Career Planning in Emergency Medicine. Society for Academic Emergency Medicine ObjectivesObjectives...

Career Planning in

Emergency Medicine

Society for Academic Emergency Medicine

ObjectivesObjectivesObjectivesObjectives

Entering the job marketEntering the job market Tips for an effective searchTips for an effective search The interview and follow-up The interview and follow-up How to evaluate a position (and offer)How to evaluate a position (and offer) Successful negotiationsSuccessful negotiations Strategies for rewarding careers in EMStrategies for rewarding careers in EM

Entering the job marketEntering the job market Tips for an effective searchTips for an effective search The interview and follow-up The interview and follow-up How to evaluate a position (and offer)How to evaluate a position (and offer) Successful negotiationsSuccessful negotiations Strategies for rewarding careers in EMStrategies for rewarding careers in EM


Finding a position in EMFinding a position in EMFinding a position in EMFinding a position in EM

Realistic appraisal of your abilitiesRealistic appraisal of your abilities Discuss with family, friends, mentorsDiscuss with family, friends, mentors Research various possibilitiesResearch various possibilities Consider more than one optionConsider more than one option Gather information and Gather information and verifyverify it it Look to trusted advisorsLook to trusted advisors Take into account personal needs, interests & Take into account personal needs, interests &

talentstalents

Realistic appraisal of your abilitiesRealistic appraisal of your abilities Discuss with family, friends, mentorsDiscuss with family, friends, mentors Research various possibilitiesResearch various possibilities Consider more than one optionConsider more than one option Gather information and Gather information and verifyverify it it Look to trusted advisorsLook to trusted advisors Take into account personal needs, interests & Take into account personal needs, interests &

talentstalents


DEFINE: 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)


DEFINE: 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?


Stages of the job searchStages of the job searchStages of the job searchStages of the job search

Stage I - PreparationStage I - Preparation

*type of position*type of position

*type of employer*type of employer

*geographic location*geographic location Stage II - InvestigationStage II - Investigation

*look for possibilities*look for possibilities

*make contact *make contact

*interview and tour ED*interview and tour ED Stage III - DecisionStage III - Decision

**negotiations negotiations maymay help help

Stage I - PreparationStage I - Preparation

*type of position*type of position

*type of employer*type of employer

*geographic location*geographic location Stage II - InvestigationStage II - Investigation

*look for possibilities*look for possibilities

*make contact *make contact

*interview and tour ED*interview and tour ED Stage III - DecisionStage III - Decision

**negotiations negotiations maymay help help


Career vs. JobCareer vs. JobCareer vs. JobCareer vs. Job

DistinctionDistinction

*Career: defines an individual*Career: defines an individual

*Job: pays the bills*Job: pays the bills

Time frameTime frame

*immediate*immediate

*short-term*short-term

*long-term*long-term

DistinctionDistinction

*Career: defines an individual*Career: defines an individual

*Job: pays the bills*Job: pays the bills

Time frameTime frame

*immediate*immediate

*short-term*short-term

*long-term*long-term


Where do I see myself ...Where do I see myself ...Where do I see myself ...Where do I see myself ...

in the next yearin the next year in the next 5 yearsin the next 5 years in the next 10 - 15 yearsin the next 10 - 15 years

Geographic regionGeographic region Emergency setting Emergency setting Hospital environmentHospital environment CommunityCommunity

in the next yearin the next year in the next 5 yearsin the next 5 years in the next 10 - 15 yearsin the next 10 - 15 years

Geographic regionGeographic region Emergency setting Emergency setting Hospital environmentHospital environment CommunityCommunity


First year out ...First year out ...First year out ...First year out ...

Learn a new systemLearn a new system Introduction to staff and consultantsIntroduction to staff and consultants Establish a reputationEstablish a reputation Get to know the communityGet to know the community Study for boardsStudy for boards

Learn a new systemLearn a new system Introduction to staff and consultantsIntroduction to staff and consultants Establish a reputationEstablish a reputation Get to know the communityGet to know the community Study for boardsStudy for boards


5 years out ...5 years out ...5 years out ...5 years out ...

Career re-evaluationCareer re-evaluation Money somewhat less of a concernMoney somewhat less of a concern

*school debts often repaid*school debts often repaid

*growth in savings*growth in savings

*partnership*partnership

*vested in pension*vested in pension Thoughts of retirement ...Thoughts of retirement ...

Career re-evaluationCareer re-evaluation Money somewhat less of a concernMoney somewhat less of a concern

*school debts often repaid*school debts often repaid

*growth in savings*growth in savings

*partnership*partnership

*vested in pension*vested in pension Thoughts of retirement ...Thoughts of retirement ...


10 - 15 years out ...10 - 15 years out ...10 - 15 years out ...10 - 15 years out ...

““Make or break” timeMake or break” time Serious travel or time awaySerious travel or time away Rekindle your passion for EMRekindle your passion for EM Thoughts of career re-directionThoughts of career re-direction

*urgent care*urgent care

*occupational health*occupational health

*administration *administration

““Make or break” timeMake or break” time Serious travel or time awaySerious travel or time away Rekindle your passion for EMRekindle your passion for EM Thoughts of career re-directionThoughts of career re-direction

*urgent care*urgent care

*occupational health*occupational health

*administration *administration


What makes me happy?What makes me happy?What makes me happy?What makes me happy?

