Transition from Resident to Attending

8 steps physicians can take when deciding where to practice

Sara Berg, MS , News Editor

The foundation for a joyful career in medicine is practicing in a positive and supportive environment. However, the wrong fit can lead to physician burnout and disruptive job changes. Physicians—particularly those recently out of training—may feel overwhelmed when evaluating potential job prospects. Knowing how to identify and evaluate job opportunities can empower physicians to find jobs that match their priorities.

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“There are things that we can as individuals control that contribute to burnout, but the job search allows you to do your best to find a place that's going to support you as a professional and as a physician and as a human being who wants to be satisfied and happy,” said AMA member Alexandra Ristow, MD, the lead primary care physician at Patina, an in-home and virtual care primary care practice for seniors in Pennsylvania. “You're going to spend most of your week at the job and making sure it's at a place that matches your values and allows you to thrive is important.”

Physicians can learn how to identify and evaluate potential job opportunities through an AMA STEPS Forward® toolkit that provides a list of key steps to help physicians find jobs that match their priorities.

Before beginning the search, physicians should take a step back to think about their priorities, such as location, schedule, practice size, compensation and patient population.

“New physicians may have a little bit of a disadvantage because you’re used to this mentality of ‘somebody let me into med school please, I need to match,’” said Dr. Ristow, who is the author of this toolkit. “The key is really to stop and think about the different realms you might have control over.”

Read about what final-year medical residents value most in their job searches.

Most physicians complete their training in a landscape dominated by large medical organizations and fee-for-service models. However, there are other options out there, which is why it is important for doctors to explore practice options.  

“Coming from residency, I was in a big multi-specialty academic center and that’s really all I had known,” said Dr. Ristow. “I knew a few words that I could use to identify how you would describe different practice settings, but I didn’t really understand what it would mean for the physician and the day-to-day life to work in these different practice settings.”

Find out how the AMA Young Physicians Section gives voice to—and advocates for—issues that affect doctors under 40 years or in their first eight years of professional practice after their training as residents and fellows.

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With top priorities in hand and a preferred practice environment chosen, physicians can begin their search for specific positions.

“The main thing is to try not to let yourself get overwhelmed,” said Dr. Ristow, adding that it is important not to “have too many leads going all at once where it becomes overwhelming to evaluate and narrow it down.”

The AMA offers a number of tools and resources that can help you map your future as a physician, including offering insight on employment contracts and a list of positions from employers around the United States and beyond. Your peers and attending physicians can also provide some insight as you begin to plan your career path.

As physicians begin to narrow down their job opportunities, it is important to have in-depth conversations with practice managers and medical directors about support and quality of life.

“There’s a wide range of how practices work, how they view physicians or how the physicians within the practice function,” said Dr. Ristow. “Trying to get an understanding of what thought has been put into the support around the physician can be tricky.”

“It’s probably one of the most important pieces as far as evaluating what your day-to-day life is,” she said.

Young doctors should know the pros and cons of these four practice settings.

An important aspect of a physician’s work-life balance is the role of the electronic health record (EHR). Physicians should discuss EHR usability and satisfaction with employees during the interview.

“Make sure that there is support around the electronic health record—support for you to be trained effectively and ideally support for some of your documentation,” said Dr. Ristow.

The AMA offers career planning resources about evaluating a prospective employer, including technology use.

It can be difficult to evaluate a workplace’s culture, but it will play a pivotal role in a physician’s daily interactions.

“As opposed to saying, ‘What is the culture around decision making in your clinic?’ you can say, ‘Can you give me an example of a new policy that was recently implemented and how that decision was made?’” said Dr. Ristow. “You’re asking for something very specific that will give you some insight into the culture.”

Learn more about three paths for young physicians: physician employee, partner or owner.

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Physician employee, partner or owner? 3 paths for young doctors

An important part of any job is the compensation. However, one number may not tell the whole story. For example, a position with a higher salary may pay less per hour after factoring in long practice hours, poor support and a clunky EHR.

“It’s important to look deep into the details and make sure the bonuses or the production requirements are based on something reasonable,” said Dr. Ristow.

It matters how your physician practice is paid. Catch up with this payment primer for young physicians.

With an offer on the table, it is important for physicians to review and negotiate their contracts based on their priorities before making a final decision. Learn more about what to do before you sign.

“You have to read the contract and if you don’t understand it or you’re concerned, have a lawyer look at it,” said Dr. Ristow. “If you’re not understanding something about it, don’t sign until you do.”

Discover the red flags and must-haves for young physicians in contract negotiations.