After several years of significant effort, you are now ready to begin your search for the perfect medical practice opportunity. Maybe you have already practiced and are looking for a change.

Whatever your situation, you now want to search for a position and it is important that you find one that is a good fit with your knowledge, skills and personal goals.

If you are completing a residency or fellowship, it is likely that the final months of your program will be very busy. In addition, you will be competing for available employment positions with candidates throughout the United States – including physicians completing their training programs and physicians interested in relocation. While you have faced many competitive situations in the past, this time it is different. You must drive the process and it will be your approach and skill, not exam scores, that place you at the top of an employer’s target hire list. Consequently, it is imperative to start early with precision and great focus as you seek your ideal practice.

As a guide and based on 25 years of academic pediatric recruiting and leadership development experience, we have developed “Conducting an Effective Employment Search” so that you may approach your search in a focused, organized and effective manner. This approach begins with a personal assessment to develop an inventory and prioritization of your goals. Once you have prioritized your goals, it is necessary to establish a search timeline that incorporates your work schedule as well as any personal events that you have scheduled during your search. The search timeline incorporates networking, research, interviews and the evaluation of employment offers. While no process can guarantee an outcome, following the suggested approach will help to assure that you have effectively identified and explored all opportunities, prepared yourself for a successful contract negotiation experience and ultimately set yourself up for great future success. With the successful completion of your search, you can shift your focus to issues related to state licensure, credentialing, relocation and career advancement and success.

Getting to Your Goals

(To be completed 2 years before completing training and amended thereafter)

Personal Assessment, Goal Inventory and Prioritization
Family, Social and Recreation Goals
In the medical profession, the term “quality of life” is often used to refer to the balance between the demands of the profession and everything else. Family, social and recreation goals make up much of “everything else.” Before embarking on an employment search, it is important to complete a personal assessment to better define your social, family and recreation goals.

While you may believe that these goals are already clear, allow some time to think through your goals in these areas. Do not try to prioritize them yet, just write down answers to the following questions:

Do you have specific family goals?

  • Will your spouse/partner need employment?
  • Will you need childcare?
  • Do you desire private schools for children?
  • Do you desire close proximity to relatives?
  • Do you desire close proximity to specific religious organizations?


Do you have specific social and recreation goals?

  • Are any of the following important to you: educational institutions, libraries, museums, theatre, opera, ballet, the symphony?
  • Do you wish to be near existing friends, settings with a younger crowd or nightlife or other settings where you can meet people?
  • Do you wish to have access to sailing, water skiing, snow skiing, mountain or rock climbing, hiking, running, cycling, tennis, golf?
  • Do you wish to have access to professional sporting events or concerts?
  • What other types of places, organizations or events do you wish to have access to?
  • Do you wish to be near a major airport?


Often, many of these goals can be achieved without having specific opportunities to achieve them in the community you choose to practice in. The real issue may be relatively convenient access to these opportunities. Ask your self these key questions:

  • How often will you participate in these organizations, activities or opportunities?
  • How close to these may you be by driving or by air travel to satisfy your goals?


Professional Goals

By now you have probably given some, if not considerable, thought to your professional goals after residency or fellowship. These goals are probably related to the type of professional setting that appeals to you. Maybe you have visualized yourself in a particular professional setting without really knowing much about the details or requirements involved and how these impact your other goals. Maybe you know that you want to be in academic pediatrics but have not given much consideration to the many types of practice settings and the resources require for success. It probably comes as no surprise that the professional setting you choose has relative advantages and disadvantages in terms of other goal achievement. For instance, if you wish to engage in research or teach, a private practice setting is likely not a good choice to achieve that goal. There are however less obvious examples. For example, if you want to be in academic practice, does the structure of the practice plan matter? How many faculty and mid-level providers should be in place to allow for the non-clinical time to accomplish your research and teaching goals? What are the long-term differences in academic tracks and does tenure matter?

