1. Location: Limit yourself geographically.  Be realistic.  Don't consider opportunities in Kansas and Connecticut unless there is a unique reason to do so, e.g. you are originally from Kansas and your spouse is originally from Connecticut.  most candidates are primarily interested in a defined geographical area, such as a southern Wisconsin and Chicagoland.  Many potential employers dismiss candidates who are unfocused.
2. Type Of Practice:  Think about what type of practice setting suits you- Are you entrepreneurial or not?  Residents generally select between the following: multi-specialty group, single specialty group, hospital employment, hospital-sponsored group practice, hospital-sponsored solo practice, HMO, or some hybrid of these.  It is difficult to imagine a physician seriously considering opportunities with both a 250-physician multi-specialty group and a solo practice.  Generally they attract different sorts of folks.  Again, many potential employers dismiss candidates who are unfocused.
3. Income:  Be realistic regarding the first year's salary or guarantee.  While there are regional differences in income, there aren't huge differences within a region unless there is a 'catch' somewhere.  Remember the old adage--if it looks too good to be true, it probably is!  Unusually high salaries frequently are accompanied with professional isolation, geographical isolation, poor call coverage, and difficult working conditions.
4. Short Term vs. Long Term Income:  Assume that you will stay in this practice opportunity fix 20 years.  Don't worry so much about the first years income--Instead focus on the fifth year's income, tenth year's income, and long term stability- Young physicians who overly concentrate on short term income frequently change jobs after two years.  Unfortunately, some physicians never learn this, and change jobs every 2-3 years for their entire careers.
5. Working Conditions:  Again, be realistic-everyone wants a high income with lots of time off and minimal call responsibilities.  Find out what the working conditions are before you interview-if they don't fit you lifestyle, look elsewhere.  Nothing irritates a hiring physician or administrator more than an applicant trying to bargain the working conditions, e.g. time off, call, office space requirements.
6. Be Honest:  If there are certain things that are non-negotiable for professional or personal reasons, tell the potential employer this upfront.  An example might be an unwillingness of a Family Practitioner to practice Obstetrics.  It is better to clear this up early rather than have it become a sore spot later.
7. Be Flexible:  Things are never as good or bad as they seem.  You will be much happier if you try to remain as flexible in medicine as possible.  In addition, with the health care delivery system changing constantly, you must be able to go with the flow.  Related to this, no position is perfect.  They all have pluses or minuses.
8. Computers:  Become computer literate.  Enough said.
9. Seek Out Other Professionals:  Early on in your professional career, you should seek out a competent attorney, accountant, and financial advisor.  If you lose confidence in any of them, replace him/her ASAP.  If you don't know whom to contact, ask other physicians in the community.  I am reminded of an expression of my father, a music teacher, now retired, said; "My attorney and I have an agreement.  I don't update my will and he doesn't give trombone lessons."
10. Balance Your Life:  Everyone needs activities outside of medicine.  Set aside time for yourself, especially physical exercise.  You will have more energy to practice medicine if you strike a balance.  By the same token, don't let your outside interest dictate your career.  Remember, you're a physician first and an amateur hockey player, musician, etc...second.  Like any other professional, you will undoubtedly have to make sacrifices to balance these competing interests.

Written by...

Chris Kashnig
Director, Physician Recruitment
Christie Clinic Association
101 W. University Ave.
Champaign, IL 61820
Phone: 217-366-5374
Fax:217-373-6872
Email: ckashnig@christieclinic.com
Member of ISPRNet.org