Patient care Patient care TeachingTeaching SupervisingSupervising Research Research AdministrationAdministration LearningLearning

Patient care Patient care TeachingTeaching SupervisingSupervising Research Research AdministrationAdministration LearningLearning


What is important to me?What is important to me?What is important to me?What is important to me?

PowerPower Fame and notorietyFame and notoriety Personal timePersonal time Fancy vacationsFancy vacations Material goodsMaterial goods MoneyMoney

PowerPower Fame and notorietyFame and notoriety Personal timePersonal time Fancy vacationsFancy vacations Material goodsMaterial goods MoneyMoney


What is What is reallyreally important? important?What is What is reallyreally important? important?

Family and friendsFamily and friends Career satisfactionCareer satisfaction SecuritySecurity

*position *position

*financial*financial RespectRespect WellnessWellness

Family and friendsFamily and friends Career satisfactionCareer satisfaction SecuritySecurity

*position *position

*financial*financial RespectRespect WellnessWellness


What do I What do I enjoyenjoy when I am at work? when I am at work? What do I What do I enjoyenjoy when I am at work? when I am at work?

Nice patientsNice patients Supportive staffSupportive staff Functional facilitiesFunctional facilities Challenging casesChallenging cases TeachingTeaching CamaraderieCamaraderie

Nice patientsNice patients Supportive staffSupportive staff Functional facilitiesFunctional facilities Challenging casesChallenging cases TeachingTeaching CamaraderieCamaraderie


AutonomyAutonomyAutonomyAutonomy

Physician autonomy is possible despite the Physician autonomy is possible despite the advent of practice guidelines, managed advent of practice guidelines, managed care, and government agencies (although care, and government agencies (although more difficult).more difficult).

Test orderingTest ordering Decision-makingDecision-making Best practicesBest practices

Physician autonomy is possible despite the Physician autonomy is possible despite the advent of practice guidelines, managed advent of practice guidelines, managed care, and government agencies (although care, and government agencies (although more difficult).more difficult).

Test orderingTest ordering Decision-makingDecision-making Best practicesBest practices


What would I like to What would I like to avoidavoid??What would I like to What would I like to avoidavoid??

Unmanageable patient volumeUnmanageable patient volume Delays affecting patient care Delays affecting patient care Difficulty getting patients admittedDifficulty getting patients admitted Hassles with consultantsHassles with consultants Non-supportive environment Non-supportive environment Administrative headachesAdministrative headaches Frustrations with ED/hospital designFrustrations with ED/hospital design

Unmanageable patient volumeUnmanageable patient volume Delays affecting patient care Delays affecting patient care Difficulty getting patients admittedDifficulty getting patients admitted Hassles with consultantsHassles with consultants Non-supportive environment Non-supportive environment Administrative headachesAdministrative headaches Frustrations with ED/hospital designFrustrations with ED/hospital design


Beyond graduationBeyond graduationBeyond graduationBeyond graduation

FellowshipsFellowships Chief residencyChief residency Additional residency trainingAdditional residency training PositionsPositions

*clinical*clinical

*academic*academic

* “hybrid”* “hybrid” TravelTravel

FellowshipsFellowships Chief residencyChief residency Additional residency trainingAdditional residency training PositionsPositions

*clinical*clinical

*academic*academic

* “hybrid”* “hybrid” TravelTravel


Clinical settingClinical settingClinical settingClinical setting

RuralRural SuburbanSuburban UrbanUrban CountyCounty Academic medical centerAcademic medical center VAVA MilitaryMilitary

RuralRural SuburbanSuburban UrbanUrban CountyCounty Academic medical centerAcademic medical center VAVA MilitaryMilitary


Learning the marketLearning the marketLearning the marketLearning the market

AHA AHA Guide to the Health Care FieldGuide to the Health Care Field PDs & faculty (yours and ‘theirs’)PDs & faculty (yours and ‘theirs’) Recruiters (companies or ED groups)Recruiters (companies or ED groups) InternetInternet Hospital operatorsHospital operators Family or friendsFamily or friends Phone bookPhone book EDsEDs

AHA AHA Guide to the Health Care FieldGuide to the Health Care Field PDs & faculty (yours and ‘theirs’)PDs & faculty (yours and ‘theirs’) Recruiters (companies or ED groups)Recruiters (companies or ED groups) InternetInternet Hospital operatorsHospital operators Family or friendsFamily or friends Phone bookPhone book EDsEDs


Effective searchingEffective searchingEffective searchingEffective searching

Be focusedBe focused Be assertiveBe assertive Be creativeBe creative Start earlyStart early

Don’t take NO for an answer, it may Don’t take NO for an answer, it may become YES laterbecome YES later

Be focusedBe focused Be assertiveBe assertive Be creativeBe creative Start earlyStart early

Don’t take NO for an answer, it may Don’t take NO for an answer, it may become YES laterbecome YES later


Job search vs NRMPJob search vs NRMPJob search vs NRMPJob search vs NRMP

Search ends once candidate acceptsSearch ends once candidate accepts *time and money*time and money

*mutual decision*mutual decision May be offered position at end of the May be offered position at end of the

interview, or within a short timeinterview, or within a short time Make sure your PDs and references are Make sure your PDs and references are

available and know when, where, and available and know when, where, and whywhy you are interviewingyou are interviewing

Search ends once candidate acceptsSearch ends once candidate accepts *time and money*time and money

