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The 2008-2009 Job Market: Location, Location, Location

Katz, Barbara

doi: 10.1097/01.EEM.0000338060.16775.d0
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.

Part 1 in a Series



Candidates remain in the driver's seat this season with about three positions available for every residency trained physician on a job hunt, but opportunities are sliding downward in trendy locations. About 25 percent of the positions available are left over from last season, some of which have been open more than a year, but most have been available for six to nine months.

A whole new crop of jobs hit the web sites and classifieds between July and September so check the dates of submission on any opportunity of interest. Expect to compete for jobs in popular lifestyle areas but to be wooed, sometimes spectacularly so, in the less popular and semirural areas.

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The Southeast

The top region for opportunity is the Southeast again, but the jobs are more evenly distributed across the region than last year. Florida will have 16 percent of the jobs, including a few with national contract groups in Tampa-St. Petersburg, quite a few on the west coast, and a smattering along the east coast and in Miami. Primary care physicians with experience will be accepted in 60 percent of the jobs, and about 15 percent are six months old or more.

Next is Tennessee with 16 percent, including great opportunities in Nashville, Knoxville, and Memphis, and 50 percent accepting PC boards. Like Florida, nearly 75 percent of the positions are with contract groups, primarily TeamHealth in Tennessee.

North Carolina has 14 percent of the region's jobs, but forget the Raleigh-Durham area. Look carefully at any ads claiming to be in Research Triangle Park; most will be at least an hour away. Charlotte and the Great Smoky Mountains will offer some opportunity this year, 46 percent with groups and 34 percent with contract groups, though very few in rural spots.

Georgia provides 12 percent and Mississippi 10 percent of the region's jobs. You might even find a spot or two near Atlanta, but about 40 percent of the jobs in both states are open to PC boarded doctors. Fifty-one percent of Georgia's jobs will be with contract groups, while half of Mississippi's will be with private groups. Alabama, South Carolina, West Virginia, and Louisiana will have about six percent each. Alabama and Arkansas are running about 33 percent rural, and more than 50 percent of the jobs in Arkansas are more than six months old. Look for a few spots in Birmingham and in Charleston, WV. Even a Charleston democratic group has an opening for the first time in years, but it should go fast if it hasn't already. New Orleans is looking for a few good doctors, but half the job listings statewide are from last season.

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The Midwest

Nearly 25 percent of the nation's jobs will be in the Midwest's 13 states. Ohio will be wide open with 22 percent of the region's opportunities. Look for good jobs in all the “C cities” (Cleveland, Columbus, and Cincinnati), 60 percent with groups, 21 percent with national groups, and 19 percent with hospital employers. Following close behind is Illinois with 18 percent of the region's jobs, including quite a few in the general Chicago area. More than 46 percent are older than six months, primarily by a group specializing in rural opportunities.

Illinois will split 50 percent between national groups and private groups. Missouri is in hiring mode this year with 12 percent of the area jobs, including a few in Kansas City and St. Louis. About 25 percent are rural and will accept PC board certification, and nearly half will be with hospital employers, leaving only about 10 percent with private groups. Indiana will have about as many opportunities (11%) with only one or two in Indianapolis, 30 percent accepting PC boards, and 33 percent over six months old.

Providing about seven percent each are Iowa, Michigan, Wisconsin, and Kentucky. Half of Iowa's jobs are rural, and 84 percent will accept PC boards, which explains why half are nearly a year old. Michigan will offer 70 percent hospital employee jobs with only one or two in the Detroit area and about 35 percent rural accepting PC boards. Only 20 percent of Wisconsin jobs accept PC boards, with none in the few jobs turning up in Milwaukee and Madison. Most of the state is split between private groups and hospital employers.

Kentucky will have no opportunities in Louisville, and splits most of the jobs between national groups and hospital employers with 46 percent accepting PC boards. Minnesota will have some positions, but none in the Twin Cities, offering 45 percent rural with national groups. Kansas offers a smattering around the state, a few in Kansas City and all divided equally among private groups, hospital employers, and national groups. Nebraska is thin, with maybe one in Omaha. Both North and South Dakota's sparse opportunities enter the picture for the first time in years, evenly divided between groups and hospital employers with a few national group spots in South Dakota.



