1. Crossing the Finish LineCrossing the Finish Line
What to expect andWhat to expect and
How to prepare for the job searchHow to prepare for the job search
Mila Felder, MDMila Felder, MD
Credits to multiple ACEP, SAEM presentations and multipleCredits to multiple ACEP, SAEM presentations and multiple
Christ faculty membersChrist faculty members

2. Faculty DisclosureFaculty Disclosure
I do not have any relevant financialI do not have any relevant financial
relationship(s) with any commercialrelationship(s) with any commercial
interest(s).interest(s).

3. Goals and ObjectivesGoals and Objectives
After this lecture, the resident should be able to:After this lecture, the resident should be able to:
• DiscussDiscuss
– The timeline and necessary licensure/The timeline and necessary licensure/
credentials/ costs involved (handout)credentials/ costs involved (handout)
– Initial steps in the job searchInitial steps in the job search
– CV overviewCV overview
– Evaluating opportunities (and options)Evaluating opportunities (and options)
• Preview : FinancialPreview : Financial
• Attending tips for the first years out ofAttending tips for the first years out of
trainingtraining

4. What We Are Not Going to TalkWhat We Are Not Going to Talk
About TodayAbout Today
– Interviewing wellInterviewing well
– Living through your first litigationLiving through your first litigation
– Extensive Financial planningExtensive Financial planning
– Initiating a successful business practiceInitiating a successful business practice
– WellnessWellness
– Careers in Academic EMCareers in Academic EM

8. What do I do Now?What do I do Now?
• Obtain extra copies of medical school diplomasObtain extra copies of medical school diplomas
– 1-2 weeks : YESTERDAY… YOU MEAN YOU1-2 weeks : YESTERDAY… YOU MEAN YOU
HAVEN‘T?HAVEN‘T?
• Print out and fill out USMLE III application (orPrint out and fill out USMLE III application (or
online)—combined with IL License application inonline)—combined with IL License application in
some states, including IL:some states, including IL:
– 4-6 weeks to register/ schedule and 4-6 weeks for4-6 weeks to register/ schedule and 4-6 weeks for
results. Do not stress about the test.results. Do not stress about the test.

9. And Later?And Later?
• License processing fee to Springfield: 8 weeks andLicense processing fee to Springfield: 8 weeks and
$700.00.$700.00.
– Locums will pay for states they send you toLocums will pay for states they send you to
• State Physician-controlled Substance License $5.00State Physician-controlled Substance License $5.00
and up to 8 weeksand up to 8 weeks
• DEA application 6 weeks and $751.00DEA application 6 weeks and $751.00
• Apply for NPI number (on line, a few minutes, free)Apply for NPI number (on line, a few minutes, free)
• Talk to your potential references, ask to prepareTalk to your potential references, ask to prepare
letters in advanceletters in advance

10. Send in a Picture you Identify withSend in a Picture you Identify with

11. • Seniors: when your ABEM paperworkSeniors: when your ABEM paperwork
arrives in April-May, send it in ASAParrives in April-May, send it in ASAP
– Registration for Boards $355.00 (Apr-Jun30)Registration for Boards $355.00 (Apr-Jun30)
– Written exam registr. $960.00 (June-Oct.)Written exam registr. $960.00 (June-Oct.)
– Nov 11-17 Qualifying (written)examNov 11-17 Qualifying (written)exam
– Oral Board Exam May $1225.00Oral Board Exam May $1225.00
• Staff privileges application $100.00 andStaff privileges application $100.00 and
up; save IL State Healthcare Providerup; save IL State Healthcare Provider
Application DataApplication Data

12. Totals?Totals?
• $4000-5000, without the travel expenses$4000-5000, without the travel expenses
• 4-7 months, depending on the state4-7 months, depending on the state
applied forapplied for