Your practice choice will impact other goals. For example, if you have a goal of devoting a substantial number of evenings at home with your family and you join a division with only one other physician in your specialty, the required on call every other night may not allow you to achieve your family or social goals. We do not attempt here to provide all the advantages and disadvantages of each type of setting. Your mentors and research will help you understand the trade-offs in achieving your goals in these various settings. The intent here is for you to think about the various types of settings and how your professional goals may be achieved in these settings, as well as how other goals will be impacted by these settings. Ask yourself the following questions and think about the opportunity to achieve your professional goals in each.

  • Do you want to be in academic or private practice?
  • Do you want to practice in a large academic medical center smaller children’s hospital?
  • Do you want to teach medical students and residents?
  • Do you want to engage in research? Clinical or basic science research?
  • Are you interested in further education and training?
  • How much time do you intend to devote to the profession on a weekly basis?
  • What kind of call schedule are you comfortable with?
  • What value do you place on working with other physicians with backgrounds and interests similar to your own? 

Financial Goals

In addition to family, social, recreational and professional goals, we assume that you want to achieve financial independence and build wealth. If you are like most physicians, you have borrowed at some point to fund your education and training and will begin your employment search with student loans outstanding. The sooner these loans are eliminated the sooner your financial net worth will begin to climb. Since you are entering your more significant earning years at a later age, you may have some catching up to do for certain financial goals. Achieving financial independence and building wealth requires diligent financial goal setting and planning. While your starting salary is easy to focus on, recognize that your longer-term income opportunity in your choice of position coupled with careful expense and investment planning is critical to achieving your financial goals. Recognize also that your level of expenses is just as important, if not more important, than your income in achieving your goals. If this sounds familiar, it is because it is a fundamental aspect of developing a budget. Planning your expenses to be much less than your income will do more to help you achieve financial independence and build wealth than merely focusing on increasing your income.

Unfortunately, like others, some physicians live beyond their means and end up in bankruptcy or spend their months and years struggling to make ends meet. Given the level of income a physician can achieve in the medical profession, bankruptcy is certainly not an expected outcome. Income is in fact only part of the equation. Anyone can live beyond his or her means, and physicians are no exception. Understand your financial goals and have a plan to achieve them. Of course, unexpected events can derail the best financial plan. Do not underestimate the financial importance of professional liability insurance, life insurance and disability insurance. Always consider professional guidance in areas involving financial risk. Financial investments, including practice buy-ins, equity investments and various business opportunities should be approached with professional advice. Attorneys, accountants, financial planners, and consultants can offer significant and often necessary guidance in helping you realize your financial goals.

Of course, economic goals have an impact on other goals. For instance, if you have an opportunity to earn bonuses based on increased productivity (i.e. more patients, more revenue) other goals such as family, social and recreation goals may be more difficult to achieve. This does not mean that achieving your financial goals requires you to significantly modify your professional, family, social and recreation goals. It means you must clearly understand your financial goals and live by a budget that balances your various goals. Once you understand and write down your financial goals, it is much 4 easier to prioritize these goals with other goals. Again, the purpose here is to identify goals, later these goals can be prioritized with other goals. Consider the following exercises and attempt to develop answers for each question.

Develop a Statement of Net Worth – Where are you now?


  • What is the value of your checking and savings account?
  • What is the value of your non-retirement investments?
  • What is the value of your retirement investments?
  • What is the value of your other investments?
  • Total Assets



  • What is the amount of your debt?
  • Total Liabilities


Net Worth

  • Subtract your Total Liabilities from your Total Assets


Develop a 24-month Budget – where are you heading?

  • What do you anticipate your minimum living expenses to be each month?
  • What annual amount are you legally allowed to invest in retirement accounts given your chosen position?
  • What amount do you intend to save for unplanned events?
  • What amount do you intend to invest?
  • What amount do you plan to devote to debt elimination?
  • What benefits such as continuing medical education and related travel, health, life and disability insurance, and expenses such as mobile phones will be paid by your employer, which will you have to pay for?
  • Given the above, what monthly cash compensation do you need to meet your financial requirements?


