Factors to consider when you evaluate job offers right out of residency or fellowship include:
1. Clinical duties – how do these correspond to your areas of interest?
2. Academic opportunities – will you have protected time for research? What teaching duties will you have? How does the position meet your academic expectations?
4. Opportunities for your spouse or partner
5. Perks and benefits
6. Location – is this a part of the country where you want to live?
While all of these may influence your decision, I suggest that you spend some time deciding which factors matter the most to you. That first job will shape your future career just as surely as your training will.
Take special notice of the clinical and academic opportunities, and those for your spouse and partner. If these are excellent, the rest of the list becomes less important. Make sure you will have a good mentor.
A fortunate few may find the ideal first job in the perfect location, but most of us end up compromising. Before you compromise, decide what matters most to you.
Commit to that first job for at least four or five years, even if you find that the position is less than perfect. Take time to get your boards behind you. Become a Fellow of the American College of Surgeons. Consolidate your clinical skills and get your research going. Publish. Take advantage of every opportunity in this first position. Let your family settle down for a while. Enjoy the difference between faculty and resident.
The job may or may not grow on you. If, after those four or five years, you still feel that the job is a bad fit, then start looking for your next position. This second job search can be done on your own timeline (rather than the deadline of looming end of residency) and you can afford to be more choosy.
Set a goal for that next position. Will it be a move to a larger, more prestigious university where you can specialize in exactly your area of interest? Do you want to lead a clinical service line? Do you want to become a program director?
Think about getting some additional skills while you look around. Perhaps you want to add a new clinical skill. Maybe you could use some additional research or leadership training. It helps to be a bit flexible, even opportunistic – see what is available at your university or in your city or town.
Next week, we'll explore that first promotion.