*mutual decision*mutual decision May be offered position at end of the May be offered position at end of the

interview, or within a short timeinterview, or within a short time Make sure your PDs and references are Make sure your PDs and references are

available and know when, where, and available and know when, where, and whywhy you are interviewingyou are interviewing


Foot in the doorFoot in the doorFoot in the doorFoot in the door

Telephone contactTelephone contact

*not Monday AM or Friday PM*not Monday AM or Friday PM

*find out when someone will be available*find out when someone will be available

Personal communicationPersonal communication Someone who knows the right personSomeone who knows the right person Right place at the right timeRight place at the right time

*introduce yourself at a meeting*introduce yourself at a meeting

*stop by the ED*stop by the ED

Telephone contactTelephone contact

*not Monday AM or Friday PM*not Monday AM or Friday PM

*find out when someone will be available*find out when someone will be available

Personal communicationPersonal communication Someone who knows the right personSomeone who knows the right person Right place at the right timeRight place at the right time

*introduce yourself at a meeting*introduce yourself at a meeting

*stop by the ED*stop by the ED


PreparationPreparationPreparationPreparation

Find out what is going onFind out what is going on

*hospital and ED*hospital and ED

*leadership*leadership

*research*research

*community*community

Why is the position open? How long? Why is the position open? How long? Most recent hire? Departure? Why?Most recent hire? Departure? Why? Turnover rate? Turnover rate?

Find out what is going onFind out what is going on

*hospital and ED*hospital and ED

*leadership*leadership

*research*research

*community*community

Why is the position open? How long? Why is the position open? How long? Most recent hire? Departure? Why?Most recent hire? Departure? Why? Turnover rate? Turnover rate?


ResourcesResourcesResourcesResources

Faculty interestsFaculty interests EM textbooksEM textbooks Medline / PubmedMedline / Pubmed Internet home pagesInternet home pages Residency websitesResidency websites Conference facultyConference faculty Your program’s Your program’s

faculty may know ...faculty may know ...

Faculty interestsFaculty interests EM textbooksEM textbooks Medline / PubmedMedline / Pubmed Internet home pagesInternet home pages Residency websitesResidency websites Conference facultyConference faculty Your program’s Your program’s

faculty may know ...faculty may know ...

Job opportunitiesJob opportunities Journals/newslettersJournals/newsletters Job catalogsJob catalogs Postings (meetings, Postings (meetings,

internet, bulletins)internet, bulletins) ‘‘Local’ program Local’ program

directors & residentsdirectors & residents Word of mouthWord of mouth RecruitersRecruiters

Job opportunitiesJob opportunities Journals/newslettersJournals/newsletters Job catalogsJob catalogs Postings (meetings, Postings (meetings,

internet, bulletins)internet, bulletins) ‘‘Local’ program Local’ program

directors & residentsdirectors & residents Word of mouthWord of mouth RecruitersRecruiters


Professional recruitersProfessional recruitersProfessional recruitersProfessional recruiters

Use judgment before giving out CVsUse judgment before giving out CVs Many have excellent skills / reputationsMany have excellent skills / reputations Firms vs. recruiters for contract groupFirms vs. recruiters for contract group

*who do they represent?*who do they represent?

*for whom do they work? answer to? *for whom do they work? answer to?

*how do they get paid? when? by whom?*how do they get paid? when? by whom? Weigh benefits vs. downsidesWeigh benefits vs. downsides Not for everyoneNot for everyone

Use judgment before giving out CVsUse judgment before giving out CVs Many have excellent skills / reputationsMany have excellent skills / reputations Firms vs. recruiters for contract groupFirms vs. recruiters for contract group

*who do they represent?*who do they represent?

*for whom do they work? answer to? *for whom do they work? answer to?

*how do they get paid? when? by whom?*how do they get paid? when? by whom? Weigh benefits vs. downsidesWeigh benefits vs. downsides Not for everyoneNot for everyone


Questions for recruitersQuestions for recruitersQuestions for recruitersQuestions for recruiters

Years experience in EM? Exclusive?Years experience in EM? Exclusive? Background? Previous employment?Background? Previous employment? Knowledge of EM? Geographic region?Knowledge of EM? Geographic region? Percentage of academic placements?Percentage of academic placements? Willing to give reference(s)?Willing to give reference(s)? Success rate? Other ‘data’?Success rate? Other ‘data’? Financial arrangement?Financial arrangement? Why them?Why them?

Years experience in EM? Exclusive?Years experience in EM? Exclusive? Background? Previous employment?Background? Previous employment? Knowledge of EM? Geographic region?Knowledge of EM? Geographic region? Percentage of academic placements?Percentage of academic placements? Willing to give reference(s)?Willing to give reference(s)? Success rate? Other ‘data’?Success rate? Other ‘data’? Financial arrangement?Financial arrangement? Why them?Why them?


