I have been getting calls recently from employers all over the country asking me what's with the candidates this season, especially graduating residents. They report that many are walking into interviews with a primary focus on perks instead of practice. “How much is the sign-on bonus?” and “Will you pay my school loan debt?” are far too often the first questions a candidate is asking on an interview. Where is this unprofessional approach to interviewing and inflated sense of entitlement coming from?
Certainly an experienced, boarded, residency trained emergency physician in this candidate-driven market has strong grounds for negotiation, but if you are a graduating resident with no real work experience, perhaps you might consider just how smart it is to sit across from a potential employer and begin your interview with demands for unearned perks. What happened to the concept of proving oneself? Sign-on bonuses for graduates made the scene about eight years ago but averaged under $10,000, and were meant primarily to help with relocation expenses. Apparently, graduates are now interviewing with the expectation of bonuses in the $25,000 to $30,000 range.
Loan repayment always has been the last resort for rural EDs and employers in tough recruiting locations, not a matter of course. It's a mystery where they think money like this is going to come from, especially in these severely challenged economic times, but for some reason, graduates are marching into directors' offices demanding these perks as if they were an accepted standard.
Give some thought to the potential outcome of such a tactic. If the employer is especially desperate, he could promise you the moon just to get you to sign on the dotted line. But what kind of job would you end up with? How are you going to feel in six months when you've spent that bonus or have to give them four more years to earn that loan payback? If you're unhappy in your job, your life and family will be unhappy, too!
Just as important is the reaction of the interviewer. If you are interviewing with a quality group or department, what are they going to think if your attitude is rife with greed and entitlement? There are many jobs this year, but there aren't many great jobs. The good employers will not react well to candidates who lead with questions about compensation before getting into the meat of the practice profile. Certainly, employers in places like San Antonio, San Francisco, and Chicago don't need to buy physicians with perks. Look for the quality of the practice first, and make sure it's a place you can be fulfilled over the long run.
If you are savvy, you won't set up any site interviews without first conducting a phone interview with the department director, but are you smart enough to know the right questions to ask? Most candidates know to get patient volume, practice statistics, coverage details, schedules, and of course, compensation numbers. What about the history of the job? Every job opportunity has a history, and if you don't know what that history is, you could be in for a rude awakening.
The Job's History
Is the job a new position created to add coverage? Is the additional coverage due to an increase in census or slacking off by the staff? No director is going to confess his staff has grown lazy, but if the census reports over the past few years don't support adding an additional full-time physician, that should raise a red flag. The only other reason a job opening occurs is to replace someone who is leaving. So why is that person leaving? That's a perfectly legitimate question to ask, and any employer who won't answer it has something to hide.
Once you know why a job opportunity exists, you need to ask how long it's been open. If a job has been open for a year or more, wouldn't your first thought be, “What's wrong with it?” You also want to know the interview history. How many people have been interviewed for the job, how many offers were made, and why were the offers turned down? If a job has been open for a year, they have interviewed six physicians and made five offers, and every candidate turned them down, your internal alarm system should be going off.
On the other hand, if a job has been open for a year, and they have interviewed six physicians and made no offers at all, you should be asking, “What are they looking for?” The point is to get a picture of the position. A good director will understand why you are asking these questions, respect your good sense to ask them, and give you honest answers.
It is equally important to find out how many candidates are currently in the pipeline and what their status is. Don't be dismayed if the employer is currently conducting multiple interviews; that's to be expected. This is a wide-open market, and employers are looking to hire the best candidates as soon as they can. The best way to accomplish that is multiple interviewing. You do, however, want to find out if there are any outstanding offers.
Some employers will continue to interview after an offer has been extended in case the offer is turned down. If the employer is waiting for a response, your standing as a candidate is limited to second-best. I'm not saying not to accept the interview, but I would ask the employer whether he is prepared to extend another offer should your interview go well, or if they intend to continue to wait for a response from the first physician. My advice is to go only if they are willing to give you an equal shot.
These questions also help you find out the longevity of physicians in the department. It is important to know if the department retains physicians or has a reputation as a revolving door. You should be looking for an opportunity that provides stability and demonstrates the ability to retain good physicians. Simply ask, “What is the turnover ratio of physicians in the department?” If the average physician stays around for only two years, do you want to work there?