Geographical Preferences – Location
It often seems that initially, the number one item of importance for physician candidates is geographical preference. This is understandable, since it appears to directly affect the achievement of other goals, particularly family, social and recreation goals. In fact, recall the questions from those areas of the goal inventory:

  • Will your spouse/partner find employment?
  • Will you need childcare?
  • Do you desire private schools?
  • Do you desire close proximity to relatives?
  • Do you desire close proximity to specific religious organizations?
  • Are any of the following are important to you: educational institutions, libraries, museums, theatre, opera, ballet, the symphony?
  • Do you wish to be near existing friends, settings with a younger crowd or nightlife or other settings where you can meet people?
  • Do you wish to have access to sailing, water skiing, snow skiing, mountain or rock climbing, hiking, running, cycling, tennis, golf?
  • Do you wish to have access to professional sporting events or concerts?
  • What other types of places, organizations or events do you wish to have access to?
  • Do you wish to be near a major airport?


Clearly, geographical location can be closely tied to realizing your goals related to these questions. Nevertheless, recall the very relevant questions:

  • How often will you participate in these organizations, activities or opportunities?
  • How close to these may you be by driving or by air travel to satisfy your goals?


As previously discussed, many of these goals can be achieved without having specific opportunities to achieve them in the community you choose to practice in. Geographical location preference seems to be the one goal that slowly changes from one of the most important to one of the least important goals once employment opportunities are more carefully evaluated based on non-geographical factors. While you do not want to sacrifice many goals to achieve a few, there are in fact a very large number of potential locations where you can likely achieve your family, social, recreational, professional and financial goals. You may be surprised by the opportunity to achieve your goals in locations that were not initially on your preferred list. While you should keep an open mind to various location possibilities, you should have a sense of the general areas where you would like to practice. Since you will be asked similar questions countless times during your search, answer the following questions.

  • Where do you want to live, east coast, west coast, central, south?
  • Which states are most appealing within these regions?
  • Within these states, do you want to live in a metro, suburban, or rural area?
  • If married, do you and your spouse agree on geographic locations?


If you have specific geographical needs necessary to meet immigration requirements, begin identifying areas within your location preferences that will allow you to meet those requirements. You should state in your cover letter accompanying your CV that you have such geographical needs.

Now that you have assessed your goals, it is time to prioritize. Review the goals that you have identified in the areas of family, social, recreational, professional and geographical preferences. Before evaluating and attempting to balance varied goals, attempt to rank your goals in each area from most to least important. This may be difficult at first but attempt to prioritize for the purposes of this exercise.

Family, Social and Recreation Goals

Goal 1________________________________________________________
Goal 2________________________________________________________
Goal 3________________________________________________________

Professional Goals

Goal 1________________________________________________________
Goal 2________________________________________________________
Goal 3________________________________________________________

Financial Goals

Goal 1________________________________________________________
Goal 2________________________________________________________
Goal 3________________________________________________________

Geographical Preferences – Location

Goal 1________________________________________________________
Goal 2________________________________________________________
Goal 3________________________________________________________

To conduct an effective search, you should determine which goals you believe are the very most important to you; however you should not immediately eliminate opportunities that meet some but not all of these goals. You many find that some goals are met beyond your expectations and that such situations may call for relaxing goal requirements in other areas. For instance, if you have an opportunity that does not satisfy all of your family, social and recreational goals but meets or exceeds your professional or financial goals, you may find that an hour drive to a major airport is sufficient in providing access to other goals. Clearly there are trade-offs between family, social, recreational, professional, financial and geographical preference goals.