CV & Cover letterCV & Cover letterCV & Cover letterCV & Cover letter

Equally important with different rolesEqually important with different roles Curriculum vitaeCurriculum vitae lists professional lists professional

accomplishments, abilities, interests, and activitiesaccomplishments, abilities, interests, and activities Cover letter Cover letter is a personalized attempt at is a personalized attempt at

convincing someone to offer you an interviewconvincing someone to offer you an interview Both include name/address/phoneBoth include name/address/phone

Equally important with different rolesEqually important with different roles Curriculum vitaeCurriculum vitae lists professional lists professional

accomplishments, abilities, interests, and activitiesaccomplishments, abilities, interests, and activities Cover letter Cover letter is a personalized attempt at is a personalized attempt at

convincing someone to offer you an interviewconvincing someone to offer you an interview Both include name/address/phoneBoth include name/address/phone


Curriculum vitaeCurriculum vitaeCurriculum vitaeCurriculum vitae

Make it look like it “wants” to be readMake it look like it “wants” to be read

*professional style*professional style

*use white space appropriately*use white space appropriately

*good texture*good texture

*easily read*easily read It should copy wellIt should copy well Descending chronological orderDescending chronological order Include special skills, esp. languageInclude special skills, esp. language

Make it look like it “wants” to be readMake it look like it “wants” to be read

*professional style*professional style

*use white space appropriately*use white space appropriately

*good texture*good texture

*easily read*easily read It should copy wellIt should copy well Descending chronological orderDescending chronological order Include special skills, esp. languageInclude special skills, esp. language


Important informationImportant informationImportant informationImportant information

Include professional degreeInclude professional degree Reliable phone numberReliable phone number Current contact addressCurrent contact address Email addressEmail address

Do not use pager, ED, or secretary #sDo not use pager, ED, or secretary #s Keep contact information simple!Keep contact information simple!

Include professional degreeInclude professional degree Reliable phone numberReliable phone number Current contact addressCurrent contact address Email addressEmail address

Do not use pager, ED, or secretary #sDo not use pager, ED, or secretary #s Keep contact information simple!Keep contact information simple!


CV do’s & don’tsCV do’s & don’tsCV do’s & don’tsCV do’s & don’ts

DODO Emphasize your Emphasize your

accomplishments and accomplishments and special skillsspecial skills

Include your name on Include your name on every pageevery page

Keep it simple and Keep it simple and legible legible

Number each pageNumber each page

DODO Emphasize your Emphasize your

accomplishments and accomplishments and special skillsspecial skills

Include your name on Include your name on every pageevery page

Keep it simple and Keep it simple and legible legible

Number each pageNumber each page

DON’TDON’T Include irrelevant Include irrelevant

informationinformation Use dark paper that Use dark paper that

doesn’t copy welldoesn’t copy well Make grammatical or Make grammatical or

spelling errorsspelling errors Inflate your Inflate your

accomplishmentsaccomplishments

DON’TDON’T Include irrelevant Include irrelevant

informationinformation Use dark paper that Use dark paper that

doesn’t copy welldoesn’t copy well Make grammatical or Make grammatical or

spelling errorsspelling errors Inflate your Inflate your

accomplishmentsaccomplishments


Cover letterCover letterCover letterCover letter

Personalize - address it to someonePersonalize - address it to someone Send with your CVSend with your CV Check spelling (esp. names)Check spelling (esp. names) Give a reason why you should be invited for an Give a reason why you should be invited for an

interviewinterview Include personal information that doesn’t go on Include personal information that doesn’t go on

your CVyour CV

Personalize - address it to someonePersonalize - address it to someone Send with your CVSend with your CV Check spelling (esp. names)Check spelling (esp. names) Give a reason why you should be invited for an Give a reason why you should be invited for an

interviewinterview Include personal information that doesn’t go on Include personal information that doesn’t go on

your CVyour CV


InterviewInterviewInterviewInterview

Dress professionallyDress professionally Let them interview you Let them interview you Interview themInterview them Learn about the position, hospital, and Learn about the position, hospital, and

communitycommunity Meet as many people as possibleMeet as many people as possible

Find out as much as you can about as much as Find out as much as you can about as much as you can.you can.

Dress professionallyDress professionally Let them interview you Let them interview you Interview themInterview them Learn about the position, hospital, and Learn about the position, hospital, and

communitycommunity Meet as many people as possibleMeet as many people as possible

Find out as much as you can about as much as Find out as much as you can about as much as you can.you can.


InterviewsInterviewsInterviewsInterviews

Don’t waste their time or your ownDon’t waste their time or your own Practice at your residency programPractice at your residency program Be preparedBe prepared

*to present a case*to present a case

*to give a lecture*to give a lecture

*to share your CV / articles*to share your CV / articles

*to discuss your (and their) research*to discuss your (and their) research

Don’t waste their time or your ownDon’t waste their time or your own Practice at your residency programPractice at your residency program Be preparedBe prepared

*to present a case*to present a case

*to give a lecture*to give a lecture

*to share your CV / articles*to share your CV / articles

*to discuss your (and their) research*to discuss your (and their) research


Bring to interviewBring to interviewBring to interviewBring to interview

Map with directionsMap with directions Change for parkingChange for parking Copies of CV and writing sampleCopies of CV and writing sample Interview itineraryInterview itinerary Names of faculty and administratorsNames of faculty and administrators List of interview questionsList of interview questions Pen, paper, business cards, folderPen, paper, business cards, folder Toothbrush and mscll. health careToothbrush and mscll. health care

Map with directionsMap with directions Change for parkingChange for parking Copies of CV and writing sampleCopies of CV and writing sample Interview itineraryInterview itinerary Names of faculty and administratorsNames of faculty and administrators List of interview questionsList of interview questions Pen, paper, business cards, folderPen, paper, business cards, folder Toothbrush and mscll. health careToothbrush and mscll. health care


Interview questionsInterview questionsInterview questionsInterview questions

Which questions? Which questions? Address questions to the right peopleAddress questions to the right people Ask same question to different people Ask same question to different people Clarify answers to questions from earlier in Clarify answers to questions from earlier in

the interview processthe interview process

Ask a question when asked if you have one Ask a question when asked if you have one (even if you don’t have any).(even if you don’t have any).

