Career Resources articles posted on NEJM CareerCenter are produced by freelance health care writers as an advertising service of the publishing division of the Massachusetts Medical Society and should not be construed as coming from the New England Journal of Medicine, nor do they represent the views of the New England Journal of Medicine or the Massachusetts Medical Society.
Maintaining professionalism, one of medicine’s core competencies, is a crucial component of a successful job hunt. As we become habituated to brief and abbreviated emails, text messages, and social media encounters, old-school etiquette is still required to create a positive first impression and to distinguish yourself from those vying for the same position. Follow-up telephone calls are essential to express keen interest and to avoid lengthy email and text threads. Memo to those on social media: Prospective employers are watching!
—John A. Fromson, MD*
Technology has altered the search process considerably, but recruiters’ and prospective employers’ expectations regarding physician conduct remain essentially unchanged.
By Bonnie Darves, a Seattle-based freelance health care writer
A surgery resident running from the OR to check in on her post-operative patients sees an email message flash across her smartphone’s screen that her ideal opportunity — a partnership-track position with an established, cutting-edge group situated 30 minutes from her hometown — has opened up. Delighted, her first instinct might be to dash off a quick text reply to this effect: VRY INTERESTED PLS WAIT 4 MY CALL.
That might be precisely the wrong thing to do, and the physician who replies so hurriedly could run the risk that she won’t even make it into the initial running. Although employers and recruiters welcome — even expect — email responses and inquiries from prospective candidates, most would be turned off by a hastily constructed communication replete with abbreviations, especially when it constitutes the initial contact. Those exchanges may be generated electronically, but they shouldn’t read as clipped, hastily constructed missives that haven’t been thought through.
“Physicians should keep in mind that although email breeds informality, these are business exchanges, and a certain level of formality is in order,” said Tammy Johnson, director of physician and executive recruitment for Lehigh Valley Health Network in Allentown, Pennsylvania. “Complete sentences should be used — especially before a relationship has been established. And choppy or text-like email responses are inappropriate in any business communication.”
Many other professionals who work in physician recruitment echo Ms. Johnson’s view. Even though surveys and anecdotal reports indicate that up to 70 percent of the initial activities involving physician recruitment or job searches are conducted via email or social media, old-fashioned manners do matter. A basic code of conduct — not unlike the one expected two decades ago — still applies.
“The same rules still apply, but we’re just using new tools to do things more efficiently — and on the fly,” said Bill Horton, senior vice president for strategic services at All Children’s Hospital in St. Petersburg, Florida, whose organization has hired more than 100 physicians in the past 3 years and recently linked with Johns Hopkins Medicine. “And email etiquette distinctly applies — you are representing your personality as much as your skills.”
Cover letters, formal yet reasonably concise, are still very important; and thank-you notes sent promptly following a lengthy phone discussion and especially an on-site interview, are absolute musts — regardless of how they’re delivered. “The cover letter says things about you that the CV doesn’t address. And in this digital age, that often gets overlooked,” Ms. Johnson said.
Young physicians who have grown up in the digital age and e-converse with friends and fellow residents informally may need to remind themselves that the stakes are high when they’re looking for a job — even if they’re exploring multiple opportunities simultaneously. In short, first impressions remain extremely important.
“Physicians in general are moving at light speed these days, but they still need to carefully review their email responses — and count to 10, ideally — before they push ‘Send,’” advised Victoria Mulhern, executive director of faculty affairs and professional development at the University of Pennsylvania’s Perelman School of Medicine. “Most physician responses we receive are professional, but sometimes we worry about the ‘cringe factor’ when we receive a message that’s inappropriate.”
Such inappropriate e-missives range from messages riddled with typographical or grammatical errors, or words rendered in all capital letters intended to convey emphasis, to the five-paragraph email that’s far too detailed, Ms. Mulhern maintains, for this communication mode. “All caps are a definite no-no,” she said, adding that fast-firing, back-and-forth exchanges are also inadvisable — and possibly unproductive. “At some point, it’s better to just pick up the phone!”
Don’t Forget about the Phone
Ms. Mulhern and other sources interviewed for this article concurred that the telephone remains a viable, and sometimes preferred mode of communication when the discussion is likely to be lengthy or the topics addressed potentially sensitive. And it’s crucially important when clarification regarding certain CV details is in order. Most organizations wouldn’t consider scheduling a site interview before that mutual-introduction call occurs, so physicians should be prepared to shine in that venue regardless of their qualifications.
“Email is ideal for that initial contact, but it doesn’t replace the phone conversation that should occur when the physician is very interested,” Ms. Johnson said. “People can look very good on paper, but there may be a gap in the CV that needs to be explained, for instance, or the physician may have changed jobs quickly for a very good reason. We make a decision whether to proceed to a site interview based on that phone conversation.”
Anne Folger, senior director of physician recruitment for Banner Health in Phoenix, Arizona, and president of the National Association of Physician Recruiters, urges physicians to prepare for that call accordingly. “Some organizations are beginning to use videoconferencing for those calls, so physicians should prepare for and treat it like an interview — and dress for it,” she advised.
In the digital age, when smartphone use is ubiquitous, it can be difficult to ensure an error-free message in every situation. When individuals are communicating on the fly, some devices may try to “correct” an entry, spelling, or word that’s intentional, and the message just “gets away.” Ms. Folger is inclined to be understanding of an odd email message when that’s ostensibly what happened — if it’s from a physician with whom she has previously communicated.
