Top five considerations when taking your first attending job!

A guest post by Smart Money MD

Many of us are finishing up our residencies and fellowships around this time of year, and are probably finalizing your job selection. Some of us will continue on in a practice in the same city or state, while others will pack up and move across the country. Either way, it’s not easy transitioning into any new job.

While it has been many years since I looked for my first job, I’ve learned quite a bit over the years from my own mistakes and from what I’ve seen happen to my colleagues. Don’t expect your first job to be a slam dunk, but you can do some due diligence to help prepare you for the real world:

1) Look for the non-compete or restrictive covenant clause.

These rules are going to vary state-by-state. What this means is that if your practice has a restrictive covenant or “non-compete,” you will not be allowed to practice medicine within a certain radius of your employer for a set amount of time. This may not make a huge difference if you decide to take a job out in Alaska where you might not ever want to live, but the sting can be bad if you need to be close to family. Be aware, some restrictive covenants include all offices that a practice might own. In densely populated areas like New Jersey, you could be locked out of the entire state!

2) Mentorship opportunities are critical, especially if you are in a surgical specialty.

Look, it doesn’t matter if you are the best surgeon to come out of your residency or fellowship. You will have less experience than someone who has been practicing for even three years before you. It helps to have someone to bounce ideas from whenever you get into trouble. Joining a group as the sole doctor in your specialty can be nerve-wracking. Be sure you know what you’re getting into. It can be more stressful than you realize.

3) Pay attention to the details of the daily workflow.

For outpatient medical offices, the front desk, medical assistants, technicians, and support staff are critical. It’s nearly impossible to identify all of the inefficiencies on a brief visit, but you should speak to the people in charge. Office managers or lead technicians are the ones you should speak with. Do they seem lazy, unorganized, or flat-out incompetent? You might be surprised.

4) Are there any family members employed in the business?

This usually doesn’t come up on our radars as a common question to ask, but it makes a huge difference. I’ve seen plenty of medical practices where a direct relative to the senior partner runs a critical part of the business. Office manager. Front desk head. Chief Financial Officer. While we shouldn’t be critical of family members in small businesses, we still have to be cognizant of the politics and logistics of working in a practice where any outsiders might be at a disadvantage.

5) Learn about the financial arrangements of a practice.

We all know to ask about money aspects but struggle with being politically correct. It takes time and practice to actually figure out what exactly to ask and what issues are actually important to ask. Since every specialty and employment will have different nuances, it is simply important to speak to enough people in your field to get a good handle on what questions should be asked. Don’t expect to be an expert in finance. It’s certainly easier than the USMLE Step 1, but it does take time to learn.

That’s it for now. If you’d like to read more financial and lifestyle tips, head over to SmartMoneyMD.com. Sign up for the mailing list, and get a FREE Financial Cheatsheet (you know, like the handouts you guys made in Embryology!)

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