In a couple of short months, we will be finally done with training. In addition to our clinical duties, many of us have also been searching for a job. For this column, we sent out a questionnaire asking second-year fellows about their job search experiences. We hope this information is interesting to second-year fellows, and also helpful for first-year fellows intimidated with this daunting task.

This survey was sent to all second-year fellows who attended the 9th Annual Retina Fellows' Forum in Chicago, IL from January 30, 2009 to February 1, 2009. A total of 84 surveys were emailed and 22 surveys (26%) were received and analyzed. All responses were strictly confidential and submissions were anonymous allowing respondents to answer all questions freely. Darrell Baskin, MD, and Jeremy Wolfe, MD, two first-year vitreoretinal fellows at Wills Eye Institute, contributed to this article.

-Omesh P. Gupta, MD, MBA; and Anita G. Prasad, MD

When did you start your job search?
Almost 55% of respondents started their job search in the first year of fellowship. Less than 5% started their job search before fellowship, 23% started between July 2008 and September 2008, and the remaining 18% started between October 2008 and December 2008.

A number of respondents commented that they wished they had started their job search sooner. There are a number of reasons for this. Choosing a job is an incredibly important decision that requires a significant amount of thought, time, and resources. Beginning this process as early as possible allows you to make the best decision. Some respondents noted that because of time constraints, they were not able to interview at as many places as they would have liked. Starting the process earlier and exploring these other options also allows you to have a better understanding of what you are looking for in a practice.

How much time were you allowed from your fellowship to interview for jobs?
Over 35% of respondents were allowed 1 to 5 days to interview for a job, 27% were allowed 5 to 10 days, 14% were allowed 10 to 15 days, and 18% were allowed unlimited days.

We all hope that the job we choose will be the one where we spend the rest of our career. Unlike our undergraduate, medical school, residency, and fellowship choices, this may be our last move. In addition to the practice that we are thinking of joining, many of us might be interested in looking at different areas to live and school districts, among other considerations. Those of us with significant others may also need time to explore their options as well.

One respondent would have liked more time to also look around the area with a realtor to estimate housing prices and cost of living. This type of information may help with negotiating your contract and relocation expenses.

How many job interviews did you attend?
Over 40% of respondents had one to three job interviews, 36% had three to six interviews, 18% had six to nine interviews, and 5% had more than nine interviews.

It is surprising how many respondents went on only a few interviews. Some of these respondents may have already been familiar with the practice that they are joining. Other respondents wished they had more time to interview with more practices. Visiting practices can be helpful to gain a better understanding of how different practices are set up physically and financially. For example, one respondent discovered that one practice had many different offices scattered throughout town, while another practice had a couple of offices in close proximity. Due to traffic patterns, however, the commute was longer for the practice with offices closer in proximity. Some practices might be financially contracted with multispecialty groups; others may have their own offices. These subtle details are difficult to elicit over phone conversations. These physical and financial arrangements can have a significant impact on your lifestyle and on the ultimate success of a practice.

In which part of the country did you interview?
Approximately 50% of respondents interviewed in the Northeast or Southwest areas (including the west coast). Approximately 30% interviewed in the Midwest and Southeast and only 5% interviewed in the Northwest and Mountain region area.

These responses are consistent with population density and practice opportunities. The majority of respondents focused on one or two areas. Outside of the west coast, other areas in the Southwest region that were popular included Arizona and New Mexico.

What was the highest priority during your job search?
Interestingly, location of the practice was the top priority for respondents comprising 41% of those surveyed. Prospective colleagues was the second most popular choice — 31% of those surveyed made it their highest priority. The type of practice (academic, retina-only group, etc.) was most important to 23% of respondents and the opportunity for personal and practice growth was most important to 5% of respondents. No respondent reported salary as the highest priority during their job search.

Lifestyle considerations have become increasingly more important over the last decade. Many respondents only searched for a job in one region and some respondents were only interested in a particular portion of that region (ie, Southern California in the Southwest region or New York City in the Northeast region). Personal connection to physicians in a particular practice also was a driving force in job selection. Respondents commented on the uncertainty in this process. Even after visiting a practice more than once, it is difficult to truly get the inside scoop on a practice. If they want you to join them, employers may have an incentive to try to hide some details about the practice. Often only physicians who have left the practice or who have personal connections within the practice may have this valuable information.

Were partnership opportunities discussed during contract negotiation?
Partnership opportunities were discussed with 95% of respondents. Partnership discussions can be a very delicate, but important part of your job search. A clear understanding of the opportunity for partnership is essential for all of us to feel comfortable with our job choice. Speaking to as many partners in the practice as well as physicians who have left the practice helps validate partnership opportunities.

Were the terms of the partnership agreement put into your contract?
The terms of the partnership were included in 63% of respondents' contracts. Discussing the exact terms of the partnership is also helpful in managing your expectations. Putting explicit terms in the contract may eliminate room for negotiation after your years of hard work as an associate. Conversely, no mention of partnership opportunities can leave you guessing as to when those discussions will take place.

How many years are you contracted to work as an employee until full partnership is offered?
Forty-two percent of respondents are eligible for partnership at 2 years, 42% between 3 to 4 years, 10% between 5 to 6 years, and 5% between 7 to 8 years. Some practices rationalized a longer buy-in process based on full partner salaries, reputation of the group, stability of the practice, and trends in the area.

When did you sign your contract?
Nearly 60% of respondents signed their contract from January 2009 to the present. Approximately 20% signed either during their first year of fellowship or from October 2008 to December 2008. Fewer than 5% signed their contract from July 2008 to September 2008.

How would you best characterize the practice you are joining?
Forty-five percent of respondents signed with a retina-only group. Interestingly, academic medical centers were the second most common choice for 40% of respondents and 15% chose multispecialty ophthalmology groups. No respondents joined a multispecialty medical group or plan on entering into solo practice.

Perhaps a more recent trend is a growing interest with academic medical centers. In addition to lifestyle considerations, many have the opportunity to individualize their career. Recent economic changes may have also decreased hiring opportunities in the private practice setting.

Omesh P. Gupta, MD, MBA, and Anita G. Prasad, MD, are second-year fellows at Wills Eye Institute in Philadelphia. They are both members of the Retina Today Editorial Board. Dr. Gupta may be reached via e-mail at ogupta@hotmail.com; Dr. Prasad may be reached via e-mail at anita.g.prasad@hotmail.com.