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Emergency Medicine News:
doi: 10.1097/01.EEM.0000398966.32150.c9
Career Source

Career Source: Cold Feet

Katz, Barbara

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It is not at all unusual for job seekers to experience doubts and uncertainties some time between accepting a position and reporting for work. Cold feet can strike at any time after the contract is signed: during the massive paperwork extravaganza of credentialing, during the long waits associated with licensing, or even in the midst of relocation madness, especially if you have a house to sell. Doubts are certainly nothing new to emergency physicians, except instead of “Oops, maybe I shouldn't have leased that Lexus on a resident's salary,” it's “Oops, maybe I shouldn't have taken that job in the Everglades!”

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If you've recently accepted a new position, and find yourself questioning your decision, there are a number of things you can do to quell your fears. Begin with defining your doubts. Make a list of all the things that are making you uneasy. Once you've listed your fears, go back and analyze each item to see why it is causing you to doubt your decision, and what the worst-case scenario would be.

Let's say your main concern is the potential departure of the wonderful department director. You could call the Psychic Friends Network or (gasp!) ask the director yourself. It never ceases to amaze me how reluctant some candidates can be about asking direct questions. Call the director, and be blunt: “I've been hearing some rumors that you are considering taking another position. Is there any truth to this?”

If, indeed, the director has thrown his hat in another ring, tell him how uncomfortable the possibility of his leaving makes you. He's still the director of the department, and it's still his responsibility to prevent the loss of a new physician. Let him tell you what effect his leaving will have on you and the department, who his possible successor may be, and whether his move should concern you. There is the remote possibility that the director won't be honest with you, but if that's the case, is his leaving really such a loss?

Whatever form your doubts take, there is a source out there that can allay or confirm them. It's in your best interest to find out who that is, contact him, and ask direct questions. If you worked with a recruiter on the position, that recruiter is the best place to start. A professional recruiter's reputation can be severely compromised if a position turns out to be different from the way the recruiter presented it. Emergency medicine is still a relatively small specialty, and word gets around quickly. To a truly professional recruiter, reputation is everything. Give the recruiter some time to dig up the details.

Once you have the facts, you can effectively reevaluate your decision. Should research present negative or disturbing new information that you did not know when you signed a contract, you have the right to act. You do not, however, have the right to overreact! Don't charge in waving legal papers and screaming about foul play. Present the facts to the employer in a professional way in writing. It would be best to consult an attorney, particularly if you have already signed an employment agreement before contacting the institution. If the specifics of the job have significantly changed, particularly if they affect compensation, you have fairly good grounds for nullifying the contract.

Most graduating residents settle for the sure thing when finding they have to choose between a compromised version of the job they accepted or starting over. The idea of navigating the market anew is so horrific, they just hope for the best. But this is one instance when a bird in the hand is not necessarily the best way to go. Your first job seriously affects your career direction and progress. You are better off taking locum assignments while continuing to look for the right position. There are many excellent opportunities available during the summer months and early fall, particularly in this candidate-driven market. Some of the best opportunities for graduating residents begin interviewing in mid- to late August. Any prospective employer will jump at a physician available immediately rather than waiting until next July. But be careful when explaining the circumstances of your lost job. Make it clear why the changes in the job description rendered it unacceptable to you, and do it without whining!

On the other hand, if all you turn up are minor changes in scheduling or a new chart system, get over it! As an emergency physician, you pretty much need to be ready for anything. Demonstrate adaptability, and focus on the positive aspects that made you choose the position in the first place. Try dwelling on the contributions you will be able to make. You are going to make a much better impression if you ask not what your ED can do for you, but what you can do for your ED.

Comments about this article? Write to EMN at emn@lww.com.

Ms. Katz is the president of the Katz Company, an emergency medicine consulting firm dedicated to providing expert physician recruitment services and training emergency medicine residents in effective job searching.

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Read all of Ms. Katz's past columns in the EM-News.com archive.

© 2011 Lippincott Williams & Wilkins, Inc.

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