Urology Job Guide

So after years of taking resident call and receiving resident pay, you’re finally starting to see the light at the end of the tunnel.  To help you navigate your way into a job, this guide was put together by David Kunkle, MD, job seeker extraordinare.

Planning your Job Search Strategy

Once you start your pre-chief year (PGY 4 or 5), you need to figure out what you want to do with your life (e.g. fellowship, straight to practice, research job, etc.).  Please see the Fellowship Guide for details on fellowships if you are considering this option. If you are going to into practice, the most important thing to determine is what kind of practice you want to join.  You also need to start figuring out the geographic locations in which you would want to live.  This is also a good time to start thinking about your priorities for the job…which is most important: location, starting salary, income potential as partner, size of group (which may determine the call schedule and number of hospitals you’ll cover), ability to perform certain procedures, rapport with current partners, etc. . .

Making Contacts

Well ahead of time, you should start cultivating any contacts that you have within the urologic community.  If you have any acquaintances who are urologists, you should call them early on so you’ll be on their mind if they ever decide they need another urologist.  You may want to start feeling your way through generic questions like: “Do people in private practice think it’s important to do a fellowship?” “What should I be doing now as a resident to prepare myself for private practice?” or “How did you find your job when you were finishing residency?”  In addition to getting valuable advice, you are also cultivating a contact for the future.

During your pre-chief year, you will start getting calls from “head-hunters.”  This is flattering at first but will get annoying later.  Let them know your year of graduation and job/geographic preferences, but know they WILL call/email you later so think ahead of time about what information (eg cell vs home phone number) you want to give them.  In fact, it may be advisable to set up a new email account to be used for only this purpose.  You will get a lot of junk email from these people and you don’t want it all sent to your personal account for the rest of your life.

Start looking for job opportunities in the backs of journals and in the job magazines you get in the mail (if you aren’t receiving “Unique Opportunities” magazine, you need to sign up for it).  Get in touch with the contact person in these advertisements and ask for more information.  Early in the process, you can tell them “I will be finishing residency in the year 20XX, and was wondering if you expect this opportunity to still be available at that time.”  Even if they are looking for someone sooner, they will keep your name/information/CV on file for any additional positions that open up.

Jobfinder Websites

The AUA Jobfinder Website is an important means of learning about openings.  Some of the jobs are listed through headhunters, but there are also many good jobs that are listed directly by the practice.  Often the contact information listed in the ad will be directed to one of the partners in the group.  I know several residents that found good jobs (i.e. not the kind you find through headhunters) on this website.  You can set up an account to have all jobs that meet your preferences mailed directly to your email account (use the new account you set up for this purpose).  Go ahead and start reviewing these jobs 2 years before you will finish residency to get a good idea of what is out there.  Again, don’t be afraid to try and establish some contacts using the aforementioned techniques.  Many times groups will list a job up to 18 months before they expect a new urologist to start to allow enough time for interviewing, etc.  It takes a long time to get paperwork (contracts, malpractice insurance, licensing, etc) done, so groups that have planned appropriately will start looking well ahead of time.

"Cold Cold" Technique

About 18 months before completing residency, you need to start getting serious about where you want to end up.  Think about cities/locations where you would want to live and search for groups on the internet.  You can find a lot of information about urology practices on the internet, such as number of partners in the group, where they trained, which hospitals they work out of, and what types of procedures they perform.

Once you have a phone number for a group that seems appealing, give them a call.  Chances are that you will get a receptionist when you call.  You should identify yourself and state that you are finishing a urology residency & looking for a job (Most receptionists may not really know what to do with this information), then ask to speak with a managing partner or office manager/administrator.  Try to get a name and extension for wherever they transfer your call at this point -- you may be calling back later, and this information will make it easier.  Once you get a hold of someone, just tell them your situation.  If they say they’re not looking for anyone, ask if you could send your CV for them to keep on file in case something opens up.

KUNKLE EXAMPLE 1: I cold called a group in Virginia.  The first time I called, the receptionist said she didn’t know who I should talk to and asked if I could call her back later. The next time I called I was told to check their website where they post all of their job openings. Well, the website was where they posted jobs for custodians, receptionists, etc. . . The third time I called, I was referred to the CFO and got his voicemail.  Luckily, I got his extension and was able to be patched directly to his phone the next time I called (after he didn’t return my voicemail).

KUNKLE EXAMPLE 2:  I called a group that I had heard might be looking for someone.  I got in touch with the CFO, then one of the partners.  It turns out they were looking for someone fellowship trained, but they said they’d keep my CV on file. Three months later, one of the older partners unexpectedly retired and they called me back to set up an interview.

KUNKLE EXAMPLE 3:  I cold called a group I had found on the internet.  The receptionist referred me to the practice manager.  The practice manager stated that the practice had recently been bought by the health system and referred me to the health system’s HR department.  The HR department referred me to the in-house recruiter.  Finally, I had a phone interview with the recruiter who went back to the physicians in the practice to share my information.  One of the partners then called me to talk about the practice.  Then the recruiter called me to set up the site interview.

