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Lessons with Dick and Jane (and Spot)

Katz, Barbara

doi: 10.1097/01.EEM.0000269599.21027.63
Career Source

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.



Dick is graduating from a Chicago emergency medicine residency program in June, and being a tremendous catch, he's already found the job of his dreams. Of course, being such a hot commodity, he made sure to give everyone a chance to hire him.

Dick went on 14 interviews. He hit eight groups in the Midwest, two in the Pacific northwest (let's face it, pickings are always slim there), three groups in California, and one in Texas (I mean, the money was so great, he just had to) before granting a lucky group in Wisconsin the pleasure of his employment beginning in July. Dick sent a beautiful thank you letter to his new director, and even dropped a note with an interesting article in the mail to his soon-to-be hospital administrator.

Dick considers himself very slick, and calls this “greasing the path.” He is under the assumption that he has completed his job search. Of course, the 13 other employers who interviewed him and from whom he received offers don't know anything about Dick's new job. They place calls that aren't returned and send e-mails that aren't answered because Dick thinks, “Well, if I don't respond, they'll get the message. Besides, I didn't choose them so there's no reason to grease those paths.”

Each one waits weeks to hear from him, losing other candidates with every passing day before finally writing off Dick and moving on. About two years from now, Dick will do what nearly 65 percent of all graduating residents do. He'll get his board certification, and go looking for a new job. So let's time-travel to April 2009: Dick is absolutely drooling over the interview he has scheduled.

He recently married, and has a Dick Jr. on the way. His interview is with a great medical center in one of the most desirable areas of North Carolina. The city has an award-winning school system and great amenities. The group has outstanding partnership potential, and their doctors are earning big bucks. An old classmate from residency managed to arrange for Dick to come by for an informal, pre-interview meeting. Dick walks into the ED chairman's office and shakes hands with the head man himself, thinking, “Wow, he looks familiar!” That's because he's the director Dick interviewed with in Texas two years before. No doubt the chairman is thinking, “Wow,” as well, but the rest of the thought is quite different from Dick's.

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See Jane Renege

Jane also is graduating from an emergency medicine residency program, but hers is in Boston. In fact, Jane will do just about anything to stay in Boston. His name is Chad, and he is such a hunk. He's an attorney with great financial prospects. Unfortunately, jobs are slim in Boston this year. Jane decides to head outside the metro corridor to job hunt. She looks at jobs in northern Connecticut, southern New Hampshire, and western Massachusetts.

Finally, Jane gets a really terrific offer with a group in New Hampshire. They delivered on everything she told them she wanted. Jane calls the director, and verbally accepts the position and asks that the contract be sent. The director has already made it clear that she has a 14-day deadline to sign the contract, after which the offer will be rescinded and made to the next candidate.

Jane is happy. She works out a lifestyle plan with Chad. Two days later, Jane gets a call from the ED director of a hospital in Boston. He offers her an immediate interview for the following week. The interview goes very well, and Jane wants the job. She seems to have forgotten that she has already accepted a job, and has a contract to sign. She now has only three days to return the signed contract to the director in New Hampshire, but she still doesn't know if she has the job in Boston. She signs the contract, and mails it to New Hampshire. The next day, Jane gets a call from the Boston director who extends an offer, which she accepts immediately.

Jane is thrilled. Chad is thrilled. But what will the director in New Hampshire be when he receives her letter of resignation one week after receiving her signed contract? Oh, and guess what? The director in Boston is going to accept a new academic position across town in a year, and his position will be filled with a new director hired away from a terrific group in southern New Hampshire.

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See Spot Lie

Spot is graduating from a program in Arizona. His wife and kids are really happy there. They have a lot of friends in the area, and they have picked out a wonderful home in a great neighborhood where the little ones can enjoy a terrific private school nearby. Their dog, Buster, is allergic to mold so the low humidity in Arizona is much better for his furry hide.

Spot has been on three interviews at hospitals close to home, and he has received two offers. One offer was so-so, so he turned it down. The other offer was quite good, and he is really interested, but it's not the offer he really wants. The offer Spot really wants is with the top hospital in the area, and it has yet to come in. He has been told they are still completing their search process, and will be notifying him of their decision within two weeks.

In the meantime, the group that made the offer has already been waiting a week for his response, and is starting to get a bit antsy. They have given him a deadline that ends in four days. Spot decides he has to get creative. He calls the director, Dr. Smith, and verbally accepts the offer, but says that his grandmother is very ill in Wyoming, and he is rushing to her bedside. That means he won't be able to complete the contract process with his attorney for at least two weeks. (Granny's going take at least a week to recover.) He persuades Dr. Smith to agree to a two-week extension. And now the waiting begins.

In the meantime, Spot's grandmother is actually scheduled to run the seniors' marathon in Tempe this weekend, and there's a much better than even chance that she will “run into” Dr. Smith's mother, and they will have a detailed conversation about “my son the doctor and my grandson the doctor.” Dr. Smith is a very good son, and calls his Mom every Sunday. Chances are pretty good Spot is going to have some explaining to do!

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The Lessons

Yes means yes. You can't have your cake and eat it, too. Lies will usually catch up with you in the end. Emergency medicine is a very small world.

© 2007 Lippincott Williams & Wilkins, Inc.