Onboarding is crucial to every physician’s success. But if you’re a physician transitioning to practice, the stakes are especially high. Knowing what an optimized onboarding program looks like can be make-or-break to your first job and even the rest of your career.
A new AMA STEPS Forward® toolkit details some of the best practices employers should follow to pave the way for physician success, satisfaction and well-being. Its content can help job applicants determine whether prospective employers provide adequate onboarding.
“There's a huge variation between employers, and that’s partially due to resources—a large organization may have a lot more to devote to onboarding than, say, a small private practice does,” said Sea Chen, MD, PhD. He is physician director of practice sustainability at the AMA and co-wrote the onboarding toolkit.
But no matter the size of the organization, what matters most is its culture, he noted.
"Every organization is unique and may have specific strengths or limitations in its onboarding program, especially when resources are thin. This is especially true of small, independent practices,” the toolkit says. “The key is to ensure the organization's onboarding program has been well thought out and the principles of open communication, physician support, and adequate clinical ramp-up are embraced."
Dr. Chen said that “many employers haven't emphasized onboarding or the transition to practice, which can cause pain for young physicians. ... If you start behind your peers, you're not going to be able to achieve your goals as quickly and you may never catch up to them. You may even start to feel burned out before your career gets off the ground.”
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.
It’s all about preparation
“The onboarding process starts well before a new physician's first day,” the toolkit says. According to the toolkit and an included sample onboarding process used at a North Carolina academic health system, it begins with credentialing—a process that takes months to complete.
Meanwhile, other key stakeholders should be working on a pre-orientation checklist, and sometime ahead of your start date, you should be contacted with the employer’s orientation or training plan for you. This can include the following:
- When you will complete any online learning and orientation modules.
- When EHR training will take place and whether you will shadow other team members.
- When you will begin to see patients.
- An outline of your ramp-up schedule.
- When support will be on site to help you learn the EHR system.
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By this time, an employer with an optimized onboarding program will also have ordered or arranged numerous other items, with some variation based on the clinical setting. Following are materials and resources you may expect to find on your first day:
- Computer and workstation materials.
- Access to clinic or office space, such as keys, ID cards or badges, and security codes.
- Laboratory coats.
- Learning modules and EHR training.
- A schedule in the EHR.
- A regular check-in from medical leadership.
- A welcome sign.
- A workspace with necessary IT equipment.
- Billing system access.
If you’re seeking your first physician job post-residency, get your cheat sheet now.
Dive deeper:
- What to look for when onboarding at your first physician job
- In transition to practice, know these 8 steps for evaluating jobs
- When seeking new physician job opportunities, follow this advice
- What I wish I knew in residency about being an employed physician
Your interviews can provide insight
Given how much variation there is in employers’ onboarding efforts, Dr. Chen said it is perfectly appropriate to ask about onboarding at some point in your interview process.
“You can ask directly: What kind of things do you do for onboarding? That question is innocuous enough, but it also shows your genuine interest in how one would get started in practice with them,” he said.
Their answers, he noted, will speak to the “organization of the organization.”
“The impression you want to get is that they're looking out for you, that they have thought things through, so you're not tripping all over yourself during that process,” he said. “If they don’t sound organized, that can be a red flag.”
For residents transitioning to practice or those already in practice who are considering a midcareer switch, a separate AMA STEPS Forward toolkit, “What to Look for in Your First or Next Practice: Evaluate the Practice Environment to Match Your Priorities,” will help you identify available practice settings and understand how they may impact your experience, clarify your priorities, and tailor your search for a fulfilling career in a positive and supportive environment.
Learn more 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.
