Finding a Job After Internal Medicine Residency

"You can't always get what you want ... but if you try sometimes, ... you get what you need."
-- The Rolling Stones

Finding a job is not an easy job.

Decide What You Want

First, you have to decide what you want - hospitalist or primary care, or both. Check these articles: How to Find the Job That's Right for You 12/00 and You Can't Always Get What You Want ... But Sometimes You Can 12/99 - Family Practice Management.

Where - Which States?

Focus on 2-3 states. Check what the licensing requirements for those states are. Remember that if you are an IMG, some states do not give you a state license until you have done three years of residency, which pretty much rules out finding a job there immediately after residency. Examples of states with a 3-year requirement are Texas, Pennsylvania, North and South Carolina. Check the state requirements on Physician Licensing.com.

Get a state license. What are the requirements?

Get at least 2-3 state licenses. For Ohio, start your FCVS application immediately after you start your second year of residency. It is very helpful to ask for advice from your colleagues who already got their license for a certain state. "Knowing how" to apply can shorten the time for getting a license from 6 months to 2 months. Some states, like Florida or California have elaborate requirements, including fingerprinting, etc. and you have to send multiple documents. In this case, it is very helpful to keep a log of what papers you send to who and when. Be proactive if you want to get your license in time. Do not just sit and wait for your license to come in the mail. Ask the state board representatives and your colleagues what is the typical waiting time for each step of the application process, and if it takes longer, just call the board, and ask what the reason for the delay is.

Once you have all your papers in order, it is time to focus on finding a job.

Finding a job

Finding a job is directly related to your activity level. The more active you are, the more offers you get.

Visa issues

If you are an IMG, first check if you prospective employer is willing to sponsor an H-1B visa. If they have never heard of H-1B visa, the chances are that after they learn more about it, there will not be willing to sponsor it. There are a lot of attractive job offers but they are not for H-B applicants, so please check in advance to save them and yourself a lot of time.

Immigration law changes quickly. Check for updates like visa quotas, etc. regularly.
News - Updates on U.S. Immigration Law - Law Office of Sheela Murthy

Prepare your resume and cover letter

Do several drafts and ask your friends and mentors to check it. Ask to see your colleagues CVs if it is OK with them. Prepare an online CV on Blogger.com and include the link in your email so that it will be only a click away. Making a website CV is very convenient because the employer/recruiter does not need to download attachments, they just click on the link.

How to look for a job

There are multiple channels here:
- Networking - friends and contacts
- Advertisements
- Mass mailing or calling

Networking

The best way is to call doctors you know. If you have not been in touch with former graduates, mentors, etc., you can find their current location by looking on dr-411.com (physician search website).

Very often though, the offers you get from your friends or acquaintances are not exactly what you want.

Advertisements

There are two situations:
1. You know that they are looking for a physician because they have posted an advertisement. This is easy. You see the ad in JAMA and you fax them your resume. Advantages: you target an employer who is looking to hire a doctor. Disadvantages: chances are that hundreds of applicants have done the same and there are piles of CV on this overworked physician's desk.

2. You use mass mailing to send your resume and cover letter to all practices in a particular geographic area. Advantages: A lot of jobs are never advertised. A practice can be looking for a physician out there, and you may never know it they do not place an ad in JAMA or NEJM. Also, fewer people know about the job, fewer people apply and your chances are bigger. Even if the person you sent your resume to does not have a job to offer, they may know somebody who has. Disadvantages: This is a "cold call" and resembles spamming. It looks like those credit card offers you get in the mail - they offer you something that you do not need.

Print Advertisements

Focus on NEJM, JAMA, and Annals of Internal Medicine. Check them every week and mail or fax your resume. Contrary to the popular belief, most of the ads a real, and I do know a lot of people who found job that way.

Online Advertisements

Check the online career sections of NEJM, JAMA and ACP Online. Post your resume.

Online Companies

This is less effective than printed ads because you will get a lot of far-fetched offers, for example, you are looking for a job in California, but the recruiters are offering a job in Minnesota.

You have to create an online profile and provide an email and a phone number for contact information.

Open a separate email account just for job offers an list it on all your resumes, cover letters and online postings. Get a cell phone and record a friendly voice mail message. You definitely will not be able to answer all the recruiter calls because they start calling from 7 AM until 11:30 PM.

Online MD jobs companies: Physician Work.com and Practice Link.com.

Mass Mailing

85% of all physician jobs are not advertised because the employers do not want to pay recruiters. In an act of desperation, if nothing else works, you can resort to mass mailing.

