When residents are looking for their first physician job out of training, they quickly will realize the power dynamic has shifted. Employers are now competing for them. Unaccustomed to the role of job-seeker, though, early career physicians may not know what kind of position will make them happiest.
“You have a huge physician shortage in the country. They [residents] are getting inundated” with job offers, said Tony Stajduhar, who is president of Alpharetta, Georgia-based recruiting firm Jackson Physician Search. “Many receive a lot of job offers. It can be overwhelming for a new physician.”
A national report from Jackson Physician Search and the Medical Group Management Association (MGMA) sheds light on exactly why physicians leave jobs—and what helps them stay. Here are five questions whose answers are likely to shape whether your first physician job out of training is likely to be a lasting fit.
Will your first physician job be a stepping stone?
Most early career physicians won’t stay long in their first job. The Jackson-MGMA data taken from surveys shows, in fact, that “close to 60% of physicians will leave within the first three years of joining their first practice,” Stajduhar said.
The report, taken from responses given by hundreds of physician clients, shows the length of time that physicians reported staying at their first role before leaving was:
- Less than a year: 13%.
- 1–3 years: 46%.
- 4–6 years: 15%.
- 6-plus years: 26%.
Meanwhile, the data shows that more than one in four physicians said they considered leaving their first post-training role even within the first year.
The reasons for early departure are understandable. Resident physicians coming out of a program “are finishing up their program and have little time for much other than focusing on their training,” Stajduhar said.
He said a scramble can take place once the person realizes that they need to be job-hunting: “While they're training, they probably have fairly limited time in terms of traveling for interviews, so it becomes: What's the easiest thing to do? That's what seems to be the default.”
Is it all about the money?
Pay is important, especially for physicians newly out of training with significant medical student-loan debt to repay. But physician job satisfaction is about far more than a paycheck, especially for doctors, who can feel called to deliver high-quality care and put patients first.
The study calls physician pay “table stakes”—that is, it is the minimum required to enter the conversation in terms of doctor retention.
“Money can get you in the door, but ultimately, I think many come to the conclusion that culture is what matters for the long term,” Stajduhar said. “For those physicians, they may get to a point where money is not enough.”
The Jackson Physician Search-MGMA data supports that. Here are the shares of physicians who left their job for various reasons (respondents could select more than one):
- Leadership or administration issues—45%.
- Culture—39%.
- Compensation—39%.
- Work-life balance—34%.
- Career advancement opportunities—18%.
- Geographic preferences—17%.
- Lack of mentorship—9%.
- Governance structures—9%.
So, while two-thirds of respondents said a higher base salary might cause them to stay in a role, pay wasn’t the most commonly cited reason for leaving a role.
Once compensation has been hashed out and it comes time to look at that all-important first employment contract, physicians need an attorney on their side who is trained in health care law.
That’s why the AMA has partnered with Resolve to provide custom contract review and negotiation services to AMA members at a discount. Resolve specializes in reviewing physician employment contracts, so their team has the experience needed to help physicians secure the best contract terms at any career stage.
Ready to access your AMA-member Resolve discount? Learn more now.
Is the onboarding process up to snuff?
For physicians entering their first postresidency training job, the weeks between their hiring date and their start can be key to establishing a positive work experience.
The Jackson Physician Search-MGMA data shows that early career physicians want introductions to colleagues and regular check-ins—weekly communications seem to work best for increasing job satisfaction. They also want orientation resources, invitations to events and community information.
The alternative situation, where a new physician comes into their first job without that feeling of support and knowledge, can be detrimental.
“You've left the protection of a program where you've got people around you and mentors and people that are teaching you for the last four years. And now you're moving to a place where you know no one, your family knows no one,” Stajduhar said. “It's almost like: Here are the keys. Good luck, God bless you.”
In fact, the more often an organization checks in during this preboarding process, the higher the physician’s satisfaction is with the experience as a whole.
The AMA STEPS Forward® toolkit, “Onboarding Optimization: Pave the Way for New Physician Success and Satisfaction” outlines what should be covered in the onboarding process. Some of the items include the scope of practice for clinical teammates, informing the physician of important policies and procedures such as medication-refill protocol and sharing reference materials for billing and coding.
It is enduring material and designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit™. Learn more about AMA CME accreditation.
Also, dive deeper on the seven steps to adequate onboarding that young physicians should know about.
Is it an organization where relationships matter?
Physician survey respondents also said that work relationships heavily factored into a decision to stay with an organization. The most important relationships were those with their peers (68%), the support staff (54%) and their physician leaders (48%).
Doctors who develop connections at their jobs are the same ones who decide to stay, said Stajduhar, who said that it may be better for physician employers to think less in terms of “retention” than in terms of “relationship.”
The term “retention” can, at times, feel as though health care organization leaders are in a transactional mindset, he said. Instead, the question for physician employers should be: “How do we put them [doctors] in a place where they feel loyal and want to stay to be a part of something bigger?”
Mentors are important too—18% of physicians in the survey rated theirs as a vital factor—but it’s the colleagues with whom you will work every day who create the environment.
If you’re searching for your first physician job after residency, get your cheat sheet from the AMA now.
Does the organizational culture help you thrive?
When a resident physician begins job-hunting, they may not know how to evaluate a workplace not as a residency or fellowship program that they will complete, but as a role where they can start and hopefully sustain a flourishing physician career. Job-seeking doctors should investigate by talking to those who will be your peers and support staff, and by asking questions of prospective employers about their culture.
What kind of environment do physicians need? According to the survey, the largest factors in leaving a job were too much bureaucracy, excessive workload or poor work-life balance, and subpar leadership interaction.
Stajduhar advised that health care organizations’ work environment should be “something that you've got to be thoughtful about every day: How do you continue to grow a culture? How do you continue to make people want to be here?”
The factors that physicians most often talked about wanting in culture were:
- Team collaboration—53%.
- Physician voice in leadership—53%.
- Clear communication—48%.
- Work-life balance—48%.
Create that optimal environment, Stajduhar said, and physicians will want to stay.
“Let's start from the beginning instead, immersing them in our culture. Let's start setting up some kind of rhythm with somebody once they've signed the agreement,” he said. “That's the beginning.”
Explore further with the AMA STEPS Forward toolkit, “What to Look for in Your First or Next Practice: Evaluate the Practice Environment to Match Your Priorities.”
