do you expect to earn?
You need to answer these questions even if you plan to stay put in your current location, so it’s best to start making decisions early. "Lack of clarity is one of the biggest reasons for procrastination," says Kenneth Hertz, FACMPE, principal consultant with the MGMA Consulting Group. He says that once you’ve set goals and made some decisions, you’ll be better able to focus your search.
John Rodriguez, M.D., an orthopedic surgeon at Texas Orthopedics in Austin, says job applicants need to think beyond salary requirements. He recommends considering other important factors, such as job freedom and flexibility.
Stephanie Benjamin, M.D., a fourth-year emergency medicine resident at UCSF Fresno and author of Love, Sanity, or Medical School: A Memoirsays not to pigeonhole yourself. "Determine your priorities and think every decision through so you are building the career that you - and not someone else - want," she says.
That’s what Sasha Thomas, M.D., did when a job opportunity in Kansas came up unexpectedly. At the time, he was practicing in North Carolina as an executive health physician. "My wife and I sat down with legal pads and made lists of the pros and cons of staying where we were or moving to Kansas," he says. "We took everything into consideration." Ultimately, the pair decided to move.
"You should be having ongoing conversations with your spouse about lifestyle, location and career goals throughout residency and throughout your lives," says Lara McElderry, creator and host of the Married to Doctors podcast. When you do talk, she says it’s important to "be honest with your feelings, and keep an open mind."
Stephanie Benjamin’s husband, Alex Angeli, says he asks his wife questions to ensure she’s making decisions that will truly make her happy. "I’ll ask her what move makes more sense to her in terms of what she wants to accomplish professionally," he explains. "What location will help toward that goal?"
"The first thing you should do before a job search, if you haven’t already, is pull together your curriculum vitae or update it," says Kambies. "It’s the first thing you’ll be asked for when you contact anyone for a job."
Matt Wilson, M.D., a hospitalist and clinical assistant professor at the University of Kansas Medical Center, says he used free online resources to help with writing and formatting his resume. "I also asked a couple of residents a year ahead of me to send copies of their CVs for me to look at," he says.
Don’t forget to check your social media presence. "We address this from day one," says Barr, explaining that your public persona may prevent you from getting a license in certain states. "All social media accounts should be set to private - only visible to family and friends," advises Wilson. And Benjamin says that even though she uses only her first and middle name on media sites, she’s still careful about what she posts.
Now is also the time to research potential locations and make other preliminary preparations. "Handle the process like it’s a job," says Hertz. "Take notes on paper or online. Hone your interview skills. Spend time researching jobs. Sign up for PracticeLink."
Faculty can be great resources during this time since many of them have developed a wide network of professional connections. "One of our residents had to narrow his search to Texas and North Carolina because those were the best places for his wife to find work," recalls Barr. "He asked if any of the faculty had connections to either of those places. It turned out we did."
As a physician’s spouse, there’s a lot you can do to take the weight off your partner during this phase of the search. For instance, you can help with his or her CV. McElderry says, "Most physicians will take care of the writing themselves," but if you’re skilled at communication, you might be able to pitch in.
Even if you don’t help draft your spouse’s CV, you should give it a once-over before it goes to an employer. Angeli did exactly that for his wife during her job hunt. He proofed her CV and helped organize it. "I also made sure it had her voice," he says. "It highlighted what she wanted in a job and what she can offer."
If you have time, you can also help research locations and job opportunities. "In your initial conversation with your spouse, choose the top three geographic areas where you want to live and work and expand from there," advises Kambies.
"It helps to build a spreadsheet," adds McElderry. "Organizing prospects will help you both better determine the best jobs and areas to explore." Once you’ve narrowed the field, she says you should learn as much as you can about the area. She explains, "I researched everything: climate, schools, cost of living, neighborhoods and commute times."
Kavitha Thomas, Sasha Thomas’ wife, took a less structured approach to her research. "My husband’s a data person; he made spreadsheets," she remembers. "I’m a feelings person. I researched the area and tried to imagine what it would be like to live there."
This is the point where physicians can fall behind, according to Kambies. "They become extremely busy and the search for a job can fall off their radar. On occasion, they will wait until after their boards to start the search, but that is the time when they most need to be reaching out to recruiters and prospective employers.
"Starting early doesn’t hurt," advises Kambies. "We don’t know what our needs will be two years out, but if this is a place you want to work, you can contact us if nothing else and form a relationship."
That’s exactly what Wilson did. "At the end of my second year, I emailed the head of the hospitalist program at my medical school since I wanted to work there," he says. "They told me to contact them around September when they were ready to start hiring for the next year."
After reaching out to an employer, it’s a good idea to let the organization’s contact guide you through the process, according to Debbie Gleason, director of physician recruitment for The University of Kansas Health System. "This person is often an in-house recruiting professional who will be adept at road-mapping the process and provide guidance for the timing of the next steps," she explains.
This part of the process is a good time to play the role of motivator and coordinator, says Gleason. "Spouses and significant others could be helpful in gathering documents that will be needed for updating CVs, completing applications and other paperwork that will be necessary once a decision is made about what position will be accepted," she explains.
You should also plan to go with your spouse on site visits. "Many hospitals will set up realtors for you and school tours - and may even connect working spouses to contacts in their field," says McElderry.
"It’s not unusual for in-house recruiters to offer to visit with spouses to answer their questions about the community or professional options," adds Gleason. If this resource is available through an employer, she recommends taking advantage of it.
At this point, you should have your interviews and site visits arranged. Before any interview, Gleason says it’s a good idea for physicians to research potential employers. "It can be a way to show they’re serious about the position and the community as well as enhance the research they started at the time they launched their job search," she explains.
