9 Post-residency Mistakes

Learn these common errors now to know what to avoid in your early career

By Vicki Gerson | Feature Articles | Spring 2011


Mistake 3: Accepting your first job offer
Think carefully about the first job you take after residency, and ask probing questions to make sure you’ll like it. Most likely, as a new doctor within the practice, you’ll have to sign at least a one- to two-year contract.

“Being miserable for one year or longer is a long time,” says Jamie Hutton, M.D., of Bluestone Pediatrics in Harrisonburg, Va.

Hutton says too many residents jump at their first job offer because they are so excited about completing their residency—and the money is enticing. Sometimes, money becomes the only factor they consider.

It is difficult to determine how many job offers each resident should consider before making a final decision since it depends upon whether he or she knows where they want to practice.
In Hutton’s case, she knew she wanted to return to her hometown area, and realized her choices were limited due to the number of pediatric practices in the surrounding communities.

Too many residents jump at their first job offer because they are so

excited about completing their residency—and the money is enticing.

Mistake 4: Ignoring working and living environments
“Don’t be lured by very high salaries, especially in psychiatry,” says Steven Schlozman, M.D., associate training director for child psychiatry at Massachusetts General Hospital in Boston.

“Our residents get cards in the mail almost every day offering them outlandish salaries. But what they are being asked to do on the job is not doable.”

Many times, Schlozman points out, the job offer will state “‘the call schedule to be discussed.’ Never spend time checking out a job offer if they are going to have you on call every single night—especially if you have a family. You want to make sure you don’t miss out on those years with your children because you can never get them back.”

Schlozman says residents interviewing for a job should ask: “Am I the only doctor of this kind in the area? What are the resources in my area for continuing medical education, and who will cover for me if I want to go on vacation?”

In addition, pay close attention to the colleagues that you’ll be working with to make sure your work environment is something you can tolerate. Talk frankly with the doctor and the doctor’s spouse. Bring your spouse or significant other with you so they can assess the situation as well.

Mark Potter, M.D., director of the family medicine residency program at the University of Illinois Medical Center in Chicago, believes finding people you can trust to work with is very important. Unfortunately, some of Potter’s graduates have gotten into business arrangements with people who weren’t as forthright as his graduates would have liked. It’s crucial to determine if you can trust your future partners. Arrange to spend time with them, and bring your spouse or partner with you. They may see things that you don’t.

“Keep in mind if your spouse or partner isn’t happy, you won’t be happy with your career decision. They need to have their turn for a decent life situation.”

And don’t forget to consider the community environment, the schools for your children, recreational activities, cultural opportunities and the cost of living. All of these should factor into your decision.

Mistake 5: Ignoring a hospital-based practice option
If you really hate paperwork, consider being on staff at a hospital. As Schlozman points out, your salary may be a little less, but you don’t have to be responsible for the paperwork.
There is a big shift in medicine as hospitals are recruiting graduating physicians from their residency programs. A hospital-based practice has many perks, such as health insurance, an administrative staff in place, and other benefits.

When you’re in private practice, you can be overwhelmed keeping up with your notes, seeing your patients and returning their phone calls. If you don’t fill out the insurance forms in a timely manner, you don’t get paid and are essentially providing care for nothing. “Residents don’t realize that the paperwork can be totally overwhelming at times,” says Schlozman. “It’s not just practicing medicine anymore.”

Residents must decide if they want to be small business owners or start out as attending physicians at a hospital. “If you don’t want to be a small business owner at the same time you are learning how to be an attending doctor, then being an employee is simpler,” Potter says. “Becom-ing an employed physician may be a better fit for you.”

Mistake 6: Signing a contract without expert advice
Potter recommends to his residents that they pay to have an attorney look at the contract, one who knows the “ins and outs of medical hiring. Department heads and program directors can also provide valuable experience by noting the current trends in hiring.”

Rarely do medical residents get any teaching information about how to negotiate a contract. “Not negotiating a contract could be the biggest mistake of your life,” says Hutton. If you can, she recommends talking to people who are older than you, who have already made mistakes. They are the ones who can teach you the most.

Hutton points out that women physicians should make sure there is a maternity leave clause in the contract if they plan to start a family.


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