Emergency Physician Job Selection and Satisfaction Insights

Job Selection and Satisfaction Among Emergency Physicians Joe Lex, MD Temple University School of Medicine

Job Selection New Grads Need information about job searching contracts negotiation career options financial planning malpractice insurance

Job Selection New Grads Barb Katz, physician recruiter working with Emergency Medicine graduating residents and physicians since 1991, writes The Katz Report for Emergency Physicians Monthly www.thekatzcompanyinc.com

Job Selection New Grads START EARLY! Make a to-do list with a timeline Use your elective time wisely Realize all the other crap you have to do!

The Other Crap. Complete residency Life insurance Administrative rotation Disability insurance Loan Consolidation Licensing House hunting Credentialing Relocating Financial planning Study for boards

Job Selection New Grads Set goals / priorities in job search: Practice Profile Geography / Lifestyle Finances see www.aaemrsa.org/resources/finance/guide.php

Practice Profile Volume: patients-per-hour Acuity: Level 1 tertiary referral or St. Elsewhere-in- the-Boonies Physician coverage: single, double, multiple (and PAs and NPs) Academic vs. non-academic Patient population / demographics

Practice Profile Hospital employee vs. group partner vs. independent contractor vs. faculty member Personal goals: research, teaching, administration, part-time, etc.

Geography / Lifestyle Location Family needs Lifestyle Cost of Living City size / characteristics Keep list as broad as possible

Financial Considerations 2004 Tower Survey of EM Salaries: National average, non-academic: $165,000 180,000 National average, academic: $140,000 160,000

Financial Considerations 2004 Tower Survey of EM Salaries: West and Northwest: $160,000 Northeast and Southeast: $180,000 Midwest: $200,000 Texas: $225,000

Job Selection New Grads Prepare your CV and cover letter Decide on your search strategy Research the Job Market

Do You Need a Recruiter? If you are focusing on a limited geographic area, probably not If you re trying to enter a tight market, YES

Best Open Markets Texas Missouri New York Illinois Pennsylvania North Carolina Florida Virginia California Tennessee

Tightest Markets San Diego Atlanta Alaska Las Vegas Hawaii Utah Delaware Idaho Vermont Montana Seattle Chicago

What ED Directors Want Survey by Barbara Katz 28 ED Directors Academic facilities, large trauma centers, average and small community EDs All areas of country 10 questions

What ED Directors Want What criteria will you use to evaluate graduating resident job candidates? 41%: personal knowledge of and experience with the candidate s residency program 41%: recommendation from a colleague 29%: candid reference from program director

What ED Directors Want What criteria will you use to evaluate graduating resident job candidates? 29%: interpersonal skills 24%: no response at all 24%: enthusiasm for the job 18%: understanding the Big Picture 12%: professional demeanor 7%: long-term goals

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? MEDICAL SCHOOL Most important Very important Somewhat important Not important 0% 6% 6% 18%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? RESIDENCY Most important Very important Somewhat important Not important 30% 41% 29% 0%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? APPEARANCE OF CV Most important Very important Somewhat important Not important 0% 30% 69% 1%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? APPEARANCE OF CANDIDATE Most important Very important Somewhat important Not important 6% 94% 0% 0%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? ARTICULATION Most important Very important Somewhat important Not important 24% 76% 0% 0%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? SENSE OF HUMOR Most important Very important Somewhat important Not important 12% 59% 29% 0%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? TEAM PLAYER Most important Very important Somewhat important Not important 76% 24% 0% 0%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? LEADERSHIP Most important Very important Somewhat important Not important 24% 47% 29% 0%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? ENTHUSIASM Most important Very important Somewhat important Not important 65% 29% 6% 0%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? KNOWLEDGE OF THE AREA Most important Very important Somewhat important Not important 0% 29% 29% 42%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? PROFESSIONAL GOALS Most important Very important Somewhat important Not important 12% 47% 29% 12%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? PERSONAL AND FAMILY GOALS Most important Very important Somewhat important Not important 18% 35% 41% 6%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? TIES TO THE AREA Most important Very important Somewhat important Not important 6% 47% 29% 6%

What ED Directors Want How would you rate the following elements when evaluating a graduating resident job candidate? REFERENCES Most important Very important Somewhat important Not important 71% 24% 5% 0%

What ED Directors Want What is the SINGLE most important factor in choosing a graduating resident job candidate? Ability to get along with and work well with others: 44% Professional demeanor and work ethic: 24%

What ED Directors Want What is the SINGLE most important factor in choosing a graduating resident job candidate? Genuine enthusiasm for job: 24% Reliability and flexibility: 12% Ability to move patients: 12% Character and values: 12%

What ED Directors Want What pet peeves do you have about graduating resident candidates? Inflated sense of entitlement, over-confidence: 24% Lack of aggressiveness: 12% Poor communication skills: 12%

What ED Directors Want What pet peeves do you have about graduating resident candidates? Early questions about income and schedules: 12% Protracted negotiations: 12% Overwhelming list of questions: 6%

What ED Directors Want What are your major complaints about graduating resident CVs? None: 53% Too much information: 24% Fancy format, no substance: 12% Important data hard-to-find or missing: 12%

What ED Directors Want What do you look for in a graduating resident candidate during social interview situations? Social skills, poise, responsiveness to others: 47% Warmth, friendliness, outgoing personality: 35% Interests outside of EM 29%

What ED Directors Want How do you make hiring decisions? Department consensus: 35% Input from everyone, director makes final decision: 25% Director alone: 18% Group partnership vote: 6% Search committee: 6%

What ED Directors Want What can residency programs do to make graduates more marketable? Teach about documentation, billing, coding: 24% Teach communication / compassion: 24% Teach interspecialty team work: 12%

What ED Directors Want What can residency programs do to make graduates more marketable? Administrative rotation: 12% Teach efficient patient management (speed): 12% Let seniors moonlight: 12% Make all residency programs 4 years: 12%

What ED Directors Want On average, how long do graduating residents stay on the job? Why do you think they leave? Average retention 2.5 years: 53% Relocation: 36% Unhappiness of spouse: 36% More money: 18% Can t handle the job: 10%

One Directors Perspective Success Attribute I am joining a noble specialty of honorable men Respect and honor the founders of the specialty New Grad Reality Those who have come before are out to screw me Denigrate the founders, emphasize their flaws

One Directors Perspective Success Attribute Strength in professional unity New Grad Reality False pride / sense of superiority in being a contrarian Screw the non- residency trained interlopers All for one, one for all in the specialty

One Directors Perspective Success Attribute Compensation in proportion to contribution Talented leadership / administration the differentiator New Grad Reality Equal compensation just because I deserve it Group leadership and administration are parasitic

One Directors Perspective Success Attribute Humility - I still have things to learn from experience New Grad Reality These incompetent jerks could learn a thing or two from me Begrudge those who have come before their due Gratitude for opportunity and mentoring

One Directors Perspective Success Attribute Earn your position in the group practice The means is more important than the end New Grad Reality Demand / steal your position at all costs The end justifies the means

Job Satisfaction 70% of graduating residents will leave their first job within 2 years!

Why Do New Grads Leave? No formal research on why so many new grads change jobs within 2 years Recruiters individual track records are best source of info available.

Why Do New Grads Leave? Lack of clear-cut career / personal goals during / initial job search Change in priorities Initial priorities: Location / lifestyle: 73% Financial considerations: 15% Practice Profile: 12%