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The Middle Atlantic

The six states of the Middle Atlantic are hopping with Pennsylvania, as usual, leading the way. Look for a few spots in the Pittsburgh area and multiple academic opportunities in Philadelphia along with some national group spots. The jobs are fairly split among the three types of employers, and very few are rural or accept PC boards. Virginia and Maryland follow with a combined 40 percent of the region's jobs. A few are in the Washington, D.C.-Baltimore corridor, with none on the Virginia side.

Both states are fairly evenly divided among private groups and hospital employees with Virginia featuring nearly 40 percent national group openings. Look for a few spots in Richmond and in the Tidewater area. New Jersey will offer about 15 percent of the region's jobs with about four in the New York City area and a few close to Philadelphia. Very few are rural or accept PC boards, and 44 percent are with national groups. Delaware also makes a small blip on the radar for the first time in a few years, with more than 75 percent national group penetration.

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The West-Southwest

Seventeen percent of jobs are available in the nine states of the West-Southwest. The most jobs in any state will be in Texas, with 43 percent private groups, 46 percent national groups, and the rest hospital employers. Lots of opportunities will exist in Houston and Dallas, and look for opportunities in San Antonio and El Paso and even one or two in Austin. Twenty-four percent of the Texas jobs will be rural, and nearly half will accept PC boards, and nearly 30 percent are more than six months old.

California will have 27 percent of the region's jobs, including a few in San Francisco and Los Angeles. There's also a job in San Diego; it's in urgent care, but even that's a first. Thirty-seven percent of the jobs in California are more than six months old, and nearly 70 percent of those appear to be through one national group. Few employers in the state are in rural areas or accept PC boards. Major employers include CEP America, Valley Emergency Physicians, TeamHealth West, and Permanente Physicians Group.

Arizona will have a few good jobs around Phoenix mostly with hospital employers and private groups, as well as a smattering around the state including a number of pediatric emergency medicine spots. Oklahoma and New Mexico will have some new opportunities this year, evenly divided between all three categories in Oklahoma, and split evenly between private groups and national groups in New Mexico.

Albuquerque and Santa Fe have private group spots that may well be gone by now. Las Vegas is hot this year with an academic spot and a bunch of national group jobs. (One group needs six doctors in multiple sites.) Colorado will have the usual openings in Pueblo and Colorado Springs as well as a rural spot or two, and Utah will provide a few rural openings that accept PC boards. In the one-can-always-dream department, you can try Hawaii.

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The Northeast

The Northeast's seven states include the country's third largest opportunity center, New York, with 46 percent of the region's jobs. At least a dozen will be around New York City, and will be evenly split among the three categories of employers. Only 20 percent will accept PC boards and about 10 percent will be rural. Look for good opportunities in the western and northern parts of the state.

Massachusetts will have more than half a dozen jobs near Boston, 65 percent hospital employer positions and few accepting PC boards. Look for good opportunities along the coast and in the western areas. Maine also has quite a few jobs with 93 percent hospital employers, but nearly half are rural and open to PC boards. Quite a few of these are six months or older. New Hampshire makes a splash this year with private groups and hospital employers, about a third of which are rural and accepting PC boards. Connecticut is not the state for PC-boarded doctors, and the affluent southeastern part of the state is lacking in opportunity as well. Seventy-five percent of the state's jobs are with hospital employers, mostly in the central and northern regions. Rhode Island will have at least one academic slot plus a few others, and even Vermont shows up with a few, mostly rural and PC spots.

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The Pacific Northwest

As usual, bringing up the rear are the six states of the Pacific Northwest, but there actually will be a job or two in the Seattle area this year; that's rare. Northwest Emergency Physicians, a division of TeamHealth, is a principal employer in Washington (which features nearly 40 percent of the region's jobs) with 65 percent national groups and 30 percent rural and PC boarded spots.

Another surprise will be a private group position in Portland, OR (though it may well be gone by the time you read this) and additional decent jobs around the state, 63 percent with hospital employers. Idaho and Montana will have a few positions as well, more than 50 percent rural and with national groups in Idaho. Wyoming also is more active this year with about 20 percent of the region's jobs, at least one in the Rockies. And then there is Alaska: one job with the Yukon Native Health Service, which brings us to my annual When Pigs Fly Award. The award for total lack of opportunity goes to Alaska!

© 2008 Lippincott Williams & Wilkins, Inc.