13. I have a license, but no job.I have a license, but no job.
Now what?Now what?
• Prepare CV and customize itPrepare CV and customize it
• Find 1-2 geographically desirableFind 1-2 geographically desirable
recruitment firmsrecruitment firms
• Window shop (and follow-up)Window shop (and follow-up)
• Learn the market (network)Learn the market (network)
• Go on “practice interviews”Go on “practice interviews”
• Think of what you are bringing to practiceThink of what you are bringing to practice

15. Where do I Start?Where do I Start?
• Write out your dream:Write out your dream:
– cases, type of practice, lifestyle, group size,cases, type of practice, lifestyle, group size,
patients per day, on call?patients per day, on call?
• Ideally, where do you want to be?Ideally, where do you want to be?
– Geography/ weather/ family/ social goalsGeography/ weather/ family/ social goals
• Community with greater need (problems)Community with greater need (problems)
with offer more money.with offer more money.
– If that’s what you want, prepare to sacrificeIf that’s what you want, prepare to sacrifice

17. What if I don’t love it?What if I don’t love it?
• Remember ACEP, EMRA, SAEM, recentRemember ACEP, EMRA, SAEM, recent
graduates and networkinggraduates and networking
• First job (or any job) does not have to beFirst job (or any job) does not have to be
foreverforever
– 43% of physicians that start a job are no43% of physicians that start a job are no
longer there after 2 years.longer there after 2 years.
– This may be a learning experience and isThis may be a learning experience and is
good as thatgood as that

18. Mechanics of a Job SearchMechanics of a Job Search
• What are my goals?What are my goals?
• How do I want to be compensated?How do I want to be compensated?
• Do I want ownership?Do I want ownership?
• Where will I be happy (geography)?Where will I be happy (geography)?

19. FORCEFORCE
• FFamily satisfaction with location/ lifestyleamily satisfaction with location/ lifestyle
• OOpportunity to become a partner and earnpportunity to become a partner and earn
compensation based on individual effortcompensation based on individual effort
• RReasonable working conditionseasonable working conditions
• CCamaraderie with co-workersamaraderie with co-workers
• EEquity from day one with shift assignment andquity from day one with shift assignment and
incentivesincentives

20. Goals for the DayGoals for the Day
• Mechanics of a job searchMechanics of a job search
• Preparing a CVPreparing a CV
• Identifying your goalsIdentifying your goals
• Evaluating a potential offerEvaluating a potential offer

21. Mechanics of a Job SearchMechanics of a Job Search
• Most residents use one of the following:Most residents use one of the following:
– Residency search (who do I know here?)Residency search (who do I know here?)
– Hometown search (who do I want near me?)Hometown search (who do I want near me?)
– ““Guess where I’ll live”Guess where I’ll live”

22. Mechanics of a Job SearchMechanics of a Job Search
• 74% of all residents rate location as #174% of all residents rate location as #1
prioritypriority
• 14% compensation14% compensation
• 11% type of group11% type of group

24. Mechanics of a Job SearchMechanics of a Job Search
• Over 50% change jobs after first yearOver 50% change jobs after first year
• Most of these moves are PHYSICIAN’sMost of these moves are PHYSICIAN’s
CHOICECHOICE

25. Geography of a SearchGeography of a Search
• CollegeCollege
• Medical SchoolMedical School
• ResidencyResidency
• NOW, YOU CHOOSENOW, YOU CHOOSE

26. Mechanics of a Job SearchMechanics of a Job Search
It’s NOT a job search…It’s NOT a job search…
It’s the beginning of yourIt’s the beginning of your
CAREER!CAREER!

