Career resources content posted on NEJM CareerCenter is produced by freelance health care writers as an advertising service of NEJM Group, a division of the Massachusetts Medical Society and should not be construed as coming from, or representing the views of, the New England Journal of Medicine, NEJM Group, or the Massachusetts Medical Society

By Nisha Mehta, MD, a physician leader whose work focuses on physician empowerment, community building, and career longevity in medicine  

Nobody asks for their daily schedule during medical school or residency interviews. For years during medical training, you go to work when somebody tells you to, you take as much vacation as has been allotted to you, and do the work that you’ve been assigned — and then some.

That attitude often carries over into the job search. It’s shocking how many physicians will apply to and even accept positions without a realistic picture of what a normal day in a particular job looks like. We often wear our ability to get the job done as a badge of honor, and rarely question it, not realizing that as time goes on, this is often to the detriment of our career longevity.

The fact is, “full time” for physicians is often greater than the normal 40-hour work week experienced by many other professions, and many times, “part time” for a physician doesn’t feel so part time. To state the obvious, the number of hours worked is inversely proportional to the number of hours of free time you have. While most of us derive significant personal satisfaction from our jobs, we also need time with our families and time for other activities that fill the proverbial cup.

These days, I spend a lot of time encouraging physicians to “create the life in medicine that they want,” the essence of which comes down to being more intentional about how you approach your career. Job turnover is quite common in the early years of practice, and can even lead physicians to want to exit medicine entirely. Therefore, when searching for your job, it’s imperative that in addition to all the other factors that go into the job search, the number of hours you want to work is also considered.

There are many factors that may play into this decision, including finances, debt, children, the work schedule of your significant other, interests outside of medicine, the practicalities of a specialty, and what types of positions exist. While there’s no guarantee that all of these can align perfectly, mapping out what an ideal work week looks like will allow you to tailor your job search better. At the end of the day, if you can work 30 years as a 0.8 FTE because you love it and feel that your personal and professional goals are aligned, many would choose this over working at a 1 FTE but experiencing such significant burnout that you elect to stop working as soon as possible. It may also be that you still want to work the full complement of 1 FTE, but that you’d like the hours to be different — for example, you may want to work 7:00 a.m. to 3:00 p.m. instead of 9:00 a.m. to 5:00 p.m.

Ultimately, for many coming out of training, this is the first time where you have the option to think about the terms of employment, and you should explore it. It’s also important to keep in mind that life changes, and what’s right for you at one stage of your career may not be at another stage. Being proactive about these decisions and changes before burnout occurs will ensure a long, healthy career. So often, physicians assume these options are not available to them, and will even choose to leave medicine entirely or make significant shifts in their careers without exploring how to make a job they otherwise love fit the life in medicine that they want. Remember, if you don’t ask, it won’t happen.