When it comes to the interview itself, Hertz says small stuff matters. "Be professional, dress appropriately, remember basic social skills," he recommends. And Rodriguez says it’s worthwhile to imagine yourself on the other side of the table. "I changed how I thought about the job search," he says. "I try to see it from the other side, to think about the employer’s needs. Would I be a good hire for them? I want to make sure I’m what they’re looking for."
Thomas says he goes into every interview with a list of questions. "The employer’s responses will help you make a better decision about the position because you’ve raised points that are important to you," he explains.
And while you’re thinking about what’s important to you, Barr says to remember that employers are not allowed to bring up your family unless you do. Depending on your situation, you may choose not to. "There can be discrimination with regard to physicians and families," she says. That’s true whether the applicant is male or female, so if this is something that concerns you, keep your family out of the interview.
Once you’ve finished the interview, your contact at the employer will likely give you a timeline for the decision. Follow-up emails and calls are appropriate. "The timing can vary, but I would say an email every week or two is likely appropriate," Gleason says.
Since a job decision will affect both of you, it’s a good idea to join your spouse for on-site visits. "Alex comes to every potential job site to help check out the city and to ensure the location would provide professional opportunities for him as well," says Benjamin.
"The site visit was helpful," agrees Kavitha Thomas. "No matter how much research you do, you don’t know how things really are until you experience the place for yourself."
If you have kids, consider their interests and needs as you tour the area. For example, during her site visit, McElderry wanted to learn about the orchestras and sports teams at local schools because she knew those would be important to her children.
No matter what you hope to learn while you’re visiting, make sure you remain professional throughout the stay. Hertz warns, "You don’t want to say anything negative about your spouse that could get back to the employer."
After a site visit, Hertz recommends offering to write thank-you notes to employers. It’s an easy way to take something off your spouse’s plate. You should also sit down with your spouse and discuss expectations for the typical work/call schedule and vacations.
"Be part of the conversation," says Kambies. You’ll want to provide your feedback before a job offer is accepted and contract negotiations begin. "We had these conversations early on," remembers Wilson. "That made the whole process relatively smooth."
If you started your job search a year in advance, you should have an offer by January at the latest, says Barr. But before you can accept a job, you have some decisions to make - especially if you’ve received multiple offers.
"Most in-house recruiting professionals would expect that candidates are looking at other opportunities," says Gleason. "It’s perfectly acceptable to let organizations know you’re looking at other opportunities and to ask for their timeline." This will let you know how long you can safely delay your decision.
But organizations have their own timelines for considering candidates for positions, which means you may or may not have as much time as you think. Effective communication and long-term decision-making may be better tools for negotiating offers than pitting employers against each other.
According to Gleason, if physicians falter at the finish line, it’s typically because of one of two reasons: compensation expectations or contract negotiation parameters. "A physician going into a job search should research what factors play into their particular personal family needs and practice setting type and location," she says. "Understanding a potential compensation model for a future position and what is reasonable for their geographic setting and practice type is highly important."
She adds that many organizations have standardized contacts. "It’s not uncommon for only a few components of the agreement to actually be negotiable," she explains. "An interviewing physician would do well to understand this aspect as he or she begins discussions."
When you’re presented with a contract, Rodriguez says, "The first person you negotiate with is yourself. Are you happy with the terms? Then sit down with your spouse and discuss it together." Only after these steps should you negotiate with an employer.
As your spouse makes career decisions, it’s reasonable for you to weigh in. "You’re in a partnership with your spouse, but the job will be just as much a partner in your relationship," explains Angeli. "This is something you need to be involved in."
McElderry says asking your spouse questions can help him or her make a decision. For example: Are there good mentorship possibilities at the facility? Does the workplace culture seem like a good fit? Will he or she enjoy the coworkers? How is the salary structured?
"I think it’s helpful to talk with the spouses of physicians who work there," she adds. "They may give you a better idea of what kind of relationship your spouse plans to enter into."
Your own career may affect your spouse’s choices. "My wife’s biggest priorities were location and job opportunities," recalls Wilson. "Thinking back to medical school, there was a particular residency program that I loved but ranked low because I knew my wife wouldn’t be able to easily find a job there."
However, according to Barr, these roles are often reversed. In a two-career marriage, the non-physician spouse often makes the professional sacrifices during residency because of the match. "When it comes time to finding a job, that’s where I think the physician spouse might want to give the non-medical member of the marriage a bit of an edge," she recommends.
No matter where you land, you and your spouse should base your decision on the jobs and lifestyle you feel are right for your family. And if you end up relocating, Gleason says it’s best to have all hands on deck. Help your spouse with relocation planning and transitioning your children to a new community and school.
Throughout the job-search process, a spouse is often part of the decision-making. And that’s as it should be. That’s why Gleason recommends that physicians include partners in their research, thought processes and decision-making from the very beginning. "This will reduce any additional delays in deciding on an offer," she says.
"Talk to each other even when you’ve made the move," adds Kavitha Thomas. "Know things will change. If that happens, begin the process again - knowing you can make it work."
"I hear residents tell me they’re too busy to start their job search. But I remind them, the whole point of residency is to get a job. If the search is delayed, they can go a month or two without a paycheck while they wait for the paperwork to be done."
"Lack of clarity is one of the biggest reasons for procrastination," he says, adding that once you’ve set goals and made some decisions, you’ll be better able to focus your search.
"You’re in a partnership with your spouse, but the job will be just as much a partner in your relationship."