Title: Career Planning in
1- Career Planning in
- Emergency Medicine
2Objectives
- Entering the job market
- Tips for an effective search
- The interview and follow-up
- How to evaluate a position (and offer)
- Successful negotiations
- Strategies for rewarding careers in EM
3Finding a position in EM
- Realistic appraisal of your abilities
- Discuss with family, friends, mentors
- Research various possibilities
- Consider more than one option
- Gather information and verify it
- Look to trusted advisors
- Take into account personal needs, interests
talents
4DEFINE Personal/Family/Professional Goals
- Most doctors choose to practice close to home, or
within 100 miles of their training program - Many leave original practice within 2 years due
to unmet expectations - Where you want to live and raise your family will
ultimately determine where you stay long-term
(Recruit the spouse and you will recruit the
doctor.-- Recruiter Colloquialism)
5DEFINE Personal/Family/Professional Goals
- Key practice where you want to live
- How much money do I need to make to meet my
needs? - What will fulfill my professional needs?
- What type of practice?
- Is there a documented need for my services?
- How many patients a day am I comfortable
seeing?
6Stages of the job search
- Stage I - Preparation
- type of position
- type of employer
- geographic location
- Stage II - Investigation
- look for possibilities
- make contact
- interview and tour ED
- Stage III - Decision
- negotiations may help
7Career vs. Job
- Distinction
- Career defines an individual
- Job pays the bills
- Time frame
- immediate
- short-term
- long-term
8Where do I see myself ...
- in the next year
- in the next 5 years
- in the next 10 - 15 years
- Geographic region
- Emergency setting
- Hospital environment
- Community
9First year out ...
- Learn a new system
- Introduction to staff and consultants
- Establish a reputation
- Get to know the community
- Study for boards
105 years out ...
- Career re-evaluation
- Money somewhat less of a concern
- school debts often repaid
- growth in savings
- partnership
- vested in pension
- Thoughts of retirement ...
1110 - 15 years out ...
- Make or break time
- Serious travel or time away
- Rekindle your passion for EM
- Thoughts of career re-direction
- urgent care
- occupational health
- administration
12What makes me happy?
- Patient care
- Teaching
- Supervising
- Research
- Administration
- Learning
13What is important to me?
- Power
- Fame and notoriety
- Personal time
- Fancy vacations
- Material goods
- Money
14What is really important?
- Family and friends
- Career satisfaction
- Security
- position
- financial
- Respect
- Wellness
15What do I enjoy when I am at work?
- Nice patients
- Supportive staff
- Functional facilities
- Challenging cases
- Teaching
- Camaraderie
16Autonomy
- Physician autonomy is possible despite the
advent of practice guidelines, managed care, and
government agencies (although more difficult). - Test ordering
- Decision-making
- Best practices
-
17What would I like to avoid?
- Unmanageable patient volume
- Delays affecting patient care
- Difficulty getting patients admitted
- Hassles with consultants
- Non-supportive environment
- Administrative headaches
- Frustrations with ED/hospital design
18Beyond graduation
- Fellowships
- Chief residency
- Additional residency training
- Positions
- clinical
- academic
- hybrid
- Travel
-
19Clinical setting
- Rural
- Suburban
- Urban
- County
- Academic medical center
- VA
- Military
20Learning the market
- AHA Guide to the Health Care Field
- PDs faculty (yours and theirs)
- Recruiters (companies or ED groups)
- Internet
- Hospital operators
- Family or friends
- Phone book
- EDs
21Effective searching
- Be focused
- Be assertive
- Be creative
- Start early
- Dont take NO for an answer, it may become YES
later
22Job search vs NRMP
- Search ends once candidate accepts
- time and money
- mutual decision
- May be offered position at end of the interview,
or within a short time - Make sure your PDs and references are available
and know when, where, and why you are interviewing
23Foot in the door
- Telephone contact
- not Monday AM or Friday PM
- find out when someone will be available
- Personal communication
- Someone who knows the right person
- Right place at the right time
- introduce yourself at a meeting
- stop by the ED
24Preparation
- Find out what is going on
- hospital and ED
- leadership
- research
- community
- Why is the position open? How long?
- Most recent hire? Departure? Why?
- Turnover rate?
25Resources
- Faculty interests
- EM textbooks
- Medline / Pubmed
- Internet home pages
- Residency websites
- Conference faculty
- Your programs faculty may know ...
- Job opportunities
- Journals/newsletters
- Job catalogs
- Postings (meetings, internet, bulletins)
- Local program directors residents
- Word of mouth
- Recruiters
26Professional recruiters
- Use judgment before giving out CVs
- Many have excellent skills / reputations
- Firms vs. recruiters for contract group
- who do they represent?
