Apart from the part-time job that provided pocket money while you were in high school or during your undergraduate years, physicians generally have little experience in the job-hunting arena. A physician’s career path requires much skill at applying for such educational endeavors as medical school and residency training, but applying for a “real” job can be a strange concept for most.
Not lost in the equation is the fact that the application process doesn’t begin until most physicians are in their late 20s. While many of our non-physician friends are on their second or third jobs, graduating residents looking to launch their careers often struggle with the transition to the world of HM. In order to help navigate these waters, we have put together a yearlong guide to help make the transition from third-year resident to hospitalist a little smoother.
The first step in landing a job is to find a mentor who can assist you through the entire process. Choose your mentor wisely; an experienced hospitalist can provide valuable feedback during your job search. If your goal is employment with a private hospitalist group, find a hospitalist with private-practice experience.
Choose your senior-year electives carefully. Consider focusing on areas of weakness or areas that are pertinent to HM (e.g., infectious disease, cardiology, neurology, critical-care medicine). Think about an outside elective in HM.
If you haven’t done so already, now is the time to create a curriculum vitae, also known as a CV, and a cover letter. The CV is a vital document. It might be the key element in determining whether you are worthy of an interview. Work on this document early, as you will need time for edits, updates, and mentor review. The cover letter should clearly describe the type of position you want and confidently state why you would be an asset to a particular hospitalist program. Edit your words carefully; spelling errors or typos in documents can be costly.
Once the Labor Day holiday has passed, you should start requesting letters of recommendation. Think hard about who you want before asking for a letter of recommendation, as these typically carry a lot of weight in the interview selection process. Although program directors, chiefs of medicine, and hospitalists can be good choices, it is important to choose people who know you well, as they tend to generate a more personal and powerful letter. Because letter-writers often are busy people, it is appropriate to give a deadline for when you need the letter.
Actively start the job search and apply for desired positions. This is the time of year when HM jobs are heavily advertised and programs are looking to fill positions. Hospitalists are in high demand throughout the country. Some great places to find job openings are:
- SHM’s Career Center (www.hospitalmedicine.org/careers);
- Classified ad sections in the Journal of Hospital Medicine, general medicine journals, and HM news magazines like The Hospitalist (see “SHM Career Center,” p. 35); and
- Hospitals and HM groups of interest, even if they are not advertising; contact them personally.
Begin the interview process by researching the hospital and HM group in advance. Prepare appropriate interview questions. When you interview, try to meet with as many people as possible to get a feel for what the job entails. Talk to the everyday hospitalists and try to gauge how satisfied they are in their jobs.
Bring extra copies of your updated CV and look sharp. Shine your shoes. Is it time to replace the suit you used to apply for residency?
Send a thank-you note or e-mail to the person(s) you interviewed with. If possible, do this within three days of your visit. It’s an important step in the process, yet this simple task often is overlooked. Remain in contact with the HM programs you are most interested in. Think about a follow-up visit or phone call to address any unanswered questions.
Hopefully you will have one or more offers by now. This is the time to negotiate a contract and accept an offer. Review the contract carefully and don’t hesitate to ask for clarification of unclear points. Some applicants prefer to have a lawyer review the contract prior to signing (see “The Art of Negotiation,” December 2008, p. 20).
Register for your board examination. Most specialties, including internal medicine, family medicine, and pediatrics, as well as board exams for osteopathic medicine, have registration deadlines in February. Given the significant cost of applying for these exams, it pays not to be tardy, as late fees can set you back hundreds of dollars.
Apply for state medical licensure. This process varies by state, but it can take several months to complete, especially if you are applying in a state other than where you trained. For example, California recommends starting the application process six to nine months in advance. International medical graduates who require a work visa need to ensure their paperwork is processed in a timely manner.
Each hospital is different, but applications for hospital credentialing generally means filling out a mountain of paperwork. Most hospitals will perform a thorough background check, so don’t be surprised if fingerprinting is required. The hospital or hospitalist group usually helps new hires navigate through this process, which can take several weeks or even months.
Moving to a different city or state can be exciting—and stressful. Start talking to hospitalists at the facility where you will be working to get a feel for the city and recommendations for places to live. Revisit the location to become more familiar with the surroundings. Some hospitals are very helpful; some provide new hires with a real estate agent. Moving expenses often are covered as a condition of employment, but it depends on your contract.
Consider taking a vacation to either further explore relocation options or to simply relax. If you have followed the recommendations outlined in the previous months, you should have time to unwind as your residency comes to an end. Some future hospitalists like to use this time to intensify board review; others cringe at the thought.
Transitioning from resident to hospitalist is no easy task, and it shouldn’t be taken lightly. It’s not a one-month process, either, so planning is essential. Although it might seem to be a daunting journey, it’s very rewarding in the long run. TH
Dr. Grant is a hospitalist at the University of Michigan Health System in Ann Arbor. Dr. Warren-Marzola is a hospitalist at St. Luke’s Hospital in Toledo, Ohio. Both are members of SHM’s Young Physicians Committee.