When Should a Physician Resident Start Looking for a Job? | Job Search

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.

Researching a Residency Physician Job

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 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. 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 looking. 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.

Other Blogs of Interest

• When Should a Physician in Fellowship Start Looking for a Job?
• Can a Physician Back Out After Signing an Offer Letter?

How Should a Resident Physician Look for a Job? 

How should resident physicians look for a medical job? Literally, what steps should they take to find a position they’ll be satisfied with? The timing certainly is important. Most physicians generally start looking for positions early in their PGY-3 year. Some specialties will even sign contracts in their PGY-2 year if they’re not going into fellowship. If a physician is moving from residency into fellowship, they usually won’t start looking until the end of their last year of residency. Or maybe it’s a multiple-year fellowship. Maybe at the beginning of the last year of their fellowship as well. There are several ways physicians can find jobs.

How Physicians In Residency Can Look For A Job

The easiest way I’ve found is through colleagues. If you’ve trained with somebody, they’ll usually know of a recruiting place. Or maybe they joined a practice during their career. And they say, it’s a great environment that we’re looking to add another physician in a specialty. Maybe you should look at it. Now, that can vary wildly in location, and location is very important to some, while not important to others. So, it can go all over the place if you’re getting some leads from fellow residents or fellows. One way is to talk to colleagues, mentors, or other people you’ve met in training. And that’s also a great way of determining the market value at the time. The MGMA data is like an annual physician compensation survey across the nations broken up into geography, specialty, and physician-owned versus hospital-based physicians. In some specialties, the sample size is so tiny.

I don’t think it’s a great tool. Other specialties can usually be a pretty good gauge if there are hundreds and hundreds of responses. I don’t think any physician should base a physician job search solely on compensation. I think that’s shortsighted. Anyone coming out of training needs to be in an environment where they can learn. Or they’re going to have mentors where they’ll feel safe and have an opportunity to grow.

Consider This in Your Career

I often see it, especially in rural environments, where they need a specialty. They’re willing to throw a bunch of cash at somebody. But they’ll be the only ones in their specialty out there. Like there’ll be no others, no one to learn from, train with, or pick someone’s brain, at least locally. Those scenarios are tough. Some physicians can thrive in that environment, but it’s more complicated for others. So, I think they need to consider that. 

Any physician contract is going to have without-cause termination. If a physician is unhappy in their practice, they usually provide 60- or 90-days’ notice. And they can move on. Even if you’re in a job at the beginning, you’re not stuck there forever. You can find something better. I mean, I find a lot of physicians coming out of residency or fellowship will take the first medical job. And then they’d say, alright, now I know what I don’t want. So, they can search for work more appropriate to the practice they’re looking for. 

You Could Also Apply Through Recruiters

One of the tips is to start applying to physician recruiters. There are two types of them. You have in-house recruiters. Many big hospital networks employ physician recruiters who go out to different residency programs. Maybe there’s a job fair, something like that. Or they’ll specifically reach out to people in training, saying, hey, I have this opportunity in this place. Would you be interested? They’re free to physicians. You do not have to pay the recruiter or anything. The employer is the one that pays the recruitment fees.

So, physician recruiters. Both in-house and those that are just a private group where they just go out and broker these deals. Typically, they would get a percentage of the first-year salary of the physician, or maybe a flat fee. Something like that. But there’s absolutely no harm in discussing positions with recruiters. It’s a usual way of doing business nowadays. They usually have their ear to the ground and know many different opportunities that could be exciting for physicians. 

Start Applying Online

Another way is if you have a specific region in mind. Is just doing job searches for clinical practices in your specialty in one specific area. Most places will have job posts on regular job sites if they’re looking. Then you can search for those in the city you want, find that, and contact them from their work listing.

That’s another way. So, those are the three biggest ways and tips to start your career. Word of mouth through colleagues, doing it through a physician recruiter or searching in specific cities through job search websites. Now, for those who are maybe J-1 or something like that, that’s like an entirely different kind of job search. And I can do a separate video about that. But this is more geared towards those looking for the normal position just coming out of training.

When Should a Resident Receive a Signing Bonus?

When should a medical resident receive a signing bonus? The timing of it is essential. When medical residents finish training, they have likely already signed an employment contract. More importantly, when negotiating the contract, usually in their early PGY-3 year, some PGY-2. When they receive the signing bonus is crucial for a couple of factors. One, as physicians in residency, don’t make much money. Say they’re training in New York and get a medical job in California. Depending on their family size, moving across the country could be a substantial amount of money.

Almost every employer someone signs with as a resident will offer relocation assistance. Usually, between $5,000 to $15,000. You won’t see above $15,000 as far as relocation assistance goes. Somewhere along there, they should pay for the entire amount, to be honest. And some people moving a short distance can also use the relocation assistance money for traveling back to the city. To search for an apartment or a home. So, airline lodging, all that kind of stuff. Some people could use that money for a security deposit or maybe the first couple of months’ rent. Most employers are flexible in what the physician can use that money for. But they want it to be housing-related or relocation-related in some manner.