- for whom do they work? answer to?
- how do they get paid? when? by whom?
- Weigh benefits vs. downsides
- Not for everyone
27Questions for recruiters
- Years experience in EM? Exclusive?
- Background? Previous employment?
- Knowledge of EM? Geographic region?
- Percentage of academic placements?
- Willing to give reference(s)?
- Success rate? Other data?
- Financial arrangement?
- Why them?
28CV Cover letter
- Equally important with different roles
- Curriculum vitae lists professional
accomplishments, abilities, interests, and
activities - Cover letter is a personalized attempt at
convincing someone to offer you an interview - Both include name/address/phone
29Curriculum vitae
- Make it look like it wants to be read
- professional style
- use white space appropriately
- good texture
- easily read
- It should copy well
- Descending chronological order
- Include special skills, esp. language
30Important information
- Include professional degree
- Reliable phone number
- Current contact address
- Email address
- Do not use pager, ED, or secretary s
- Keep contact information simple!
31CV dos donts
- DO
- Emphasize your accomplishments and special skills
- Include your name on every page
- Keep it simple and legible
- Number each page
- DONT
- Include irrelevant information
- Use dark paper that doesnt copy well
- Make grammatical or spelling errors
- Inflate your accomplishments
32Cover letter
- Personalize - address it to someone
- Send with your CV
- Check spelling (esp. names)
- Give a reason why you should be invited for an
interview - Include personal information that doesnt go on
your CV
33Interview
- Dress professionally
- Let them interview you
- Interview them
- Learn about the position, hospital, and community
- Meet as many people as possible
- Find out as much as you can about as much as you
can.
34Interviews
- Dont waste their time or your own
- Practice at your residency program
- Be prepared
- to present a case
- to give a lecture
- to share your CV / articles
- to discuss your (and their) research
35Bring to interview
- Map with directions
- Change for parking
- Copies of CV and writing sample
- Interview itinerary
- Names of faculty and administrators
- List of interview questions
- Pen, paper, business cards, folder
- Toothbrush and mscll. health care
36Interview questions
- Which questions?
- Address questions to the right people
- Ask same question to different people
- Clarify answers to questions from earlier in the
interview process - Ask a question when asked if you have one (even
if you dont have any).
37Their questions
- Tell me about yourself?
- What are your strengths? Weaknesses?
- Tell me about a mistake you made and how you
handled it? What did you learn? - What do you see yourself doing in ... ?
- How/what/when will you contribute to our ED?
- Why should I hire you?
38Your questions
- Why is this position open?
- When was the last new physician hired?
- How stable is the nursing staff? Hospital?
Physician group? - May I speak with the most recent hire? Physician
who most recently left? - Credentials of MDs? Nurses?
- How can I make myself more competitive?
39Other questions
- Anticipated changes in the ED
- staffing (MD, RN, mid-level providers)
- census (ED, hospital, community)
- facility (expansion, observation unit, other)
- Progressiveness and creative planning
- Responsiveness of hospital administrators to the
needs of the ED
40Wish list
- Nice practice environment
- Stable hospital / growing ED census
- Good community (growing)
- Democratic group
- Similar colleagues (family)
- Opportunity for social/family happiness
- Fairness with respect to schedule, compensation,
and future potential
41Chief
- Leadership
- Innovation
- Creativity
- Respect (within group? hospital?)
- Business sense/plan
- Fairness
42Democratic group
- Competitive salary with reasonable administrative
overhead - Open books
- Equitable schedule with flexibility
- Evenly distributed workload
- Shared opportunity for advancement
- professional
- partnership (non-financial)
- financial parity
43Emergency department tour
- Age
- Layout and design
- Size and space
- Telephones
- Computer access
- Waiting room condition
- Plans to remodel
44Make sure you ...
- meet as many physicians as possible
- speak to nurses and paramedics
- talk with consultants about the ED
- meet administrators, if possible
- talk to benefits office(r)
- show an interest in the rest of the hospital and
the community - make an effort with (quick) good-byes
45Interview follow-up
- Thank you
- personalize (name and experience)
- telephone, email, US mail
- additional chance to express interest
- Dont skimp
- anyone helpful or made time for you
- Timely manner
- even if you arent interested in the position
or they did not seem interested in you
46Contracts
- Professional review
- Reference manuals may help, but its like reading
a foreign language - Read, understand, and amend what is important to
you - Not everything can be changed
- Employee manual is contract
47Concerns with contracts
- Termination clause
- Restrictive covenants
- Malpractice coverage
- who provides?
- type of coverage (claims-made or occurrences)?
- tail (who pays?)
