PERSPECTIVE

Senior Residents' Weekend Prepares New Hospitalists for the Real World

Philip Clarkson , MD, MSc

Hospitalist, Sonora Regional Medical Center

Published March 21, 2018

Internal medicine residents, wouldn't it be amazing to land your ideal hospitalist job straight out of residency? Not only would you enjoy your shifts, but you'd also have a head start in your career advancement. And of course, you'd never have to interview again.

Well, if that sounds good to you, here's an event that can help you get there. Every summer, Vituity hosts a Senior Residents' Weekend (SRW) to help aspiring hospitalists make a successful transition from resident to attending physician.

As a participant, you'll hear straight talk about employment models, finances, interviews, and finding and landing your ideal first job.

To help you learn more about the event, we recently sat down with Philip Clarkson, MD, MSc. Philip attended SRW in San Diego and went on to join Vituity as an attending physician and an Administrative Fellow in hospital medicine. Here's a look at SRW through his eyes.

Welcome, Dr. Clarkson. To start things off, tell us how you heard about Senior Residents' Weekend.

As a senior internal medicine resident at Jersey Shore University Medical Center in Neptune, N.J., I was planning to become a hospitalist, but I was also very interested in the business side of healthcare. The practice of medicine is evolving quickly, and I wanted to be part of that.

I started reading up on fellowship opportunities at the Society of Hospital Medicine's webpage. And this led me to Vituity's Administrative Fellowship for Hospital Medicine.

I reached out to a Vituity recruiter, who of course invited me to Senior Residents' Weekend. I chose to attend both the main event and the optional interview day in order to explore opportunities within the partnership.

At that point, where were you in your job search?

When residents think ahead to that first attending job, they usually focus on two factors: location and pay. They haven't necessarily thought through other factors that affect their future career and happiness.

I think I was slightly ahead of that curve, especially with the early exposure to the Senior Residents' Weekend. My priceless interactions with experts in finance and human resources, physician partners, and Regional Directors broadened my understanding far beyond location and pay.

What challenges did you face in finding your ideal job?

Well for one thing, it can be hard to identify the best offer, especially when you haven't yet practiced medicine in the real world.

Senior residents get bombarded with calls and emails from recruiters (I remember one who insisted on speaking to me in the middle of my ICU shift!) who promise them the world.

They'll say something like, "You have the potential to earn $400,000!" What they don't tell you is that you'll have to work 20-plus shifts a month or that some huge chunk of the money is tied to some unattainable performance metrics. So it's theoretically possible to earn that income, but it's very impractical — and probably not the lifestyle you're looking for.

But there's an even more important reason to be proactive. We know that about half of new attendings end up changing jobs within five years. But moving early or often can be red flags to future employers. It's better to choose the first job wisely so you can stick around, establish yourself, and gain some experience.

What did you learn at Senior Residents' Weekend? Were there any presentations that were particularly helpful?

The discussion of hospitalist practice models was a real eye-opener for me. Residents are generally W-2 employees and haven't necessarily been exposed to other models. And we know that new attendings tend to gravitate toward hospital and corporate employment — often because they perceive it as secure and predictable.

But at SRW, Vituity Vice President of Hospitalist Operations, Surinder Yadav, MD, does an excellent job of breaking down the employment, locum, and partnership models and showing you the benefits and challenges of each. And another presenter talked about the financial implications. For example, locums make more up front. But they then have to turn around and pay for their own health and malpractice insurances.

I also learned some useful tips on evaluating compensation packages. For example, it's important to factor in cost of living. A lot of providers want to work in urban locations. But those who do tend to earn less while paying more for housing and consumer goods.

To some, it's worth it. But personally, I'm happy to work in a smaller California town, which is more affordable.

SRW also illuminated for me the complexities around bonuses. Hospitalist compensation packages often include bonuses that are conditional on the entire group hitting certain metrics.

It's one trick recruiters use to boost the "potential earnings" figure. Sure, you might make $400,000 a year if everyone in the group performs well. But that's out of your control and by no means a given.

I understand you also participated in the optional Interview Day. Any advice for future attendees?

SRW Interview Day is set up like speed dating. You will have up to 10 short interviews with medical directors from across the country. It's an amazing opportunity you probably can't have anywhere else. But you will also need to ask the right questions so you can quickly determine which hospitals are good fits.

Before you arrive for Interview Day, take some time for reflection and research. Get very clear about what you want and don't want in your ideal job.

Then assemble a list of questions for the medical directors. Some examples:

What schedules do your hospitalists work? Do you offer any flexibility around scheduling (for example, the option to work either 7 or 14 days on)?
What's the group culture? What expectations do your providers have of one another? How would you characterize your group's relationships with nursing and ancillary services?
Which specialist consults are available to your hospitalists? How long do these typically take?
What procedures do your hospitalists perform? Do they run codes? Is your ICU open or closed?
What additional administrative duties do your hospitalists perform? For example, are they expected to sit on hospital-wide committees like sepsis or transfusion? Do they receive any stipends for these additional duties?

The answers to these questions should give you a pretty clear idea of how your day as a hospitalist will look at different locations. Note which opportunities resonate with you and keep the conversation going after you leave. Hopefully some of these short interviews will soon lead to on-site visits.

So you went on to join Vituity as an Administrative Fellow. Can you tell us a little about that program for residents who might be interested?

The Administrative Fellowship was a huge factor in my decision to join Vituity. It really exposed me to a side of medicine I didn't see in medical school and residency.

For one thing, it's a fast track to leadership. In most practices, physicians work clinically for up to 10 years or even more before becoming medical directors. And many take that step without any formal training in leadership or business.

By contrast, Vituity's Administrative Fellows complete a business and leadership curriculum taught by some of the partnership's top physician executives. Fellows also attend operations and board meetings to learn not only the "how" but also the "why" behind the decision-making processes. These are lessons I could never learn from clinical work alone.

Fellows also complete a project in their area of interest. For example, I'm piloting an application to improve clinical documentation. This is an area I'm very passionate about, so it's been an exciting experience. I would love to become Vituity's clinical documentation champion!

As a fellow, I've been able to essentially perform roles as an Assistant Medical Director in my first year as an attending, and I hope to become a Medical Director soon. In fact, I've already been offered more leadership roles than I can realistically take on. It's wonderful to have these opportunities so early in my medical career.

Any final words for hospital medicine residents who are thinking about attending Senior Residents' Weekend?

SRW is worth attending, even if you don't plan to pursue a job with Vituity. You'll get a helpful overview of what to expect as you transition from resident to attending. The speakers also help you clarify what you really want out of your first job, which will help you to ask the right questions no matter where you interview.

Another great thing about SRW is that it's pretty much free. Vituity helps cover your airfare and hotel. So think of it as a mini-rotation!

One final thought: I just gave a talk to the second-year internal medicine residents of UCSF Fresno, where I passed along many of the lessons I learned at SRW. The advice the presenters gave me has definitely stood the test of time. If anything, it rings even more true today.

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2019 Senior Residents' Weekend for hospitalists will be held Friday and Saturday, August 23–24 in Chicago.

2019 Senior Residents' Weekend for emergency physicians will be held Friday and Saturday, August 9–10 in Chicago.

One night hotel and airfare up to $500 is covered. And, if you accept an offer before Sept. 30, you will receive a $10,000 bonus. For more information, email ResidentEvents@vituity.com.

Originally published March 21, 2018. Updated March 21, 2019.

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