Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions. 

Life After Residency: Tips for Making Your First Job Your Last

6/29/2016 1:53:33 PM | 2 comments

As you approach the end of your training, something you'll often hear is that your first attending job will probably not be the one you keep for the rest of your career.
 
In other words, it's just not that important.
 
In my opinion, this advice does a disservice to new professionals. Finding the right job can jumpstart your career by offering early opportunities to grow. A poor choice can lead to years of stagnation and force you to start your next job search from square one.
 
I would argue that your first job can be your last job if you take the longer view and think carefully about where you want to be five years down the road.
 
In today's post, I'll share some tips for vetting potential employers and organizations to see what they offer in terms of professional growth. While much of my advice is aimed at physicians, it may also be useful to PAs, NPs, nurses, and other healthcare professionals.
 
Entering the Workforce
 
When I was looking for my first job about 10 years ago, I was very focused on where I wanted to live. Pay was also a factor, but that was the extent of my planning.
 
In the back of my mind, I thought that perhaps a democratic group was important, but I figured most groups were probably the same. And did it really matter as long as the paycheck was decent at the end of the day?
 
I was also pretty sure that leadership was out of the question for a new attending.
 
As luck would have it, I landed at CEP America for my first job out of residency. Like everyone else in the first few months, I learned to make clinical decisions on my own and passed my boards. But, in addition, I practiced in a setting where my voice was heard and my opinion respected. Having a vote in matters meant that I learned more about the practice of emergency medicine and developed relationships that fostered my career. I was open to learning and worked hard.
 
After my first year, I became the assistant medical director at my site. So just over a year into my first job, I started on my leadership path and I haven’t looked back.
 
I realize now that I fell into my first job somewhat haphazardly and feel fortunate that I landed in a good place. I now have a deep appreciation for how important choosing a job that offers upward mobility can be to your career.
 
In the intervening years, I’ve moved across states and worked at different practice sites with CEP America. Throughout my journey, there has always been room for growth. By contrast, many of my peers from residency training are in a very different position where their career growth and understanding of the business side of medicine is more limited.
 
Finding a Good Fit
 
As I reflect on my last 10 years in practice — starting out as an attending and eventually moving into the regional director role — I’ve experienced firsthand how important those early career decisions are.
 
I encourage you to think about your first job as an investment in your future. As you evaluate potential career opportunities, here are some factors to consider and questions to ask in an interview.
 
Leadership opportunities. Leaders are not necessarily born but can be developed through regular opportunities for growth. While attending leadership conferences and mini-MBA programs can be helpful, it really starts with group transparency and good mentorship.
 
Understanding challenges and having a good mentor can help you take advantage of opportunities. You can get a better understanding of industry trends that are driving changes in healthcare and be prepared for future leadership roles.
 
Group structure. Consider what type of employment model is a good fit for you. Some people prefer the predictability of being a W2 employee (i.e., the Kaiser Permanente model). Those who want to take a more active role in their career trajectory and have a strong voice in how they practice may be a good fit for a partnership.
 
It’s important to understand that partnership models can vary significantly from one organization to the next. At CEP America, physicians become an equal partner from the first day of their clinical practice.
 
Other organizations bring new physicians in as associates with the potential to move into a partnership role in the future. In some of these cases, the partnership offer doesn’t materialize for a long time — or sometimes not at all. When evaluating an offer, make sure you fully understand the group structure.
 
Opportunities to make an impact. What are some interesting things that new hires have done for the practice? How does the organization support the development of new professionals? These questions will help you understand how much the group values new talent and where you might fit in.
 
Patient experience. The best opportunities are at hospitals and groups that put patients first. Ultimately, that's why we all got into healthcare. A good way to assess this is to ask about the patient experience. What are the most common complaints and most common praises patients give? What are you most proud of in patient care at your hospital or organization?
 
(An interesting aside: in my years of recruiting, no candidate has ever asked me about the patient experience. But I really wish they would, because I believe the answers would really illuminate the values and culture of the workplace.)
 
The day-to-day. As a new attending, I remember feeling really awkward when asking about benefits, pay, and scheduling. But while these shouldn’t be the first questions you ask in an interview, they are important considerations and completely appropriate to raise.
 
Taking the Long View
 
Hopefully, your first job can be your last job. It was for me. I never lost any time “starting over” with a new organization. I joined CEP America as a Partner, quickly moved into a leadership role, and have had opportunities for growth ever since.
 
As a new healthcare professional, your career is your most important investment, and your time is a valued asset. You're only young once! Avoid the mindset that you’ll only stay in your first job for a couple of years before moving on.
 
I encourage you to give careful thought to where you see yourself in five years. Consider the total package and opportunity for growth when evaluating job opportunities, and watch your first job blossom into a fulfilling, long-term career.
 


Comments
David Birdsall
What a great article! Thanks for sharing Jeff. I think your advice is ABSOLUTELY germane to PANPs.
I remember coming out of residency and I was just happy to have a job (not because I was a bad doctor I just wanted to work in an area that was really competitive). I took to heart the adage that ED docs move around to 3-4 jobs before they find the right one. However in retrospect, I should have thought more like you suggested. Thanks for your wise words
7/23/2016 4:39:59 PM

Anne Bruce
Your thoughts on starting out where your voice was clearly heard and your opinions and input was respected is the most critical foundation you could have had for your longterm success. CEP provided that and more. Great article Dr. Tsai!
7/4/2016 12:54:37 PM