There is a company called The Doctor Job.com that can do the job for you. It is expensive though. The cost is $2 per letter for up to 1,000 letters, and $ 1 per letter for over 1,000 letters. The total goes up to $ 1600 for 1000 letters because they want to revise and "extensively rewrite" your CV and cover letter ($ 600). The company prints and mails the letters.

Of course, many of the CV end up in the trash bin and the expected result is 4-24 interviews from 1000 letters (note: interviews not job offers). The success rate is 90%.

Come to think about it, you can probably do the same job yourself without the hefty price tag. Use the old fashioned yellow pages or Google Local and start calling.

Calling practices and Mass Mailing - to whom?

Mass mailing is not cheap - expect to spend anywhere between $ 100 to $ 500. Buy envelopes in bulk, and get printing labels from Staples to print your own return labels.

Send letters with your CV and cover letter to targeted hospitals/practices in a particular area. Use Google Local or the US News & World Report website (for hospitals only). You can check which hospitals are not-for-profit.
- Call hospitals and practices
- Check local county medical societies listings/websites. Call them and fax your CV to be posted on their news boards.
- Try to reach the employers by using PhysicanWork.com as described above
- Check ads in JAMA, ACP, Annals, and NEJM - both printed and online

Google Local

This is very useful for mass mailing. You can get all the doctors addresses and phone numbers in a particular geographic area. It functions like virtual yellow pages and more. If you decide to call, get a long distance calling card. Do not use your current employer phone because this may get you fired before you land your next job.

Find the Hospital

US News & World Report
Hospital human resources specialists sometimes are asked by local physician groups to help with recruitment and they can give your resume to physicians who are interested.

Medical Societies

Similar to the hospitals - your resume will be posted and the interested physicians will call you.

Once you get the offer

You need to research where you going - use Wikipedia.

Prepare for the interviews. The Wall Street Journal has a very useful interview advice section. Think of both what they want and what you want. You have to offer them what they want to see in candidate in order to get the job. Since most of the time you do not know what exactly is that they are looking for, ask them “"Can you describe the ideal candidate for this position?". Then you can tailor your responses to portrait yourself as this person. Be careful though. Never, ever lie. People will sense it and even if you get the job, if you are not a good fit, you will regret it. Be yourself - this is the best advice anybody can give you.

Employers rarely are looking for a genius. They want to hire somebody who is optimistic, energetic and can work with people. In short, somebody who is a "good fit" for their practice.

CNN gives some tips on Answering 6 common interview questions.

Talk to your referrals and ask for a good letter of recommendation. Tell them briefly about the job, so that they can tailor the letter to the offer. Check the BMJ Career Focus article with Tips on getting a good reference - 03/05.

Further reading

ACP: Timeline for how to apply for a job after IM residency but good stuff for any resident - start one year prior http://bit.ly/bjRVI
Becoming a Rural Doctor, Part 6: Job-Seeking & Job Choice. Rural Doctoring, 08/2008.
Simply Hired.com - a Google-like engine searching 3,642,979 jobs
Job Search and Licensing
State Licensure and more - Paperwork is coming - SVCH.blogspot
General interviewing tips - Plaxoed.com
Interviews when looking for a job in medicine - BMJ Careers 8/05
The Ugly Truth about Credentialing & Privileging - Part II - MSSP Nexus Blog
Answering 6 common interview questions - CNN 12/05
Reality Check (Ruthlessly Candid). A resident looking for a job is sharing his experience. InternalMedicineDoctor.blogspot.com
Your Job Search Expenses May Be Tax-Deductible. MyMoneyBlog.com.
Hunting Season. Dr. Wes, 08/2007.
Searching for a dream job and online resume sites. Go2Web2.0, 12/2007.
LinkedIn Tips and Tweaks: Do More with your LinkedIn Account. Digital Inspiration, 05/2008.
Top 10 interview mistakes. CNN, 05/20008.

Audio/Video

Business of Medicine, Noon Conference. Podcasting Project for the UT Internal Medicine Residency Program, 11/2007.
IMG Orientation, Noon Conference. Podcasting Project for the UT Internal Medicine Residency Program, 2006.

"You can't always get what you want ... but if you try sometimes, ... you get what you need."
-- The Rolling Stones (listen, from Walmart.com)

The Rolling Stones - You Can't Always Get What You Want - Live 1990 - YouTube http://bit.ly/10w0scB

Published: 06/11/2005
Updated: 09/25/2009

Job Search and Licensing

"You can't always get what you want ... but if you try sometimes, ... you get what you need."
-- The Rolling Stones

It's difficult to find a good job but not impossible. It feels like it was yesterday when we were looking to find a residency spot and now we have to hit the road again.

