Reaching my third year of fellowship was like glimpsing the light at the end of a really, really long tunnel. The process of looking for my first job outside of The Match was exciting, of course, but also a little terrifying – I felt like I was charting new territory at 31 that many friends had already navigated at 22. I learned a lot that year, and some lessons in particular stuck with me.
A family friend gave me the advice to look for a five-year job. As she (rightfully, in my opinion) pointed out, it is a lot of pressure to plan for a lifetime. I didn’t know what was going to happen in my career or my personal life, which made it hard to anticipate everything I would need and left me feeling overwhelmed. Reframing my job search in terms of a few years made it much easier – after all, I had done the same thing before, for residency and fellowship. I asked myself if the job gave me the opportunity to refine current skill sets and grow new ones, and if the answer to both was yes, I went with it. Now, three years in, I have no regrets. The truth is, a surprisingly large number of physicians change jobs in their first five years out of training, and while the reasons for that may vary, the fact remains that adjusting expectations makes the decision process immensely easier.
Speaking of expectations, another friend told me to find a job that meets number one and number two on my list. When he said this to me, it was like a light bulb went off! I had worked really hard for seven years and wanted my first job to be perfect. The reality is that almost no job is perfect, and frankly now, I am not sure that the first one out of training should be. When I actually wrote down what mattered to me, it was easy to see that being close to family and being able to teach residents were my true priorities. Knowing these in turn made assessing my job offers and the final negotiation process almost effortless.
When I was interviewing, I was so focused on ensuring that my wants and needs were clear, I did not think nearly as much as I should have about what an institution or a practice might need from me. And sadly, the world was/is in fact not my oyster. Understanding what I brought to the table was as paramount as understanding what I took away. I had my epiphany after I essentially blew an interview with an academic center director (who needed someone with multi-modality imaging skills, while I was focused on getting level 3 in echo). Maybe this should have been common sense, but in some ways training felt like one big exercise in refining my career goals, so the idea got lost. I wish I had taken the time and energy to systematically identify the anticipated needs of potential employers, and ways in which I could fill those gaps. Even now, this is advice I often hear: find a niche that needs filling and fill it.
And finally, do not over commit. I interviewed at another institution where performing a specific procedure – one I had only minimal experience with – was part of the job. Everything else about the offer was fantastic, and I had a lot of mental anguish about whether or not I could take on the task. Finally one day, my clinic preceptor said to me, don’t over commit. He told me that I would be miserable signing up for something I didn’t feel comfortable doing, and that my employer would equally be disappointed if I did not deliver – and he was right. In a field like ours where technology is continually advancing, I think this is a really important concept: yes, we can expand our skills after graduation, but we should do so in a supportive environment, and that assessment is personal.
The whole year of job-searching was stressful, to say the least – even my eczema flared! But looking back now, I can appreciate that it was a year of tremendous growth, and that it helped me articulate what I am now doing with my professional life. I’m also glad to note that the ACC has since created a great podcast which explores many of the topics relevant to this task that is definitely worth checking out.