We are excited to introduce a new feature in Retina Today, Fellows' Focus. This column is specifically geared toward medical, surgical, and professional issues pertaining to our level of training. Both of the co-editors are first-year fellows at Wills Eye Institute. The column will selectively focus on topics that are pertinent and timely for retina fellows.
This is the first of a two-part series that discusses the job search. For over a decade, our lives have concentrated on education and graduate medical training. Applications, personal statements, and recommendations are all too familiar to us. Discovering job opportunities, evaluating the organizational and financial setup of different practices, and negotiating contracts are much more foreign topics. David A. Eichenbaum, MD, a recent graduate of a vitreoretinal fellowship at New England Eye Center, recently completed the job search. We asked him to share his experiences and offer advice for those of us who are beginning to tackle this daunting task. The first part of this series discusses the job search and interviewing. The second half of this feature will address contract negotiation and partnership.
So you are dating. You are a desirable professional—young, sharp, well-educated, and good-looking. People call you a "catch," and you even have your parents and their friends setting you up with other well-known debutantes, certain that you will find a good match. All this may even be going to your head, and, really, how could it not? You are at the top of your game, you are hearing about how great you are from all over, and you are meeting all sorts of very eligible singles. But once you meet someone you like, you have to tackle the tougher relationship questions—how do you know if someone is your one and only? How long do you live together before you get married? When do you even begin to talk about marriage—before or after you sign that first apartment lease? And, worse, when do you two lovebirds begin to share a bank account or discuss a prenuptial agreement? Of course you know those discussions are important, but don't they ruin the romance?
Most of us have been through such social processes as young adults. This is great, because, as a graduating retina fellow, you will find many parallels to romance in your job hunt. By the time you sign a contract, you should be able to make a relationship simile for every aspect of your employment pursuit. And, although the process is daunting and will certainly not be pleasant the entire time, you will have grown throughout as an individual and as a professional. Plus, with the right amount of directed searching, as you begin your career as a new associate, you should be able to say you are "going steady" with someone who shares your values and goals, and that you two have a reasonable chance at tying the knot.
SEARCHING
Create a focused job search; come up with career criteria that are important to you. First off, we are in a high-growth industry, and there are plenty of retina jobs almost all over the country. A job search that is too extensive will spread the candidate too thin. There are plenty of techniques for creating filters, such as deciding on two or three regions and focusing there. Decide on multispecialty or subspecialty practice, or decide on academic or private practice environments. Once you go through a few series of cuts, the resulting opportunities will be manageable enough to sift through. You can also attempt to maximize your efficiency by using "dating services," such as job fairs, the American Society of Retina Specialists and American Academy of Ophthalmology Web sites or ophthalmic headhunters to review many jobs rapidly. The plethora of opportunities you will find through these avenues are best navigated if you have at least a few filters in place.
Remember that many of the best people to date (opportunities to accept) are not found at match.com (job Web sites), but they are brought together with you through your existing relationships. Of course, ask your faculty which of their friends is hiring, but first tell them what you are looking for. It is silly and somewhat embarrassing to have your service director call his solo private practice friend in Buffalo when you are looking for an academic multispecialty practice in the Midwest. At this stage in your career, you have already established a network you may not realize you can utilize. Your other relationships include industry representatives (they are all part of well-organized national companies with direct marketing arms, and everyone wins if they help you find a job), your prior senior fellows and residents, and even much more senior alumni of the many institutions where you have trained. You can be assured that, with a little diligence, you will find plenty of practices willing to talk with you. In fact, use these networking conversations to prepare your professional, independent self for the next step in your job hunt.
INTERVIEWING
Showtime! Here is where it is very important to remember that this is dating, and you must put your best foot forward. Your interview starts with your first communication with a prospective employer. Whether it's a call to the front desk, an e-mail to the practice administrator, or a dinner with the managing partner, it is imperative to act as you would expect any senior retina specialist to act. You will go on many interviews, but you will only sign one contract. Regardless, you already know that our subspecialty is a very small world, and you will cross paths with every one of your interviewing practices in the future. Be polite and respectful, and remember that although you are an outstanding candidate and a potential asset to their business, there are still plenty of applicants for good jobs. You do not have to remind anyone about the details of your CV, as the partners have already seen it. You have to be positive and friendly, and remember that the point of the interview is to ensure that both you and the practice appear as great in person as you do on paper.
Interviews are about social interaction, and there are often many steps to the process. You wouldn't move in with someone after just meeting for coffee, so you shouldn't expect a practice to offer you a contract after the first time you meet the doctors. The age-old advice of taking it slow is certainly appropriate here, so budget time into your interviewing plans. The entire interviewing process may start with a brief greeting at a national meeting, or it very well may begin with a 3-day practice visit. You should expect the practice to host you through the interview process, and you should expect them to include your significant other during dinners or community tours. You should not, however, expect discussions about contracts during the first day of a visit or the first dinner you have with the partners. In fact, I would avoid contractual discussions in such settings, as you may make concessions verbally to avoid "ruining the chemistry." In fact, that point is worth emphasizing; chemistry is what it is about at this point. See how well you get along with the partners of the group and if you want to be like them in 10 or 20 years. Every ophthalmic group is basically a small corporation, and each will have its own corporate culture. Interview time is really to see if you fit with the group—to see how well everyone "clicks" —and not to talk about the details of your employment.
That being said, as the interview process progresses, there will often be a point where you have a chance (or may even be expected) to ask a practice administrator or managing partner questions. For most applicants, as they seek partnership-track positions, I find that the value of that opportunity is maximized by talking about the long-view. For example, don't ask "How much will I make next year?" or "How busy is call?" Those are questions better addressed, respectively, in forthcoming contractual negotiations or through more casual conversations with all members of the group. Ask, "How are decisions made in the practice, and how often do the partners meet to discuss the direction of the group?" or "How is the partnership structured financially, and how do the partners divide income?" or "How many associates have left the practice, and may I have a chance to speak with them?" Those questions are certainly much more difficult to ask, but this is the appropriate milieu, and you will garner the respect of the group with such queries and be much more comfortable when you sign on the dotted line.
Omesh P. Gupta, MD, MBA, and Anita G. Prasad, MD, are first-year fellows at Wills Eye Institute, Philadelphia. Dr. Gupta may be reached at ogupta1@hotmail.com; Dr. Prasad may be reached at anita.g.prasad@hotmail.com
David A. Eichenbaum, MD, is in practice at Retina Vitreous Associates of Florida, Tampa Bay. He may be reached at deichenbaum@retinavitreous.com; phone: +1 727 323 0077; fax: +1 727 323 7627.
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