Now that you have ranked your goals in each area, it is time to rank goals across areas. Call these goals your top priority goals. Determine which of your goals, while important, are less than top priority. Finally, determine which are desirable but not as important as the others. While it may be difficult to do, it is important to really think about these goals and rank all of them from most to least important.

Top Priority Goals

Goal 1________________________________________________________
Goal 2________________________________________________________
Goal 3________________________________________________________
Goal 4________________________________________________________
Goal 5________________________________________________________
Goal 6________________________________________________________
Goal 7________________________________________________________
Goal 8________________________________________________________
Goal 9________________________________________________________
Goal 10________________________________________________________

Now you can begin your search with a very clear direction in terms of your goals. Once you begin evaluating employment opportunities, consider each of your top priority goals and note that trade-offs that may be required by each opportunity. Recognize that your goals may change in priority once you are evaluating opportunities. You may find that some goals, such as geographical preference become less important to you as you visit new places and meet new potential partners. You may find that goals such as working with other physicians that share similar interests and backgrounds becomes more important to you than access to skiing or sailing. Various trade-offs will become more apparent once you begin evaluating employment opportunities. As you progress in your search, it is okay to revise your top priority goals. As you revise your top priority goals, evaluate opportunities with the objective of finding the closest match to your expectations.

Executing a Proactive Search Timeline

Search Timeline

“While this will catch many off-guard, the target goal of a highly effective practice search is the execution of an employment agreement prior to starting your last year of training.” Your reaction to this statement will tell you if you are following traditional search timelines of prior generations of pediatricians or a timeline that will foster your success in these times of increasing subspecialty shortages and advancing employment timelines of medical schools and children’s hospitals. Regardless of your year in training, it is time to get started and there is plenty to accomplish. In fact, if you have completed the Personal Assessment, Goal Inventory and Prioritization above, you have taken the first step in your search timeline – Congratulations!

Many aspects of the search, such as creating a curriculum vita and cover letter, developing a list of references and networking should also begin immediately with the inception of your final training program. Today, many employers and recruiters begin searching for candidates for available positions as much as 24-months in advance. More often, top programs and recruiters are attempting to fill positions or make opportunistic hires not less than a year in advance. Since state medical licensure and health plan credentialing can take 4-6 months followed by a few months of credentialing and payor plan access, you should attempt to allow enough time for these to occur to prevent delays in your employment. While circumstances will always vary timelines, an ideal search timeline follows.

Curriculum Vita, Cover Letters and References

CV: You have by now probably developed a current, highly detailed curriculum vita (CV). If not, it is time to do so. If you have, it is time to update it to reflect your most recent activities and accomplishments and the reasons you would be a strong faculty hire. If you prefer, you can have your CV prepared by a professional firm or use the resources offered in your faculty affairs office. You should always have a mentor review your CV prior to distribution.

Cover Letter: Once you have updated your CV, create a general cover letter that briefly introduces you and your passions and accomplishments across all missions and provides any relevant professional information not provided in your CV. Your cover letter can also highlight family ties to a region and/or personal ties to a particular employer to further strengthen your application.

References: In addition to your CV and cover letter, prepare a listing of references to be provided upon request. For trainees seeking employment, it is equally as common for references to be provided with CV and Cover Letter do to minimal confidentiality concerns. You should select at least three references and attempt to include those that are in a position to provide information about your knowledge, skills and work ethic based on a recent professional working relationship. Expect employers, or someone on their behalf, to contact your references. Only provide people as references that you have discussed the matter with, and based upon that discussion, you are confident that they will provide excellent references for you.

Pay great attention to these documents as they will represent you in the absence of your presence.

Professional Networking

Ideally, you will begin your professional networking the day after selecting the specialty in which you plan to focus your career. At a minimum, beginning to network as you start you final 3-year residency or fellowship will still lead to success. No matter the profession, connections and the related advocacy are a key contributor to opportunity and success. You goal in the early phases of networking is not to ask for a job but to seek career and professional education from successful people in your field that are achieving the goals you have laid out for yourself. Understanding the ups and downs of their career journey will have a profound impact on yours. At the appropriate time and without you asking, your contact will ask the question, “What do you plan to do when you finish training?” And then it begins.

