Start sooner to keep your sanity, and organize the process

By Bonnie Darves, a freelance health care writer

For physician residents and fellows, starting the job search is likely to produce one or more of a wide range of feelings: total excitement, high anxiety, immense relief, fear, and maybe even disbelief that a goal that once loomed incredibly distant will actually come to fruition. That’s understandable, and it’s to be expected. It’s been a long haul, with a lot of heavy lifting along the way.

Physicians who find that initial flurry of emotions edging toward the negative should recognize that the search process, though daunting, is doable. Jobs are plentiful in most specialties. Most physicians who approach the task in a thoughtful, diligent, and organized manner will land, if not the job of their dreams, at least a good opportunity.

One of the most important aspects of launching a successful job search is the timeline itself. If there’s one piece of advice about when to get started that holds up historically, it’s this: The sooner you start, the better off you’ll be.

That’s true for both psychological and practical reasons. Procrastination can trigger anxiety, which is counterproductive to the task at hand. Waiting too long might also result in a smaller pool of potential opportunities, especially for physicians in either highly competitive or high-demand specialties.

Tara Osseck, regional vice president for recruiting with Jackson Search in Saint Louis, Missouri, observed that in high-demand specialties such as family medicine with obstetrics, ENT, neurology, and urology, hiring commitments might be made well in advance, sometimes two to three years out. “For physicians in these fields, starting early not only increases access to top opportunities but also enables them to align their training, electives, or research interests with the specific role they’ll be stepping into,” Ms. Osseck said.

Physicians in low-demand specialties such as neurosurgery, sleep medicine, or family medicine with a sports medicine focus also might need extra time for their search, according to Patrice Streicher, director of operations for VISTA’s permanent search division. “They will need to start early, at least 15 months out from the target job start date, to ensure they’re competitive — especially if they only want a particular location or geographic region,” Ms. Streicher said.

When to start the search

There’s no hard and fast rule about when to launch the job search in earnest. However, the consensus among experts — recruiters who’ve helped scores of physicians find a job and physicians who’ve navigated the process successfully — is that 12 to 18 months before the end of training is the ideal window.

That might seem like a long time, but it isn’t, according to Ms. Streicher. “There are a lot of moving parts to a physician job search, and all of them take time. You need time to prepare, time to interview, time to assess and finalize a contract, and time to get through licensure,” Ms. Streicher said.

In her presentations to residents, Ms. Streicher sometimes encounters physicians who are mere months out from completing their training and just getting started. “That’s not ideal,” she said, because even if those physicians land a position relatively quickly, factors such as licensure and credentialing delays might delay the start date. “It also adds a lot of stress when your colleagues are well into their search.”

Ms. Osseck adds a reason for opting for the 12- to 18-month timeline: to enable physicians to get a big-picture view of the marketplace. “That timeline allows for thoughtful exploration of the market, time to evaluate what ‘fit’ really means both professionally and personally,” Ms. Osseck said, and the flexibility to consider multiple options without pressure.

Farzana Hoque, MD, co-director of the medicine acti ng internship program at Saint Louis University School of Medicine and a longtime physician mentor, stresses the importance of backing up the process when special requirements or considerations are an issue. These might include the following:

• When targeting a highly competitive region or institution.
• When an international medical graduate (IMG) trainee will require a visa, such as a J-1 waiver or H1-B sponsorship, which might narrow job options and affect timelines.
• When pursuing a practice niche or a hybrid role.
• When the physician must accommodate personal or family considerations — a dual-career household, school-aged children, or necessary proximity to a specific geographical location.

Leah Grant, president of the physician solutions division at ANM Healthcare, echoes Dr. Hoque’s counsel about niche-practice searches. “If you’re an orthopedic surgeon and you know that you want to do only total joints, start the search early — at least 18 months out,” Ms. Grant said. Ms. Grant added that today it’s not uncommon for physicians with well-defined practice or personal priorities to start their search as early as two years out. “That would have been unheard of five years ago, but we’re seeing this now,” she said.

Another potential benefit of an early start, several sources noted, might be access to financial stipends during training and, possibly, a better sign-on bonus or relocation package.