Which questions? Which questions? Address questions to the right peopleAddress questions to the right people Ask same question to different people Ask same question to different people Clarify answers to questions from earlier in Clarify answers to questions from earlier in

the interview processthe interview process

Ask a question when asked if you have one Ask a question when asked if you have one (even if you don’t have any).(even if you don’t have any).


Their questionsTheir questionsTheir questionsTheir questions

Tell me about yourself?Tell me about yourself? What are your strengths? Weaknesses?What are your strengths? Weaknesses? Tell me about a mistake you made and how you Tell me about a mistake you made and how you

handled it? What did you learn?handled it? What did you learn? What do you see yourself doing in ... ?What do you see yourself doing in ... ? How/what/when will you contribute to our ED? How/what/when will you contribute to our ED? Why should I hire you?Why should I hire you?

Tell me about yourself?Tell me about yourself? What are your strengths? Weaknesses?What are your strengths? Weaknesses? Tell me about a mistake you made and how you Tell me about a mistake you made and how you

handled it? What did you learn?handled it? What did you learn? What do you see yourself doing in ... ?What do you see yourself doing in ... ? How/what/when will you contribute to our ED? How/what/when will you contribute to our ED? Why should I hire you?Why should I hire you?


Your questionsYour questionsYour questionsYour questions

Why is this position open?Why is this position open? When was the last new physician hired? When was the last new physician hired? How stable is the nursing staff? Hospital? How stable is the nursing staff? Hospital?

Physician group?Physician group? May I speak with the most recent hire? May I speak with the most recent hire?

Physician who most recently left?Physician who most recently left? ‘‘Credentials’ of MDs? Nurses? Credentials’ of MDs? Nurses? How can I make myself more competitive?How can I make myself more competitive?

Why is this position open?Why is this position open? When was the last new physician hired? When was the last new physician hired? How stable is the nursing staff? Hospital? How stable is the nursing staff? Hospital?

Physician group?Physician group? May I speak with the most recent hire? May I speak with the most recent hire?

Physician who most recently left?Physician who most recently left? ‘‘Credentials’ of MDs? Nurses? Credentials’ of MDs? Nurses? How can I make myself more competitive?How can I make myself more competitive?


Other questionsOther questionsOther questionsOther questions

Anticipated changes in the EDAnticipated changes in the ED

*staffing (MD, RN, mid-level providers)

*census (ED, hospital, community)

*facility (expansion, observation unit, other) Progressiveness and creative planningProgressiveness and creative planning Responsiveness of hospital administrators to the Responsiveness of hospital administrators to the

needs of the EDneeds of the ED

Anticipated changes in the EDAnticipated changes in the ED

*staffing (MD, RN, mid-level providers)

*census (ED, hospital, community)

*facility (expansion, observation unit, other) Progressiveness and creative planningProgressiveness and creative planning Responsiveness of hospital administrators to the Responsiveness of hospital administrators to the

needs of the EDneeds of the ED


Wish listWish listWish listWish list

Nice practice environment Nice practice environment Stable hospital / growing ED censusStable hospital / growing ED census Good community (growing)Good community (growing) Democratic groupDemocratic group Similar colleagues (‘family’)Similar colleagues (‘family’) Opportunity for social/family happinessOpportunity for social/family happiness Fairness with respect to schedule, Fairness with respect to schedule,

compensation, and future potentialcompensation, and future potential

Nice practice environment Nice practice environment Stable hospital / growing ED censusStable hospital / growing ED census Good community (growing)Good community (growing) Democratic groupDemocratic group Similar colleagues (‘family’)Similar colleagues (‘family’) Opportunity for social/family happinessOpportunity for social/family happiness Fairness with respect to schedule, Fairness with respect to schedule,

compensation, and future potentialcompensation, and future potential


ChiefChiefChiefChief

LeadershipLeadership InnovationInnovation CreativityCreativity Respect (within group? hospital?)Respect (within group? hospital?) Business sense/planBusiness sense/plan FairnessFairness

LeadershipLeadership InnovationInnovation CreativityCreativity Respect (within group? hospital?)Respect (within group? hospital?) Business sense/planBusiness sense/plan FairnessFairness


Democratic groupDemocratic groupDemocratic groupDemocratic group

Competitive salary with reasonable Competitive salary with reasonable administrative overhead administrative overhead

Open booksOpen books Equitable schedule with flexibilityEquitable schedule with flexibility Evenly distributed workloadEvenly distributed workload Shared opportunity for advancementShared opportunity for advancement

*professional*professional

*partnership (non-financial)*partnership (non-financial)

*financial parity*financial parity

Competitive salary with reasonable Competitive salary with reasonable administrative overhead administrative overhead

Open booksOpen books Equitable schedule with flexibilityEquitable schedule with flexibility Evenly distributed workloadEvenly distributed workload Shared opportunity for advancementShared opportunity for advancement

*professional*professional

*partnership (non-financial)*partnership (non-financial)

*financial parity*financial parity


Emergency department tourEmergency department tourEmergency department tourEmergency department tour