Don’t forget to keep in close touch with those colleagues that completed their training a year or two before your completion and discuss their first-year employment experiences. Ask them about the pros and cons of their chosen position. Ask them about issues that were not anticipated. Professional networking provides an opportunity to evaluate your top priority goals based on the experience of individuals that have been through the search process.

Share information with your peers and discuss opportunities that are comparable. Recognize that the key word is comparable. For instance, if a peer is accepting a position at an outreach location of a university practice and will be the only specialist in town, their offer may vary significantly from yours if you are considering a position on main campus with many faculty providing services. Ask your peers if they are aware of opportunities in which you might have an interest.

Plan ahead and waste no opportunities to network. Headed home see family, connect for coffee with a colleague. Headed to PAS, SPR or your specialty society meeting, ask for an opportunity to connect for coffee with colleagues you have identified from institutions in your geographic goal locations. Big meetings are a huge opportunity for connection and education. Go to these meetings with copies of your CV readily available. Gather contact information such as email addresses and phone numbers of physicians in locations where you have an interest. These contacts may be able to provide information to you regarding practice opportunities that arise in their areas and they may also be a source of information regarding physicians or organizations that wish to interview you. In addition to meetings, contact your professional association. If you are not a member, consider the benefits of membership. Professional associations provide outstanding opportunities for you to network with physicians in your specialty. Often, association meetings are an excellent source of employment opportunity information.

Highly competitive candidates are always networking. While jobs will always be posted due to university guidelines, many of the top opportunities are unofficially filled long before they are posted. Professional contacts can provide an invaluable source of information throughout your career that can help to ensure your opportunity to compete for top jobs.

Of course, other people’s experiences differ with varying circumstances. While networking is a source of information, do not rely exclusively on this source. Evaluate the information gathered through networking relative to other sources of information in your research.


It is not too early to begin conducting research regarding employment opportunities. While professional networking is a valuable component of your research, your search timeline should incorporate other sources of information. The Internet is valuable source of information regarding employment opportunities. Most specialty and national pediatric societies now have job boards. LinkedIn and Doximity allow you figure out who is where and select the appropriate colleagues for education and information and networking. Websites offering resources for evaluating cost of living, quality of schools, crime, employment and other potentially relevant areas of interest are also helpful.

Almost all medical journals with classified advertising include such information on their website. Review medical publication classified advertising each month. Look for available opportunities in general and specialty specific journals and publications that potentially meet your professional and geographical preference goals. If you see an opportunity that appears to meet these goals, contact the organization immediately. Even if you are 12-24 months away from accepting a position, university employers are looking farther and farther into the future for great faculty talent.

If you are not currently receiving mail and phone calls from potential employers or search firms, you will soon be on their lists. Read and consider these opportunities, particularly those directly from hiring practices or organizations. Often potential employers will advertise and send direct mail to candidates to attempt to fill a position before they engage a search firm. If you are interested in one of these potential employers, it would benefit them significantly from a financial perspective if you would communicate your interest to them and prevent them from having to rely on the services of an outside organization to find you. In fact, money saved from search firm fees is potentially a signing bonus for you!


Your research will lead you to consider positions and interviews that appear to meet your goals, particularly your professional and geographical location goals. It is likely that several opportunities will lead to an initial virtual interview with one or all members of an opportunity. These interviews will likely be short in nature and more about the program getting to know you and your potential to add cultural value to their program. All going well, an onsite interview will follow. The onsite interview is your family’s best opportunity to determine if the position will meet your established goals. The interview is critically important because you have the chance to meet and discuss the position with people that you may end up working very closely with on a day-to-day basis.

