Fresh hiring market news and perspectives.
ETS is your greatest resource.

Searching for the right position can take a lot of effort.

Knowing where to start and how to navigate the job search process ahead of time can save quite a bit of time and energy. These are the most common actions that will improve the quality and number of your job offers. Please note: This article focuses on family medicine residents seeking permanent outpatient only positions in the US.

As you read this, look for “Key Actionable Items” that can help streamline your search process.

Where to start?

To join a practice, the opportunity has to match what you’re looking for and they have to be hiring. As you navigate the search process, it’s important to remember that a normal timeline from your first application to accepting a position is around 3 months. 1 month is quick but common. 12 to 14 months is on the longer side and also common.

 1. Is this what I’m looking for?

Location is a great starting point for finding out what is important to you. Here are some questions you can ask yourself to narrow down the geography:

• Where is my family located? Do I want to live near them?
• Where is my spouse’s family located? Do we want to live near them?
• What’s a place I’ve lived in and enjoyed?

Trying to weed out all the less-than-perfect jobs at this stage hurts you in the end. The group or position that is the front runner will change as more information comes to light. Limit yourself to one or two absolute requirements. For family medicine physicians, that is typically geography and inpatient/outpatient.

Hold off on filtering by community size, revenue model, large or small organization, and compensation at this stage.

Community size becomes too restrictive. Most physicians we work with are willing to bend on geography to trade for something else they want. Would you commute ten extra minutes for a four-day work week? Live in the next town over for 15% more money? Trade a city of 400,000+ people for a city of 250,000 if it meant a strong team and charismatic leader?

• Large population centers often have more doctors per person than rural areas or mid-sized cities which makes it harder to find positions.
• Mid-sized places tend to have more openings than doctors, but it varies on the local market (mainly because of how many residencies are in the area; 1 in 4 family medicine physicians take their first position where they did residency).
• Rural areas tend to have greater needs, but one or two physicians can cover the needs of a large geographic area.

Considering positions one hour outside major metros will make your life a whole lot easier. Where you work, where you live and where you spend your free time don’t all have to be the same city. Some of the sweetest set-ups will be working one hour from a major city, competing against fewer applicants, getting paid more, having a 30-minute commute, and having a 30-minute drive to major concerts and Trader Joe’s. Be open to differing community sizes at this stage.

>>> Key Actionable Item: Broaden your search to any geography you would even consider.

Revenue Models have been the source of a lot of conversation lately. Namely, three major ones are fee-for-service, value-based care, and direct primary care. None are perfect. There are good and bad physicians in every revenue model. Try not to filter openings based on revenue at this stage.

When considering large organizations versus smaller ones, take the time to get to know how they work and what the management philosophy is. Don’t eliminate a group before finding out all you can about them.

Applications are requests for more information. You’re not committing now and you can decline at any point. If it’s possible the position could be a fit, make the low-commitment request to learn more. Bad potential employers will make themselves known.

Family medicine residents often don’t apply for positions because the compensation seems low relative to what they’ve heard. The high/average/low compensation comparisons only matter for the written offers you’ve received. Seeing “competitive pay” is a good thing, regardless of if the pay is competitive because the phrase “competitive pay” is an invitation to negotiate. Compensation matters a lot. Talk to practices you’re concerned may offer below market compensation at this stage. There’s also the chance that they offer you more than they initially posted or discussed.

I spoke with a current PGY-3 family medicine resident looking for an opening near a large city where her family lives. One of the positions she had applied for had solid pay. Her phone interview was the next week. The resident was excited. I spoke with her about a nearby position which didn’t pay as well. She said she wasn’t interested because it paid less than the other. Fast forward 2 months, the initial interview hadn’t worked out with the first practice and she became open to other opportunities. Don’t count your chickens before they hatch.

Once you’ve set one or two basic non-negotiables, typically geography and inpatient/outpatient, then start looking at having a conversation with the practice. Aim to be fairly broad at this point because the second condition of “Are they hiring?” will narrow your search a great deal. A conversation isn’t a commitment.

