Do you have questions about transitioning from your training program to your first attending position? We have a checklist that will cover the most important aspects of the process. 

Completing these four steps will help you get off to the best start possible as a new attending.

1. Prepare or edit your CV/ resume

When was the last time you updated your CV or resume? (Not sure of the difference? Click here!) If you're like many residents, you last made serious edits between medical school and residency. 

As you near the end of residency, you should think back about the skills and experiences you have acquired since starting your training and update your documents accordingly. 

Your CV summarizes your educational background and professional experience. Your resume does the same thing, but is more of a marketing document meant to persuade an employer why you're the best for a position.

Since many potential employers spend only a minute or two skimming it it’s important to be sure that your resume highlights your most relevant skills. 

This might mean having different resumes or CVs depending on that employer to which you’re applying—for example, a CV for an academic position and a specific resume made just for a private practice position.

Any errors will carry a heavy weight in the mind of a potential employer

It’s also extremely important to make sure to follow citation and formatting rules. Since your CV/ resume will be one of many considered, it must allow the reviewer to scan it quickly and still see your accomplishments. 

As a physician, it’s important that the details matter to you in practice, so any lack of attention to detail in your documents will have an impact on how a hiring manager sees you. 

When you send your CV or resume to a potential employer they have very little data to use to build an impression of you, so any errors will carry a heavy weight in the mind of a potential employer. 

A good choice is to have someone read it over and make sure that there aren’t any typos and your language is clear and concise. It usually helps to have another person or professional editor take a look!

To see our 4 tips to perfect your resume, click here!

2. Find your ideal attending position

Now that your CV or resume is updated and carefully edited, it's on to the job search! 

One of the biggest fears we've heard from residents and fellows is that they will end up in a first practicing position that isn't what they wanted. 

Decide what is a “must-have” and what is a “nice-to-have”

So before you start considering positions, you should decide what is a “must-have” and what is a “nice-to-have”. 

Knowing what is most important to you will help when you start your job search. Think about aspects of the job such as the geographic area, lifestyle preferences, patient volume, current job market, and practice type.

Even if something seems like an impossible demand, put it on your list anyway. It’s a goal to aim for that will help shape your decision in a positive way.

When deciding what makes your “ideal position,” consider aspects of the position such as the types of patients and cases you want to see and the number of hours a week you’d like to work. 

Think about the pay and benefits you’re looking for, how big of a group you’re seeking, and the sort of work environment you’d like best. Finally, what geographic area are you interested in?

Describing your dream position will help you to compare that with the positions for which you interview and see how much overlap you can get.

As you consider your ideal position, make sure to consider employer types too

As you consider your ideal position, make sure to consider employer types too.

Each type of employer, from universities to HMO's to hospitals or private practices, will have its own unique pros and cons. 

When deciding where to work, think about the compensation, risks, benefits, opportunities, technology, call, ownership, duties, marketing, and staff.

For example, private practice will have better compensation than a teaching hospital, but it will also entail more risk. 

All of these organizational and operational differences should be taken into consideration when deciding which type of organization you want to work for and also to evaluate the contract you receive.

There are various ways to apply for jobs, from conferences, colleagues, recruiters, websites for physicians, and the professional society for each specialty.

Most residents or fellows begin a job search during the final year of residency or fellowship, so it’s a good idea to have your ideal job description completed early during your final year of training. 

Having that ideal job description in your mind will help you to navigate everything from networking at conferences to working with recruiters.

And once you find a job and turn in your CV, don’t forget to prepare for the interview. For our top 10 interviewing tips for physicians, click here. 

3. Understand and negotiate your contract

Congratulations! You found a great offer in the perfect location, and you have the contract to review. 

But how do you know if the contract is a good one? 

Many physicians from previous generations went without employment contract reviews for their first post-training job, while others simply let an older physician or friend review their agreements. 

From the non-compete clause to work relative value units (wRVUs) and other compensation models, contracts have become increasingly complicated. 

Today's residents and fellows are trending toward using physician contract specialist attorneys because it’s extremely important to understand exactly what is contained in your contract. 

It definitely makes sense to do so because of the increasingly intricate nature of employment agreements. 

Employment contracts are designed to protect the employer

Employment contracts are usually written in legal language that few speak, and are designed to protect the employer (sometimes at the expense of the physician). You don’t want to be startled to learn what’s in your contract only after you’ve signed it! 

You have to make sure that you know exactly what your contract is saying about malpractice, indemnification, restrictive covenants, your duties and responsibilities, and potential causes for termination.

