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How to Choose the Right Clinical Job Opportunity

Posted on Mon, Oct 31, 2016
How to Choose the Right Clinical Job Opportunity

It’s hard to believe that we are already two months into the 2017 residency recruitment season.

Over the next several months, residents across the country will interview at multiple places until they find the ideal opportunity. Residents will receive advice from current and former colleagues, their residency directors and others. So for what it's worth, I’m going to offer you my advice.

First, enjoy the moment. Reflect on what you are about to accomplish. Ten-plus years of learning, training, dedication and sacrifice is finally leading to the start of your emergency medicine career.

Choosing the right opportunity brings a mixture of excitement and stress, so I encourage you to develop a career plan. The first step is to ask yourself what’s truly important to you today. Long term, the number one criteria for landing an ideal opportunity is location. In the short term, you may want to travel, practice in a variety of settings, pursue a leadership track or find a location that will assist in paying down your student loans. Once you answer this question, you can plan accordingly.

Several years ago, I recruited an EM physician. His first name was Dan, and for a five years, worked on average 1,800 hours per year. During his residency, Dan was a chief resident. He was brilliant physician. The nursing staff liked working with him and his patient satisfaction scores were always high. Our leadership team easily formed the opinion that he would make an outstanding medical director in the future. When Dan interviewed with us, he expressed that his long-term goal was to become a medical director or chief medical officer. At the end of Dan's second year, he was offered an associate medical directorship. He turned me down. When I asked him why he stated, "It is not part of my plan today." His plan was to pay off all of his student loans within the first five years after he completed residency. Once Dan paid off his loans, within one year, he accepted a leadership position.

The second step of finding the right opportunity occurs during the interview process. During the interview, you must evaluate who you will work with. This starts with evaluating the medical director during and after the interview. Finding a medical director who will mentor, guide, teach and inspire you will create an environment that will encourage you to stay long term or prepare you for the next opportunity. This is not always easy to determine, but you can assess the medical director by asking questions to the other physicians, nursing staff or other members of the hospital leadership team. The second part is evaluating the physicians and advanced practice providers that you will work with. The medical director and nursing staff will help you to determine if these are the types of colleagues you want to work with.

The third step is determining if the location has what you are looking for, from housing, schools and shopping to recreational activities, religious activities and other considerations. This may conflict with your first plan out of residency, but the location will be the primary factor for choosing an opportunity for your long-term plan.

The last piece of free advice is when you find the right opportunity, one month before you start work, and before you start making 4 to 6 times what you were making as a resident, hire a financial advisor to help you develop a plan. You'll sleep better at night knowing your financial future is in good hands.

Jim McMillin


Jim McMillin is the National Director of Provider Recruitment for EmCare.

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7 Tips I Learned During Residency

Posted on Wed, Mar 02, 2016
7 Tips I Learned During Residency

By Steven Mahon, D.O.
 
It was July 2011, and I was just sitting down for my emergency medicine residency orientation. Wearing slacks and a tie, I had my new white coat clean and pressed with three uniform pens in the chest pocket. Those pens were sitting just above my name, the new letters “D.O.” appearing as an alien addition. A rather weathered old attending rose to the podium and congratulated us on completing one of the most difficult journeys of our lives. He commended us on the embarkation of our young physician careers and said that our days as residents would be “over in the blink of an eye.”
 
Well, here I am almost a year after graduation. I'm wearing a scrub top pulled from the "I think it’s clean" pile of my closet, a red marker is the only writing utensil in reach, and I haven't seen my white coat in at least two years. I look back to those early days and reflect on residency, which was not easy, and most certainly it wasn’t quick.
 
There were some very long nights, frustrating cases and endless reading. It’s a grueling time meant to teach young doctors everything they need to graduate as competent, confident emergency department attendings. During that time I had the benefit of working with many great attendings who imparted words of wisdom. Some were good, some were not, but there have been many “one-liners” which have stuck with me throughout the year, and I now find myself repeating them to my own students. These are a few of my favorites:
 

  1. “The eyes cannot see what the mind does not know.” Essentially this boils down to the core of residency, to keep reading and expand your core knowledge. As EM physicians, we are tasked with the overwhelming responsibility to diagnose the undiagnosable. While no one is expected to regurgitate the treatment plan for perivenous encephalomyelitis (don't be afraid to look it up), you do need to be familiar with what is out there. You cannot diagnose or even look for a disease that you don’t know even exists. So plain and simple, read as much as you can and pick up as many cases as you can handle. This will allow your mind to reveal what your eyes are seeing.

