Mapping Out Your Career Strategy

You have sacrificed and worked hard to complete medical school and begin your residency training. If you already have a clear picture of what you envision for yourself and what your career ahead will look like, that’s fantastic! If you are still undecided about what practice setting is best for you or unsure about whether to pursue fellowship, then you should take some time to prepare and map out your career strategy.

“The Three R’s” are meant to help you think about yourself and job possibilities, and help you lay the groundwork for your career.

The Three R’s include: reflection, research, and relationships.

Reflection

The first important step as you plan your career is self-reflection. By answering some key questions about yourself and your personal priorities, your decision to move toward fellowship or a specific job may become much easier.

• What motivates you? As you attend courses and participate in different rotations, are there topics or certain types of patients that really grab your attention and interest? These feelings of engagement or excitement should tip you off to areas of your training that you may want to pursue further.
• What are your geographic needs/preferences? For some coming out of training, their job search is the first time when they can choose where they want to live and work? (You are not reliant on a match or interview to determine where you will be headed the following summer). If there is a place you've always wanted to live, this may be the time to head to Hawaii or New Orleans. On the other hand, you may already have roots in Jersey or Nebraska or another place where your spouse or your family lives. The geographic location may drive your decision on where to search for a job.
• How big a role do financial considerations play in your decision?Depending on how burdensome your student loans are or how eager you are to start making lots of money, you may want to limit your search to certain areas of the country. For example, Federal Student Loan Repayment is only offered in certain cities or regions where there is an identified community need. You may want to consider venturing to one of these places to help pay back your loans. Also, certain areas of the country tend to pay more than others – think geographic regions where there aren't a lot of medical schools or doctors nearby and they must "import" all their physicians. In these types of areas, you may be paid more than in populated metro areas (despite the difference in cost of living).
• What type of patients do you want to treat? Some physicians love the complex challenges that oncology cases offer, others really enjoy delivering babies. Caring for nursing home patients or patients in underserved cities may be most rewarding for you. Be sure to think about what type of patients you enjoy caring for and then try to tailor your search around these preferences, too.

in addition to the introspective questions and analysis, you also want to consider what will make your marketable to a fellowship program or prospective employer.

• Think about your unique skill set. Do you speak other languages, or have you had interesting experiences, like participating in a medical mission trip? Think about your personal strengths and how you can differentiate yourself from your peers.
• Consider participation in hospital committees. Volunteering on committees will be especially helpful if you plan to teach or become an administrator. Ask your Program Director if there are opportunities for you to participate that don't conflict with your schedule.
• Work on research projects/presentations. Research and presentations will be important when applying to fellowships so that you can demonstrate your strong interest and knowledge about a specific clinical area. See whether you can participate/present at your local or regional society meeting. Ask your Chief Resident and Program Director for more guidance on publishing.
• Take your Boards! Be sure to schedule, study hard, and pass your Boards. This is often a requirement for employment, not to mention a crucial condition for insurance companies too. Make sure you can be paid for all the work you are putting into your career!

Research

The next step toward building a strong career strategy is research.

Learn About Various Career Settings

The job marketplace for physicians is changing and especially with the advent of the Affordable Care Act, there still may be many changes to come! Here are some common options for employment:

• Private practice – solo, group, partnership, etc.
• Hospital-based – Employed by the health system as a faculty member or clinician. One example would be our Medical Group (these physicians are employed or aligned with the health system, but often work in a private practice-like setting)
• Dedicated Inpatient physicians – i.e., hospitalists, laborists, surgicalists, etc.
• Faculty/teaching positions
• Clinical research
• Innovation – i.e., inventing medical devices
• Managed care

Universities vs. Community Setting

There are differences between working at a university setting as compared to a community setting. For example, there may be a requirement on the number of research papers that you must complete each year within an academic setting. There are also "hybrid" type institutions like the teaching institutions at Barnabas Health (Jersey City Medical Center, Newark Beth Israel Medical Center, Monmouth Medical Center, and Cooperman Barnabas Medical Center) that have an academic environment with a community hospital setting.

Trends for Different Specialties

It is also important to look at marketplace trends for your specialty. For example, Primary Care Physicians have joined hospital / health systems rapidly since approval of the Affordable Care Act. However, some specialties like Dermatology or Plastic Surgery still remain private. It is helpful to understand the dynamics at play within your specialty.

Relationships

Don't underestimate the information you can gather about job opportunities and the market from networking. Here is a short list of individuals that would be ideal to speak with or ask for mentorship:

• Faculty
• Attending physicians
• Residency alumni groups
• Professional organizations

Building strong relationships with other physicians can help you in developing your own career path, and can also help you identify advocates for fellowship or references. Be brave and ask for even 15 minutes of time from a physician you admire or whose career path you identify with and ask them if they have advice for you. You will be amazed how much information they will share!