Transition to Practice

Pandemic significantly alters job market for residents, fellows

For physicians entering practice for the first time the job market has shifted dramatically in the wake of the COVID-19 pandemic

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Released this past December, a report on final-year resident employment opportunities, conducted by the physician recruiting firm Merritt Hawkins, indicated that 66% of residents in their last year of training received 51 or more job solicitations, while 45% received 100 or more.  

“In a matter of two months the reverse is now true,” said Travis Singleton, executive vice president of Merritt Hawkins and AMN Leadership Solutions. “It’s a seller’s market for those offering practice opportunities to residents or in-practice physicians seeking jobs. The number of candidates per job opening we have now has never been higher in my experience.” 

Positions changing, being eliminated 

Most residents and fellows have had their training dramatically altered by the pandemic. That also seems to be the case with those seeking employment. Most who anticipate completing their training by mid-summer have likely landed practice positions, though some of those accepted positions could change or be eliminated. 

“Many 2020 residents and fellows who thought they had a job lined up now may not,” Singleton said. “As furloughs and job cuts have gone into effect, the last hired, first let go rule is being implemented, which falls on residents the hardest.”  

Jason Lesnick, MD, is chief resident of emergency medicine McGovern Medical School at the University of Texas Health Science Center in Houston. He accepted a position with a local health system in September but is still waiting on a finalized contract.  

“It’s been pretty hectic,” said Dr. Lesnick, an AMA member. “[COVID-19] has delayed my contract significantly. I have multiple friends who have had their start dates pushed back or their contracts have been changed from full-time to part-time.  

“I’m thankful to be one of the lucky ones and have a good employer,” he said. “I’m very sad for many of my colleagues who are not so lucky. They are going through the stress of residency and then graduation. Many people are moving across the state or country and not knowing that your finances will be stable adds another layer of uncertainty.” 

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Looking forward 

Hans Arora, MD, a pediatric urology fellow at Lurie Children’s Hospital of Chicago, is in his seventh year of post-graduate training. He will have completed eight total years of residency and fellowship when he begins practice in the summer of 2021.  

Because Dr. Arora and his wife are both physicians, he began his job search earlier than most in his specialty—about 18 months in advance of when he would start. The initial phases of the job search process are the same, Dr. Arora said. That changes when it comes to interviews, which have now shifted to online video-conferencing software. At the conclusion of those interviews, Dr. Arora has been told the hiring organizations would like to bring him in for another in-person conversation in the coming months.  

That visit, if possible, could benefit both sides.  

“You want to see the facility in which you are going to work. Is it a work space that is conducive to you being able to provide optimal patient care the way you think you should,” he said. “Also, there are things about the culture of an organization that you are only going to pick up through smaller interactions you have with individuals or the way you observe people interacting together. You are not going to see those on a Zoom call.”  

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The risk in waiting 

With roughly 50 fellows in pediatric urology across the nation, Dr. Arora works in a highly specialized field. For candidates seeking opportunities in larger specialties, waiting on an in-person visit may be a risk. If you do have an appealing offer in-hand, even if you are unable to do an in-person visit, Singleton advises residents and fellows to strongly consider it. 

“Be open-minded about accepting an offer early in the process if it meets most of your needs,” he said. “The era of comparison shopping during 10 interviews over six months is in abeyance. You may have to make a decision without having physically been to the location and without having personally met the people. That may be difficult, but there are physicians who have lost their jobs who will be willing to accept virtual offers.” 

The job market conditions for all physicians are likely to improve once the virus is contained. The timetable for when that happens, however, is another question. 

“As the economy recovers and employer-based insurance rebounds, demand will recover,” he said. “Health care is a huge priority for most people and patients can only postpone physician visits for so long. But the process must be seen as safe. [Personal protective equipment] and safety protocols that protect caregivers and patients need to be in place before we will get back to some semblance of normal.” 

The AMA has developed a COVID-19 resource center as well as a physician’s guide to COVID-19 to give doctors a comprehensive place to find the latest resources and updates from the Centers for Disease Control and Prevention and the World Health Organization. The AMA has curated a selection of resources to assist residents and medical students during the COVID-19 pandemic to help manage the shifting timelines, cancellations and adjustments to testing, rotations and other events.