As a resident physician, are you thinking about where you want to build your future in medicine? Meet AMA member Zachary Coffman, MD, a pediatric cardiologist and a featured voice in the AMA’s “Finding My Place in Medicine” series.
In this series, physicians reflect on what influenced their decisions when choosing where to work—and what they wish they had known earlier. Explore his journey to help guide your own path toward a fulfilling medical career.
If you are looking for your first physician job after residency, get your cheat sheet now from the AMA. In addition, the AMA Transitioning to Practice series has guidance and resources on deciding where to practice, negotiating an employment contract, managing work-life balance, and other essential tips about starting in practice—including in private practice.
Also, check out Dr. Coffman’s profile in the AMA's “Shadow Me” Specialty Series, which offers advice directly from doctors about life in their specialties.
"Following” Dr. Zachary Coffman
Specialty: Pediatric cardiology, with a subspecialty in pediatric cardiac critical care.
Practice setting: Hospital.
Employment type: Employed by Atrium Health Levine Children’s Hospital, part of Advocate Health, in Charlotte, North Carolina. Advocate Healthis part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Years in practice: Seven.
Key factors that led to me choosing to work at Advocate Health: I wanted to work with team members who respected each other and embraced the mission of providing the best possible care to children with congenital heart disease. The Congenital Heart Center team at Levine Children’s understood that you have to trust each other and help lift each other up—in good times and bad—to give your best to the children we care for.
What stood out to me during the interview and hiring process: The amount of respect and support various teammates provided to each other stood out most. Medicine is inherently a hierarchal system, which can occasionally breed resentment and frustration, especially in a high stress environment like the pediatric cardiac intensive care unit.
Everyone I met at Levine Children’s supported their teammates without question. When someone got knocked down (metaphorically, of course), there were several people there to help pick them back up. That’s how high-functioning teams work and how you ensure you’re providing the best care possible to your patients.
How feedback from peers and mentors influenced my evaluation process: I had been looking for a new career opportunity after working at another institution for several years. I was happy with my position, but I wasn’t quite sure if I was ready to leap to a new one. In the process, I spoke to several of my mentors who, thankfully, all gave me varying versions of the same advice. They all told me that multiple opportunities will appear over the course of your career, but you need to decide at any given moment what is right for you, your family, and your career goals.
No job will ever be perfect, but you want to find a team that will help support you with both your career and your personal ambitions. Find a team that will invest in you as much as you will invest in them.
Why I chose to work in this practice setting: As a pediatric cardiac intensivist, I can only primarily work in pediatric cardiovascular intensive care units (CVICUs) within hospital systems. I wanted to work in an academic setting where I could help teach medical professionals from varying backgrounds and disciplines. I’ve had the opportunity to teach physicians, nurses, non-physician providers and respiratory therapists within my role and have appreciated learning as much from them as I hope they learned from me.
The top three qualities for a great place to work for physicians: Work-life balance, clinical autonomy with good administrative support, and investment in your growth and development within your specialty.
How my current practice supports physician well-being and work-life balance: Our institution encourages regular communication between the clinical side and the administrative side. There are also many benefits and opportunities supplied to employees at our hospital system that help to involve families in faculty get-togethers in addition to those that allow you to just spend some time getting to know co-workers outside of the hospital. We have get-togethers at Top Golf, local restaurants, and even Fun Runs to help get people together in enjoyable environments outside of the clinical grind.
This job is a calling, but it’s also tough day-in and day-out. You want to make sure you find a job that understands that and gives you the time outside of your job to invest in your family and friends. They’re the ones who will celebrate you in the good times and keep you grounded in the tough times so you can perform at your best for your patients.
The workplace attributes that contribute most to my job satisfaction at Advocate Health: Teamwork requires reliability and trust, and you have to make sure you put effort into building that trust from the minute you start any position. It takes time and it takes effort, but you need to ensure that you are all marching towards the same goal and you can trust that the person beside you will help to build you up in your best moments and lift you up at your worst. I know that everyone I work with comes to work with the same goal, to take care of our patients to the absolute best of their ability.
The biggest challenges I faced when transitioning from residency to practice: Without a doubt, it was imposter syndrome. As a resident or fellow, you always have backup available. There is always someone present with a watchful eye over every decision you make. When I first became an attending, I knew my fellowship training at the Medical University of South Carolina was great and I had confidence in myself, but I couldn’t help but feel fearful that I was making mistakes.
Despite my nagging concerns, I found people who supported me and discussed patients with me. I did my best to surround myself with people who would talk through decision pipelines and made sure I didn’t feel like I was on an island with my patients. That helped my growth immensely and gave me the confidence to continue to grow.
What I wish I had known about evaluating a job offer before choosing my first position: At the top of the list is how to effectively negotiate and understand benefits. Contracts are long and complex and, despite our expansive medical lexicon, they use terms that many of us are not familiar with or understand. I thankfully found people outside of the medical establishment who helped me decipher the code and gave me advice on how to understand a contract.
We are incredibly well-trained as medical professionals in many things, but contract evaluation and negotiation is not one of them. If there is one piece of advice I could give to any new attending looking at a job, it’s to spend a small chunk of change to have someone with the right credentials to review your contract for you. At best they’ll tell you it looks great, and at the worst they can find something that will help your career to get off to a better start than expected.
What I would have done differently when choosing my first job after residency: I wish I had known more about how to negotiate for career growth opportunities. Graduating fellowship at the height of the COVID-19 pandemic didn’t give me much bargaining power, and I would have liked to request more in terms of support for future learning opportunities or degree/certificate programs that would help me grow as a physician within my specialty.
You never know where your career trajectory will point or what new interests you’ll develop the more you practice. Having support built in to develop new interests will help you to take advantage of those opportunities when they arise.
Why I changed practice settings midcareer: I was looking for more career growth than I thought was possible in my position. I wanted to find a role that would support my growing family and my career ambitions within pediatric cardiac critical care and quality improvement and patient safety.
How I knew I was ready for a change: In all honesty, I didn’t. In my role in the CVICU as well as in my career as a whole, I frequently said, “No plan is ever certain. You’ll never know what could be until you take the leap.”
I knew I wanted to see what other positions might be available, but I made the decision after talking with my mentors, my wife and several of my colleagues. I found a supportive team who cared for their patients, their families and their teammates. Ultimately, when I put everything together, all the pieces aligned and we thought it’d be best for me and my family to take a chance on a new opportunity.
How my current role compares with what I imagined: It’s exactly what I had hoped for. Our team works together incredibly well, and we all support each other to do the best we can for our patients. Everyone knows that the mission is to provide the best care possible to each patient who steps through our doors, and all egos go out the window the minute one of them needs our collective help.
