A resident asks if the relative prestige of the training program matters when looking for a job.

If you’re looking for a job at a prestigious academic institution, or in a very competitive area such as New York City or are competing for a fellowship spot, I think that it is worthwhile to be at a top-rated residency program. Otherwise, I rarely have employers asking me for graduates from the top-rated residency programs. Most employers such as hospitals and rehab companies don’t even know which residency programs are ranked best.
Private practices typically don’t have a preference for residents from top-rated residencies. I don’t see more job offers to graduates of top-rated residencies. I also don’t see graduates from top-ranked residency programs commanding higher compensation. I more often hear of a preference for a resident because he/she came from the same residency program as the employer.
Employers most often prefer residents who have a connection with their area. It can be through family, the residency program being in the same state, hobbies that match the area’s features, etc. Employers want a doctor who will stay for the long-term and doctors who are familiar with the area tend to stay longer.

Here is some advice to consider when being interviewed.   Listen to the questions being asked.  Relax as much as possible so that you can understand the questions being asked.  It’s not good to provide an answer that doesn’t address the question.  This happens when we’re not listening well.    I’m not talking about not understanding the question in which case you should ask for it to be rephrased.  I’m talking about the unconscious situation when you don’t realize that you didn’t hear the question.   So you might want to not only practice answers to questions but to practice repeating the question if you’re working with a someone who’s posing sample questions to you.  They can then tell you whether you listened and have stated the question correctly.

STEPS TO BRINGING ON A NEW PHYSICIAN

1.  Prepare an itinerary for the candidate’s visit to include names and titles of the people the candidate will be meeting.  Provide this itinerary to the candidate before the visit.

2.   Allow for time for the candidate and significant other to see the community; Monday and Friday visits allow the weekend for this activity

3.  Make the travel arrangements or reimburse the candidate quickly for travel receipts presented

4.  Have a basket of local goodies in the hotel room upon the candidate’s arrival.

5.  Fill their hands with paraphernalia, e.g. brochures on the area, local newspaper, housing, etc.

6.  Ask if a babysitter will be needed

7.  Remember that this person must be sold on the facility, your physicians and the community and made to feel they will be proud to associate with them!

8.  Make sure there are no mixed signals during the interview process.  Prepare staff to avoid this if necessary.  Make sure all involved on the agenda will be saying the same things re:the job, area, medical community, policatial and/or third party culture, etc.

9.  Don’t allow the candidate to meet with a potentially hostile practice representative.

10.  Be on time for dinner.

Usually, I don’t recommend a cover letter.    Most of the individuals who review curricula vitae do not have the time to review more than the curricula vitae.  The only time I would recommend a cover letter is if you have something to feature about yourself which isn’t in your curriculum vitae.

I can’t provide you with a sample cover letter as it has to be specific to you but what follows is a sample of a cover letter minus your specifics.  It might be helpful to include your philosophy of practice and goals, if you know enough about the practice that you’re sure they’re a match with it.

Date

Name and Address to whom you are sending the letter

Dear ____________:

I would very much like to learn more about your practice opportunity, to include your needs and the goals of the opportunity.   I am certain I have the background and commitment to fill this position.

Body of the letter specific to your skills, experience, training, etc.

Thank you for your kind consideration.  I look forward to hearing from you.

Sincerely,

More and more entities are asking behavioral-type questions during the interview. I even had one practice require that candidates talk with an employment psychologist. These questions require more thought than the standard questions so you should prepare your answers. They delve into your personality. Here are some behavioral questions:

1. Describe your approach with patients? Show empathy and compassion in your response. Note items such as attention to listening, interest in patient education, and engaging the patient in conversation when responding to this question.
2. Tell me about a specific patient who came to you unhappy with the care they received elsewhere. How did you handle it? Once again, show compassion and empathy when answering this question. Your answer will inform they how you deal with worried patients. The same attitude should be displayed in your answers to the following questions too.
3. Please describe a difficult patient, family member or colleague with whom you had to work and how you handled the situation.
4. Please describe a difficult patient, family member or colleague with who you had to work and how you handled the situation.
5. Tell me about a specific patient who came to you unhappy with the care they received elsewhere. How did you handle it?
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Perhaps you wonder what kind of questions might be asked about you when a reference is done. Some of the typical questions follow. It’s best to prepare your reference before your reference receives the call. Tell your reference who will be calling and their position. Coach your reference on the qualifications the practice opportunity is seeking and how you match/exceed the qualifications.

How does he/she rank with other you have worked with?
How would you describe his/her clinical judgment?
How well does he/she know her limitations?
What type of practice would best suit him/her?
How would you describe her abilities as a team player?
What number of patients can he/she see per day?
What will a patient’s first impression be upon meeting her?
How curent is he/she with specialty knowledge, CME and/or reading?

Sometimes I’m asked what the future holds in physiatry needs. When one considers that the vast majority of physiatry residents are going into interventional fellowships, one might conclude that the market demands this service and it is being satisfied. On the other hand, we may be at a saturation point of interventional specialists. One might also conclude that the need for inpatient physiatrists is growing even though some rehab units and facilities have or are in the process of closing.

The upcoming election will have a strong impact on the future needs. With Obamacare, one might predict very large health care systems like Kaiser. Either way, the matter of economies of scale predict large physiatry health care systems and large physician groups. Everything seems to be consolidating. Some solo practitioners have called me looking for work as it’s too dificult to maintain referrals and deal with the business side of the practice.
My stance is to provide a variety of services so that you are not affected by the downturn of any particular service. Census’s vary, the ability of private payments vary, and the payment for interventional services changes so, as such, one has to be flexible and responsive to the marketplace.

Recently a physiatrist who is considering making a practice change asked me what I would do with her cv.  As is the norm, she and I talked and I shared information in writing with her about the practice opportunities of potential information with her.  This is my routine procedure.  I find out where  and about what you have an interest.  If I have matching practice opportunities, I present them to you and provide them to you in writing.  I always want you to know as mmuch about the opportunity as I do.  I then follow-up with you in a few days to see what you think about the practice opportunity(s).  It is at this point that I ask for your cv if you respond that you are interested in the opportunity(s).

I’ve written earlier that you should hesitate to provide a cv to a recruiter unless they have done the same process as I described above.   I do not circulate any doctor’s cv to any practices.  Your cv is your possession so it shouldn’t be released without your knowledge.  Although it’s not my practice, some physician recruiters use a blind cv to canvas for potential practice opportunities.  Or, they present your cv before securing your agreement to do so.  Of course, this is not an ethical practice.   For this reason, I always advise against presenting your cv until you have heard about a specific opportunity and have an interest in it.

I recently came upon some hard-hitting questions which might come up during a job interview for experienced physiatrists.   Even if these questions aren’t asked, it would be a good idea to bring the subjects up during an interview presuming the answers that you have are impressive.  These questions mostly focus on experienced doctors doing inpatient work.

1.  What is your current acuity level/CMI?  What is your typical average length of stay?

2.  How many patients/day are you accustomed to seeing and how many would you like to see?  How many would you consider to be a full load?

3.  What are your patient satisfaction scores?  What type of survey process is your hospital using?

4.  What is your discharge to community rate?  Discharge to SNF?  Discharge back to Acute Care rate?

5.  Describe your relationship with your current hospital administration.

6.  What type of financial support are you looking for in your new position, e.g. stipend, income guarantee?

7.  What types of physician in-services have you done in the past year?

8.  Describe your record regarding quality outcomes such as functional improvement gains and program development and growth.

9.  Describe your ability to sell and market the rehab program.

10.  Describe your ability to build physician and staff relationships.
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