Securing Your First Job After Residency

The end of December not only marks the passing of another calendar year, it also signifies the halfway point of another year in residency. Many of us are finalizing our first job offer or eagerly networking in anticipation of marketing our skills to potential employers.

During residency, directions are clear and choices are finite - match into a good program, work hard, expand your knowledge base, and prepare for boards. After residency, choices become numerous. Begin a fellowship or find a job? Choose a multi-specialty practice or join with other physiatrists? Focus on outpatient or inpatient? Work in academia or private practice? It is safe to say that I am not the only one pondering these questions and excited to begin the next phase of my career, yet anxious about the future!  Below is a summary of interviews I held with physiatrists who completed their residencies or fellowships this past year. 

Interview Participants:

• Madhuri Are, MD, UT MD Anderson Cancer Center, Houston, TX

• Sooja Cho, MD, Moss Rehabilitation Hospital, Philadelphia, PA

• C. Lan Fotopoulos, MD, Dickson-Diveley Midwest Orthopedic Group, Kansas City, MO

• Ajay Kumar, MD, Moss Rehabilitation Hospital, Philadelphia, PA

• Sam Miceli, DO, Saint Luke’s Hospital, Kansas City, MO

• Maurice G. Sholas, MD, PhD, LSU Health Science Center, New Orleans, LA

When asked what they believed most and least prepared them for their first job, most stated that the “technical” aspects were the easiest – patient assessment and treatment and medical decision making. The more challenging aspects of their jobs were related to the business side. Dr. Sholas recalled, “The nuances related to introducing myself to a new market and physicians at my hospital that had never heard of pediatric PM&R.” Those physiatrists in private practice have found the steepest learning curve to involve coding and billing. Dr. Miceli stated, “I would have pressed my attendings to involve me more in that process. I think it takes drilling, and I’ve learned that; just like there are many different practice styles, there are also different coding/billing styles.”

The physiatrists were asked to discuss the interview process. The length of time to secure a position ranged from five weeks to eight months. Those who transitioned from resident to staff at the same program experienced shorter transition time. Those who wanted to relocate to another region took extra time to assure that it was the position they believed most matched their interests. Dr. Cho emphasized, “When you go for interviews, it should feel comfortable, especially with the people with whom you will be directly working.” The majority of interviewees had good leads or secured their position early in their last year of residency or fellowship. Dr. Kumar advised, “Start looking for your jobs early. If you are looking for a fellowship, have your CV ready within the last two months of PGY-3. If you are looking for a job, you should be ready two months into your final year.”

Dr. Sholas stated, “PM&R is a small field. One should never make disparaging comments about one site to another. Employers from different sites in different regions of the country talk. Always represent yourself in a positive and professional manner that does not denigrate another applicant or site.”

Regarding relocation, Dr. Kumar remarked, “If you are very sure about the geographic location where you want to work, apply for licenses in the two to four states. While it is expensive, this process can take a long time. Sometimes, the difference between somebody who gets the job is not his qualifications or experience, but who already has the license for that state.”

In looking back on their training, all physiatrists interviewed were satisfied with their education and training. In general, everyone believed they were well prepared to put their acquired knowledge to use. Dr. Miceli encouraged, “Not to intentionally limit your knowledge base. Even if you think you are going to be doing a certain type of physiatric practice, don’t ignore what you think are ‘unrelated’ topics, because they still come up.”

Take advantage of the education opportunities available to you during residency. If your time is stretched thin now, it will become even more so when you begin practicing.

A sincere thank you to everyone who took time out of their busy schedule to share their experiences and insights for this article!

Linda R. Ladesich, MD, MS

University of Kansas Medical Center

LLadesich@kumc.edu