Finally arriving at the end of training and landing your first physician job after years of medical school, residency, and fellowship is an exciting milestone in every physician’s career. However, starting the job search during your last year of training can be overwhelming. All of the rules you had for how to pick your medical school, residency, and fellowship based on things like prestige and quality of education are no longer the singular guiding factor. Now you must factor in what practice environment you want, how much money you need to make, where you want to live permanently, your personal and/or family situation, and more. You may find yourself hounded by recruiters and having a difficult time figuring out whether the jobs you’re being pitched are good ones or not. Or you might not know where to start looking for a job or how to reach out to find open positions. Below, we guide you through the basics to help you successfully navigate the search for your first physician job so you can build a career and life in medicine that meets your professional and personal goals.
Note: This article is part of our resources for graduating residents and fellows and transition to practice series. We’ve compiled a list of other relevant resources below. If you are not a part of our transition to practice series and would like to sign up, you can:
Disclosure/Disclaimer: Our content is for generalized educational purposes. We are not formal financial, legal, or tax professionals and do not provide individualized advice specific to your situation. You should consult these as appropriate and/or do your own due diligence before making decisions based on this page. To learn more, visit our disclaimers and disclosures.
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Assessing opportunities during your physician job search
When assessing different job opportunities, there are several factors to consider that impact how well a job might fit with your career and lifestyle goals. Consider the following:
Salary
This is one of the main factors many resident and fellow physicians graduating from training consider when finding a job. After all, after years of student loans and no savings, many feel behind in the financial realm and are eager to catch up. While we don’t think it should be the sole factor in what makes a job attractive, we are huge advocates of knowing your worth and asking for it. Physician contracts can be based on different models including a straight salary model, a straight RVU model, or a hybrid model of a base salary + productivity. It’s important to understand how an offered salary is calculated and if it’s guaranteed or estimated based on their expectations for work volume. Make sure you utilize all the compensation data available to you to see if you’re getting a good deal. We have many below!
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Compensation package
Salary is only a portion of the overall compensation package. Others to consider include a signing bonus, vacation time and/or paid time off (PTO), retirement plan and employer match, student loan repayment programs, and more. These can be significant additions to the overall package on top of your salary.
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Work volume and hours worked
How many patients are you expected to see in an hour? How many hours is your standard work day? On average, how many hours are you expected to work a week? Does this include enough administrative hours to complete charting and other tasks during the day, or are you expected to do that after hours at home? What volume of on call are you expected to complete (and is it paid)? What happens if a physician leaves the group/how is their call divided among the remaining doctors? The answers to these questions can help you assess what your potential stress level might be, which can factor heavily into physician burnout.
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Location
Is the job in a state or local area where you would like to live? Is it close to family or in a lower cost of living than where you currently are? Physician salaries vary widely by location, as does the cost of living and how much money you’ll have to make (read: how hard you’ll have to work) to have the lifestyle you desire. Relocating for a position can give you the potential to geoarbitrage your situation so that you can have a similar lifestyle while working less. Location can also provide a better quality of life by aligning your career with where you ultimately want to be (beaches versus mountains, colder versus warmer climate, etc.).
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Flexibility
Different positions offer different levels of flexibility. Some have set 7-on, 7-off schedules booked out months in advance. Others have flexible days and hours, depending on your desire and availability. You may have the option to work hybrid telemedicine and in office hours, or you might be required to be on location all the time. Some may even have restrictions on the type of physician side gigs you can do while employed.
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Growth opportunities
In our how much doctors make by specialty series, we’ve seen the earnings potential of becoming an owner/partner in a private practice. If this is a future goal of yours, the practice environment can be important in your job search. It’s also important to know what the track to partnership looks like. How many years does it typically take to make partner? What does the buy-in structure look like? If you aren’t interested in being a partner but do want growth potential into other administrative roles, it’s important to know what other opportunities exist outside of working with patients. Additionally, if you’re in academic medicine, it’s going to be important to know how much professional support and mentorship you’ll have as well as what the potential for upward mobility within the leadership at that institution is.