AgeAge Layout and designLayout and design Size and spaceSize and space TelephonesTelephones Computer accessComputer access Waiting room conditionWaiting room condition Plans to remodelPlans to remodel

AgeAge Layout and designLayout and design Size and spaceSize and space TelephonesTelephones Computer accessComputer access Waiting room conditionWaiting room condition Plans to remodelPlans to remodel


Make sure you ...Make sure you ...Make sure you ...Make sure you ...

meet as many physicians as possible meet as many physicians as possible speak to nurses and paramedicsspeak to nurses and paramedics talk with consultants about the EDtalk with consultants about the ED meet administrators, if possiblemeet administrators, if possible talk to benefits office(r)talk to benefits office(r) show an interest in the rest of the hospital show an interest in the rest of the hospital

and the communityand the community make an effort with (quick) good-byesmake an effort with (quick) good-byes

meet as many physicians as possible meet as many physicians as possible speak to nurses and paramedicsspeak to nurses and paramedics talk with consultants about the EDtalk with consultants about the ED meet administrators, if possiblemeet administrators, if possible talk to benefits office(r)talk to benefits office(r) show an interest in the rest of the hospital show an interest in the rest of the hospital

and the communityand the community make an effort with (quick) good-byesmake an effort with (quick) good-byes


Interview follow-upInterview follow-upInterview follow-upInterview follow-up

Thank youThank you

*personalize (name and experience)*personalize (name and experience)

*telephone, email, US mail*telephone, email, US mail

*additional chance to express interest*additional chance to express interest Don’t skimpDon’t skimp

*anyone helpful or made time for you*anyone helpful or made time for you Timely mannerTimely manner

*even if you aren’t interested in the position or they did *even if you aren’t interested in the position or they did not seem interested in younot seem interested in you

Thank youThank you

*personalize (name and experience)*personalize (name and experience)

*telephone, email, US mail*telephone, email, US mail

*additional chance to express interest*additional chance to express interest Don’t skimpDon’t skimp

*anyone helpful or made time for you*anyone helpful or made time for you Timely mannerTimely manner

*even if you aren’t interested in the position or they did *even if you aren’t interested in the position or they did not seem interested in younot seem interested in you


ContractsContractsContractsContracts

Professional reviewProfessional review Reference manuals may help, but it’s Reference manuals may help, but it’s

like reading a foreign languagelike reading a foreign language Read, understand, and amend what is Read, understand, and amend what is

important to youimportant to you Not everything can be changedNot everything can be changed Employee manual is contractEmployee manual is contract

Professional reviewProfessional review Reference manuals may help, but it’s Reference manuals may help, but it’s

like reading a foreign languagelike reading a foreign language Read, understand, and amend what is Read, understand, and amend what is

important to youimportant to you Not everything can be changedNot everything can be changed Employee manual is contractEmployee manual is contract


Concerns with contractsConcerns with contractsConcerns with contractsConcerns with contracts

Termination clauseTermination clause Restrictive covenantsRestrictive covenants Malpractice coverageMalpractice coverage

*who provides?*who provides?

*type of coverage (claims-made or occurrences)?*type of coverage (claims-made or occurrences)?

*tail (who pays?)*tail (who pays?)

Termination clauseTermination clause Restrictive covenantsRestrictive covenants Malpractice coverageMalpractice coverage

*who provides?*who provides?

*type of coverage (claims-made or occurrences)?*type of coverage (claims-made or occurrences)?

*tail (who pays?)*tail (who pays?)


Employee vs. Independent contractorEmployee vs. Independent contractorEmployee vs. Independent contractorEmployee vs. Independent contractor

Benefits Benefits Financial (tax) implicationsFinancial (tax) implications Recent pressure from IRS to redefine EM Recent pressure from IRS to redefine EM

relationships as employee/employer rather than relationships as employee/employer rather than ICIC

Security ??????Security ??????

Benefits Benefits Financial (tax) implicationsFinancial (tax) implications Recent pressure from IRS to redefine EM Recent pressure from IRS to redefine EM

relationships as employee/employer rather than relationships as employee/employer rather than ICIC

Security ??????Security ??????


NegotiationsNegotiationsNegotiationsNegotiations

Be prepared (find out what is negotiable Be prepared (find out what is negotiable beforebefore you begin negotiating) you begin negotiating)

Understand what the other side needsUnderstand what the other side needs Practice negotiations - getting to ‘yes’Practice negotiations - getting to ‘yes’ Keep your ego out of the dealKeep your ego out of the deal Be creativeBe creative Consider factors (skills, demand, need)Consider factors (skills, demand, need)

Be prepared (find out what is negotiable Be prepared (find out what is negotiable beforebefore you begin negotiating) you begin negotiating)

Understand what the other side needsUnderstand what the other side needs Practice negotiations - getting to ‘yes’Practice negotiations - getting to ‘yes’ Keep your ego out of the dealKeep your ego out of the deal Be creativeBe creative Consider factors (skills, demand, need)Consider factors (skills, demand, need)


Negotiations (cont.)Negotiations (cont.)Negotiations (cont.)Negotiations (cont.)