Former Residents

You already have something in common with former residents in your program, and you should contact them if you have questions about how they conducted their job search.  You should also contact them if you’re interested in moving to their area -- even if they’re not hiring, they might know of other groups in the area that are.

Good Job vs. Bad Job

Each person’s perspective of what represents a good job versus a bad job is potentially different.  Many of the jobs that use headhunter services represent the jobs that are more desperate to hire someone and often aren’t getting “cold calls” and CVs from job seekers.  However, this may simply indicate that a job simply isn’t one of the higher profile practices (due to less desirable geographic location, small group size, or overshadowed by other groups in the are).  When discussing one of these opportunities, try to figure out why they are paying a headhunter to find someone for them. These advertised jobs often provide a lot of incentives up front: loan repayment, signing bonus, high starting salary, etc. . ., but make sure you determine the financial situation once you become a partner (which is in the long run, the more important factor financially).

Interviewing

Once you schedule an interview, you can expect to have all of your expenses paid to go visit a practice. Also, pay attention to how the group handles the interview.  Groups that are disorganized about interview plans often seem to have disorganized practices.  You can learn a lot from how the interview is scheduled and planned Similarly, it reflects poorly on a practice’s part if it takes them a long time to get in touch with you after interviews and could represent either difficulty making decisions within the group or lack of professionalism in their job search.

KUNKLE EXAMPLE (bad):On one interview (that had been scheduled 3 months ahead of time) no itinerary had been planned for my visit.  Physicians were seeing patients per their normal routine and were not available to talk to me.  Several physicians were actually on vacation that week.  In fact, the office manager, who had arranged everything, was also away on vacation.  I spent most of the day standing in the hall talking to nurses.  Although I had to drive 5 hours to get to the interview, they never offered to pay any expenses (fortunately I was able to stay with relatives).  Following the interview, it took them over 2 months to contact me to offer me the job.  Not surprisingly, this group earned in the bottom 10% for urologists and had problems getting operating time at the hospital.

KUNKLE EXAMPLE (good):After speaking with the managing partner by phone, I was offered an initial interview.  The partner had their office manager/CFO (who was an MBA) contact me the next day and set up the interview.  They actually purchased an airline ticket for me and reserved a hotel room using their business credit card.  Partners had staggered schedules to allow for me to spend time with each physician throughout the day and actually printed out an itinerary for me.  I received tours of both offices as well as the hospital at which they worked.  They contacted me within a week afterward to express their continued interest.  Not surprisingly this group earned in the top 10% for urologists.

Generally, the interview timeline is as follows:

1. First interview: see the practice and hospital, meet the physicians.  Usually go out for dinner with the partners.  Remember that you’re trying to find the best fit for you and your family--don’t try to say sell yourself as something (e.g., god of female urology or laparoscopic genius) unless that is really how you hope/expect to practice.  The job interview process differs from the residency interview process dramatically in this regard.
2. Sometime in the days to weeks afterwards, get back in touch. Usually the practice re-initiates contact after they have had a chance to talk about the first interview.
3. Arrange second interview.  The spouse should be invited for this interview.  The second interview may include a tour around neighborhoods where you could live, hopefully with a realtor.  They may want to show you schools, local activities, etc. . .  You will probably have dinner with the partners and their spouses.  If there is an appropriate opportunity, you may get some specifics regarding financial information.  However, don’t expect to talk about the salary details at dinner.  Note: some groups may simply have you for one site visit to their practice, with spouse. This might happen with groups you already interviewed with at a meeting (eg AUA convention).  You may also interview with groups that prefer a single longer visit (eg. several days) after an extensive phone interview.
4. If they like you and think you will fit in with the group, they will re-contact you in the subsequent days/weeks to make you an offer.  Prior to making an offer, they may ask you for references or they may just call the chairman without notice to ask about you.  Usually the offers are somewhat negotiable.  So if there’s something that is totally unacceptable, ask to have it changed.  Beware, though, of starting out your relationship with your future partners by haggling over every detail.  The offer may come in the form of an actual legal contract or it may be an outline of what would be included in the contract if you accept the offer.
5. An offer is like a marriage proposal, and they would love to hear a quick “YES!” from you.  If you know that you will need more time to think it over or finish interviewing, you should tell them early.  Otherwise, they will get nervous if they haven’t heard anything from you and start exploring other options.
6. Once you have a contract, plan to have a lawyer look it over.  It is a good idea to be transparent about this (ie let them know upfront), and they should understand.
7. Some things you may want to have included in the contract:
   1. Equal call schedule compared with the partners
   2. Office, computer, etc. . . paid by practice
   3. Moving expenses paid
   4. Practice to pay for license/certification/credential fees
   5. Practice to pay for review courses for boards and registration fee for boards
   6. Date when you will start work
   7. Length of time to become partner; process for becoming partner and determining buyin
   8. Salary/amount of vacation during pre-partnership years

Once you’ve signed the contract, you can finally live your life again.  Sit back, relax, enjoy your chief year, and study for the boards.  Congratulations!

 

Questions to Ask on Job Interviews (coming soon)

 

This guide was prepared by David Kunkle, MD.

Dr. Kunkle is a graduate of the Temple University Residency Program.  He is in practice in North Carolina with the Carolina Urological Associates.