  2. “As a resident, pick up cases which make you uncomfortable.” Everyone has their happy place; their zone of comfort where nothing can go wrong. We all love treating a classic chest pain and the five year old with ear pain. However as the ER physician, especially in a solo-covered shop, you’re going to have to pick up cases regardless of how comfortable you are. It’s important to expand your comfort zone as much as possible while you have an extra pair of hands to back you up. So rather than pick up yet another chest pain, instead pick up something where you have no clue how to work it up, something that makes you sweat a little. Discomfort now is better than discomfort later.

  3. “I don't care how you treat them, just don’t harm anyone.” This is one of my favorites, spoken by a rather jaded attending in a high-volume ER. A kidney stone will probably turn out the same whether you use opiates or NSAIDS, so don't sweat the details on the little stuff. Just know your dispositions, who is staying and who is going home, and do your best not to cause any harm. I think Hippocrates had something to say about this.

  4. “The room is yours, kid.” A terrifying thing to say to a young resident, but it’s sometimes necessary to push home a point. Eventually, we will be the only ones sitting at a desk, managing a room full of sick people. We are the captain of this ship; our crew is here to support us and we keep it moving. As a resident, it’s important to practice moving a busy room and keeping all the plates spinning, especially as you near your final year.

  5. “If the stomach works, use it.” A short one, but a good one. It means that in a room full of vomiting people (cold and flu season anyone?), if you can control and rehydrate orally, spare the IV. Both your staff and your patients with thank you in the end, not to mention that the room will move much quicker.

  6. “Trust your nurses.” The bottom line is that in the ED, we’re all in the trenches together. When “it” hits the fan, we’re exclusively reliant on our nurses to get the job done, and trust is key. I’m friends with almost all of our department’s nurses. I know their families and socialize whenever I can. The department always runs smoother on a road without potholes.

  7. “What you do matters.” A good one for final thoughts, which maybe doesn't need to be said, but maybe it does. One of the biggest enemies of ER physicians is burnout, essentially treating the endless droves of patients with coughs, colds and bruises in the waiting room. But remember that three year old with a simple ear infection you just discharged, which probably shouldn't have even been here? Her mother was terrified when she got the call from daycare, and she was crying when she left work early to get her daughter to the ER. Those five minutes that you just spent rolling your eyes while you tried looking in her daughter's ears were probably the most important minutes of that parent’s day, maybe even the most important minutes she has had being a mother up until that point. What we do matters, whether it’s pulling a last-minute “Hail Mary” and saving someone's life, or sitting down and giving 30 seconds of reassurance to a worried parent. We are in the business where nothing should be routine. 

So I hope some of my favorite one-liners stick with you as they have stuck with me. In reflection, residency is a time to absorb as much as you can. Read, practice, make yourself uncomfortable, be friendly and compassionate, and certainly do no harm.
 
Steven Mahon, DO

Steven Mahon, D.O., received his medical degree from the Chicago College of Osteopathic Medicine and completed his emergency medicine residency at St. James Midwestern University, Olympia Fields, Ill. He is an attending emergency physician at St. Anthony's Hospital in Crown Point, Ind.
 

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How to Make the Most of Your Emergency Medicine Residency

Posted on Mon, Feb 29, 2016
How to Make the Most of Your Emergency Medicine Residency

In honor of Emergency Medicine Residents' Appreciation Day on March 2, an attending emergency physician offers a few tips for making the most of your residency.

By Shilpa Amin, MD, FACEP

Dr. Seuss said it best: “Congratulations! Today is your day. You’re off to great places! You’re off and away! You have brains in your head. You have feet in your shoes, you can steer yourself in any direction you choose.”
You have worked extremely hard to get into your residency program, now make the most of these important years! Each year is a stepping stone to help you find the perfect job; you are the person who’ll decide where to go.

There is no manual to surviving residency, but there are a few pieces of advice I’d like to offer.

Intern Year: Learn the basics. There is no real substitute for understanding the fundamentals of teamwork, hard work and efficient work. When you are an intern, you are working the most shifts, doing many procedures and learning to absorb direction from many people: senior residents, attendings and consultants. Take this year to really understand how the ED functions, because the operations of the ED are unique. Use this year as a base for success for the rest of your residency. Ask lots of questions. Read when you have time. And most importantly, HAVE FUN.