Look to the futureLook to the future Consider the risk vs. benefit ratioConsider the risk vs. benefit ratio

*ending up with nothing*ending up with nothing

*getting what you want in the present*getting what you want in the present

*people remember frustrations*people remember frustrations

*negotiate for a promising future*negotiate for a promising future Don’t resent how negotiations turn outDon’t resent how negotiations turn out

Look to the futureLook to the future Consider the risk vs. benefit ratioConsider the risk vs. benefit ratio

*ending up with nothing*ending up with nothing

*getting what you want in the present*getting what you want in the present

*people remember frustrations*people remember frustrations

*negotiate for a promising future*negotiate for a promising future Don’t resent how negotiations turn outDon’t resent how negotiations turn out


TimeTimeTimeTime

Clinical duties most importantClinical duties most important

*arrive early*arrive early

*work hard*work hard

*finish your work*finish your work

*be pleasant to staff, patients & families*be pleasant to staff, patients & families

*no distractions!*no distractions! Make yourself available for switching shifts (or extra Make yourself available for switching shifts (or extra

duties if needed)duties if needed) Study for boardsStudy for boards

Clinical duties most importantClinical duties most important

*arrive early*arrive early

*work hard*work hard

*finish your work*finish your work

*be pleasant to staff, patients & families*be pleasant to staff, patients & families

*no distractions!*no distractions! Make yourself available for switching shifts (or extra Make yourself available for switching shifts (or extra

duties if needed)duties if needed) Study for boardsStudy for boards


Time (cont.)Time (cont.)Time (cont.)Time (cont.)

ExerciseExercise Sleep is a prioritySleep is a priority Take classesTake classes Develop hobbiesDevelop hobbies Personal growthPersonal growth Commit to family and friendsCommit to family and friends

ExerciseExercise Sleep is a prioritySleep is a priority Take classesTake classes Develop hobbiesDevelop hobbies Personal growthPersonal growth Commit to family and friendsCommit to family and friends


Medical licensesMedical licensesMedical licensesMedical licenses

Start earlyStart early Consider expenseConsider expense PhotosPhotos FingerprintsFingerprints Diploma (translation)Diploma (translation) CourseworkCoursework

Start earlyStart early Consider expenseConsider expense PhotosPhotos FingerprintsFingerprints Diploma (translation)Diploma (translation) CourseworkCoursework


Things to avoidThings to avoidThings to avoidThings to avoid

Practice shiftsPractice shifts Arguing with nurses or consulting staffArguing with nurses or consulting staff Lack of interview preparationLack of interview preparation Not ready for first shift (get a ‘tour’ first)Not ready for first shift (get a ‘tour’ first)

You will be expected to provide You will be expected to provide expertexpert care care and compassion beginning with your first and compassion beginning with your first patient on your first shift! patient on your first shift!

Practice shiftsPractice shifts Arguing with nurses or consulting staffArguing with nurses or consulting staff Lack of interview preparationLack of interview preparation Not ready for first shift (get a ‘tour’ first)Not ready for first shift (get a ‘tour’ first)

You will be expected to provide You will be expected to provide expertexpert care care and compassion beginning with your first and compassion beginning with your first patient on your first shift! patient on your first shift!


Fear of “leaving home”Fear of “leaving home”Fear of “leaving home”Fear of “leaving home”

Comfort with what’s familiarComfort with what’s familiar No need to relocateNo need to relocate Know what you’re gettingKnow what you’re getting Already have reputation within hospitalAlready have reputation within hospital

““No one would take advantage of me here...”No one would take advantage of me here...”

Comfort with what’s familiarComfort with what’s familiar No need to relocateNo need to relocate Know what you’re gettingKnow what you’re getting Already have reputation within hospitalAlready have reputation within hospital

““No one would take advantage of me here...”No one would take advantage of me here...”


Moonlighting vs. StaffMoonlighting vs. StaffMoonlighting vs. StaffMoonlighting vs. Staff

AdvantagesAdvantages check out various check out various

opportunitiesopportunities no commitmentno commitment schedule flexibilityschedule flexibility determine which determine which

ED is best ‘fit’ED is best ‘fit’

AdvantagesAdvantages check out various check out various

opportunitiesopportunities no commitmentno commitment schedule flexibilityschedule flexibility determine which determine which

ED is best ‘fit’ED is best ‘fit’

DisadvantagesDisadvantages why not hired?why not hired? clinical error or clinical error or

staff/patient complaintstaff/patient complaint not considered a not considered a

member of the teammember of the team someone else hired someone else hired

insteadinstead staffing needs change staffing needs change

DisadvantagesDisadvantages why not hired?why not hired? clinical error or clinical error or

staff/patient complaintstaff/patient complaint not considered a not considered a

member of the teammember of the team someone else hired someone else hired

insteadinstead staffing needs change staffing needs change


Buying a houseBuying a houseBuying a houseBuying a house

Complicated processComplicated process Emotional experienceEmotional experience May be prohibitively expensiveMay be prohibitively expensive

Get to know the area firstGet to know the area first Make sure you like the position Make sure you like the position Make sure the position is stableMake sure the position is stable

Complicated processComplicated process Emotional experienceEmotional experience May be prohibitively expensiveMay be prohibitively expensive

Get to know the area firstGet to know the area first Make sure you like the position Make sure you like the position Make sure the position is stableMake sure the position is stable


What can I do now?What can I do now?What can I do now?What can I do now?