“One recent candidate’s message included a tagline that read: I apologize in advance for any typos or grammatical errors, as I am sending this from my iPad,” Ms. Folger said. “I wasn’t offended because I already knew him — and I actually thought that it was a smart idea, in that situation.”
What absolutely should not make its way into cyberspace, Ms. Folger and other sources remind job-searching physicians, is any missive that’s incorrectly or generically addressed. “To whom it may concern” salutations, or worse, messages mistakenly addressed to the wrong recruiter, at another hospital, are absolute no-nos.
Tone, Timing, and Accuracy Are All Key in e-Communications
Physicians expressing interest in potential opportunities via email should strive for a middle ground in terms of the initial message’s length and content, Breanna Elliott, senior director of recruiting for Merritt Hawkins & Associates, advises. She recommends that messages be detailed enough to let a recruiter know what the physician is looking for generally — the preferred geographical location, practice setting, and start date — as well as his or her basic qualifications.
“It’s not a cover letter, but it’s like a shortened version of one that covers the basics,” Ms. Elliott said. “That’s immensely helpful to recruiters; it’s also a smart way to approach the initial communication.” That provided information may be sent on in some form to a prospective hiring entity, Ms. Elliott explains, if the physician has given permission for sharing it. “It’s a nice way to control what’s being said about you,” she said.
Richard Demir, MD, chairman of gynecology at Arizona Regional Medical Center in Mesa, Arizona, and president of the Society of Elite Laparoscopic Surgeons, acknowledges the balancing act that’s sometimes needed now when technology is rapidly changing the job-search landscape. In principle, he supports any advance that streamlines physicians’ communication — he started a practice website in the 1990s, is active on Facebook and Twitter, and even launched a YouTube channel for the Massachusetts Medical Society. But he expects a professional demeanor when he is approached about possible opportunities.
“With the convergence that’s occurring, we’re all using handhelds and pecking out messages in a sentence or two. But when you’re communicating something important, such as ‘you wants to do a rotation with us or explore a future opportunity,’ I expect a high level of professionalism,” said Dr. Demir. In his book, that means a proper salutation, sign-off, complete sentences — and no smiley faces.
South Carolina internist Sandeep Grewal, MD, founder of CareerMedicine.com and author of the Mini-Guide to Physician Job Search, puts emoticons, such as smiley faces, and urban abbreviations near the top of his don’t-do list, along with casual usernames. “Emoticons should be reserved for friends, not recruiters or prospective employers,” he said. “And usernames such as ‘looking4u’ or ‘monster35’ are inappropriate for your job search. Remember that usernames are considered representative of your personality.”
On the should-do list of the digital age, Dr. Grewal urges physicians to ensure they include their last name and specialty in the subject line of any email missive with recruiters or prospective employers. “You want to make it easy for the person to locate your email in the future,” he said.
On the other side of the spectrum, job-seeking physicians should steadfastly avoid sending out anything that remotely suggests it’s part of an email blast, Mr. Horton stresses. “Those tend to be discounted. If it’s important, and you’re interested, slow down enough to personalize your message.”
All sources agreed that any starting message that comes across as even remotely sarcastic or snide, even if it’s intended to be humorous, is a bad idea. Ms. Johnson cites a recent example: A message from a physician who introduced himself by writing, “My CV will probably intimidate you because it’s 24 pages.” That physician, despite his qualifications, didn’t even receive a phone call. “Our physicians were affronted,” she recalled. “It’s best to avoid anything that might sound flip.”
Thank Yous — They’re Still Very Important
Even when a physician knows that he or she has a very good chance of being offered an opportunity, careful attention should be paid to the content and timing of the thank-you note following a site interview. This applies whether it’s hand written or sent by email. Prospective employers expect that gesture of common courtesy, and they will generally read into and decipher from that communication whatever the physician intends to convey. So it’s not a missive to be dashed off without considerable forethought, especially if the physician wants the job.
“Remember that as a candidate, it’s your last chance to sell yourself,” Mr. Horton said. “So take the time to say that you enjoyed the interaction, and to write about the people you met and the contribution you think you can make to the organization. And send it right away.”
Last but not least, ensure the thank-you note is completely error free. “It’s important to double and triple-check the spelling and the grammar,” Ms. Elliott said. “I have seen a candidate who was offered a position, only to have that offer rescinded when she wrote a thank-you email that was full of errors.”
Other Do’s and Don’ts for a Job Search in the Digital Age
Sources who contributed to this article offered these additional tips for physicians to consider when using electronic communication and digital tools:
• Be friendly — but never casual — in email communication.
• Always respond promptly — ideally within 24 hours — to any clearly personalized and detailed email from a recruiter or prospective employer.
• To get ahead of the pack when pursuing a highly attractive opportunity, take the time to craft a catchy — but not over the top — subject line, and follow up with a phone call.
• Take the time to review the website of any practice or health care organization of interest before crafting an email of introduction or response to a recruiter’s inquiry.
• Avoid using incomplete sentences in a response or query, unless the “conversation” is well underway and the recruiter or prospective employer simply asks for a minor detail or clarification.
• Be very careful about what’s included on a personal Facebook or MySpace page, or any social media presence. Prospective employers are absolutely looking at them.
*Dr. Fromson serves as the editor for Career Resources and is Vice Chair for Community Psychiatry, Brigham and Women’s Hospital; Chief of Psychiatry, Brigham and Women’s Faulkner Hospital; Associate Professor of Psychiatry, Harvard Medical School.