When it’s time for residents and fellows to search for their first physician jobs out of training, the choices can boggle the mind. The American Hospital Association estimates that there are 6,100 hospitals alone in the U.S. Add to that solo practice, group settings, academic positions and locum tenens roles and the options for early-career physicians can be staggering.
As with any important decision, having a plan is key to selecting your first physician role. Searching for a job is unlike searching for a residency spot, and it requires different strategies.
“When you are entering into that job space, this is the first time after many years of training that you're really looking at something that's going to be long-term as opposed to, “OK, I'm going to complete this step and then move on to this next step,” said Keedra McNeill, MD, regional medical director of physician recruitment services for The Permanente Medical Group.
The Permanente Medical Group (TPMG) is 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.
“If residents and fellows are really intentional about what they're looking for in the job search, it can help reduce [first-job turnover],” said Dr. McNeill, a pediatrician who first joined TPMG 18 years ago, fresh out of residency training.
“It was really a full-circle moment because that was the clinic where I received my care as a child,” she said of her first physician role. “I had a chance to work alongside my pediatrician and my mom's OB who delivered me. It was such a wonderful opportunity to be there practicing with them and working in my community. It also really showed me the longevity of the career that was available with TPMG.”
In addition to being responsible for recruitment at TPMG, the nation’s largest physician-led medical group, Dr. McNeill knows what it’s like to be a resident with a multitude of options. She offered her expertise on how to seek out—and land—a first physician role with staying power.
Physician, know thyself
When it comes to the first step of transitioning to practice, Dr. McNeill recommended that residents and fellows who are about to enter their final year of training take some time to explore different practice settings and consider their futures in a holistic fashion. It’s never too early to think things through, she said. You may even want to begin reflecting during your internship year.
“Literally sit down and make a list of your personal and professional priorities,” she said, suggesting new physicians ask themselves, “What is the practice setting that you want to see yourself in? What are your interests? What are your short- and long-term goals and objectives?”
Factors you may wish to consider would include:
- Whether you would like to teach or engage with residents and/or medical students.
- The amount of research you would like to engage in.
- Whether you want to solely focus on clinical practice.
- What geographic location would work best for you.
- What salary and compensation package you will seek.
Physician job seekers also should explore the JAMA Career Center®, which presents physician career opportunities, news and information relevant to the full spectrum of medical practice. Search for physician jobs by specialty and location or browse all the physician jobs by specialty.
Seek stability in a first role
As more health systems and practices are purchased by venture capital firms, Dr. McNeill said anecdotal experience suggests there has been
an increase in physicians in “start-up” type practices that do not stand the test of time. She recommended that residents and fellows investigate the fiscal health and stability of any potential employers.
“When researching potential jobs, consider the practice’s longevity, affiliations, and overall intentions” she said. “That is going to help you, as a new graduate, avoid a situation where you're seeking another position six or 12 months later.”
If you’re searching for your first physician job after residency, get your cheat sheet from the AMA now.
Remember the value of well-being
With many physicians emerging from residency or fellowship training with significant educational debt—on average, $200,000 or more—compensation will naturally be an important factor. But do not sell yourself short regarding your desired lifestyle.
Dr. McNeill said at TPMG, physician well-being leads focus on meeting the needs of physicians beyond their professional interactions.
As physicians, “we are not just a monolithic practicing person,” she said. “There are other aspects to our personalities and to our well-being that we have to make sure we address and these are also really important for retention.”
At work, you also want to ensure that there will be opportunities for mentoring and peer support, she added.
“It’s one thing to be practicing under the direct supervision of your attending physicians, but once you graduate and put your foot out of the door, it's like, ‘Oh my goodness, I'm here practicing in this wide world all by myself,’” Dr. McNeill said. “You want to make sure that the practice culture is one that is welcoming and nurturing for someone who's new, knowing that you may have questions, knowing that you may want to consult with someone so that you're not feeling so stressed out and feeling as though you have to go it alone.”
Support is one of the six pillars of the AMA Joy in Medicine® Health System Recognition Program, which empowers health systems to reduce burnout and build well-being so that physicians and their patients can thrive. TPMG achieved gold status in 2025.
Download the 2025 AMA Joy in Medicine® magazine (log into your AMA account to view) to see which other organizations are in the prestigious group currently recognized for their dedication to physician well-being.
Try before you buy in?
Beyond researching an organization, you may even want to consider working at a potential employer before accepting an offer. Dr. McNeill said an away rotation before or during your final year of training may provide invaluable inside information.
“You actually get a chance to be boots on the ground working there for four to six weeks, engaging with the patients, the staff, the other colleagues so you can really determine: ‘Is this a good fit for me and can I see myself working here?’” she noted. “The more hands-on experience you can get, the better, as well as the more engagement with individuals who are working there, to make sure it aligns with what you would really like to do and what will satisfy you professionally and personally.”
If you’re deciding on your first physician job out of training, learn more with the AMA STEPS Forward® toolkit, “What to Look for in Your First or Next Practice. Evaluate the Practice Environment to Match Your Priorities.” It is enduring material and designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit™. Read up on AMA CME accreditation.
