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Are you ready for your first job?
Four areas to focus on are type of job, location, colleagues and support, and compensation.
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One of my mentors in residency used to say, “My worst day of private practice is better than my best day of residency.” And this is from someone who often spoke fondly of the adventures of residency training. This quote gave me hope that the future would be bright. It turns out that the practice of ophthalmology is not quite that simple, but it is true that every year is better than the previous one.
Yes, there can be challenges along the way, but it is a great time to be an ophthalmologist. Visual results from our treatments, both surgical and medical, are better than ever, and there is an endless pipeline of new technology that will help us deliver even better outcomes to our patients. But the business of medicine is changing, and it could be perceived as less promising as it evolves. The key to the future is not predicting it, but rather being able to adapt to it.
You have spent 4 years in college, 4 more in medical school and at least 4 more in post-graduate training. Add in years for fellowship training, research or other graduate degrees and you can quickly approach 15 to 20 years of education build-up, culminating in a practice position. In choosing your first job, the key factors are the type of job, location, colleagues and support, and compensation.
Type of job
The types of jobs include academic positions, multispecialty groups and private practice jobs. The academic positions may include research components and the ability to work with medical students, residents and fellows. The multispecialty groups, sometimes in the form of HMOs, tend to offer a good work-life balance and an instant pool of referrals. Private practice jobs can span the spectrum from solo practice to a large group practice, both of which may require skills to run a business. And there are also hybrid positions in which parts of each are meshed together.
Location
The location of a job is critical to happiness. Some people seek to be near family, while others look for great weather year-round or the attractions of a big city, but regardless the reason, if you want to be in a specific location, you should focus your efforts on finding a position locally. The cost of living, job opportunities for a spouse and commuting times also factor into the decision.
Colleagues and support
Having supportive colleagues makes the transition into the job less stressful and provides guidance for future development of your career. This group can help ensure your future success, aid in developing referrals and even assist in challenging surgical cases. One of the biggest surprises in the transition from resident or fellow into the first year of practice is the sparsity of surgery. In your training, you will do many surgeries every week and as many as a thousand in a single year. But in your first year of practice, this may fall by a factor of 10. Patience is the key, and with time, typically at least a few years, surgical volume will grow.
Compensation
Compensation is often the first concern of job seekers, but it only tells part of the picture. Look at the structure of the payment and determine if it feels reasonably fair. There should be the ability to grow your revenue as your clinical and surgical volume builds up. A partnership track is important for your long-term happiness in the group, and your buy-in should be reasonable. Mandatory restrictive practice covenants are a warning sign that the group could twist your arm in the future and limit your options. Ownership interest in an outpatient surgery center should be considered as well.
More recommendations
Finally, the most important recommendation is to hire experts to help you. An experienced attorney can assist in reviewing your job contract. A business consultant can do an independent valuation of the practice to determine if your buy-in proposal is reasonable. And even asking the advice of your mentors is quite useful. Most ophthalmologists, me included, have learned from our many mistakes over the years and would be happy to help you avoid these pitfalls.
Understand that while it is possible that your first job will be your only job for the rest of your career, it is perfectly acceptable to switch jobs. And your specific job description and practice focus will evolve over the years. You may limit your practice to a narrower focus, prefer to do more surgery than clinic, or even add other facets such as industry consultant, key opinion leader or writing a monthly column in Ocular Surgery News.
Ophthalmology is an amazing field, and we are blessed to have the opportunity to help patients improve their most precious sense, their sight. With an increasingly aging population, we will be busier than ever, and we will have the opportunity to enjoy practicing our profession.
- For more information:
- Uday Devgan, MD, is in private practice at Devgan Eye Surgery, Chief of Ophthalmology at Olive View UCLA Medical Center and Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, UCLA School of Medicine. He can be reached at 11600 Wilshire Blvd. #200, Los Angeles, CA 90025; email: devgan@gmail.com; website: www.DevganEye.com.
Disclosure: Devgan reports no relevant financial disclosures.