When Should a Physician in Fellowship Start Looking for a Job?

When should someone in fellowships start to search for a job? I think the answer to that depends upon how long the fellowship is. I think more and more fellowships are tending to be two years minimum. Some are three, depending upon what specialty you’re going into in your career. I think there’s been a shift from the one-year fellowship to a little longer. But regardless of the length of the fellowship, I think it would make sense for a physician in fellowship to start looking for a job immediately. Looking for a job is different than actually signing a contract for a job.

There is no harm in going out and seeing what the market offers. If you are in fellowship, you are likely in a high-demand specialty and will probably have an easier time finding jobs. However, the opportunities are less when you are in some subspecialty. 

How to Conduct a Job Search for Fellows

Tips on how I would go about looking for jobs. One, you need to find the area where you want to live. Suppose you’re entirely open to living wherever. In that case, you can generally find a great deal if you have to live in a specific area, maybe due to a significant other. Or you’re involved, engaged, or married to another person in medical training. Then you need to follow them, or they’re in a program and will start, and you need to be there. 

Well then, obviously, that limits your options if you’re in one specific city. But if you’re wide open, you will have more opportunities. But as far as when to search, do it right away. What are the downsides of identifying a position and signing a contract? Let’s say you’re in a three-year fellowship. You sign a contract in year one. Circumstances can change. So you could have some family issues, an illness in the family, maybe you had kids in the interim, and that changed your thinking of where you want to be, perhaps you were planning on moving back home and then decided that you didn’t want to do that. So, if you sign an agreement and then want to back out of it, there are complications. It’s not impossible to get out of it.

Reach Out to Recruiter When Applying for Work

I mean, no one’s going to want to employ a physician that doesn’t want to be there. But there may be some legal complications associated with terminating a job that you haven’t even started yet. In my experience, the sooner, the better. Ways of finding jobs, communicating with people in your residency program, and other doctors in your fellowship across the country, and physician recruiters. These are excellent places to start in your career. Some employers hire a recruiter to find specific candidates. You can reach out to the recruiters, and you won’t have to pay anything. The employer will have to pay that fee. Those are all good options as far as how to find a job.

Other Blogs of Interest

• Can a Physician Back Out After Signing an Offer Letter?
• Can a Physician Back Out After Signing an Employment Contract?

How Much are Fellowship Physician Salaries?

What is the average salary for a physician in fellowship? At the basic level, after a physician graduates from medical school, they go into an internship and then into a residency program in their specialty, and some specialties require extra training. And that’s what’s called a fellowship. Depending on the specialty, most fellowships last between one and three years. And after that, they can then move on and have an employment relationship where they can practice in their specialty. 

Average Physician Resident and Fellowship Salary

Is there a huge difference between residents and fellowship salaries? The answer is no. There isn’t. The average resident salary is around 63,000 a year. Now, that’s the average. So, there will be some lower than that and some higher. It’s specialty-dependent.

I think the average for family medicine, the physician in training in the residency makes around 51,000, and then maybe some of the surgical specialties can be in the high 60s. But you logically would think, alright, if I’m going to get through residency and move on to my fellowship, I’ll make more money. And the answer is not really. The average fellowship salary is about the same as the average resident salary. Now, the fellowships, anyone who must move into a fellowship is on the higher end of a specialty. So, if the range is between 50 to 70, they’ll be higher towards the 70 range. But there will not be a significant jump between the money you make as residents and the money you make as fellows.

Moving Expenses and Bonuses for Fellows

One word of advice if you are coming out of a residency or fellowship and starting your career. When you have a new job offer after you are either done in your PGY-3 or your fellowship, people in training are not flush with cash. And so, almost any employer will offer the physician a signing bonus, relocation assistance, or both. But most of them will have language in the contract that states they will either reimburse the physician once they start or they will offer the signing bonus with their first paycheck after they’ve begun providing care. That can burden some physicians who don’t have $10,000 to $15,000 to move. 

A Physician’s Contract Must Have This Written in Their Agreement

Suppose a physician has a family and they’re living in New York. If they get a job in California, it can easily be $15,000, and sometimes having to pay that out of pocket at the beginning can be an enormous financial burden. So it would be best if you made sure that any of these languages are in your contract:

• Your contract will state that the employer will pay the moving expenses directly to the moving company before the move.
• You will get that money before moving so that you can use that for the moving expenses.
• You can use a portion of the signing bonus to do that.
• And then most contracts will have language that states that if the physician leaves within the initial term, they’ll have to pay back a prorated amount of those bonuses, which I think is fair.