This is a concise guide outlining the main stops in your quest to get a license and a job.

FCVS

FCVS - start here, it takes a long time (3-6 months) but simplifies the procedure when applying for a state license because most boards accept it. You have to be done with your PGY-2 year in order to apply. You have to fill out the online application and pay the fee with your credit card ($ 400).

You will need a FedEx account because FCVS uses FedEx to send the verification papers to your medical school.

Which State Board?

Next check the requirements of the different state boards. Beware the boards that require that you must have completed your PGY-3 before you can apply for a license since it eliminates most IMGs. All boards have downloadable application forms - click here for the Ohio application.

Verify What They Know About You

You can check if your ECFMG information is correct and up-to-date by visiting their online information service named OASIS. You can also check your Ohio license information on their website. Verify your date of birth, year of graduation, etc.

Request Different Forms

Most state boards require an AMA ePhysician profile which is free for AMA members and it takes 2 weeks to receive.

Some state boards require a self query from the National Practitioners Data Bank - NPDB-HIPDB. This is another rate limiting process which takes 2-3 weeks and involves several steps. First you fill out an online self query, then you get the paper form in the mail. You have to take it to Linda for notarization and to mail it back to NPDB-HIPDB. Then finally they send you the final report. The whole thing will cost you $ 16.

If your board requires fingerprinting this is another thing to do early since the FBI check takes 3-4 weeks. Fingerprinting is done at your local police office, just ask them about the hours of service.

Career Advice Centers:

NEJM Career Center - advice articles and online ads, you can also post your CV for prospective employers to see
JAMA CareerNet - a new website with ads, similar to the NEJM site plus info on location, licensure and personal finance
ACP Online
How to Find the Job That's Right for You - Family Practice Management 12/2000
You Can't Always Get What You Want ... But Sometimes You Can - FPM 12/1999

In addition to FedEx and UPS, USPS Global Mail is a good and cheap way to send mail internationally.

Dr. Feterik wrote an excellent article -'State Licensure and more: Paperwork is coming' for the April 2004 issue of 'Survivors in Scrubs'.

Travel Advice by Kayak.com

This is a Google-like search engine for low price plane tickets, hotels and rental cars. Its ease of use is truly comparable to Google.

Immigration Advice - H1-B Visa Questions

News - Updates on U.S. Immigration Law from the Law Office of Sheela Murthy
H1B Cap FAQs

This website is really good and very up-to-date. You can subscribe to their free weekly newsletter and you'll be getting the latest immigration news delivered to your email every Friday.

Another useful website is Immigration.com and its forum Immigration portal.com. They have a special section for physicians.

Also, check the The ABC’s of Immigration: The H-1B Visa from VisaLaw.com and Are You Moving? advice articles.

Personal Experience

Dr. Chen shares his experience with the credentialing process:

"Last year the third years kept warning me about something. The interview process forfinding a position is really pretty easy. Obtaining a license from the state where you are planning to work, is difficult and may take some time, but it is still very doable.But...The Credentialing process for Medicaid, Medicare, healthcare plans, and hospital privileges are the ones that will kill you.

Remember my last email to you about the insurance letter. This is when they need a copy ofthat. Heck, I was very very unfortunate to be a practicing pharmacist before going into medicine. They want to see proof of malpractice coverage during those times I worked, soI'm really digging into my closet, pantries, shelves, and even the trash (y'all haven'tseen my apartment yet) to find papers that I thought weren't that important until now...

I just wanted to warn you to save and make several copies of proof of malpractice insurances, diplomas, official documents such as social security, DEA licenses, clinical certifications such as your BLS, ACLS stuff, and anything else you can think of, and copies of your licenses, official forms of ID, and Immunization records. I was amazed. I even jokingly asked if they want to see my kindergarten graduation diploma, andthe girl said sure, and I'm not so sure if she was serious...

I hope y'all have a good day!"

Eddie Chen, DO

Further reading

Finding a Job After the Internal Medicine Residency
Becoming a Rural Doctor, Part 6: Job-Seeking & Job Choice. Rural Doctoring, 08/2008.
Reality Check (Ruthlessly Candid). A resident looking for a job is sharing his experience. InternalMedicineDoctor.blogspot.com
Your Job Search Expenses May Be Tax-Deductible. MyMoneyBlog.com.
Hunting Season. Dr. Wes, 08/2007.
Searching for a dream job and online resume sites. Go2Web2.0, 12/2007.

The Rolling Stones - You Can't Always Get What You Want - Live 1990 - YouTube http://bit.ly/10w0scB

Updated: 08/25/2008