Jul 07, 2021
By Asrar AlAhmadi, MBBS, MAS
As you approach your final year of training, you will most likely hear this question: “What are your plans after graduation?” Innocent as it is, this question can be anxiety-provoking. You have been working so hard for the better part of your life for this moment, yet our fellowship curriculums do not prepare us as trainees for the next steps. Thanks to the internet and social media (i.e., Twitter), identifying possible jobs is easier now than ever before, but finding your ideal job takes a systematic approach. I hope this piece provides some guidance for fellows to help navigate this exciting yet stressful experience.
Know Yourself and Start Early
Towards the beginning of fellowship, start reflecting on who you are and what you want. What are your strengths and weaknesses? What brings you joy? What are your goals? As you progress in your training, you will rotate through multiple subspecialties, and knowing yourself and what you hope to give and achieve may help you land on the right subspecialty or passion early, giving you the advantage of several years of focused training.
Second, prepare a professional curriculum vitae (CV) and update it regularly throughout your training with achievements and experiences. Your CV is a living document that you will be working with continually throughout your career, and getting an early start on this process will help you to focus on your current strengths and skills, assess where you stand, and provide an opportunity to fill gaps.
Third, attend organizational meetings (ASCO, American Society of Hematology (ASH), American Association for Cancer Research (AACR), etc.) and workshops. Don’t hesitate to reach out, be proactive, and expand your professional networks. There are many volunteer opportunities for fellows to serve on different committees through ASCO and ASH, which will help you grow your network and create opportunities during and after your training.
Write an Ideal Job Description and Identify Your Goals
As you progress through your training, observe and reflect on your values and priorities in medicine and in life. Do you value purpose, compassion, growth, fun, duty, tolerance, or tradition? Priorities such as personal interest, family, health and wellness, relationships, and professional development (teaching, clinical, research) vary from one person to another, and every subspecialty and position brings its own specific set of perks and challenges. Knowing what matters most to you will help you focus your time and energy appropriately, find your right work-life balance, and provide you a tool to realistically filter your job search.
The vast majority of oncology training occurs at academic institutions; many fellows spend as much as 50% of their training on research rotations. While there is little exposure to work outside academia during fellowship, there are many career paths for an oncologist to consider. Private practice, federal agencies, pharmaceutical companies, and biotech are all career opportunities to which fellows have little exposure. In academia, for example, there are four main aspects to consider when writing your job description: clinical, education, research, and administrative. Other sectors have different aspects, and different benefits and drawbacks. Try to network outside of academia and seek mentorship to learn about them and narrow down your options.
Once you establish your priorities and your desired career trajectory, it’s a good exercise to clearly map out your career goals. Write them down. Using tools such as SMARTER Goals helps to create a clear and attainable vision of the future. It can also help you later in your interview process to clearly articulate your intended career path, explore potential collaborations, and find the work environment that will bring you closer to your goals. Try to outline 3- and 5-year plans.
Become Job-Search Savvy
There is no right time to start the job search, though trainees usually start looking the summer before graduation. International medical graduates tend to start earlier to accommodate visa obligations. The job search can seem daunting, but there are many ways to find job openings. The ASCO Career Center is a good place to start. Personal connections through networking and mentors are still the main way to identify jobs that are not posted online. In the last few years, many job openings are posted on Twitter, and having an active digital presence can be advantageous. National meetings such as the ASCO Annual Meeting have locations where both academic and private practice jobs are posted, now in a new virtual format due to COVID-19.
Recommended Resources for Your Job Search
- Alpert JS. Finding the right job in clinical practice or academia: advice for young clinicians and investigators. Circulation. 2010:121;1862-5.
- ASCO. 9 Tips for Finding and Landing an Oncology Job. ASCO Connection.
- Mehta SJ, Forde KA. How to make a successful transition from fellowship to faculty in an academic medical center. Gastroenterology. 2013:145;703-7.
- Sedrak MS. Finding Your First Oncology Job: A Mini-Workbook for Career Success. ASCO Connection. Jul 19, 2019.
- Provider Solutions & Development. 12 Physician Job Search Priorities That May Surprise You. JAMA Career Center. Feb 8, 2021.
The following are some tips to help you in the process:
1. Make the right impression.
- Make sure you have your CV and cover letter ready. Review both with your mentor and customize your cover letter for each job inquiry.
- Review your potential job list with your mentor and program director. Academic oncology is a small world, after all, and a good introductory email can go a long way.
- Prepare for and practice your job talk if you are applying to academic institutions. I was advised to prepare my job talk before contacting any potential program. The advice came in handy when my first job talk was scheduled a few weeks after I submitted a CV.
2 Get to know your potential future peers and faculty.
- If you are interviewing at an academic institution, you can look up the accomplishments of junior faculty, the commitment of senior faculty to mentorship, opportunities for collaboration, and the use of shared resources.
- Keep an eye open for red flags: the absence of a mid-career academic physician at an institution or low retention rate of faculty, for example, should raise questions.
- For private practice jobs, inquire about hospital affiliations, the practice’s reputation in the community, retention, work-life balance, and support from other specialties (radiology, pathology, radiation oncology).
3 Know what to expect in your job interview.
- A screening phone interview with the division chief or team leader is usually the first step. It gives both of you an opportunity to assess if your priorities and goals align before committing to a site visit.
- The site visit is usually a 1- to 2-day interview. It can be long and tiring. Be professional and genuine. Do not inflate your accomplishments. Ask questions, be curious, and be your authentic self.
- Inquire about the hospital system's values and culture, as it will inform the leadership styles and how they support their employees.
- Enjoy the process. You will see a lot of programs and learn about different leadership styles and work cultures. Through the experience and with reflection, you will understand what matters the most to you and develop a clear vision of your priorities.
4 Prepare to navigate the job offer.
- If a job is offered, usually either an offer sheet (typical in academia) or a formal contract (typical for private practice roles) will outline the main details of the position, such as salary, benefits, and expectations. It is essential to consider the whole package—both financial and non-financial aspects—before making a decision. In academia, you should consider allocated time for clinical duties (inpatient service, clinics, and administrative committees), teaching activities, protected time for research, expected annual number of publications and scientific presentations, clinical trial responsibilities, incentives opportunities, mentorship committees, continuing medical education funds, and retirement plans. Inquire about available resources for academic pursuits such as research coordinators, statisticians, and shared resources. Additionally, in private practice, one should clarify opportunities for partnership, loan reimbursement, and marketing strategies.
- Negotiate. Negotiate. Negotiate. Balance what you must have and what you are willing to compromise on. Salary, startup package for research, incentives, or an escape clause are only a few examples. Knowing your strengths and non-negotiables and being transparent about them is essential for a successful offer negotiation.
- Analyze your offers and weigh the pros and cons of each. Ask for advice from mentors and colleagues. As you finalize your decision, keep these two questions in mind: Will I grow professionally in the position? Will I be happy here 5 years from now?
Just like in life, there is no one-size-fits-all approach to the job search, but a positive attitude and dedication to your goals will get you far. I hope this guide will help you convert any potential job-search anxiety to an enjoyable milestone of reflecting on your values and priorities, identifying your goals, and finishing strong by landing on the career opportunity that fits you best—and you won’t need to fear the question, “What are your plans after graduation?