How to plan and prepare for the search: documents and priorities key

It might sound trite, or obvious, to say that physicians should have their documents and references ready and their priorities straight before they contemplate posting their CVs on job boards or reaching out to recruiters. But many don’t, several sources noted, based on their experience. “Don’t do anything before you have your CV ready to disseminate,” Ms. Streicher said, and polished. Dr. Hoque recommends asking a trusted mentor or advisor to review the CV for completeness and tone.

To avoid becoming overwhelmed early on, break down the job search into defined tasks and phases. The phases, roughly, are as follows:

• Self-assessment and preparation: 12 to 18 months out from job start
• Marketplace exploration: 9 to 12 months out
• Offer evaluation and contract execution: 6 months out

This article focuses on the first two phases, before physicians start evaluating offers and reviewing employment contracts.

Once the CV and references are in hand, physicians should tackle their priorities. This can be challenging if some priorities are in conflict. A desired location might conflict with supply-and-demand realities, for example. A desire for work-life balance and a flexible schedule might conflict with the hope of earning top compensation.

The priorities list should address the following issues in a nuanced, not general, fashion:

• What are your “must-haves”? Which ones might you cross off your list if they’re not feasible? “No job will match 100% of your expectations, so clarify preferences you would be willing to overlook,” Dr. Hoque advised.
• Where do you want to practice? Are there any locations you would not consider? “Don’t go into the market saying, ‘I’m open to everything’ — you might not find the opportunity you want if you’re too broad,” Ms. Grant cautioned.
• What does the ideal role look like, professionally and personally? Be specific about components that are particularly important. These might be outpatient only practice, potential for teaching, a reasonable call schedule, or the opportunity to do procedures if you’re in primary care.
• What practice setting do you want? What size and type of organization do you hope to join? The range of possibilities outside of academic practice is broad, from small clinics to mid-sized multispecialty practices to mega-systems. Explore the marketplace in geographical areas you’re considering, Ms. Osseck said, “to understand where your interests might align with emerging opportunities.”
• What kind of schedule would you prefer? If there are family or personal needs that might affect your ability to work specific schedules, note those.
• What are your key financial needs, beyond market compensation? Are there perks, such as training stipends, loan repayment, or ample relocation benefits, that might be important starting out?

In this early phase, a preliminary market exploration, from the standpoints of both compensation and marketplace dynamics, is a must. It’s also important to gain a grasp of the different compensation models, Ms. Streicher said, because that’s not something physicians generally learn during residency. Salary-based models are straightforward, but productivity-based, capitation-based, and value-based models are more complex. Knowing how these models work will be key later when physicians compare practice opportunities.

When the priorities are clear, physicians should update their profile on LinkedIn and professional sites to indicate they’re looking for a job. A brief summary should reflect key priorities but not include financial or desired-compensation specifics.

Be intentional and specific about what you’re seeking

The best approach is to be very intentional from the start, several sources stressed. “Understand your goals, know the dynamics of your specialty and geography, and treat your search as a strategic investment in your future,” Ms. Osseck said.

For Tejas Sangoi, MD, a hospitalist who trained in Saint Louis and finished residency in 2022, clear intentions drove his first job search. He knew exactly what he was looking for in part because he planned to stay in Saint Louis. “I prioritized a high-acuity, busy practice that included teaching opportunities six months into the role,” said Dr. Sangoi, whose mentor, Dr. Hoque, helped him refine the scope. For his second job, as a hospitalist at Mills-Peninsula Medical Center in Burlingame, California, location and scheduling flexibility were top priorities.

Family medicine physician Timothy Abels, MD, who went into medicine after a decade in nursing, knew exactly what he wanted but was open to the where. “I wanted to be in a small town where I could get to know the community and feel like a partner. I wanted to be the family doctor with little, round glasses,” Dr. Abels said. “But I also wanted a setting that was fully staffed and had low turnover.”

For Dr. Abels, that ideal job surfaced in Rock Valley, Iowa, with Hegg Health Center, where he will practice when he completes residency this summer at the University of Arkansas. The opportunity, which he landed through Jackson Physician Search, ticked all the boxes when he made his site visit.