If they’re going to outlay the cash up front, they certainly don’t want a physician to leave after a few months and take all the bonuses with them. A physician in fellowship is around mid $60,000. I think 47% of physicians have over $200,000 in student loan debt. And then, if you think that they’re working 70 to 80 hours a week, which some of them are. It works out to be like $15 an hour. Which is tough to support a family at that point in your career.

When Should a Physician Resident Start Looking for a Job? 

When should resident physicians start looking for medical jobs? This is a complicated question. First, I do contract reviews daily for physicians. Many are individuals getting their first jobs who’ve never had an employment contract before. They’re either in their last year of residency or fellowship and have an offer they want me to review. There are occasions where there’s a multiple-year fellowship, maybe a PGY-2 or something like that. Wherein residents already have an offer that won’t begin for two years and want me to look at, as well.

Insights on Job Hunting While Doing Medicine Education 

Let me give some words of wisdom, just from doing this for a couple of decades now. One, if you are a resident or a fellow. You know where you need to be geographically. Maybe you have to move home, or you have a significant other completing trading themselves elsewhere. Want to move close to your family, whatever it is. If you have a pinpoint location in mind, getting started sooner than later is probably a good idea. Start looking or applying for work when you still have two years left in training. Think of it from an employer’s perspective. Some employers don’t have immediate needs for physicians, right? So, if they are well run, they’ll have financial forecasts.

Forecasts as far as the patient load will be, perhaps the practice is expanding and opening a new office. But they’re not going to open it for a year. I guess I’m saying that employers know that they’d have a need for a physician. But sometimes, it’s not for a couple of years. That’s why an employer will start looking immediately for a position that’s not immediately available. Once they get out there and see some candidates, even if that candidate has two years left in training. It’s not uncommon for them to offer them a position and make them sign an employment contract. One benefit of looking early is simply getting in before someone else takes the part. So the earlier you look at the job, the more likely you’ll have a chance to get it. It’s never too early to start applying, if that makes sense. 

If You Take a Medical Practice Early 

Next, the downsides of going early. What’s the negative part of finding a position far out from when medical residents have completed training? Suppose you sign an employment agreement that doesn’t commence for two years. And then you have some change in the family. Maybe the significant other that was supposed to move to one city is now moving to another. Or there’s a sickness in the family. There are a million reasons why a location is perfect at one point, and two years later, it’s not. The downside of signing early is that things may change in your life, but you have signed the employment agreement. Then it gets into: how can I terminate this agreement even before I’ve started? Are there any penalties associated with it? Some contracts have built in that if the physician doesn’t start, they will owe some penalty.

Which Year to Start the Job Search?

I would suggest. Before signing an agreement with that kind of language, probably get it reviewed by someone to review the ramifications. What happens if I sign the agreement, I either can’t start or don’t want to start. And then need to get out of the contract? Another possibility is you sign early and get a better offer. So maybe it’s just a better opportunity for you. The compensation is more. The benefits are better. The concern is that if you sign a contractor early, you’re foregoing any potential opportunities down the road. Now, some employers are okay with letting someone out with enough notice. 

The contract will have a notice requirement, but if you haven’t even started, most employers are understanding. If there is some actual change in family circumstances. They’re not as forgiving if it’s simply that this person is paying me more than you. I don’t want to complete the terms of this agreement. Once the contract is signed, the employer relies upon you to start, so they will stop recruiting anyone else. They’re going to make plans to either bring in more patient volume. Or maybe the office they’re opening up is contingent upon you being there.

Residents Should Start Looking at Multiple Offers

So, I guess there are problems for both sides if the physician doesn’t want to start. The employer could have some damages associated with the physician not completing the terms of the agreement. Overall, I’d say the sooner, the better to start applying. However, taking the first offer and signing an employment agreement without comparing different bids is a bad idea. There are almost always multiple opportunities for somebody just starting their career. Just to accept the first one just because they are the first doesn’t make a lot of sense to me. So I’d suggest you look at multiple offers, gauge the compensation structure amongst them, and then go from there.