To become an attending physician has taken me four years of medical school and six years of post-graduate clinical training. Now, five years out of training, I feel as though I am finally finding my way.
I have been an attending physician long enough to no longer be considered a junior faculty member by that five-year standard. But I feel like I am just beginning my career – and for that, I feel behind my peers. At a medical conference, I sit in a room of fresh, new junior attendings, wishing I could turn back time and step into their shoes. How did they get it right? I thought I had found the perfect job right out of training. How did I miss the mark?
To better understand what happened, I have had to take a hard look at the past decade and then some. Hopefully my story will help someone else make more informed decisions as they leave training and enter their career as a full-fledged attending physician.
A few years ago, as I entered my last year of fellowship training, we received advice on how to find and secure a job, as well as some information on contracts. With the pressure of a looming deadline – the end of training and the end of my secure income — I pressed on with the job search.
I prioritized practice location above all else. Compensation and research were top of the list as well — my loan balance was well into the six-figure range, and I had a strong desire to incorporate research into my career. However, I looked past the inner desire for research that I had already found incredibly fulfilling, and I heavily narrowed my job search to a handful of cities. Then I sat back and hoped a job opening would appear. I even obtained state licenses for where I wanted to practice. One day in January, I opened a journal to find a job advertisement at one of my selected cities. I was ecstatic. The excitement grew even more because the job was at a hospital I knew well and loved.
The excitement of getting the interview continued when my research interests were welcomed by administration during the interview. This really was the cherry on top. A desire for research had almost outweighed location and now it seemed I could get both! The subsequent job offer did not “protect” or carve out specific research time, yet I was thrilled and suppressed any doubtful thoughts. Did I mention the fabulous salary? Life was definitely on track.
At the same time, a good friend was also on the job search with location as a top priority. She was able to get her location too, and the job had potential, even if it didn’t completely line up with her career interests. We were both looking forward to our future careers. But this is where our two paths diverged.
Naively, I had assumed that the stars would continue to line up. I was not prepared for what actually happened.
Over the next year, my good friend and I compared the realities of being out on our own. I worked on finding my niche and volunteered to take on quality improvement projects. However, promises were not kept and other physicians left our department, compounding the clinical work load. At home, my spouse and I were fostering a rambunctious toddler while pursuing expansion of our family through adoption. I craved more time at home with family, but the opposite was quickly becoming reality for the foreseeable future. Burnout had recently become the new buzzword (and lecture topic of the month). I felt it.
Meanwhile, my awesome friend sounded like she was blossoming at her job. Prior hesitancies were quickly disappearing. She was provided more opportunity in medical education – her passion and a natural talent, an area in which she excelled. Her colleagues and boss were thoughtful and considerate as she pursued expansion of her family. I knew I needed to make a change.
Less than two years in, I came to the decision to leave full-time practice and solely work as a locum tenens physician. Over the next three years, I experienced a range of clinical opportunities. I practiced at a variety of locations – community hospitals, academic centers, and private practices. My schedule was my own to arrange, and time with family became the priority. Along the way, I met many other people well into their career, now seeking a new or different one. Some were practicing at their ideal job, and others had found the sweet spot in their career, but subsequently lost it after departmental or hospital restructuring.
I began to delve into the ideals I wanted in my career. By now, I knew that for me, location was the cherry on top – not the priority. My heart ached to get back into research, and I knew that had to be the priority. From there I read every job post I could find for months. I heavily researched the department, the faculty, and any university association. This time I narrowed it down using a completely different set of criteria, including a more defined workload, the opportunity for academic career advancement, and availability of both academic and clinical mentors. While the research takes time, it is worth the additional work on the front end to be better satisfied on the back end.
The job I wanted has taken some time to find, and I’m glad I found it.
At least for now.
What would be your top priorities for a new job? Share in the comments.
Dr. Eleanor Gradidge is a pediatric intensivist in Omaha, Nebraska. She is passionate about providing care to both her patients and their families. In her free time, you will find her enjoying the outdoors with her family in any way possible. Dr. Gradidge is a 2022–2023 Doximity Op-Med Fellow.
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