Interviewing for the first job after retina fellowship is a foreign concept to most of us. Previously, we scrambled to fill out applications, write personal statements, and get recommendation letters for a match process, but now we enter a brand new system. We asked attending surgeons at Mid Atlantic Retina to share their advice on what to ask and to look for in job interviews—and what traps to avoid.

WHAT SHOULD I ASK DURING THE INTERVIEW?

James F. Vander, MD

What to ask: What is the practice’s philosophy toward the growth and development of new associates?

Why to ask: This is a very broad question, and the answer lies at the core of ensuring a good fit for both sides. Some practices expect a new doctor to open a new geography for the practice and attract new referral sources from scratch. Others expect to share existing sources in a busy practice.

The compensation and buy-in policies often reflect these variations. A booming practice may shift volume and make a new doctor busy very quickly. In that case, there will likely be a significant buy-in or sweat equity component (eg, a significant percentage of the new doctor’s production goes to the practice initially). In other practices, the new doctor may simply be sharing overhead and, in a sense, competing with the existing doctors. In that case, the cost of entry should be much lower.

What to ask: Have any doctors left the practice? If so, why did they leave? If I were to ask them what happened, what do you imagine they would say?

Why to ask: It is not uncommon for people to move on from their first or second jobs. Some reasons reflect circumstances that should not raise concern (eg, moving closer to family, spouse’s job requirements, etc.). Every practice has a culture. If no one has left the practice, that is probably a good sign. If someone has left and the reason was a bad fit, that does not necessarily mean there is a problem. If there is a pattern of multiple departures, or if the departures occurred just as the departed was about to buy in, that is a red flag. Do not just accept the remaining practice members’ version of truth; call the doctors who left! If any practice is offended by this question, you do not want to be with them.

Marc Spirn, MD

What to ask: How will I obtain patients?

Why to ask: You may be expected to develop your panel of patients from spillover from the other doctors. There is a chance you will be competing with established doctors in the practice for referrals. You may even be expected to generate your own referral sources. It is important to understand the landscape and the situation in which you are getting involved.

What to ask: How does the practice handle emergency surgeries?

Why to ask: More than anything else, emergencies have the potential to affect your lifestyle. Do partners share emergency cases to minimize after-hours OR time, or will you be expected to handle all emergencies that arise after hours? In some practices, you might be operating multiple nights a week at 10 pm when the OR is available, whereas, in other practices, the end of the day surgical add-on can be scheduled with your partner the next day during his or her block time.

What to ask: Who handles inherited retinal degenerations, oncology, retinopathy of prematurity, etc.?

Why to ask: If you are not comfortable treating some unusual retinal conditions, you want to know how these cases are handled in the practice. Will you be expected to treat babies if you did not do much of it in fellowship? Make sure you know what the job requirements are and that you are comfortable with them.

What to ask: Is there a restrictive covenant?

Why to ask: If you are committed to a specific geography—for example, because your in-laws live nearby and they watch your three children while you and your spouse work—make sure you are comfortable with a restrictive covenant. Pause and think twice about whether you would be willing to leave the area or take a hiatus for a few years while the restrictive covenant is in force.

Carl Regillo, MD

What to ask: How are the practice and the terms of employment structured?

Why to ask: A practice may hire you as an employee with or without a partnership track. If there is a partnership track, ask about the terms of buy-in and buy-out. Check whether the rules are the same for all the doctors in the practice. The terms of compensation, profit sharing, productivity formulas, and bonuses are all important factors in your bottom line.

What to ask: What is a normal week like?

Why to ask: You want to get a sense of what a normal schedule is like. Will you be in one office only? Will you be in multiple offices on the same day? Will you have a designated OR day, and where is the OR? Does the practice use electronic health records and scribes, or do physicians still use pen and paper? The answers to these questions will give you a sense of what life will be like in the practice.

Allen C. Ho, MD

What to ask: Will there be any work with premature babies?

Why to ask: Retinopathy of prematurity (ROP) screenings and treatment, as well as the evaluations of young children for nonaccidental trauma, are important work. Managing these conditions is difficult and requires expertise. There is also substantial risk involved in this work.

What to ask: What is the process for partnership, and what is the process for retirement?

Why to ask: The terms of your retirement can be as important as the terms of your employment. Make sure this is clear in order to avoid misunderstandings with your partners in the future.

WHAT SHOULD I AVOID ASKING?

Dr. Regillo: Do not ask for any terms significantly different from what was in place for previously hired associates, unless what is offered to you is very different from the conditions for other doctors currently in the practice. Fairness is established by precedent.

Dr. Vander: Do not ask for specific details about compensation, benefits, and on-call obligations. These are important matters that should be addressed before signing any agreements, and certainly a general understanding about compensation structure is important enough that it might be a deal-breaker. The details of the package, however, are secondary to ensuring a compatible relationship, and they can wait for the follow-up discussions and negotiation of a contract if you get that far.

Dr. Spirn: Honestly, there are very few questions you cannot or should not ask. Obviously, be respectful and courteous. When I was embarking on the job hunt, I was advised that you should not bring up salary and benefits on the first interview. That is probably good advice. If you both like each other after the first interview, salary structure can be discussed at a second interview or through future correspondence.

Dr. Ho: Trump or Hillary? Politics can be rough, especially when there is no good answer.

PARTING ADVICE

Dr. Spirn: Before deciding what questions you should and should not ask on your job interview, it is important to understand the playing field. You are no longer applying for limited resources with abundant applicants, as you did for residency and fellowship. Unless you have your heart set on one particular job, there will likely be several potential employment opportunities. You want to be happy and to optimize your likelihood of staying at your first job; therefore, remember that you are interviewing them as much as they are interviewing you. n

 

Section Editor Murtaza Adam, MD
• second-year retina fellow at Wills Eye Hospital in Philadelphia, Pa.
• madam@midatlanticretina.com

Section Editor David Ehmann, MD
• second-year retina fellow at Wills Eye Hospital in Philadelphia, Pa.
• dehmann@midatlanticretina.com

Section Editor Sundeep Kasi, MD
• second-year retina fellow at Wills Eye Hospital in Philadelphia, Pa.
• skasi@midatlanticretina.com

Allen C. Ho, MD
• director of retina research, Wills Eye Hospital; surgeon, Mid Atlantic Retina; professor of ophthalmology, Thomas Jefferson University, all in Philadelphia, Pa.
• chief medical editor, Retina Today
• achomd@gmail.com

Carl D. Regillo, MD
• director of the Wills Eye Hospital retina service; professor of ophthalmology, Thomas Jefferson University, both in Philadelphia, Pa.
• member of the Retina Today editorial advisory board
• cregillo@aol.com

Marc Spirn, MD
• assistant professor of ophthalmology, Thomas Jefferson University and Wills Eye Hospital retina service; surgeon, Mid Atlantic Retina; all in Philadelphia, Pa.
• mspirn@midatlanticretina.com

James F. Vander, MD
• president, Mid Atlantic Retina; clinical professor of ophthalmology, Thomas Jefferson University, both in Philadelphia, Pa.