27. Mechanics of a Career SearchMechanics of a Career Search
How do other professionals evaluateHow do other professionals evaluate
opportunities?opportunities?
• National recruiting and staffing firmsNational recruiting and staffing firms
• Many different methods, depending on aMany different methods, depending on a
level of an employeelevel of an employee
• Choose a consistent process to increaseChoose a consistent process to increase
chance of successchance of success

28. ScorecardScorecard
• IndustryIndustry
• CompanyCompany
• Claim to fameClaim to fame
• Job descriptionJob description
• TrainingTraining
• Typical dayTypical day
• CompensationCompensation
• Growth opportunityGrowth opportunity

29. IndustryIndustry
• AT&T Wireless:AT&T Wireless:
– $400 billion annually, quadrupled since ’98$400 billion annually, quadrupled since ’98
– Projected ONE OF THE FASTEST growthProjected ONE OF THE FASTEST growth
industries over 10 yearsindustries over 10 years
– Profitable, stable, very fast growingProfitable, stable, very fast growing
– Dominated by a few providersDominated by a few providers
– Dynamic present growth is predicted toDynamic present growth is predicted to
continue for at least 2 decadescontinue for at least 2 decades

30. CompanyCompany
• AT&T $150 billion market valueAT&T $150 billion market value
• Merger with Cingular added up to $85 billionMerger with Cingular added up to $85 billion
• New market leader with 29% share (Verizon 24, SprintNew market leader with 29% share (Verizon 24, Sprint
10, T Mobile 9, Nextel 8)10, T Mobile 9, Nextel 8)
• Up from $5 billion in ’98Up from $5 billion in ’98
• 3 main sales channels: stores, business to business3 main sales channels: stores, business to business
sales, national/ government salessales, national/ government sales
• Proactive competitive corporate cultureProactive competitive corporate culture

32. Claim to fameClaim to fame
• Ranked #1 by JDPower for 5 conseqRanked #1 by JDPower for 5 conseq
yearsyears
• Outstanding brand name awarenessOutstanding brand name awareness
• Excellent quality cell phonesExcellent quality cell phones
• Excellent call coverage (doubled withExcellent call coverage (doubled with
Cingular)Cingular)
• Competitive pricing, one stop shoppingCompetitive pricing, one stop shopping
• Global organization, variety of servicesGlobal organization, variety of services

33. Opportunity ScorecardOpportunity Scorecard
• IndustryIndustry
• CompanyCompany
• Claim to fameClaim to fame
• Job DescriptionJob Description
• TrainingTraining
• Typical dayTypical day
• CompensationCompensation
• Growth opportunityGrowth opportunity

34. Scorecard:Scorecard:
Location not a variableLocation not a variable
• Sacrifice salary if location is moreSacrifice salary if location is more
importantimportant
• Location is the primary concern for lowerLocation is the primary concern for lower
level occupationslevel occupations
• Midlevel occupations use location as tieMidlevel occupations use location as tie
breakerbreaker
• executive rarely consider itexecutive rarely consider it

35. Emergency Medicine OpportunityEmergency Medicine Opportunity
ScorecardScorecard
• Industry: Emergency MedicineIndustry: Emergency Medicine
• Company—history, structure, track recordCompany—history, structure, track record
• Growth opportunity—directorship,Growth opportunity—directorship,
leadershipleadership
• Training—orientation, mentorshipTraining—orientation, mentorship

36. Emergency Medicine OpportunityEmergency Medicine Opportunity
Scorecard (continued)Scorecard (continued)
• Compensation—salary, benefits,Compensation—salary, benefits,
retirement, equityretirement, equity
• Typical Day-Shifts, scheduling, acuityTypical Day-Shifts, scheduling, acuity
• Job description—position availableJob description—position available
• Location—just one variable, not a keyLocation—just one variable, not a key
issueissue

37. Scorecard, continuedScorecard, continued
• Industry-Emergency MedicineIndustry-Emergency Medicine
• Typical day: shift work (how long? Acuity?)Typical day: shift work (how long? Acuity?)
• Job description—take care of sick or notJob description—take care of sick or not
so sick, academic vs community practiceso sick, academic vs community practice

38. Mechanics of a Career SearchMechanics of a Career Search
CompanyCompany
• Hospital EmployeeHospital Employee
• AcademicsAcademics
• Single hospital groupSingle hospital group
• Multi-hospital groupMulti-hospital group
• Equity vs. No equityEquity vs. No equity

39. Site Specific IssuesSite Specific Issues
• Ask to talk to other physiciansAsk to talk to other physicians
• Talk to the last partnerTalk to the last partner
• Talk to last non-partnerTalk to last non-partner
• Talk to people who have left the companyTalk to people who have left the company
• What is a partner?What is a partner?