Do not underestimate the importance of a first impression. You are interviewing to impress the potential employer with your professional medical credentials, your personality, work ethic and “people” skills. Many candidates underestimate how important social skills and EQ are during the interview. While many candidates have the credentials, knowledge, and skills to fill the position, the institution and its faculty are likely looking beyond those required elements. Their decision regarding a particular candidate will reflect their collective belief that the candidate is a person that they want to work with on a day-to-day basis and someone that they believe adds value to their culture. Just as you may have many interviews, recognize that the institution likely has many candidates.

Ideally, your objective in the interview process should be to impress and to get an offer from each of the positions with which you interview. If a position is not offered to you, you will never be in the position to accept or reject it. Maximizing the number of positions available to you increases your flexibility and give you a choice in making the decision on which opportunity might be best. Having only a single opportunity to choose from can be challenging if it does not fully meet your goals. Multiple opportunities will also have its challenges with competing offers and expected timelines for decisions. Avoid directly playing one role against another as pediatrics is a small world.

The above represents an ideal scenario with maximized choices, but it only takes one great opportunity to set your career on the right path.

Time off Required – Plan Ahead

You will need several days off to interview with potential employers. Plan on the average interview requiring an overnight stay and possibly two. While some organizations may invite you back for a second interview, it should be your goal to gather enough information from your first trip to make a decision. This may require your asking to have key people and places to your agenda if possible. Most candidates will interview with three or four potential employers. If two to three days are required for the interview, you can see that you will need anywhere from 6 to 12 days off. If you have a spouse/partner with professional requirements, it is a good idea to have them along for the first interview to ensure opportunity potential for both of you. Also, many potential employers will schedule an evening event, such as dinner, and it is a perfect opportunity for your spouse to learn about the opportunity firsthand.

Travel Arrangements

In some cases your travel arrangements may be coordinated and paid for by the potential employer. In other cases, you will be expected to coordinate and pay for your own travel with the employer reimbursing you for your travel costs. If you will be coordinating your own travel, you will want to keep all of your receipts and submit them to the potential employer promptly as many university reimbursement processes can take longer than expected.

Evaluating an Employment Offer

Letter of Intent
Some, but not all, employers send letters of Intent to physician candidates outlining the basic terms of employment. It is imperative that you engage your mentors and an attorney, if applicable, before starting the interview process so that you can be highly responsive. If you receive a letter of intent, respond promptly indicating that you accept, decline or need additional time for a decision. Most employers serious enough to outline an offer believe they are your top choice. If you request or take more than a couple weeks to provide feedback and indicate a decision, it is a red flag for employers, and they may begin questioning your candidacy for the position. While you may not lose the opportunity, it demonstrates that you are uncertain. Recognize that employers are seeking the best candidates and time is very important to them. They are competing with other organizations for the best candidates.

Employment Agreement
Following a letter of intent, universities will typically provide an employment agreement that articulates the agreed upon terms from the letter of intent and additional legalese for you and your team’s review and consideration. In almost all cases, the employment agreement is a binding contract. You should seek legal counsel regarding the employment contract. In addition to the guidance provided by your legal counsel, consider the areas that follow.

  • Term – Does the term of the agreement match the role and risk profile of the role you are accepting? How long of a period is the contract for? How many days of notice are required for termination of the contract? Can your agreement be terminated without cause?
  • Salary and Benefits – Are the salary payment and participating parties clear? What benefits are paid for by the employer? Are cost of living increase each year included?
  • Bonuses – Are the opportunities to earn bonuses and associated terms clear? What methodology or formula will be utilized to calculate bonuses?
  • Moving Expense – Is the employer’s commitment to pay moving expenses articulated in the agreement? (It is customary for employers to pay a reasonable amount for the relocation of your household goods.)
  • Professional Expense Reimbursements – What expenses are reimbursed? Are licensure fees, mobile phones, pagers and CME expenses paid for or reimbursed?
  • Call coverage – What is it and how will it be determined? Will you share equal call with other faculty? Will you receive call pay or payment for call over and above an equitable amount?
  • Restrictive Covenants – What are they? How long do they apply? What geographical areas do they cover? What is the “buy-out” or out clause if termination occurs without cause by the university?
  • Tail Insurance – Who pays for it if it is needed? What coverage levels apply?
  • Research – Are the committed resources clearly articulated in writing? Is your academic protected time for research and education clearly articulated in writing?

