Job Offers Abundant for New Doctors

More than 6 in 10 physicians say they've received 50 or more job offers during their residency, and more than 4 in 10 received more than 100 job offers, according to data from a physician recruiting firm.

Physicians completing their final year of residency say they're entering the job market with scores of job offers and most anticipate earning $176,000 or more in their first year of practice.

More than 60% of the 1,208 new doctors responding to an email survey from physician recruiters Merritt Hawkins say they've received 50 or more job offers during their residency, and 46% received more than 100 job offers.

"There is no such thing as an unemployed doctor," says Kurt Mosley, vice president of strategic alliances at Irving, TX-based Merritt Hawkins. "The good news is all of them need a job. The bad news is they only come out one time a year."

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Along with the strong job prospects, however, half of the residents say they owe $150,000 or more in students loans, and 25% of new physicians say they'd pick another profession if they had a do-over.

Ronald A. Paulus, MD, president/CEO of Asheville, NC-based Mission Health, says he's surprised the number of malcontents-in-residence is so low.

"Medical students measure extraordinarily high on compassion and empathy and by the time they're done with their residency it is very low," Paulus says. "The training process has been around since the early 1900s with only moderate changes. It is an extraordinarily grueling time."

"We need to look internally and ask what is it about this process that creates the change, because that is not what we want. We don't want to stamp out compassion and empathy. We want to boost it. We don't want people regretting their career choice. We want them embracing it."

Hospital Employment Alluring
Mosley says new physicians are entering a healthcare landscape that has changed dramatically since the day they entered medical school.

"In the past three years medicine has changed the most since 1965 and the arrival of Medicare and Medicaid. Many of the doctors who I talk to say 'Obamacare is not what I signed up for,'" Mosley says. "There are a lot of unknowns and people do not like unknowns. Some of it is trepidation, and some of it is what they are hearing from other physicians."

As for work settings, more than one-third (36%) of new physicians say they're "most open" to employment by a hospital. Mosley says that's understandable.

"That's where they were trained. There is strength and security in numbers, more depth and breadth," he says.

"When we're advising our clients about recruiting, we are saying in a lot of cases that hospitals have a better offer. It's not necessarily the geography as it is the primacy of the workshop. You've got to have a not just a reasonable schedule but a set schedule, 8–5 or 9–6, call coverage, hospitalists. Hospitals have all that and they know new docs want to be in that environment."

Rural Prospects
For those same reasons only 7% of new physicians expressed an interest in practicing in an area with a population of 50,000 or fewer. Only 2% said they'd practice in a town with 25,000 or fewer. Nearly half (47%) say they want to practice in an area with 500,000 or more people.

"This does not bode well," Mosley says.

"Most of the residencies are in the big cities, and they get a taste of it. They don't have any exposure to rural areas. We are telling our rural clients: If you don't have the complete primacy of the workshop, set schedule, hospitalist, call coverage, time off, locum tenens for solo practices, it's tough."

"Communities will have to grow their own," Mosley says. "Rotary, Chamber of Commerce, whomever: They'll have to help prepay medical school tuition in exchange for returning to practice for a few years."

The survey found that 78% of the physicians anticipated earning $176,000 of more in their first year. Mosley says new physicians are savvy about their earning potential. "They can go to our website and pull up a specialty and know what doctors make all over America," he says.
Even so, 22% of physicians expect to earn $175,000 or less in their first year.

"The average family practitioner makes $200,000 plus no matter where they are, so this indicates that some of these residents coming out are going to practice part time," Mosley says. "A lot of our clients want full-time doctors only, but in a lot of cases it could be good to have a husband and wife part time."

Paulus says his interactions with new physicians suggests that they are more mission-driven.
"It's not that they don't want to earn, but they are less fixated on maximizing income and having this life/work balance and making a difference," he says. "They also don't want to deal with many of the hassles that would traditionally be in place; starting a practice, worrying about billing and those things. It would be overgeneralizing to say that they want to come in, do their thing, and go home in a shift-like model, but that is the trend."

"Geographic location" was listed as the "most important" consideration (69%) for the new physicians, followed by lifestyle (61%), adequate call coverage/personal time (60%) and "good financial package" (60%).

Changing Expectations
Paulus says it's time to acknowledge and adapt to the profoundly changing expectations of the younger physician workforce.

"I have seen estimates that it takes 1.6 new graduates to replace one retiring," he says. "There are multiple reasons why and the biggest ones are lifestyle reasons. On average, new grads are more interested in a work/life balance than older graduates were."

"There is different speculation as to why that is the case. I am not trying to stereotype, but one thought is that over half of U.S. Medical students are female. That is a different dynamic than existed back whenever I was in medical school, and even before that. But, both males and females want to have more time with their families, more free time. So the choices that they are going to make are going to be driven by what can provide that kind of balance."

"I think most all of these things are very good," Paulus says. "The desire for a better life balance is a good thing and maybe we were the ones who were screwed up."