Be strategic in sending out CVs

Posting the CV too broadly, too quickly can undermine even the most intentional job search. It might be tempting to post the CV on a half-dozen job boards to see what’s out there, but that’s a surefire recipe for inundation, all sources concurred. Start with the professional society job board, and expand the reach slowly and carefully as needed to avoid a barrage of emails and texts. Alternatively, choose a highly experienced recruiter who does a lot of work in the specialty.

“I’ve seen doctors post their CV on job boards and pull themselves off an hour later because they get overwhelmed with responses,” Ms. Streicher said. That’s what happened to Dr. Abels. Within hours, he received more than 200 calls and scores of emails. “It was pandemonium, and I was working nights at the time,” he said.

Orthopedic trauma surgeon Lisa Cannada, MD, director of faculty integration for the UNC School of Medicine in Charlotte, advises specialists to rely initially on their professional organization’s job site to get a sense of the range of opportunities. “Trauma surgeons only know residency practice, but in fact more than 70 percent of potential jobs will not be in academic medicine,” said Dr. Cannada, who is with Novant Health. She helped launch the Orthopedic Trauma Association’s Young Practitioners Forum several years ago to support residents and fellows preparing to start their careers.

The best way to manage the influx of communication that occurs once the CV is out in the world is to create a funnel of sorts by getting a second cell phone and setting up a dedicated email inbox. Dr. Hoque advises using something similar to the following email alias structure: .

The following are other tips for organizing and managing search communications:

• On job boards, only opt in to relevant regions, roles, and practice types, and quickly unsubscribe from mass email blasts or overly broad postings, Dr. Hoque advised. Use phone settings or apps to mute unknown numbers or filter spam, she added.
• When revealing the preferred job type and location(s), be as specific as possible. Ms. Grant recommends creating a template for recurring communications that clearly lists priorities. “Clearly state what you’re looking for, and where. If you want to practice hospital medicine within 50 miles of San Francisco, put that in your template,” Ms. Grant said.
• Once the priorities and wish list are clearly indicated, only reply to messages for jobs that you’re truly interested in. “It really is OK to just hit delete,” Ms. Streicher said.
• Organize the message flow with a spreadsheet or other system. Note messages that you’ve responded to and those that warrant follow-up. Set aside at least 30 minutes a week to review messages and update search activities, Dr. Hoque advised.

Several sources mentioned the value of keeping the advice inflow to a minimum at this stage. Stick to a few key individuals whose credentials, experience, and values you appreciate, and graciously tune out the people who mean well but don’t have advice you need — or want.

Dig deep and network when exploring the job market

Once physicians have identified a brief list of potential practice opportunities, it’s time to start in-depth discussions. Ideally, this phase will start about nine months out from residency completion, with phone discussions with either recruiters or individuals who have encouraged the physician to apply.

Phone discussions should be heavily leveraged for specific job details before moving to virtual and onsite interviews. Ms. Osseck advises using these conversations as a two-way assessment, in which potential candidates ask targeted questions that get to the heart of culture, practice expectations, and long-term growth potential. Compensation is important, but it shouldn’t inordinately drive the discussion at this phase, assuming that opportunities under consideration are in the right ballpark financially.

“Partnering with a knowledgeable recruiter can streamline this phase and ensure that you’re seeing the right opportunities, not just the most visible ones,” Ms. Osseck said.

Networking is key throughout the search process, and attendance at specialty meetings (ideally, two a year) is an effective way to network strategically. The idea is to frame networking outreach as “a curiosity-driven conversation,” advised Dr. Hoque, not a request for job leads. Besides reaching out to alumni and , physicians might also contact conference speakers or physicians who work at hospitals or health systems they’re interested in. The basic script, in Dr. Hoque’s view, should go something like this: “I admire your career path and would like to hear how you chose your current role.”

“This approach feels more authentic and less transactional, and it often leads to helpful insights or referrals,” Dr. Hoque said. As a reminder, send a timely thank you to anyone who took time to provide counsel.