Navigating the job-search journey
Although physician job openings exist 365 days a year, it’s not always easy to find the right practice with the right compensation, the right work/life balance and the best timing. But understanding the typical timeline and key milestones along the way can help smooth that journey.
Interestingly, that timeline has been shifting in the last decade. According to a 2019 survey from Merritt Hawkins, 82percent of residents began seriously examining practice opportunities more than one year before completing their residency in 2008. By 2019, that number had shrunk to 25 percent. Meanwhile, the number of residents who began the search six months before completing their training rose from one percent in 2008 to 26 percent in 2019. In other words, the job-search process is now starting as much as a year later for many residents.
The factors that physicians consider important in their job search have also shifted slightly. In the same 2019 survey, geographic location (77 percent), adequate personal time (74 percent), lifestyle (71 percent) and a good financial package (75 percent) were the four most important factors to residents. And whereas 22 percent of residents were open to hospital employment in 2008, 45 percent were interested in 2019. In 2008, 24 percent of residents were open to partnering with another physician. But by 2019, only seven percent were interested in a similar partnership. Interest in other settings - such as single specialty groups (23 percent in 2008 compared to 20 percent in 2019), multispecialty groups (16 percent both years), and outpatient clinics (eight percent in 2008 to negligible in 2019) - remained fairly stable
But no matter what type of position you’re looking for or what time of year you’re looking, the major milestones of the job search are fairly similar. And though your specialty or contractual obligations may influence your timeline, it’s still helpful to know what to expect as you look ahead to finding your next job.
"At a minimum, the physician hiring process takes around six months," says Ellen Mullarkey, vice president of business development at Messina Group, a staffing firm in Chicago. "But it can take as long as a year from the time you submit your application. That’s why I always recommend medical residents submit their applications by September of their last year of training."
Physicians who are already employed and thinking of making a switch will want to build in time to give adequate notice. According to Mullarkey, "A lot of physician contracts include a termination clause that requires at least 90 days’ notice. Some clauses even require years of advanced notice before you’re legally allowed to leave. So you have to take this into account before pursuing other opportunities."
But if you’re getting started late, don’t despair. Geami Britt, M.D., now an obstetrician and gynecologist with Novant Health Providence OB/GYN in Charlotte, North Carolina, says her fourth year of residency was underway before she got serious about the job search. She admits she was "very, very late" in comparison to many of her colleagues, some of whom had jobs already lined up by the start of their fourth year.
"I’m the first generation in my family to go into medicine, so I wasn’t familiar with the process," she explains. She’s since learned that most residents try to finalize their post-residency jobs early in their fourth year so that they can turn their attention to studying for their June board certification exams.
When Britt began her own job search, she started with the question of geography. She was conflicted about where she wanted to be. She considered everything from staying close to her family in the Florida Panhandle to moving across the country to Seattle. Meanwhile, she was deluged by emails. "I was feeling the pressure," she says, recalling the experience of seeing 30 emails in her inbox. "It was overwhelming."
Realizing she was somewhat behind, she began plowing through recruitment emails, weeding out jobs in locations she wasn’t interested in. She also sifted through her letters and postcards, and that’s when a card from recruiting firm Merritt Hawkins caught her eye. It mentioned a job opportunity in Charlotte, and she was intrigued. She called the recruiter to see if the position might be a fit.
That call was promising, so she scheduled another with the Charlotte-area recruiter and an interview with the group’s CEO. She received an offer in April and was excited to accept it. But shortly thereafter, as she was signing her contract, the office announced it would be closing. Her new job no longer existed. Within hours, her former recruiter called her and promised he would find her another job. "I’m calling everyone I know," he said, trying to ease her panic. Despite the fact that he didn’t stand to earn commission, he landed Britt two more interviews in just over a week.
By May, Britt had narrowed the field to two opportunities, both in Charlotte. One was with a brand-new practice; the other was a local group that had flown her in, showed her around, and taken her to dinner. By the end of May, she received offers from both and accepted Novant’s.
Finalizing the contract took about two months, including the time it took for Britt’s lawyer to review the proposed agreement and offer feedback. There wasn’t much to change, Britt says. She signed the contract in early July 2019 and got to work. Though she was nervous at times about the process, she says, "I’m a faith-based person, so I knew it would all work out." And it did.
On the other hand, starting early has its benefits. Ann Peters, M.D., a gynecologist and surgeon with The Gynecology Center at Mercy Medical Hospital in Baltimore, was a fellow at Magee-Womens Hospital at the University of Pittsburgh Medical Center when she began looking for a job in Baltimore, where her husband was based. She had completed her residency and was beginning her second and final year of fellowship. Limiting her geographic search to Baltimore, she found four academic openings, two in private practice, and one at Mercy.