48Employee vs. Independent contractor
- Benefits
- Financial (tax) implications
- Recent pressure from IRS to redefine EM
relationships as employee/employer rather than IC - Security ??????
49Negotiations
- Be prepared (find out what is negotiable before
you begin negotiating) - Understand what the other side needs
- Practice negotiations - getting to yes
- Keep your ego out of the deal
- Be creative
- Consider factors (skills, demand, need)
50Negotiations (cont.)
- Look to the future
- Consider the risk vs. benefit ratio
- ending up with nothing
- getting what you want in the present
- people remember frustrations
- negotiate for a promising future
- Dont resent how negotiations turn out
51Time
- Clinical duties most important
- arrive early
- work hard
- finish your work
- be pleasant to staff, patients families
- no distractions!
- Make yourself available for switching shifts (or
extra duties if needed) - Study for boards
52Time (cont.)
- Exercise
- Sleep is a priority
- Take classes
- Develop hobbies
- Personal growth
- Commit to family and friends
53Medical licenses
- Start early
- Consider expense
- Photos
- Fingerprints
- Diploma (translation)
- Coursework
54Things to avoid
- Practice shifts
- Arguing with nurses or consulting staff
- Lack of interview preparation
- Not ready for first shift (get a tour first)
- You will be expected to provide expert care and
compassion beginning with your first patient on
your first shift!
55Fear of leaving home
- Comfort with whats familiar
- No need to relocate
- Know what youre getting
- Already have reputation within hospital
- No one would take advantage of me here...
56Moonlighting vs. Staff
- Advantages
- check out various opportunities
- no commitment
- schedule flexibility
- determine which ED is best fit
- Disadvantages
- why not hired?
- clinical error or staff/patient complaint
- not considered a member of the team
- someone else hired instead
- staffing needs change
57Buying a house
- Complicated process
- Emotional experience
- May be prohibitively expensive
- Get to know the area first
- Make sure you like the position
- Make sure the position is stable
58What can I do now?
- Improve your clinical skills
- Finish research project and manuscripts
- Develop administrative skills
- Learn coding, billing, documentation
- Practice dictation
- Improve language or computer skills
- Read about hot political issues
- Discuss your interests with faculty
59Mentorship
- Important throughout career
- Personal and professional
- Opportunities
- research
- academic
- career advice
- Consider more than one mentor
- Mutual benefit
60Life after residency
- Enjoy the opportunity to provide care
- Share your happiness
- Give back to your program
- Celebrate your hard work
- Know when (and how) to take care of yourself!
61Faculty development
- EMF Teaching Fellowship
- Navigating the Academic Waters
- Research design, statistics, grants, etc.
- Leadership
- Patient satisfaction
- Time management
- Physician wellness
62Avoiding physician burnout
- Identify stressors
- Learn to deal with them constructively
- Dont internalize
- Dont rely solely on family for support
- Listen to those who have concerns
- Seek professional help
- Know when enough is enough
636 Cs of graduation
- Confidence
- Collaboration
- Collegiality
- Committees
- Compassion
- Community
647 Habits of highlysuccessful physicians
- 1. Recognize your limitations
- (learn from your mistakes)
- 2. Dont speak ill of colleagues/staff
- 3. Make yourself indispensable
- 4. Lead by example
- 5. Project a positive attitude
- 6. A good team player is a good listener
- 7. Dont conserve kindness
-
65In the long run, outstanding interpersonal skills
are desired over clinical expertise.
66Remember, you only haveone chance to make
afirst impression.
67Author Credit-Career PlanningGus Garmel MD
68Postresidency Tools of the Trade CD
- 13) Negotiation Ramundo
- 14) ABEM Certifications Cheng
- 15) Patient Satisfaction Cheng
- 16) Billing, Coding Documenting Cheng/Hall
- 17) Financial Planning Hevia
- 18) Time Management Promes
- 19) Balancing Work Family Promes Datner
- 20) Physician Wellness Burnout Conrad /Wadman
- 21) Professionalism Fredrick
- 22) Cases for professionalism ethics SAEM
- 23) Medical Directorship Proctor
- 24) Academic Career Guide Chapter 1-8
Nottingham - 25) Academic career Guide Chapter 9-16 Noeller
- 1) Career Planning Garmel
- 2) Careers in Academic EM Sokolove
- 3) Private Practice Career Options - Holliman
- 4) Fellowship/EM Organizations Coates/Cheng
- 5) CV Garmel
- 6) Interviewing Garmel
- 7) Contracts for Emergency Physicians Franks
- 8) Salary Benefits Hevia
- 9) Malpractice Derse/Cheng
- 10) Clinical Teaching in the ED Wald
- 11) Teaching Tips Ankel
- 12) Mentoring - Ramundo