50% of doctors change jobs in the first few years of their career, but knowing how to properly handle a job transition is relevant to every physician at every stage of their career. Financial advice for doctors doesn’t often cover this topic and job transitions can be tricky enough when you’re careful. If you’re on the cusp of a change, here’s a checklist for you. 

1) Watch Your Start and End Dates

Know when your last working day and last paycheck is, as well as the first working day of the next job and when the new paycheck lands. Do you get paid monthly or biweekly? Do you have the funds to support yourself until that next check?

If you're a medical student reading this as you transition to your intern year, here’s a fun story: I had to take out a $5,000 loan from my grandma because I didn't know that my first paycheck would come at the end of the month, and I didn't have enough money to cover the transition while I waited to get paid.

2) Know When You’re Due a Bonus

Maybe you’re entering a specialty that offers sign on or retention bonuses. Get a good understanding of when those payments come your way: Is it when you sign, or when you start? Will it arrive as a lump sum payment, or monthly, or annually? 

A couple of things to know about bonuses:

1) It is taxable income, so you won’t get 100% of a $20,000 sign on bonus. 

2) There’s almost always a stipulation that if you quit within X time (i.e.,: 2 years), you owe that money back. 

If you’re working toward productivity bonuses, find out how often those are paid out. Are they paid based on your organization’s profit and loss, or is payment based on how you bill?

3) Understand Your Personal Time Off

Personal time off isn’t usually written specifically into your contract. There are policies that exist after you’ve signed a contract, so you may only be able to get to a certain level of specificity here before you’ve started, but figure out what you can. 

What days are official holidays? How many vacation days do you get per year and when does that renew? Do you get a rollover? How many sick days do you get, or do you have to reserve vacation days for that? How many CME days are available? Maybe you can get paid back for the days you didn’t use on vacation in your previous job. 

4) Determine Retirement Benefits and Contributions

Retirement benefits aren’t just about whether you have access to a 401(k) or 403b, because most doctors do. 

The question here is does your employer match your contributions, and when does that match start? And remember to find out when the matched money vests (which means, when it becomes fully yours). Some employers may match your contributions at 5% or 10%, but if you leave within a year, you don’t get to keep the money they matched.

With a 403b that has a maximum yearly contribution amount, be sure to find out how much you’ve already contributed that year, so you know how much you have left to meet moving forward.

Remember if you have a Roth IRA to check where you’re at on contributing to that. If you're in a high-paying specialty earning $230k for the year and you contributed to a regular Roth IRA during that year, your income will be above the threshold where you can't directly contribute to an IRA anymore. Think about having an accountant help you figure out exactly what to do in your situation.

5) Complete Your Public Service Loan Forgiveness (PSLF) Form

If you’re banking on student loan forgiveness, be sure to fill out a new form with your new employer so that your payments are still accounted for under this employer.

6) Check Your Health Insurance Status

When you’re transitioning jobs, you don’t want to miss that open enrollment period. Start thinking about whether you want a regular plan or a high deductible plan based on your needs.

It’ll also be helpful to know when coverage from your current job ends and compare that to your new job’s start date. If it’ll be a month or more before you start your new job, do you have access to COBRA during the time you’re not working?

7) Confirm Available Malpractice Insurance Coverage

This one trips up a lot of doctors when they’re leaving one organization for another. 

There are two types of medical malpractice insurance: one is an occurrence policy and the other is a claims made policy.

Occurrence is super comprehensive because it covers you for anything that occurred anytime while you worked for that employer. The drawback is that it’s very expensive.

Claims made policies are less comprehensive but more common. These cover you for claims made while you were working, but not claims made after you leave. So if someone waits to sue you until two years after you’ve left that practice, you’re in trouble. In the event that ever happens, you should find out whether your employer offers something to cover your tail, like a tail insurance policy. (Yes, that’s the actual name for it!)

Be sure to also check your non compete within your current contract and stick to the agreed parameters as you move forward on your career path.

8) Take Advantage of New Benefits

Some physicians have access to college tuition benefits. If you work for your employer for a certain length of time, you could qualify for having a percentage of your child’s tuition paid. 

Another common work benefit I’m seeing lately is a law assistance package, so see if your employer offers this. You can contribute $15-20 a month and be granted access to attorneys who can help you set up a trust fund for your kids, or get your living will in order, or help you start estate planning — all for a very affordable price. 

Institutions like Duke and Stanford offer home assistance packages where they’ll pay a percentage of someone’s mortgage in order to incentivize doctors to stay in the area. So if you’re somebody who works or wants to work for a large academic institution, be aware of that.

9) Beware of Promotion and Bonus Requirements

Know what you need to make partner or qualify for a promotion or bonus at your job. 

Do you need to publish? Do you need to teach? If you work for an academic institution, usually you start off as an assistant professor and then progress to associate. So what are the qualifications that will allow you to move forward in your role and make more money? If you’re in a private practice, how much does it cost to buy into the practice?

These are all things to consider in a new job as you explore your options and hopefully this list provides the guidance and tools you need to make the whole job transition process a little less of a hassle.

What else should one consider when switching jobs? Share in the comments.

Dr. Jimmy Turner is an academic anesthesiologist and the Chief Medical Officer and co-founder of Attend, a comprehensive financial platform built by physicians for physicians. He is also the author of The Physician Philosopher's Guide to Personal Finance and host of the Money Meets Medicine podcast.

Illustration by April Brust