If you are in the last year of your residency, you have every reason to celebrate. After years of studying, learning and making a modest income, it is finally time to improve your career significantly in terms of pay, benefits and specialization. You have worked hard to get here, and it is important to not lose sight of your career path and your goals. Stay the course and avoid common mistakes made by residents during and after their final year.
Even if you unsure as to whether you want to pursue a fellowship, apply early and ask questions. If you wait until the last year of your residency to apply for a fellowship, it may be too late. Try to apply as early as two years before your residency will come to a close and no later than 1.5 years before it ends. When you do apply in a timely fashion and are accepted for your fellowship, you may receive little information as to your expectations. Most residents are only fully informed about their pay. However, this is not enough information for you to know how many research projects you should complete or when and how much you will be on call. Have a list of questions prepared and use a bit of finesse to get them answered early on. If you have done your homework and have established expectations with the leaders of your program and then there is a change in leadership, be sure to have the conversation all over again to discover any new rules or expectations and reassess your options.
After your fellowship, don't jump into the first job offer right off the bat. Although it is tempting to get started immediately because you are excited to be finished with your residency and the money looks good, think carefully instead and ask probative questions. Make sure this is what you want. Also, take time to talk to your recruiter, if you have one. It won't cost you anything, and they may be able to help you compare options. If you already have contracts in hand to consider, you may want to take the next step and engage an attorney to help you negotiate and/or understand what you are about to sign. Apart from legal and professional considerations, think long and hard about how you want to shape your personal life. What is important to you? Likely, you will be signing a contract with a length of a year or more. One, two or three years is a long time to be stuck in an environment you don't like while missing out on precious time with your family and friends. Pay extra attention to what the local community is saying about your potential employer and closely scrutinize the schedule expectations and additional commitments that may be hidden in your contract. If you are going to be a partner, spend time with your future partners. Make sure you can trust them and that they are forthright and honest with you. Have people you trust meet them. Have frank conversations and make sure your goals, integrity and ethics are aligned.
Finally, after you have a stake in a practice that you've formed or entered into after much evaluation, you should be ready to run it and run it well. It is up to you to develop long-term strategies that will benefit you, your partners, your employees and the patients. It is important to run an efficient practice from a business standpoint while still allowing those who work there to maintain a certain quality of life. New physicians will be evaluating you as you interview them. Be ready to go beyond a simple salary explanation. Residents will likely evaluate practice opportunities with questions regarding incorporation, ownership shares, buy-in, benefits, malpractice insurance, daily census, technology, billing, marketing and profitability. Have these issues worked out ahead of time so that you make the cut and attract the best physician employees.
