Choosing your next career stop

Job hunting can be a turbulent process with a host of considerations, ranging from balancing personal goals and priorities to assessing organizational fit. It can be especially overwhelming for early career physicians applying to their first or second role postresidency, who may feel that their education and career have been mapped out for them up to this point. Experts spoke with I.M. Matters to offer advice on choosing the right job and highlighted resources that may make the decision a little easier.

What do you want?

Like making any other personal decision, the first step to picking a new job is doing some introspection and identifying what you're looking for in a new role, whether that's growth opportunities or time to pursue research or academic interests, said Daniel Blumenthal, MD, MBA, a cardiologist at Massachusetts General Hospital in Boston. Dr. Blumenthal shared some of his insights on the process in a September 2024 viewpoint article published by JAMA Internal Medicine.

Some questions to ask yourself include, “Am I looking for a temporary role? A place to work for a year? Or am I looking for a place where I want to spend five, 10, 15-plus years?” he said.

It's also helpful to figure out which two or three aspects of a new job are most important to you, because, crucially, “no job is going to be perfect,” he said. “Have a sense of what your priorities are, including what you really need to have and what you can make do without.”

To determine what those might be, candidates should know their skill set and what they can offer, said Rebecca Pauly, MD, FACP, vice dean at Virginia Tech Carilion School of Medicine in Roanoke, Va. Be sure to not undersell yourself, she added.

“If this is your very first job coming out of training … think about what's most important to you. Sometimes we refer to this as your personal mission statement,” she explained. “Then think about how you will spend your time. Is this new job going to allow you to meet your goals and your mission?”

Early career physicians who already have a few years of work experience should reflect on why they're interested in moving on and identify any tipping points that may have occurred, Dr. Pauly recommended. “Are there real things that this new opportunity can meet so there's a pull to that job rather than a push?”

If all this sounds overwhelming, tools are available to help job seekers narrow down their interests. One is ACP's Physician Peer Coaching Program. The service, available in individual and group settings to ACP members, offers enrollees the opportunity to set personal and professional goals and create an action plan to achieve them.

“It's really important when we think about transitions in life that we have a little bit of clarity in our mind, and for a lot of early career physicians, when we've been through training, we have our milestones set out for us,” said Ankita Sagar, MD, MPH, FACP, Chair of ACP's Council of Early Career Physicians and a trained ACP physician peer coach. “When we start to look for jobs after we've completed training, the world is your oyster. Having a coach really talk with you to figure out what is the outcome that you want from your job search and what is your ideal position at this point is really helpful.”

According to Kerri Palamara, MD, MACP, the lead for ACP's Physician Peer Coaching Program and director of the Center for Professional Well-Being at Massachusetts General Hospital in Boston, coaching offers a safe space outside of a typical professional environment “that's not going to be impacted by other people's opinions [and is] rather a space where you can actually unravel what you're thinking about, connecting with what's most important to you, and then thinking about what a way forward might look like.”

Dr. Sagar stressed that it's OK for early career physicians to not know what they want but said recognizing that and asking for help can make a big difference. Your first job also won't likely be your dream job, she said. It is important, “but very quickly it's going to be in the rearview mirror.”

Dr. Sagar highlighted additional ACP resources that may be helpful for early career job seekers, including the Financial Well-being Program and the I.M. Emotional Support Hub. These and other resources can also be accessed through ACP's Career and Professional Development Hub.

Another tip experts offered is to seek out and talk to people doing jobs similar to what you're interested in to get a better sense of what they entail. Most important, try not to put too much pressure on yourself, and recognize that the job may simply serve as a stepping stone toward a better one down the line, they said.

A good fit

Once you've established your own priorities, it's time to take a hard look at the new organization and other details of the position.

That includes basics like base salary and bonuses and whether you have autonomy in your day-to-day work, Dr. Blumenthal said. If you need an office, a phone, a computer, or administrative support, make sure those expectations are included in the offer letter, he suggested.

More granular details should also be ironed out, including expectations around coverage and being on call. This way you can get a sense of what life will be like week to week, as well as six months down the road, he said. Dr. Blumenthal used his own subspecialty of cardiology as an example. “If you're in clinic all day, are you then expected to read 20 EKGs and 10 echoes at the end of the day?”

Some other practical tips include cross-checking job postings across platforms to make sure the description is consistent. You should also have someone you trust review the contract before you sign it, experts said. Making sure the contract is time-limited and the offer is fair are two things to keep on your radar. “Don't ever sign the first thing that is given to you,” Dr. Palamara cautioned. (ACP offers contract review and compensation tools for members.)

Having a general understanding of the organization you're considering joining is key and can help you determine if and how your interests are represented. This includes learning how much of your pay is productivity-based, Dr. Blumenthal explained. He offered the following questions for applicants to keep in mind: How much of my pay is related to or tied to quality bonuses? Am I going to be eligible for step-ups in compensation over time? Do my benefits change over time? Will I be eligible for match contributions to my 401(k)?

Dr. Pauly added that whom you'll be reporting to, whether it's more than one individual, and how you'll be evaluated when the time comes are important factors to clarify. “What are the roles of your supervisors in determining your critique, your evaluation? How does one become promoted in that organization?” are some questions to consider, she said.

Talking to physicians who've been with the organization for a long time can help you gain insight into its culture and how things have evolved internally. This is one good way to evaluate the quality of life of physicians who work there and get a sense of what support they have, Dr. Palamara said. It also allows you to see if what's been said about the role matches up with physicians' experiences.

In addition, visiting in person “can give one a real sense of what's being communicated that may not be said in words,” said Dr. Pauly. “So looking at body language, looking at places that promote collaboration by [offering] space to have that occur.”

When determining a good organizational fit, Dr. Sagar recommends assessing the people at the helm of the organization to see if they're “people that you would follow or [who] align in the principles that they not just preach, but they actually practice.”

Asking about turnover and comparing rates to broader industry trends can be helpful too, as is inquiring about pending or ongoing mergers or system integrations. “Trying to understand the financial stability of the organization is important,” said Dr. Pauly. “Are they in a growth mode? Are they strategically oriented for the future?”

After all the details have been taken into consideration, Dr. Sagar offered the following rule of thumb: “[Ask yourself], ‘Would I recommend this role to my best friend or to my sister or a sibling or my partner?’ And if the answer is yes, then you have your answer.”