In addition to legal counsel, lean on your mentors and your financial consultant to advise you during this negotiation process. While many attorneys specialize in healthcare and have experience in physician employment contracts, they may not have certain financial or specialty expertise that will come from other sources. Attempt to identify consultants that have experience in negotiating financial issues on behalf of physicians.

Making the Decision and Accepting the Offer

It is important that you maintain transparency throughout your process and be clear on your timeline and plans for a decision. Your decision-making process should include an evaluation of your top priority goals, the information you have gathered from all sources of information and the evaluation of your employment offer. Only you can decide which of your goals are most important. Recognize that it will be difficult to find jobs that satisfy all your top priority goals.

Once you have completed final interviews with your top choices and considered the options, it is time to make your best decision. You will feel some pressure and anxiety even in the best of circumstances, this is natural. Some physicians may attempt to hold out in accepting an offer, hoping that another opportunity that meets all their goals will suddenly materialize. While this may happen occasionally, it can be a very costly mistake if your potential employer decides to offer the position to another candidate due to your seeming lack of interest or urgency. This does not mean however, that you should compromise your goals by accepting a role that you know to be a misfit or merely because an employer is overly pressuring you for a decision.

To restate a strategic imperative, many top young physicians today have done their homework, they know their goals and choose to start their processes early in an effort to complete their practice search and accept a position prior to or just after starting their final year of training. By the time you complete a personal assessment of your goals, develop a top priority goal list, interview with several potential employers and evaluate offers, you should feel very confident in your decision to accept an offer. Accepting an employment offer should be an exciting and positive experience. If you are completing a residency or a fellowship, it is the culmination of much hard work and the beginning of a new phase in your career as a physician.

State Licensure

Once you are confident that you will be practicing in a particular state, begin the state licensure application process by contacting the appropriate state licensure board. A request for a state license application should be made in writing to the applicable state medical board along with any applicable application fee. Not all state boards meet every month and the amount of time and effort required for the licensure application and approval process varies from state to state. To be reasonably sure that you will have completed the necessary requirements and have obtained your state licensure prior to starting your new employment, allow four to five months for completion. While the application process can begin earlier, you should immediately begin the process once you have accepted an offer and executed an employment contract. Documentation requirements vary from state to state but you should be prepared to document all educational degrees and completion of training program requirements. Some states will require that you pass certain exams, such as a jurisprudence exam. If you anticipate difficulties related to state licensure, you might consider the services of professionals that specialize in facilitating the process of state licensure.

If you have not already done so, develop a professional file with copies of all degrees, certificates, licenses and government permits. You will need access to this information several times throughout your career. In fact, you will need it again before you begin your new practice.

Hospital and Health Plan Credentialing

Before you begin practicing, you will need to complete an application for hospital privileges and apply for participating provider status with various health plans. The length of time and requirements for the application and approval process will vary across hospitals and health plans. It is not uncommon for health plans to require up to six months for approval and some health plans may not immediately grant approval.

To obtain hospital privileges you will need to complete an application. In addition, you will be asked to provide copies of the following documents:

  • Current curriculum vitae
  • Current state medical license
  • Current Federal DEA certificate and applicable state controlled substances license
  • Current malpractice insurance certificate q ECFMG certificate (if applicable)
  • Current CME’s q Board certification (if applicable) q Medical diploma q Internship, residency and fellowship certificates
  • Passport size photo

Any affirmative answer to questions regarding claims, suspensions, sanctions or drug impairment on the application will require an explanation. Periods of time unaccounted for during training will also require a written explanation.

