5 Things to Know Before You Take Your First Job

1. Private Practice vs. Academics?
Think critically about white route/lifestyle you prefer. 

For those considering a private practice model, make sure you understand the pathway to partnership and financial health of the group. 

For those considering academics, make sure you understand the academic appointment process.  Does the institution have a clinical pathway in addition to a tenure/research track?  What is expected of you in each track and what are the objective criteria for promotion/academic advancement. 

2.  Know the Wants and Needs of Your Group and Local Community
Critically assess what need you are filling for the group/department you join.
Ascertain whether you will be the only person practicing your sub-specialty, or will you have others to share a certain patient population? This has pros and cons for the young surgeon. Being an exclusive provider provides more cases but may be challenging when you encounter tough cases that could benefit from assistance from a senior partner.
3. Understand Your Offer (and run it by others who do as well)
Make sure you understand the nuances of how you get paid. Is it a salaried position? Are there opportunities for bonuses based on productivity? How does compensation change based on time and experience? In terms of collections, where does the money go (to you, your partners, overhead, etc.)?

Have a clear understanding of your benefits including health, dental, vision and  malpractice insurance along with retirement plans. 

Know in advance what happens if you leave. Does your contract include a non-compete clause and how strict is that? Will the care you provided be insurance by tail coverage after you leave?

It is worth the time, and money, to have your contract reviewed by a lawyer prior to signing. Encourage your spouse and/or other significant others to review it as well. 

4. Understand Your Signing Bonus
Many jobs feature a signing bonus which helps the transition from trainee to “adulthood.” Be sure that this is a “bonus” and not a loan that you are expected to repay at a later date. Understand how and when signing bonus is dispensed and whether you can negotiate for other benefits such as a relocation package. Be warned, many contracts require you to return your signing bonus if you leave prematurely. Know the stipulations of that in advance.

5.  Get to Know the People You’ll Be Working With
By joining a group, you are hopefully picking the people you will spend a significant amount of time with for many years. In many cases, you will spend more time with these people than your own family, especially in first several years. Seek out partners that are Reliable, Honest, Friendly, and Supportive. Get to know them as much as possible and determine if you “fit in”. Make sure that you understand the practice “culture” of the group and that it aligns with your personal values.
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