If you decide to have your contract reviewed by an attorney, you need to make sure that you find someone who specializes in physician contract reviews. 

A contract review attorney can help you avoid potential snares such as having to pay back a signing bonus or accepting a subpar offer. 

A physician contract review attorney will also be able to let you know how your contract compares with others that they have seen, which will give you a leg-up in negotiations. 

An attorney will also help you with contract negotiations, or even negotiate on your behalf. 

If there is less room for negotiation in your contract, it is still worthwhile to have your contract laid out so that you have no surprises later. Entering into a bad contract can cause you a lot of frustration and money, so better to understand it before you sign it.

4. Take care of financial planning

You've found a great position, reviewed and negotiated the contract, and you're set...

Well, not quite. A great idea for a resident is to make a financial plan now, so you know what to do with your soon-to-be increased income before your first attending position's paycheck.

As you are developing a financial plan in order to grow your personal wealth, you should consider budget, debt repayment, tax planning, savings and retirement planning, and catastrophe planning. 

Budgeting

The first paycheck after residency will be a big change, but don’t let yourself get there without having a financial plan in place. So what do you do with all of that extra income? While it might be tempting to spend it, that won’t grow your wealth over the long term. 

In order to make the most of your money, you should put together a financial plan

In order to make the most of your money and secure your financial future, you should put together a financial plan (including a budget) and make your money work for you .

When you’re considering your budget, keep in mind that you may have a higher debt burden than many others and are starting your retirement savings later. 

However, that is offset by the fact that physicians earn higher salaries. So by making a budget, or a “road map,” you’ll have a plan of how to best reach your financial goals.

Debt Repayment

The average medical school graduate in 2015 owed $183,000, so debt repayment is a reality for many residents, fellows, and attending physicians. 

Most new doctors have an uncomfortable amount of debt after training. 

In fact, the average medical school graduate in 2015 owed $183,000, so debt repayment is a reality for many residents, fellows, and attending physicians. 

It can be difficult to strike a good balance between spending, saving, and debt payments. A good plan to tackle debt repayment will remove a lot of the stress that arises from being in student loan debt.

We’ve put together a guide to the various programs and strategies you can use to come up with the best way for you to repay your student loans. 

Savings

Honestly, your balance sheet is probably pretty unbalanced right now. You may have a lot of liabilities and few assets (except for your future earnings). 

You may not have a lot of liquid assets, and probably little invested for retirement. As part of your financial plan, you should make sure that account for savings is an integral part of it. 

Get into the habit of paying your future self first. Insufficient savings can force you to turn to debt, which is why you shouldn’t grow into your income. 

It’s much harder to cut back than to never increase your lifestyle in the first place. Before you start making big purchases, you should have a cushion in a savings account. 

Get into the habit of paying your future self first

Beyond saving cash, safe investing can have a hugely positive impact on your financial future. Investing today, thanks to the power of compound interest, will have a huge impact on your financial health later. 

In 30 years, a $15,000 investment today at a conservative average 5 percent return will give you $67,225. A $30,000 investment will return you $134,450! 

Choosing the right investments is critical, so if you aren’t sure or don’t want to spend a lot of time on tracking the health of your investments, working with a financial advisor can maximize your returns. 

Investing

Investing is a great way to make sure your money is getting you the best return possible. 

If you didn’t have time to learn about investing as a resident, now is the time to learn or to assemble a good financial advising team. 

It’s time for a crash course in financial literacy

Between learning the difference between a backdoor Roth IRA or a 457 plan and finding the best ways to maximize your post-tax income, it’s time for a crash course in financial literacy. 

If you don’t feel comfortable setting up a financial plan by yourself or don’t have the time to do so, finding a good financial advisor who will help you develop the best plan to achieve your financial dreams is an excellent idea.

Taxes and Retirement Planning

From Health Savings Accounts (HSAs) to 401(k)s to Roth IRAs, there are various ways of both considering your tax burden while investing for your retirement. 

When you are considering how best to invest, make sure you aren’t missing out on any tax deductions and that you’re adequately saving for retirement.

Catastrophe Planning

Catastrophe planning includes disability and life insurance. 

Disability insurance is especially important to obtain as a resident, due to the discounts available to residents and the lower premiums offered when you are young and healthy. 

This is a way to protect your future earnings, instead of being unprepared if you are injured in a way that would threaten your ability to work in your specialty. 

Once you complete these four steps, you’ll have an excellent foundation to ease your transition from training to practice.