To decide which of the seven might be the best fit, Peters reached out to schedule informal interviews during subspecialty conferences she planned to attend that fall. Her efforts paid off, and she landed three informal interviews at one of the conferences. After that, she was invited to two formal on-site interviews. About two weeks after those interviews, she received two offers. Contract negotiations began, and by December, Peters had her post-fellowship job locked down.
When to start looking
Just as Britt worked to minimize anxiety about her search, physician recruiters try to avoid panic on the hiring side. "We don’t want to make a desperate hire," says Heidi Terzo, talent acquisition manager and senior physician recruiter with Deborah Heart and Lung Center in Browns Mills, New Jersey. Working at a small specialty hospital means that Terzo is almost always searching for a specialist. In fact, she usually has three to eight positions open at a time.
To give the center plenty of time to attract and consider top candidates, Terzo starts by gathering information from department heads and chairs about the type of person they’re looking for. This goes beyond what’s on their CV, Terzo explains. She asks what the department’s expectations are, which physicians the new hire will work with, what the team culture is like, and what kind of personality would be a good fit.
Once she understands who they’re looking for, Terzo gets internal approval for the position and spreads the word about the opening. She starts by placing ads on websites and those of professional associations and journals. She also meets potential candidates at medical conferences.
Even so, there’s no guarantee of success. "Searches can take up to a year," Terzo says.
The typical timeline
For most physicians, the timeline begins with submitting a CV or online application. Recruiting firms and in-house recruiters alike are always gathering applications for various positions. From there, the process usually follows a series ofmilestones:
Application received. Within a day or two, the application or CV will be forwarded to the hiring party. If no positions are open at the time, the information will be filed for future openings. Terzo says the bulk of the applications come within three weeks after a job is posted.
Application reviewed. After gathering CVs, recruiting firms review applications to decide which candidates to refer. In-house recruiters do the same, keeping in mind what department heads have said they’re looking for. On average, this process takes two to three weeks.
First interview. After identifying top candidates, employers schedule the first round of interviews - usually about 30 days after applications are received. Sometimes these early interviews happen by phone or video, while others take place on-site.
At Deborah, for example, Terzo starts with phone interviews. She says this is "to gauge [physicians’] level of interest and to see who’s serious." Her goal at that point is to determine which candidates might be good fits. She’s also looking for physicians with local ties, which may mean they’re more interested in the area.
Second interview. If a candidate looks like a good match, an employer may invite him or her for an in-person interview, especially if the physician hasn’t visited yet.
This usually happens about 60 days after the original application, and the hospital or private practice covers all travel costs. In total, there are usually at least three interviews involved in the hiring process, says Mullarkey. Some might be with practice partners, others with nurses or administrators. It all depends on the size of the group.
Contract offered. If an employer and physician agree that they’re a good match, the employer usually extends an offer and issues a contract about 90 days after initial contact. Then, negotiations begin.
Depending on the complexity of the contract and the availability of the attorneys involved in reviewing it, this stage can last several months. In total, the time between a job posting to a signed contract can be anywhere from 30 days to a year,says Terzo.
What can slow the hiring process?
When physicians are unfamiliar with the business side of the job search, it can slow the process down. And this unfamiliarity is common. In fact, in a 2019 survey, over half of residents said they hadn’t received formal instruction about the business of medicine, including issues like contracts, compensation arrangements and reimbursement methods. As a result, contract negotiations can drag out the hiring process for weeks and even months.
On top of contract negotiations, a number of other issues can interfere with a quick start to a new job. One is the relocation process. Physicians who own homes should allow extra time to sell their homes before relocating, while those with young families may want to wait until the end of the school year before moving. Another factor to consider: exams. Some fellows need time to study for certification before they can start jobs, which recruiters need to build into the hiring timeline.
Non-compete clauses can also affect a doctor’s availability. If your contract forbids you from working for a particular hospital system or within a certain geographic radius, it’s important to make sure your new position will not violate those terms. Confirming that can take weeks, and if you discover a conflict, taking legal steps to remove the restriction can take even more time.
Additionally, some physicians want a little break between finishing residency at the end of June and starting a new job.
To keep the process moving and ensure prospective employers know you’re still interested, Terzo recommends staying in touch. That way, you can make sure everything’s on track, report on your own progress and stay engaged with the team you’re working with. Britt admits that she "may have been more aggressive in following up than most" because she wanted to know where things stood and convey her continued interest. But that diligence turned out to be a good thing. Her regular check-in calls and emails helped her stay top-of-mind at Novant Health.