Junior Year: Be a mentor and true teacher to the interns. Remember the saying: “See one, do one, teach one.” You will quickly learn procedures and how to care for critically ill patients. Strive to be a strong leader in your junior year. This year you will have more time to read and more time to network.
 

  • Start talking to the seniors who just graduated and see where and how they found their jobs.
  • Align yourself with colleagues who work in a setting that you see yourself in (academic, community, administrative).
  • Attend national conferences such as ACEP, AAEM or SAEM. Visit the booths and speak to other physicians about what they like most (and least) about their jobs.


Use this year to build a foundation for your job search. Toward the end of your junior year, begin researching different employment models, consider if you want to apply for a fellowship and where geographically you want to practice. Begin drafting an initial version of your CV and have your program director and other faculty review it to help you revise.

Senior Year: This is when the job search is in full effect. Use the summer months to network, learn what an independent contractor is – speak with your accountant or adviser to see if this is the right fit for you to help better understand the job market. Reach out to alumni from your program for more information. Your program director and chairman also are great resources if you’re looking for a job in a location that you’re not familiar with. Begin thinking about who you are going to ask to fill out your references for your applications. Finalize your CV and write a cover letter. Begin sending out emails to the EDs you are interested in applying to.

September and October of senior year is when most residents start interviewing. Give yourself enough time during each interview to spend time in the ED and shadow one of the doctors for a few hours. This will give you a real sense of how the ED functions as a system and works as a team. Interview at enough places to give yourself a broader understanding of the different work environments available to you and where you would fit best. I recommend researching and preparing questions in advance of each interview. Ask for a current copy of the schedule. Be sure to fully understand compensation and scheduling, how vacations work, and what type of malpractice coverage you will have.

In November and December, review all of the information obtained from your interviews.
 
  • Ask yourself where you will be most happy and have the most successful career.
  • Ask your mentors to sit with you and decipher the information and assess each site.
  • Review your contract and have a contract attorney review it for you as well, specifically examining restrictive covenants and any confusing language.
  • As a courtesy, let anyone who extended an offer that you don’t accept know where you decided to start your career.


“Today is your day! Your mountain is waiting. So, get on your way!”

Shilpa Amin

Shilpa Amin, MD, FACEP, is a full-time attending emergency physician at Saint Barnabas Medical Center in Livingston, N.J. Dr. Amin also is the director of the physician recruiting team for EmCare Partners Group. She received a bachelor’s degree from Rosemont College in Rosemont, Pa., and her medical degree from SUNY Downstate, Brooklyn, N.Y. She completed the Jacobi/Montefiore Emergency Medicine Residency Program at Albert Einstein College of Medicine, where she served as chief resident. She enjoys spending her free time cooking, traveling and trying new cuisines with her husband and three young children.
 

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EmCare's Residency Program Takes Off!

Posted on Thu, May 21, 2015
EmCare's Residency Program Takes Off!

EmCare hosts many events for residents in Emergency Medicine and other specialties

Several years ago, EmCare recognized the importance of recruiting residents and began hosting Educational Events for programs throughout the country.  In 2014, we conducted 73 events.  During the first quarter of 2015, we conducted 33 residency events and we are planning over 125 more events before the end of the year.  EmCare is very excited about the expansion and growth of the National Residency Program to support the efforts of our growing recruitment team. We have three National Residency Program Coordinators who lead this program.  They are Stephanie Ambuehl, Amanda DiRuggieri and Jamie Morgan. 
 
The coordinators start the process by reaching out to the chief residents at select residency programs across the country.  Once they have interest, they select a date and venue and contact recruiters and physician leaders for the event.  After choosing an appropriate topic for the physician leader to speak on, they send out invitations and promote the event on the EmCare website.  The coordinators work with the venues to set-up and audio visual needs and finally select the menus for each event.  As the event draws near, they send reminder emails to the residents and updates with lists and event information to the recruiters. 
 
EmCare’s goals for the National Residency Program are to provide important educational support to our incoming physicians while in their training, to begin building relationships with these prospective providers, create brand awareness, and to offer specialized attention and support to the residents.
 
The program has primarily hosted events for these Emergency Medicine & Internal Medicine residency programs!  This year we are adding more events for Surgery, Anesthesiology and Radiology residents later on this year.
 
If you’re interested in setting up an EmCare Educational Dinner or participating in an upcoming event, please contact the National Residency Team at 855-367-3650.


Jim McMillin is EmCare's National Director of Recruiting

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