Transition from Resident to Attending

Advice for young, job-seeking physicians on assessing practice culture

Brendan Murphy , Senior News Writer

AMA News Wire

Advice for young, job-seeking physicians on assessing practice culture

Apr 9, 2024

Workplace culture can be a vital aspect of physician satisfaction. It only makes sense then that job seekers, particularly those weighing opportunities early in their careers, would want to know as much as possible about a practice environment to make an informed decision.

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An AMA STEPS Forward® toolkit, “What to Look for in Your First or Next Practice: Evaluate the Practice Environment to Match Your Priorities,” offers young physicians a comprehensive breakdown of practice settings and how they differ.

The toolkit includes insight on the ways a physician applicant can gauge culture. Having made the transition from resident to attending, AMA member Scott H. Pasichow, MD, MPH,offered some thoughts in a separate interview on how he was able to find the right cultural fit in his post-residency job search. Here’s a look at some key tips.

Dr. Pasichow values camaraderie, and he said that, to him, the way staff interacts when they aren’t patient-facing can be an indicator of how much there is.

“When you do your tour of the clinical environment, how are the nurses referring to the doctors?” he said. “How are the doctors referring to the nurses? How did the doctors refer to each other? It's important, obviously, when you're in front of patients for communication to be more formal. And that's a value that I think a lot of doctors have, maintaining the ‘doctor last-name moniker.

“But there's real value,” he added, “when you're on a first-name basis with your colleagues, whether they're fellow physicians or other members of the health care team.”

Learn with the AMA about four tech questions that young doctors should ask before joining a practice.

Work-life balance is almost always a struggle for physicians. Understanding a private practice or hospital’s commitment to it is key. One way to do that is by learning not just about personal time off and parental-leave policies but also about how much time off people actually use. This will help you understand what the expectation is when you are planning a family. It can also reveal the organization’s commitment to your work-life balance.

“There are jobs I applied for where they said: You can pick a few times to book a vacation, but wait until we send you the schedule to buy your plane tickets,” said Dr. Pasichow, who is assistant professor of emergency medicine at Southern Illinois University School of Medicine, in Springfield, Illinois. “There are other jobs that said: Don't worry about it. If you want the time off, you'll get the time off. That flexibility translates to family leave and emergency coverage as well.”

There are two key aspects to leadership within a private practice or a hospital; How much interaction do physicians have with leaders, and what roles are physicians expected to play in the leadership hierarchy?

In his interviews, Dr. Pasichow inquired about what roles emergency physicians had on hospital committees. He says it’s better if more physicians are involved.

“If one individual wears a lot of different hats for the department, it can sometimes be challenging, because it's really on that individual to maintain relationships,” he said. “Whereas, when that responsibility is spread out amongst a number of different people, it shows that the leadership is invested in the department’s success.”

Physician employee, partner or owner? Discover three paths for young doctors.

You might misread the cultural fit in a practice. Dr. Pasichow said if that’s the case, you shouldn’t be afraid to explore other opportunities.

“You may come in thinking it's a really good cultural fit for you,” he said. “After being there for a few months, you realize it doesn't work. Don't be afraid to make a change early in your career. It’s best to be comfortable where you are so it can be somewhere you want to stay for 10 or 15 years or even your whole career.”

Learn about the AMA Young Physicians Section, which gives voice to, and advocates on, issues that affect physicians under 40 or within the first eight years of professional practice after their training as residents and fellows.

The AMA provides the resources and support that physicians need to succeed in private practice. These include the “AMA STEPS Forward Private Practice Playbook” (PDF), which is based on qualitative research into physician interest in private practice and the management needs for operating a private practice, and the “AMA Thriving in Practice” podcast, with tips from experienced private practice physicians on navigating pain points and other issues.

Also, learn more about understanding physician employment contracts.