This is not a recommendation to apply everywhere (e.g., if there’s no possible future where you end up in Wyoming, don’t apply to jobs in Wyoming). However, do apply for any position that could be a fit. Experienced family medicine and internal medicine physicians looking for a new position approach their searches this way.

If you have a spouse or serious partner, be sure to share details on your approach to and viewpoint on applications. Your non-negotiables are made as a unit. If your family needs your position to pay a certain amount, you lower your chances of meeting those needs by filtering positions based on compensation before you’ve earned the formal offer.

>>> Key Actionable Item:  Keep your partner informed at every stage of the application.

2. Are they hiring?

Groups that are hiring and groups that have jobs posted for family medicine physicians do not have a perfect overlap. You’ll find plenty of jobs posted by people who aren’t hiring. They’re a big source of frustration. The only way to know who they are is by reaching out.

In the middle, you have the intuitive group which needs a family medicine doctor and has a job posting up. There are dozens of job boards. Organizations typically only post one one or two of them. Job boards favor organizations that pay more to post on them and newer posts. Checking job boards every two or three weeks is a good pace to prevent missing anyone. The better the job, the quicker it goes.

>>> Key Actionable Item:  Go beyond the job boards to find positions.

On the other side, you have practices that are hiring but do not have any job posts to be seen. I’ve worked with practices that “really need a family medicine doctor” but on their career page, it says they aren’t hiring. The only way to find these hidden jobs is through your own network or someone else’s network. An independent recruiter who specializes in family medicine physicians is a great starting point.

In rural Mississippi, I had one opening. A family medicine doctor applied to it so we talked. Come to find out, it was with a group they had worked for previously. They didn’t have any interest in returning so I let them know I’d reach out to some people in the area. There was an unpublished opportunity (i.e., no job posting on any job board) within commuting distance of their home. Two weeks after speaking with me, she had interviewed and signed with the practice. Within a month, she  started at  this new position that wasn’t published anywhere. 

Despite the drawbacks, job boards still offer value so check them regularly. However, don’t limit your scope to only those sources. New positions are posted and filled rapidly. The better the job, the quicker it goes. Again, checking job boards every two or three weeks is a good pace. Most job boards let you alerts for positions that match your criteria. The alerts are typically good but not perfect. If you set the alerts, still check the job boards yourself.

At this point in the process, the two basic conditions have been met: you’d consider working for them and they’re open to adding another physician. Now you need to apply. (Still figuring it out? Follow our decision making flowchart found here.)

Applications & Interviews

Reframe Your Applications

An application is a request for more information. It is very far off from accepting and starting a position. Since most applications don’t result in someone starting a new position, think of applying as a way of simply saying “I’d like to learn more.”

>>> Key Actionable Item: Lower the stakes of applying to a position.

I’ve heard skepticism that as an independent recruiter, I get paid if you apply for jobs. I don’t. I get paid by the hiring practice if you sign, start, and stay. Convincing tons of high earning people to waste their time is bad for me too. My colleagues and I often witness potential matches nipped in the bud as a result of a hypothetical problem. Reduce your risk by having necessary conversations.

Take my grandfather’s wisdom: You don’t know what you don’t know until you have a conversation.

Curriculum Vitae (CV)

A CV’s objective is to secure a phone interview. Almost every CV I’ve seen from a family medicine doctor is passable. The auto-generated ones from online job boards are generally terrible, so consider setting aside time to write your own. To expedite the process, consider using a professional starter template. Reading this article already qualifies you as someone who probably doesn’t need help with your CV. If you’d still like someone’s input, speak with someone who screens applicants for family medicine doctors.

>>> Key Actionable Item: Show that you’re serious about staying in the area.

The biggest thing hiring authorities look for (besides actually being a family medicine or internal medicine doctor) is ties to an area. If you own a home in that area, your in-laws live near there, or the position is near your hometown, go ahead and say it. They won’t care that you finished high school—you are a doctor, after all. They will care a great deal if you finished high school within a 30 minute drive of their practice. If you’re applying for positions in that area, go ahead and include your high school information in the education section to illustrate your connection to the community.

You’ve Submitted an Application

Congrats!