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Appetite for risk
Taking a greater risk can lead to a greater reward in terms of earning potential and career growth, but it can also open up the potential for larger setbacks temporarily. If you have hundreds of thousands in student loans and a young family to support, you may want a job with more stability and less risk. If you’re a physician entrepreneur who has always dreamed of opening their own practice and have saved up to start a practice, a solo private practice may be more your speed. It’s important to understand not just your goals, but what you can financially afford to do in this season of life. If you’re thinking about locums, this has its own risks in terms of both cashflow and doing locums for your first job out of training. If a private practice or hospital system is looking to bring you on to develop out a new office or practice scope, you’ll want to know what questions to ask to make sure they’re setting you up for success.
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Practice style and environment
There are several different practice environments, each with advantages and disadvantages. The other factors above may help dictate this decision, and we look a little deeper into this topic below, where we also list what questions you should be asking before and on your interview day to ensure it’s the right fit and that you’re set up for success.
Evaluating different practice environments for the right fit
Six main types of practice environments exist for graduating trainees to consider for their first attending position:
Academics
Employed hospital practice
Government/VA/FQHC
Private practice (corporate or group)
Solo private practice
Locums
Typically, we don’t recommend locums for your first job. Although it’s certainly doable, many in our physician communities usually recommend that you have at least a few years of attending experience to be able to quickly adapt and do well in this type of environment. While you’re gaining your attending feet, many physicians worry that you may not have resources or other doctors to ask questions to if you’re on your own in a new location.
Within these categories, you’ll also want to consider sub-categories and which best fits your desires and goals:
Patient population for the specific group
Single specialty versus multi-specialty environment
Private equity versus non-private equity owned
Availability of a partnership track
Insurance based, concierge, Direct Primary Care (DPC), or other
Again, each of these can have advantages and disadvantages. There is no one “perfect” environment to target your job search at.
In our How Much Do Doctors Make? series, we’ve seen in general that:
Government/VA/FQHC/active military physicians usually make the least, though these positions typically qualify for federal student loan forgiveness
Academic hospital employees make less than non-academic hospital employees (though academic hospital also typically qualify for PSLF)
W2 employees working for non-private equity backed practice typically earn more than colleagues working for PE backed groups, though owners/partners may initially earn more as part of a buyout offer
Doctors working in private practice groups typically earn the most, though some solo private practice owners make less than average, especially in the startup and building phase
Location and related patient populations can factor heavily into earnings
Average hours worked per week vary by practice environment within specialty, and the doctors who work more don’t always earn more
Owners/partners typically earn significantly more, and don’t always work more on average, even with additional administrative responsibilities
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Preparing for your first physician job search
Spend some time considering the factors and practice environments above to hone your ideal job. While you do, take notes for reference! There are a few steps to take before you reach out and inquire about open positions and try to land interviews.
Update your CV/resume
The vast majority of attending physician positions will want to see a copy of your CV. Make sure it’s up to date. Some positions, especially if you are considering nonclinical options, may ask for your resume instead of or in addition to your CV. They aren’t the same, and it’s important to know the differences between them.
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Check your online presence
Prospective employers will likely search for you online. Google yourself ahead of time to see what they’ll find out. Consider making your social media accounts private and setting up a LinkedIn profile to highlight your education, training, and research accomplishments.
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Prepare to dress the part
Get some professional interview clothes and a nice handbag or briefcase to have on hand. If you’re on a budget, shop sales while you prepare for your physician job search and check secondhand shops.
Budget for the year
You’ll need to budget carefully for this year, as even if places pay for your interview expenses (not all will), you’ll likely have a lot of miscellaneous expenses such as clothing, meals, ground transportation, and more related to your job search and interview process.
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Ways to search for your first physician job
When you’re ready to begin your job search, there are several different avenues to explore to find potential job opportunities.
Leverage your existing network
Reach out to colleagues, friends, and mentors in the healthcare industry and let them know you’re looking for opportunities (and what kind you’re hoping to land). See if you have mutual connections for jobs that interest you. Also check through your alumni networks and with mentors.