41. Growth OpportunityGrowth Opportunity
• How long can you do clinical medicine?How long can you do clinical medicine?
• Leadership opportunities?Leadership opportunities?
• Is the company growing?Is the company growing?
• Track others and ask for examples ofTrack others and ask for examples of
leadership advancementleadership advancement

42. Training: this is not my last job,Training: this is not my last job,
what can I learn here?what can I learn here?
• OrientationOrientation
• Ongoing clinical educationOngoing clinical education
• Coding/documentation feedbackCoding/documentation feedback
• Mentors—Clinical? Administrative?Mentors—Clinical? Administrative?
Academic?Academic?

43. Mechanics of a Career searchMechanics of a Career search
Claim to FameClaim to Fame
• Leader in the area (best residency? BestLeader in the area (best residency? Best
income? Most fair?)income? Most fair?)
• Company reputation (history behind theCompany reputation (history behind the
name)name)
• Any awards or recognitionAny awards or recognition
• Unmatched employee satisfaction?Unmatched employee satisfaction?
Retention?Retention?

44. Mechanics of a Career SearchMechanics of a Career Search
• Don’t fall for the upfront dollarsDon’t fall for the upfront dollars
• Look at 10 years projections for yourselfLook at 10 years projections for yourself
and the companyand the company
• Compare apples to applesCompare apples to apples

45. LocationLocation
• Pick a region of the countryPick a region of the country
• Be flexible within the regionBe flexible within the region
• Be willing to relocate for an opportunityBe willing to relocate for an opportunity

46. How important is it?How important is it?
• 17 shifts/ month17 shifts/ month
• 13-14 days off13-14 days off
• 60-120 min from prime locations60-120 min from prime locations

47. LocationLocation
• Spouse’s opinionSpouse’s opinion
• Spouse’s jobSpouse’s job
• Social settingSocial setting
• Children’s educationChildren’s education
LOCATION SHOULD BE A TIELOCATION SHOULD BE A TIE
BREAKER!!!BREAKER!!!

48. Emergency Medicine ScorecardEmergency Medicine Scorecard
• Industry: Emergency MedicineIndustry: Emergency Medicine
• Company—history, structure, track recordCompany—history, structure, track record
• Growth opportunity—directorship, leadershipGrowth opportunity—directorship, leadership
• Training—orientation, mentorshipTraining—orientation, mentorship
• compensation—salary, benefits, retirement,compensation—salary, benefits, retirement,
equityequity
• Claim to fame—proud to wear logoClaim to fame—proud to wear logo
• Job description—position availableJob description—position available
• Location—just one variable, not a key issueLocation—just one variable, not a key issue

49. The DealThe Deal
• Basics – CompensationBasics – Compensation
• Production basedProduction based
• Salary plus productionSalary plus production
• Salary plus bonusSalary plus bonus
• BenefitsBenefits
• Malpractice coverage – claims made,Malpractice coverage – claims made,
occurrence and tail coverageoccurrence and tail coverage

50. Give it timeGive it time
• Look at resources: ACEP, EMRA, AAEMLook at resources: ACEP, EMRA, AAEM
• Like in marriage, both need to adjustLike in marriage, both need to adjust
• Discuss with your mentor(s) and peersDiscuss with your mentor(s) and peers
• Go prepared: things to do before 1Go prepared: things to do before 1stst
shiftshift
• Maintain outside lifeMaintain outside life
• Stay in touch!Stay in touch!