Now comes one of the most common and infuriating steps for most job seekers: Not hearing back.

If they are looking to add a physician, it’s because they are busy. Consider that the practice is overwhelmed and that’s why they are hiring. A lack of response isn’t out of malice. It’s usually the result of a bad system. Most of these practices are designed to take care of patients, not process applications. Some very good practices can be very bad at the interview process.

>>> Key Actionable Item: Have a follow-up system for your applications.

Your follow-up system must work with you. I use my personal Gmail religiously and use it to schedule emails to myself. Google Calendar has added a “Tasks” feature that allows you to put tasks on a certain date and I use that now. One of my coworkers lives by the alarms on his phone. Another has a running to-do list she goes through every day.

If it’s in your head and on your mind, it’s because you don’t trust yourself to get it done. Capture it and put it in a follow-up system that works for you. Consider following up with a practice at least three times before deciding it isn’t worth your time. Make sure to switch the communications mediums: if email hasn’t worked, call. Calling not working? Try emailing. Don’t worry. You’re not being annoying. You are showing persistence and a strong interest.

If you’re too busy, just have a specialized independent recruiter do it for you.

I worked with a PGY-3 family medicine resident who was looking for a position after they finish residency in 7ish months. She was busy so I managed her applications in her desired area for her. We touched base weekly or more and I let them know where her applications stood. Things like:

• Blank Family Medicine said they enjoyed the introductory call and wants to know your availability for a face-to-face. When can you come in?
• Sorry for the delay on the response from EG Family Care, they’re going back and forth on if they are serious about hiring another physician. I’ll keep pinging them until they decide either way.
• Example Primary Care has signed another candidate and wanted me to let you know they thought you were great and hope to talk again someday.

When to Stop Applying to New Positions

Only stop applying to positions when you’ve signed a contract or letter of intent. Things that seem promising fall apart all the time. Keep starting the application process for positions that make sense based on your priorities. If you’d like to hold off because something is getting close, explain that to the practices that have responded to you. Be open and honest about where you’re at with other positions.

Starting applications while things get close makes it so when something happens, you get to reload instead of rebuild. Rebuilding is unpleasant.

>>> Key Actionable Item: Be transparent about your job search to prospective employers, including when you’re no longer interested.

You’re Not Interested Anymore…

… and that’s alright. If you signed for another position or are no longer interested because of something you learned about the opportunity, just let people know. I’ve never seen a bad reaction to it.

Keep all of your interview processes going until you’ve signed a contract. Things that look like sure things can fall through. Once you’ve signed a contract, tell the other practices that you’re speaking with. We send these types of messages on behalf of candidates all the time. If you’re uncomfortable, work with an independent recruiter who you trust not to drop the ball.

It’s awfully hard building back a burnt bridge and you never know where your path will go.

Something that’s not a fit now could be exactly what you’re looking for in the future. Even if it isn’t, people talk. Ghosting leaves a strong impression. Don’t do it. Sending the message to say you aren’t interested often takes less than two minutes. Tell anyone you’ve established contact with when you’re no longer interested. People admire the candor. It’s a rapport build. You’ll be doing yourself—and the practice—a big favor.

Interviewing

Make sure to always ask for next steps. Say something along the lines of, “It’s been a pleasure speaking with you. I’m very interested in your opportunity. What are the next steps to be considered for this position?”

Do it EVEN IF you think it’s clear what’s supposed to happen next. In the situation where they say they’ll get back to you in X amount of days, put it in your follow-up system to contact them the day after you were supposed to hear something. From our data, 23% of applications result in a phone interview. About 13% of phone interviews ultimately turn into someone accepting a position. That means it’s normal for it to take 30-35 applications to find a position you accept.

Once a month or so I’ll follow up on an introductory call that a candidate had with a practice. Both the candidate and the prospective employer will say something along the lines of, “I enjoyed speaking with them. I’m waiting for them to reach out to me.” That’s right—the hiring authorities AND the candidates say that.

>>> Key Actionable Item: Always ask for next steps at the end of each of your conversations and clarify who’s responsible.

