Given the many options that are out there, is important to take the time to reflect and think about the type of job that you want after fellowship.

Remember, your first job isn’t your last job and you will not find your dream job right out of fellowship.  No job is perfect right off the bat.  It will take time and effort (and building up relationships and credibility) to create your dream job over time.  Think about where you are willing to compromise as you negotiate your first job.

Here are some questions you should ask yourself:

In what type of setting do I want to work? 

University-affiliated tertiary care pediatric hospital?  Private pediatric hospital or corporation?  Community hospital?  Community hospital connected with a university-affiliated hospital medicine division?    Newborn nursery?

What are my interests?

You’ve had a chance to try a little bit of everything and now it is time to pick where you want to focus your career.  Education?  Quality Improvement?  Clinical Research?  Advocacy?  Business and administration?  A blend of several of these?   What is it that you want to spend the rest of your career doing?

This is a very important question and be prepared to answer this anytime you talk to a prospective job.

Where do I see myself headed in the next 3-5 years?  10 years?

This goes along with your interests and the question stated above.

In 3-5 years, do you see yourself leading QI projects or clinical research studies?  Do you see yourself applying for an early-career grant or other grant funding?  Is there additional training you hope to get in the near future?

In 10-20 years, do you see yourself as a professor?  With NIH funding?  Do you see yourself as division head one day?  Medical director of a pediatric program in the community setting?  Are you hoping to get involved on a national level?  Do you want to be in the C-suite?

These are all important questions that will help you narrow down your job search and also help you better answer those important interview questions.

What type of job do I want?

Do you want to work with trainees on the teaching service?  Are you willing to spend some time on attending/hospitalist only services?  How much time are you willing to spend in both?  What about co-management services?  Complex care services?  Sedation, transport, or ICU?

Do you want time do to non-clinical work like research, QI, or education?  Do you want a more administrative position within the division or the hospital?

What type of schedule am I looking for?

Jobs vary in their clinical schedules and even within a single institution, different hospitalists may have different schedules based on their own desires and needs so it is worth thinking about what you want and compare it to what can be offered.

Are you OK working nights?  Do you want a nocturnist position?  What about weekends?  Are you thinking about going part time?

Where do I want to live?

Are you tied down to a particular city?  Are you looking to relocate to a different part of the United States?  Do you prefer to be away from a large city?  Location plays a huge role in your where you will narrow your focus and ultimately may impact the types of jobs that are available.

What other factors will play into my decision?

At this stage in our lives, rarely are we solitary creatures so it is important to think about who or what else will play into your decision.

Do you have a spouse or significant other and will they be able to move?  Do you have children?  Where do your parents live and do you need to be closer to them? Do you have educational loans that need to be paid off?  Is there loan forgiveness?  What is the cost of living in my desired city?

Again, don’t expect the perfect job in year 1 out of training.  It takes time and effort for your dream job to evolve.

Keep an open mind…there may be opportunities in seemingly unlikely places.

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