Job Search Timeline for Residents and Fellows
MARCH/APRIL Prior to your final year of training (i.e., fourth year of a five-year residency or first year of a two-year fellowship) Schedule a few “meet and greet” sessions with colleagues to discuss job opportunities, locations and types of practices during the AUA Annual Meeting in May.
you may have the opportunity to “buy into” the practice and become a partner. This option is unlikely to be possible in a hospital-employed or academic position. A more recent trend has been the selling of urology practices to private equity groups. This occurrence can drastically affect a young urologist’s job security, quality of life and income, so consider this in negotiations.
3.1 Needs/Requests Consider the following and whether or not they should be included in your contract: • Equipment ° Office-based equipment (laptop or desktop computer, flexible cystoscope, ultrasound, etc.)
AUGUST/SEPTEMBER During your final year of training Begin interviews and hospital/practice visits.
° Hospital-based equipment (full complement of flexible and rigid endoscopes, surgical instruments, etc.)
JANUARY/FEBRUARY
° Special equipment (surgical robot, ultrasound equipment, operative microscope, surgical LASERs, etc., and an appropriate amount of dedicated surgical “block time” for use)
During your final year of training Complete contract negotiations and finalize employment selection.
• Personnel Requirements ° In your office: nursing and ancillary staff members
Figure 1: It is extremely important to follow this timeline to avoid scrambling for a job. Limited options weaken the ability to negotiate effectively.
° In the hospital: Will they provide appropriately-trained personnel for surgical procedures? It’s especially important to be staffed with a qualified assistant for procedures such as robotic surgery, ESWL and microsurgery.
3. NEGOTIATING CONTRACTS Urologists are often in a great position to negotiate their first contract immediately following the completion of training. However, as mentioned elsewhere, the first one to two yea-rs of your position can often be a “money losing” proposition for your prospective employer as you have not yet established yourself as managing a competent and bustling clinical practice. Accordingly, recognize that “overnegotiating” your job offer might put you out of a potential job, especially in a large metropolitan market where there may be many other candidates vying for the same position. Negotiating a contract may vary widely depending on the type of practice one chooses. Joining a multispecialty group or physician-owned practice versus a hospital-employed position versus an academic position will affect the type of variables present in a contract. It is important to understand what variables may change depending on practice type. For example, in a physician-owned practice, AUAnet.org
3.2 Understand Compensation Typically, a hospital will guarantee your salary for one to two years. A suggested negotiated length of an initial contract is three years with periodic evaluations and/or meetings to track progress toward target productivity endpoints. Key questions to consider include: • Does your contract specify that you’ll be evaluated on a quarterly basis? • Will you be reimbursed based on your work Relative Value Units (RVUs)?
° NOTE: Though contracts will vary, the RVUs are based on national guidelines with an average RVU production of 9,000-10,000 per year. Academic positions generally have a lower RVU requirement to accommodate research activity.
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