Residents graduating in 2007 and experienced emergency physicians planning to look for a job this year need to make choices now about the goals they want to pursue. Goal setting can be a mind-numbing experience if you are not accustomed to the process. Keep it simple but target-specific. Your goals for your first or any job search should fall into three categories: location/lifestyle, financial, and practice profile.
The first step is deciding which of these three categories will take top priority in your job search; the other two will be driven by that.
If, like most emergency physicians, you choose location/lifestyle as the category of primary importance, you will have to settle for whatever job opportunities exist in your defined location and accept whatever income those opportunities offer. Many job seekers choose this as their primary category for reasons that might not hold up in an interview: they want to be close to mountains or water, they love to ski or scuba dive, they hate winter or big cities, or their dogs are allergic to humidity. All fine reasons, to be sure, but they have little to do with work and a whole lot more to do with time off. Imagine the reaction of a director who asks a candidate, “Why do you want to work here?” and gets the reply, “Because I love to ski!” Successful candidates think with a career head, not a vacation head.
You need to be very careful about choosing location as your primary category. It can seriously limit the number of job opportunities available to you, especially if you choose a popular lifestyle area where job opportunities are scarce. Hiring authorities are looking for physicians who present the greatest chance of long-term employment, so they focus on candidates with close ties to their area. Putting location/lifestyle in the primary position also can limit income because popular regions don't need to provide the highest incomes to attract physicians.
What if you choose finances as your most important category? No one will fault you for wanting to earn as much as you possibly can, but you must understand that earning big bucks usually means a trade-off. Employers who use income to entice physicians do so because it is usually the only carrot they have to dangle. High-paying jobs can mean uncommonly high risk in less-than-desirable areas. Sometimes a group will intentionally keep coverage low to keep profits high. This scenario is a high-risk option poised to provide the onset of your malpractice history. Incomes can vary dramatically from one state to the next and from one hospital to the next, even in the same town. Variables include location, patient-payer mix, HMO penetration, employee status, and incentive or partnership formulas. Make sure you've read all the fine print, and evaluated the risks that accompany an offer before you make a high-income choice.
Practice profile refers to the job, and nothing but the job. The startling truth is that less than 10 percent of graduating residents choose practice profile as their primary goal. As physicians gain clinical experience, however, it becomes more and more important. As a recruiter, I have found that most physicians out of residency for four years or more make moves based on a search for an improved practice profile. The priorities they set as graduating residents often take a dramatic turn after the first two years on the job. Most graduates are woefully uninformed about what is available in the emergency medicine job market, and as a result, can be easily influenced by a savvy dog-and-pony show or lured by an impressive dollar amount.
I encourage every emergency physician to consider the ramifications of not choosing the practice profile as his primary goal. No matter how beautiful your surroundings or how much money you earn, if you are unhappy in your job, you will be unhappy in your life. And if you are unhappy, your family will be unhappy, too. The best approach to goal setting is to make practice profile as important as location/lifestyle, and remain open to widening your geographic search parameters until the right job for you surfaces.
Goal setting is not a solitary cerebral exercise. It requires extensive consultation with your family to develop goals that meet all of your individual and collective needs. A goal is not a goal until actually written down in detail. Chart your three-category goal list with the following headings: must have, like to have, will consider, and won't consider.
As you search for a job, this goal chart will provide you with a strong basis for evaluating each opportunity. You may find that certain items will move around on your chart within the second and third headings, so be flexible. Once you have defined your goals and committed them to paper, you will enjoy a reduced stress level and increased excitement and anticipation levels in your job search.