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August 10, 2021
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Start early to find your first job in endocrinology

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Choosing your first job out of training can be one of the most exciting and one of the most gut-wrenching experiences of your professional life. The process requires time for planning and time for self-exploration.

Those in training and starting their careers are busy, and finding time is not easy. Fortunately, you are not alone, and in addition to those who are going through the same experience, you have support from colleagues who have recently completed a job search and mentors who can guide you in determining what your strengths are and what will bring the most happiness.

Self-reflection, talking to mentors and advisors, and observing how interviewers interact are steps health care professionals should take prior to choosing their first job after training.
Jonathan D. Leffert
David C. Lieb

In this issue, Jonathan D. Leffert, MD, talks with David C. Lieb, MD, FACE, FACP, program director of the endocrinology and metabolism fellowship program at Eastern Virginia Medical School, about what to consider when making initial career decisions in endocrinology.

Leffert: When and how should fellows start in investigating options for the type of career in endocrinology they would like to pursue?

Lieb: It’s never too early to start thinking about your career after training. This takes time. Schedule a weekly slot on your calendar to go for a walk, and start creating a list of what makes you happy. Use that time to talk with your family about what makes them happy as well.

Talk to everyone you can — those who guided you into endocrinology in the first place, perhaps from your medical school or residency; talk with your faculty mentors from fellowship; meet with community endocrinologists and with the medical science liaisons from industry that you have met during training. Ask your fellowship program director to set up a local job night with endocrinologists in your area or participate in a regional or national job fair organized by an endocrine organization. Ask those with whom you speak what makes them happy, what concerns them about their job, do they see a future for themselves in that role? Make a list of pros and cons and see if it matches your own list.

Find a mentor. Perhaps someone from your fellowship program or from an endocrine organization or a community endocrinologist with whom you have developed a relationship. Work with that mentor to develop a timeline and an inventory of the things you will need to be successful in your quest to land that first job. If you have visa requirements make sure you have a mentor who understands the geographic restrictions you need to consider. While in training remember that you’ll need references. Keep a list of those individuals who mean the most to you and know you best.

Find a template for a good, simple curriculum vitae/resume, and update it frequently — at least once per month. Put a reminder on your calendar to do so. Or update it in real time with each professional experience you have, volunteer work you are engaged in and any scholarly activity you produce.

Leffert: What are the most important elements for fellows and young physicians to consider when choosing their practice settings?

Lieb: An endocrinologist has many options regarding their career path, including jobs in clinical practice, academic centers as a basic or clinical researcher or a clinical educator, the pharmaceutical and medical device industry, and government or regulatory roles, such as a position at the FDA. Determining which of these positions is best requires knowing yourself and meeting others with experience in those roles. All of these positions offer opportunities for growth and promotion — key factors in physician satisfaction and happiness. Salary should be on your list but should be only one of many factors.

It’s important to understand that one’s career path may and likely will change over time. And aspects of one path frequently intertwine with those of another. Those in clinical practice have many opportunities to teach students, residents and fellows. Private practice physicians have opportunities for becoming involved in clinical research. Those in academic positions who excel in patient care may take on more clinical care responsibilities in their division, perhaps by leading an inpatient diabetes service or outpatient specialty program at their center. All endocrinologists have opportunities to mentor others and to become involved in regional and national organizations. These experiences and relationships lead to significant professional satisfaction.

Leffert: What advice do you have for interviewing and deciding whether to take a job?

Lieb: Practice interviewing with a friend and be prepared to ask those questions that are most important to you. You’ll likely be contacted by a physician recruiter. Take advantage of those opportunities as they can help you to find positions that meet your criteria.

During your interview you should meet as many people as possible. Try to watch them as they interact with one another. These people will be your work family with whom you spend a substantial part of your time. Can you see yourself interacting with these individuals every day? Do they seem to get along with one another? This includes those that are part of the medical staff and administration. Who will be your contact for any concerns? Meet that person and ensure you feel comfortable with them whether they are the office manager, the division chief or the managing partner.

Consider where you’ll be practicing. Will you have to commute a great deal, and does that bother you? Will you practice in more than one location? Who will be your patients, and will you have opportunities to care for the populations and endocrine conditions that interest you most?

Have someone who can review contracts with you, either an experienced lawyer or a physician with significant experience in this area. National endocrine organizations can often help in this regard, and be on the lookout for programs geared toward endocrine fellows and those early in their career.

Job decisions often feel final. Once you make a choice, you may feel that you are stuck with that choice, no matter what happens next. What if you were wrong? What if what was promised isn’t so, or if real-world experience changes your view of what’s important to you?

Remember that many physicians will change their job — whether for a higher salary, an opportunity involving family, or because they see an opportunity for promotion. In fact, it’s unusual for someone to hold the same position throughout their professional life. The things that make you happy today will likely change over time as you grow and have new experiences. Remember that, and also remember that you have the support of many, and you’ll have new perspective on that first choice — and it might be less stressful.

Jonathan D. Leffert, MD, is managing partner at North Texas Endocrine Center and past president of the American Association of Clinical Endocrinology. He is an Endocrine Today Editorial Board Member and the Putting It Into Practice column editor. He can be reached at jleffert@leffertmail.com; Twitter: @JonathanLeffert.

David C. Lieb, MD, FACE, FACP, is associate professor of internal medicine and program director of the endocrinology and metabolism fellowship program at Eastern Virginia Medical School. He can be reached at liebdc@evms.edu; Twitter: @dclieb.