For Residents

First job after residency often not physicians' last

More than half of physicians will leave their first job after residency within five years, and more than half will stay only one or two years, according to a study by Atlanta-based health care recruiting firm Jackson & Coker.

The study also found that physicians who spent fewer than five years at their first practice were more likely to cite location as the top priority driving their choice. In contrast, those who stayed more than 10 years at their first practice said the most important driver for their decision was not location, but the quality of the practice.

In an article about the study, Tony Stajduhar, president of Jackson & Coker's permanent recruitment division, offers advice for young physicians searching for their first position, including being willing to step out of their comfort zone to find the practice type and location that fits their personality and is right for their family. Residents should also be realistic about money, but be willing to possibly take a better opportunity with a higher chance of career advancement over a higher paycheck in the short term, he said.

The AMA's JAMA Career Center assists residents and fellows in finding positions and offers helpful resources for young physicians at the beginning of their career development.

Physicians also can join the AMA's LinkedIn community to network with colleagues around the country. The LinkedIn jobs group features physician positions nationwide.

Swiss study offers lessons in duty-hour restrictions

As resident duty-hour restrictions continue to be a contentious issue in American graduate medical education, one country with much stricter rules offers examples for consideration before future policies are crafted.

A new study from Switzerland, where a 50-hour work week is the law, revealed that despite increased rest time the restrictions have not improved surgical patient safety. The authors conclude that the "focus of regulatory agencies and labor unions should change from hours worked to other aspects within work-hour limits." 

The authors also reviewed American literature on resident duty hours and found that a reduction in working hours to 80 hours has shown neither a clear positive effect on patients' outcomes and safety nor a clear negative effect of working in shifts, with self-evidently more handovers, transfers and a possible less continuity of patient care.

The AMA offers resources to help residents navigate their work environment and improve patient handoffs, one of the adverse effects associated with duty-hour restrictions.