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Utilize free job sites
Job boards can be a great way to find out about open positions. Several exist, some of which are targeted specifically for doctors or physicians and to other healthcare professionals. Others are general for all industries, but may still have relevant positions. We even have a PSG job board to help connect you with jobs from our members that aren't often advertised.
Network for new opportunities
Attend conferences and professional society events as a way to make new connections and to learn about more opportunities through colleagues you meet and potentially via event sponsors.
Reach out directly
These opportunities can be harder to find because they might not be listed openly, but if you’re interested in working with a specific group and don’t have a connection in your network, it’s worth the effort of reaching out to let them know you’re interested in opportunities.
Use an external recruiter
If you’re having difficulty finding opportunities with the methods above, a third-party recruiter can have access to jobs you might not otherwise hear about unless you happen to directly cold call the right place. Even then, the group may have a recruiting company contracted that they do all their staffing with. Just be prepared to hear from them often once you open the floodgates. (We recommend getting a separate email address and Google voice number to use for your job search to limit long-term access to your contact information.)
Learn more about starting your physician job search.
Nail your physician job interview
Once you’ve reached out, it’s time to prepare for your first interview. A few tips:
Research the group ahead of time
Look up the person who will be conducting the interview and learn a little about them
Make a list of your deal breakers and have them ready
Wear your professional attire you recently bought
Practice for questions they’re likely to ask, and prepare a list of your own questions for them (interviews are not just there opportunity to interview you, but for you to interview them as well to assess if they’re a good long-term fit)
The art of the physician contract negotiation for your first job
Once you’ve started the interview process and receive an offer, it’s time to prepare for contract negotiations. We’ll break this down further in a separate guide, but for now, here are some resources to help you understand different stages of the contract negotiation process, and red flags to look out for:
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We almost always recommend working with a local contract attorney who works with physicians. These attorneys can help advocate for you and help you know your worth, as well as help you avoid contract terms that can restrict you or harm your career potential in the future. Many can help guide you through the negotiation process, along with reviewing a contract before you formally accept a position.
A few negotiation tips to keep on hand:
Know your leverage
Everything is negotiable
Be respectful and polite, but firm
Take your time & have options
Set yourself up for future negotiations—never say yes right away
Budget for your first paycheck
Congratulations! You have completed your job search and landed your first attending job. Now what?
Make sure you understand how much you’ll actually be bringing home with your signing bonus and your first paycheck, and plan accordingly. Many physicians leap into a higher marginal tax bracket when they start their first attending position and don’t take into account the higher tax withholdings when they budget for their relocation and new post-training lifestyle.
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Once you’ve reached this exciting milestone, dive deeper with our guide to personal finance for graduating residents, fellows, and early career attending physicians.
Conclusion
With recent growth booms in certain localities throughout the US and with the labor shortage of physicians in the healthcare industry, we want to drive home the reminder to know your worth and, more importantly, to ask for it. Employers are seeking physicians because they need your skills and expertise. While you won’t be able to make partner right out of training, don’t underestimate your years of training and education. You have spent years preparing for this moment. You are ready to rock your first attending job.
Not every job you interview for will end up a good fit for you and what you hope to get out of your physician career. While there’s likely no “perfect” job out there, some are definitely better than others, especially when you assess how they fit your specific goals. Once you know your deal breakers, stick with them. Choosing a job that doesn’t align with your goals is the fastest way to ensure future burnout and lead to job dissatisfaction, which is one of the largest factors we see when doctors are considering leaving clinical medicine. Selecting the right fit for your first attending job can help you make the life in medicine you want for the years ahead.
Additional resources for residents and fellows
If you’re a resident or fellow, make sure you watch the recordings of the transition to practice series events on our communities, which cover the topics above and answer a lot of other FAQs we see during this time period.
Checklist of things to do as a graduating resident or fellow
Securing your life and disability insurance
Contract negotiations and job search
Personal finance
Student loan refinancing
Side gigs for residents and fellows
Figuring out what to do with retirement accounts
Housing for physicians
Moving discounts for physicians under our Resources, discounts and perks for physicians