Be kind to everyone at every step of the process. Feeling irritated? There are some disorganized recruiters out there. Maintain your poise and professionalism at every step. People work harder for people they like. Sometimes they even work against people they dislike. It’s better to fall into the first group.

The #1 reason applications fall apart is because there was a lack of communication. Communicate and over-communicate! If:

• your parent fell ill and you’re putting the application process on hold
• you are no longer interested
• you’re waiting on an offer from another practice
• you learned something that’s shown you this job isn’t a fit
• you have two kids, a spouse working nights, and can only respond on Saturday evenings

… tell your point of contact at the practice. A simple, “I got your message. I’ll read through it in its entirety and think through my response on Thursday the 14^th.” goes a long way.

Practice managers and hiring authorities can come across as a bit overbearing. They sometimes seem like they want an unreasonable response rate. From our experience, a normal primary care practice employs 3 or 4 people with one family medicine or internal medicine physician. To them, your one application is 4 or 5 applications. It may even determine the future of their own job.

Apply the Two Minute Rule. If responding to a message would take you less than two minutes, respond the moment you get the message. If a response would take longer than two minutes, put responding to the message in your follow-up system then tell them you’ll respond by that day and time.

>>> Key Actionable Item: COMMUNICATE!

Negotiate.

Since no one got into being a primary care family physician because they love negotiating all the ins and outs of an employment contract. Try to keep any requests about an offer or contract—be it substantial or just a re-wording—to a smaller number. Asking for an overly detailed, ever-changing list often frustrates the potential employer. Keep your asks to a smaller number of things.*

You should always consult with an expert in negotiations. Here, I’m relaying what I’ve personally seen. Since negotiating will make a significant difference in what your final contract looks like, you may want to read Never Split the Difference: Negotiating as if Your Life Depended on It by Chris Voss and Tahl Raz. Having the right negotiating skills may result in a salary increase or more PTO.

Don’t try to renegotiate your offer after you’ve signed the contract. Occasionally, candidates will go back and forth, get everything settled, sign, then try to see if they can get something else changed. They always come off as only in it for themselves and it always kills it. Any negotiation must happen before you sign on the dotted line.*

Before signing, pay for a medical contract lawyer. This is a legal document. Legalese is often confusing. They’ll know what’s standard and what should be removed. Negotiate the contract yourself, even if it is your lawyer’s advice. People don’t like people who talk through lawyers.*

Attorneys are highly specialized. You’ll need one who focuses on employment contracts for physicians, ideally in your specialty. Now is not the time to rely on personal connections. Avoid using family and friends who are attorneys to steer away from conflicts-of-interest.

*This article does not contain any legal advice. Always consult a qualified attorney before making any legal decisions.

How to Get the Best Job

Communicate quickly. Apply to every position that might be a fit. Be transparent at all times, extremely responsive, and your personable self. Afterall, the only time you’ve secured an offer is when you’ve formally received an offer. During the process, act accordingly. Always, always respond to any communications with all possible speed.

About the Author

Ben Kennedy was the founding team member of ETS Family Medicine in March of 2023. He now focuses on recruiting the southeastern US, including VA, WV, NC, SC, GA, FL, TN, AL, and MS. ETS Family Medicine recruits nationwide from Roanoke, VA.

ETS Family Medicine is the US’s only independent recruiting firm focused on outpatient only, primary care opportunities for family medicine and internal medicine physicians. We don’t represent a singular practice, group, hospital, or health system.

Every day, Ben speaks with physicians and hiring authorities. In his first year, Ben interviewed 176 family and internal medicine physicians; spoke with 1,600 practices; and wrote five articles.

Outside of the office, Ben spends as much time as possible with his fiancée, friends, and two cats. His journey at ETS began during a summer internship during high school; another internship during college; and full-time as the Office Coordination and Internal Recruiter for ETS Family Medicine’s parent company, ETS Recruit. Ben is a graduate of Virginia Tech’s Pamplin College of Business.

For questions, comments, feedback, or advice, contact Ben at bkennedy@etsfamilymed.com or via text or call at (540) 400-7641.

Job Search Advice for Primary Care Family Medicine Residents last edited on May 30, 2024.