You most likely believe the best time to start your medical job search is late autumn of the final year of training. That’s the standard advice, but it may not be the best for you. First, you will be just one of many job-applicants fighting for limited openings. Secondly, you will not have adequate time for preparation—you need your market value report and negotiation skills training completed before you start the process. In the rush to prepare for board exams, move, find a place to live, and find a job all at the same time you may have to skip the prep work and might not be able to bargain for the best deal.
Here’s something you may have never considered—you have likely been committed to a certain city or region of the country. Most people have a place in mind where they wish to practice. Maybe your family lives there, you went to college there, or you have another connection. You may even have a list of the top 1 or 2 practices or hospitals you’d like to join.
This commitment to a potential practice or region is highly valuable—You should be leveraging this commitment to your advantage.
I understand that idea may seem confusing. Please, keep an open mind and stick with me while I explain. Think about the job position from the standpoint of the administration and physicians who run the practice. They face several challenges—they want to be able to get a top quality candidate who has connections to the region or practice and who is willing to commit to join them. Hiring physicians is extremely expensive and on-boarding is long and tedious process that takes several months. From their standpoint, getting an early commitment from a qualified candidate is a valuable commodity.
Imagine running a growing surgical practice. You know you will need to expand your staff in the next 1-3 years. Along comes Dr Perfect. She is well trained, has strong ties to community, has the right professional skills to succeed, and she is already interested in your practice to the point where she will commit. Dr. Perfect has 2 years left in her training. If you can get Dr. Perfect to commit right now to join the practice in 2 years it would be fantastic. If you don’t get that commitment, she may go elsewhere—possibly your competition. That would really hurt! If only there were some way to induce Dr. Perfect to commit today to join the practice in 2 years…
Your commitment has a monetary value. The value is paid in the form of a stipend.
Yes. A “stipend”—as in a salary! I know what you’re thinking, who’s going to pay me for a job that I’m not even working? Well, you may be surprised to learn that several of the largest health care systems in America routinely offer a stipend, to those who are knowledgeable, as part of their standard recruiting policy. Typically, you receive $1500 to $3000 monthly for up to two years. In return, you commit to practice for a specific period of time, usually 2 years. You can even negotiate an extra 2-5 years of stipend if you are planning on fellowship, depending upon the demand for that specialty. The stipend is considered salary and is taxable. If you do not fulfill the commitment, you will owe the money back plus a penalty.
Here’s your game plan to get the best deal and collect thousands of extra dollars during residency or fellowship.
- Search your heart and speak to your friends, family, and significant others. Is there a city or region that you know you are going to practice when you complete your training? This needs to be a well thought out decision, since there are financial and reputational penalties if you commit and then change your mind. This should be as “set in stone” as possible.
- Search the market and find at least 3 and preferably 7 practices in the region. Send them a letter expressing your interest in their practice and ask for the opportunity to interview. Be sure to contact their director via phone as well. Be prepared to answer typical questions via phone.
- Now is the time to prepare for the interview. Buy a suit that fits, practice your handshake and know how to answer the questions that matter. We recommend you take a CME course that teaches interview skills. After you have had a chance to visit the sites, make a list of the favorites and plan to negotiate.
- This is a complex negotiation. It’s a lot different than buying a used car or haggling for a skateboard at the flea market. There’s a lot at risk here and you’ll want to be well trained in medical negotiation. Fortunately, there are CME seminars available, self-study, and non-physician oriented negotiation conferences. Most physicians need 4 practice negotiation simulations before they are ready to sit down at the bargaining table, so look for seminars that offer medical situation practice sessions. The time and resources spent in learning this valuable skill could end up being your best investment.
- You’ll need an accurate market value report. You will be attempting to predict market conditions 2 to 7 years in the future as you develop your medical contract. You’ll want market trend information and data beyond just the average doctor salary. You will also need some objective standards for stipend payment to support your position.
The physician job search can be a trying time. However, there are several factors that you can use to your advantage. Being committed to a particular region, hospital, or practice is of great potential value to you and your future employer. Be sure to use this value to improve your compensation by looking into 2-5 years of a stipend prior to starting your new job. The process will take some extra legwork and education on your part, but is well worth the investment. Who doesn’t want to pocket thousands of dollars of additional funds while struggling as a resident or fellow? Always keep in mind that with the proper training and skills, you’ll be able to achieve your dreams and focus on those thing that really matter.
About the Author
A neurologist with over 20 year of experience, Dr. Robert Felberg has designed and developed several well-known Comprehensive Stroke Centers. An award winning medical educator, he recognizes there is a critical lack of teaching in the factors required to be a truly successful physician beyond clinical knowledge. He founded Physician Advocates LLC to inform and help physicians learn how to become successful in their medical career.
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