Improve your clinical skillsImprove your clinical skills Finish research project and manuscripts Finish research project and manuscripts Develop administrative skillsDevelop administrative skills Learn coding, billing, documentationLearn coding, billing, documentation Practice dictation Practice dictation Improve language or computer skillsImprove language or computer skills Read about “hot” political issuesRead about “hot” political issues Discuss your interests with facultyDiscuss your interests with faculty

Improve your clinical skillsImprove your clinical skills Finish research project and manuscripts Finish research project and manuscripts Develop administrative skillsDevelop administrative skills Learn coding, billing, documentationLearn coding, billing, documentation Practice dictation Practice dictation Improve language or computer skillsImprove language or computer skills Read about “hot” political issuesRead about “hot” political issues Discuss your interests with facultyDiscuss your interests with faculty


MentorshipMentorshipMentorshipMentorship

Important throughout careerImportant throughout career Personal Personal andand professional professional OpportunitiesOpportunities

*research*research

*academic*academic

*career advice*career advice Consider more than one mentor Consider more than one mentor Mutual benefitMutual benefit

Important throughout careerImportant throughout career Personal Personal andand professional professional OpportunitiesOpportunities

*research*research

*academic*academic

*career advice*career advice Consider more than one mentor Consider more than one mentor Mutual benefitMutual benefit


Life after residencyLife after residencyLife after residencyLife after residency

Enjoy the opportunity to provide care Enjoy the opportunity to provide care Share your happinessShare your happiness Give back to your programGive back to your program Celebrate your hard work Celebrate your hard work

Know when (and how) to take care of yourself!Know when (and how) to take care of yourself!

Enjoy the opportunity to provide care Enjoy the opportunity to provide care Share your happinessShare your happiness Give back to your programGive back to your program Celebrate your hard work Celebrate your hard work

Know when (and how) to take care of yourself!Know when (and how) to take care of yourself!


Faculty developmentFaculty developmentFaculty developmentFaculty development

EMF Teaching Fellowship EMF Teaching Fellowship Navigating the Academic WatersNavigating the Academic Waters Research: design, statistics, grants, etc. Research: design, statistics, grants, etc. LeadershipLeadership Patient satisfactionPatient satisfaction Time managementTime management Physician wellnessPhysician wellness

EMF Teaching Fellowship EMF Teaching Fellowship Navigating the Academic WatersNavigating the Academic Waters Research: design, statistics, grants, etc. Research: design, statistics, grants, etc. LeadershipLeadership Patient satisfactionPatient satisfaction Time managementTime management Physician wellnessPhysician wellness


Avoiding physician burnoutAvoiding physician burnoutAvoiding physician burnoutAvoiding physician burnout

Identify stressorsIdentify stressors Learn to deal with them constructivelyLearn to deal with them constructively Don’t internalize Don’t internalize Don’t rely solely on family for supportDon’t rely solely on family for support Listen to those who have concerns Listen to those who have concerns Seek professional helpSeek professional help Know when ‘enough is enough’Know when ‘enough is enough’

Identify stressorsIdentify stressors Learn to deal with them constructivelyLearn to deal with them constructively Don’t internalize Don’t internalize Don’t rely solely on family for supportDon’t rely solely on family for support Listen to those who have concerns Listen to those who have concerns Seek professional helpSeek professional help Know when ‘enough is enough’Know when ‘enough is enough’


6 C’s of graduation6 C’s of graduation6 C’s of graduation6 C’s of graduation

Confidence Confidence CollaborationCollaboration CollegialityCollegiality CommitteesCommittees CompassionCompassion CommunityCommunity

Confidence Confidence CollaborationCollaboration CollegialityCollegiality CommitteesCommittees CompassionCompassion CommunityCommunity


7 Habits of highly7 Habits of highlysuccessful physicianssuccessful physicians7 Habits of highly7 Habits of highlysuccessful physicianssuccessful physicians

1.1. Recognize your limitations Recognize your limitations

(learn from your mistakes)(learn from your mistakes)

2.2. Don’t speak ill of colleagues/staff Don’t speak ill of colleagues/staff

3.3. Make yourself indispensable Make yourself indispensable

4.4. Lead by example Lead by example

5.5. Project a positive attitude Project a positive attitude

6.6. A good team player is a good listener A good team player is a good listener

7.7. Don’t conserve kindness Don’t conserve kindness

1.1. Recognize your limitations Recognize your limitations

(learn from your mistakes)(learn from your mistakes)

2.2. Don’t speak ill of colleagues/staff Don’t speak ill of colleagues/staff

3.3. Make yourself indispensable Make yourself indispensable

4.4. Lead by example Lead by example

5.5. Project a positive attitude Project a positive attitude

6.6. A good team player is a good listener A good team player is a good listener

7.7. Don’t conserve kindness Don’t conserve kindness

In the long run, outstanding In the long run, outstanding interpersonal skills are desired over interpersonal skills are desired over clinical expertise.clinical expertise.

In the long run, outstanding In the long run, outstanding interpersonal skills are desired over interpersonal skills are desired over clinical expertise.clinical expertise.

Remember, you only haveRemember, you only haveone chance to make aone chance to make afirst impression.first impression.

Remember, you only haveRemember, you only haveone chance to make aone chance to make afirst impression.first impression.

Good Luck!Good Luck!Good Luck!Good Luck!


Author Credit-Career Planning:Gus Garmel MD

QUESTIONS?


Postresidency Tools of the Trade CD

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

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

Career Planning in Emergency Medicine. Society for Academic Emergency Medicine ObjectivesObjectives...

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