Negotiate To Get The Amount of the Signing Bonus You Need

Now, the timing of when you get paid is important. Usually, the physician will receive different offer bonuses. One would be the relocation assistance as I said before, somewhere between 5,000 to 15,000. And also, a signing bonus is usually paid out during their first pay period. Whenever they get paid first after they start with the employer, that’s when they would receive the bonus. There’s a different way of doing it. Often employers will say, unless it’s a big hospital network that has established relationships with moving companies. Let’s say you’re running a private practice. They’ll say, pay your moving expenses, submit us the receipts, and then we’ll reimburse you. Well, for some people, outlying $10,000 to $15,000 to move is difficult. Simply because, as I said before, you’re not a wealthy doctor when you’re still in training. 

So, we assess the situation for the physician and determine if it is helpful if you get this before moving. How soon before you complete training do you need the money? We can say to the employer, “Hey, look. It will help us defray the cost of the move if we receive this before moving.” Or, more importantly, maybe the employer would be willing to pay the amount directly to the moving company. In that way, there’s no cash outlay by the physician, which is the entire point of that. The signing bonus also. The timing of when the employer pays it can be essential as well. Depending upon the size of the signing bonus, we could say, we would like half upon execution of the agreement.

Discuss Resident Physician Repayment Obligations 

So, when you sign the actual agreement, and both parties sign it, that’s called the execution of the contract. Many times, we could say, we’ll get half upon signing. And then the other half when they start. Both bonuses will have a repayment obligation tied to them. At least it usually would. This means that, let’s say, the physician has an initial two-year medical term. The employer states, that you’ll owe us a prorated portion of the bonuses if you leave before the initial two-year term. It could be quarterly forgiveness, monthly forgiveness, or yearly forgiveness. Let’s say someone has a $30,000 signing bonus. They say, alright, half of it is forgiven after the first year. And the other half is forgiven after the second year. 

So, if the physician left between the first and second year, they owe back $15,000. So, the employer is insulated from the physician, simply taking the bonuses early. And then, splitting out on the job by signing the agreement in advance. There’ll be language in there that talks about the repayment obligations. If the employer is expressing concerns about that. Or maybe they just don’t utilize that. That would be a good way of saying, look, if you’re concerned about me, just take the money, and leave.

Then let’s put in these repayment obligations; therefore, you’re protected if I were to leave. And I benefit by getting the money in advance. So, that’s a discussion of when the physician in residency should receive the signing bonus or relocation assistance. It’s just dependent upon the situation for some people. It’s fine receiving it after the fact. But for others, it’s important to have it up front—just some things to think about in starting your medical career. 

How Much are Resident Physician Salaries?

One question med students have is the average salary for a resident physician. After physicians graduate from medical school, they move on to an internship or residency within their specialty. Then get paid. But for most of them, it’s simply not even remotely enough for the work that they’re doing. So, it’s not uncommon for residents to work 70- or 80-hour weeks. The average salary for residents in the United States is around $63,000. Maybe you’re a resident right now, thinking, I don’t even make close to that, or maybe I make more. This is average across all specialties. Some specialties will make a little bit more than others in their career. 

Some could be as high as the 60s. Whereas maybe in family medicine, you could be about 50s. Can a resident negotiate their salary during training? No, they have no leverage. Anytime you’re negotiating a contract, you base it upon leverage. Even those residents coming out of medical training and moving on to their first employed job don’t have much leverage. They only have leverage in those situations if they’re in a needed specialty. Or two, if they’re willing to go to an under-served geographic area and need physicians.

So, around 63,000 is the medical resident salary. If you think of it this way, if they work 70 to 80 hours a week, they’re making about $15 hourly. And providing care as a doctor for $15 an hour. Now, once they move out of training, the salary increases substantially. And for some specialties could be an eight-fold increase, at least just coming out. But that’s what it is. One consideration we make when reviewing and negotiating the resident or fellow’s first contract. Most of them don’t have much money coming out of medical training. 

Importance of Relocation Assistance Signing Bonus

So, suppose the new employer is offering a signing bonus or relocation assistance. In that case, we want to ensure they’re getting a chunk of that before moving and starting the new job. Wherever, if they are moving from where they’re currently training. Simply most residents, especially if they have family, may be the only breadwinner. At that point, they don’t have $10,000 to $15,000 if they’re making a cross-country move. So, we need to ensure that either the employers pay their moving costs directly to the moving company. Or they’re going to front the money before the physician needs to spend it on the move.

In that way, they don’t have to outlay a ton of cash. Because it certainly is expensive moving from one place to an entirely different one. Medical residents certainly are underpaid. Unfortunately, it’s part of the process they must go through to be fairly compensated for their services. But it’s just tough when you’re making that little. And I think the average physician has about. I think 47% of physicians have student loans over $200,000. It could be a big burden on their medical career.

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

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 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.

When Should Fellows Start Applying?

I mean, no one’s going to want to employ a physician that doesn’t want to be there. But some legal complications may be 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.