The minimum length of time from application to full approval of privileges in most hospitals is two-three months. During that period of time, all of the information provided on the application will be verified in writing, references will be requested, and a report will be obtained from the National Practitioner Data Bank. When all of the verifications have been received, the completed file is sent to the Credentials Committee for approval. Once approved, the file will go to other required hospital committees, which varies by hospital, until final approval by the Medical Executive Committee or the Board of Trustees. The physician will be notified in writing when their privileges have been approved.

Most managed care plans will require that a practitioner have a state medical license and privileges at a participating hospital before they will accept an application. The required procedure to process a managed care application is similar to that of a hospital application. Keep in mind that if application is made prior to completing a fellowship, the managed care plan cannot complete the credentialing process until the fellowship is finished and has been verified.

Seek assistance from your new employer in facilitating the application and approval process. You will need to provide much of the same type of information that is required for state licensure. If you have created a professional file, make a copy for your new employer so that they can begin the application process on your behalf. Some larger medical groups have delegated credentialing which means that a particular health plan has delegated the credentialing process of a new physician to the Group. If your new employer has delegated credentialing with health plans, your approval process will be shortened significantly.


You have nearly completed the steps required to begin your new position. When you interviewed for your new position, you may have met with a real estate agent or identified areas that you would like to explore for housing arrangements. If you have not made contact with a real estate agent and intend to do so, you might consider contacting your new colleagues for recommendations from their relocation experience. Many universities now have executive relocations services that will assist with all aspect of your transition.

It is customary for employers to pay reasonable expenses for the relocation of your household goods. You should consider getting 2-3 bids from reputable national moving companies prior to your search so that you understand the expected costs for your move. Some universities will have national contracts for moving companies for your use. If you intend to move yourself, you can contact moving van rental companies such as U-Haul to obtain van rental and packing and unpacking quotes. If for some reason the employer is not covering the cost of your move, save your expenses for your associated tax return filing.

In addition to finding a place to live and moving your belongings, you will likely want to establish local banking relationships. You can determine online if your current bank and insurance carriers provide services in your new community. If you open to changing your banking relationship, consider a bank known to provide enhanced mortgage and banking offerings and services for the university’s faculty.


Following the steps provided in “Conducting an Effective Employment Search” enables you to approach your search in a focused, organized and effective manner. If you have completed a personal assessment, developed an inventory and prioritization of your goals, established and followed a search timeline incorporating networking, research, interviews and evaluation of employment offers, accepted an offer, completed the steps required for state licensure and credentialing and have made arrangements for relocation – congratulations! You are about to launch a new and exciting phase of your medical career. We hope this guide has been instrumental in your search and wish you much success in your career.


About the Author

Wesley D. Millican, MBA, is CEO and Physician Talent Officer of CareerPhysician, LLC, the national leader in child health faculty and executive search and leadership development. In partnership with the Child Health Advisory Council, a diverse group of emeritus and current national thought leaders in academic pediatrics, Mr. Millican provides critical career and professional development content to residents and fellows to help foster their effective transitions from training into academic and/or private practice roles. For more than 20 years, Mr. Millican and CareerPhysician’s Launch Your Career® Series has served as the trusted go to career training and ACGME Competency resource for U.S. residency and fellowship program directors, and most importantly for residents and fellows seeking to maximize their return on the personal, professional and economic investments and sacrifices made during training. Through Launch Your Career® Series onsite and visual programs and associated web-based content, Mr. Millican believes that residents and fellows are the future of academic pediatrics and that meaningful early investments in their career journey will have a monumental positive impact on their long-term professional satisfaction and their service to children. 

For more information about the Launch Your Career® Series and/or to schedule a program for your residency or fellowship program, contact us.

Updated 4-24-24