53. Frustrations of early attendingFrustrations of early attending
years, anonymousyears, anonymous
Not being able to spend my new wealthNot being able to spend my new wealth
fast enoughfast enough
Learning to suffer foolsLearning to suffer fools

54. What if it’s still not right?What if it’s still not right?
• EmergencyEmergency
Department DirectorDepartment Director
• Physician working inPhysician working in
freestanding urgentfreestanding urgent
care unitcare unit
• Director, Multi-Director, Multi-
hospital emergencyhospital emergency
medicine groupmedicine group
• Chief Researcher,Chief Researcher,
University ofUniversity of
Michigan, Division ofMichigan, Division of
Emergency MedicalEmergency Medical
ServicesServices
• Physician on a cruisePhysician on a cruise
shipship
• Medical Director,Medical Director,
EMS SystemEMS System

55. • Director, StateDirector, State
Department of PublicDepartment of Public
HealthHealth
• President, AmericanPresident, American
College of EmergencyCollege of Emergency
PhysiciansPhysicians
• Injury control expertInjury control expert
at NHTSAat NHTSA
• Health Policy Fellow,Health Policy Fellow,
Robert WoodRobert Wood
Johnson FoundationJohnson Foundation
• Undersecretary forUndersecretary for
Veteran's HealthVeteran's Health
AffairsAffairs
• Governor, State ofGovernor, State of
OregonOregon

56. • Volunteer, DoctorsVolunteer, Doctors
without Borderswithout Borders
• Director of MedicareDirector of Medicare
Part B, RegionalPart B, Regional
Insurance CompanyInsurance Company
• Book author, ERBook author, ER
• Executive Director,Executive Director,
Professional SocietyProfessional Society
• TV Health AdvisorTV Health Advisor
• Director, QIODirector, QIO
(Quality Improvement(Quality Improvement
Organization), StateOrganization), State
of Ohioof Ohio
• Venture CapitalVenture Capital
Specialist, HealthcareSpecialist, Healthcare
• Vice President forVice President for
Medical Information,Medical Information,
WebMDWebMD

57. What Else is There?What Else is There?
• Evaluating offer/contractEvaluating offer/contract
– Ask resources/mentor(s)Ask resources/mentor(s)
– Extra documents availableExtra documents available
• Financial PlanningFinancial Planning
– Saving/ investingSaving/ investing
– Paying off loansPaying off loans
– Starting practiceStarting practice
– InsuranceInsurance
• BillingBilling
• Malpractice PrepMalpractice Prep
• Other options?/JobOther options?/Job
Specific searchSpecific search
• Careers within EM andCareers within EM and
FellowshipsFellowships
• Starting and running aStarting and running a
businessbusiness
• Wellness: tomorrow andWellness: tomorrow and
beyondbeyond

59. Key PointsKey Points
• Simple CVSimple CV
• Think about this as a career choice, withThink about this as a career choice, with
10 year projections10 year projections
• Use leverage to maximize your tax freeUse leverage to maximize your tax free
savingssavings
• Location should be one variable!Location should be one variable!

60. Getting startedGetting started
• Sit down and identify your goalsSit down and identify your goals
• Get out on the floor this weekGet out on the floor this week
• Look at a minimum of 3-4 jobsLook at a minimum of 3-4 jobs
• Try to get it right the first timeTry to get it right the first time

61. Remember,Remember,
• Most residents will secure a job in the firstMost residents will secure a job in the first
quarter of the final yearquarter of the final year
• GOOD JOBS ARE ALWAYS AVAILABLEGOOD JOBS ARE ALWAYS AVAILABLE
FOR GOOD DOCTORS. ANYTIME OFFOR GOOD DOCTORS. ANYTIME OF
THE YEAR. IT’S NEVER TOO LATE ANDTHE YEAR. IT’S NEVER TOO LATE AND
NEVER TOO EARLYNEVER TOO EARLY

62. Questions?Questions?

63. YOU ARE IN THE DRIVER’S SEATYOU ARE IN THE DRIVER’S SEAT
GOOD LUCK!!!GOOD LUCK!!!