Okay, so now you have talked to friends and colleagues about different types of practices out there and have examined your soul to see which type of practice environment best fits your needs. What? Still waffling? That’s okay. You are in good company—the majority of graduating residents are still undecided about which practice avenue to take until after they go out and explore the opportunities available. So, Christopher Columbus, it is time to set sail and interview at potentially interesting job opportunities.

To prepare you for your journey into the real world, this chapter will discuss finding job opportunities, preparation of your curriculum vitae (CV), how to best go about getting an interview, insights into the interview process, tips on conducting a site visit, and a checklist to use before you embark.

Finding a Job

It is best (in our twenty-first century) not to just raise anchor and head blindly off into the sunset in the hopes of stumbling across a perfect employment position. Prepare yourself—there are many avenues to finding good jobs in the marketplace. The ASTRO or other professional organizations have extensive job-matching programs and facilitate interview opportunities at national meetings. Many plum jobs, however, are filled by word of mouth. Asking former residents from your training program about opportunities can be very productive, so don’t hesitate to make some calls to scout out possibilities. Your current faculty members will often get calls about opportunities as well, so ask them to keep an ear to the ground for you. If you have a particular geographic locale you are interested in, don’t hesitate to look up practices in that area in the ASTRO or ASCO directories and call to inquire—many practices may not have advertised a position but might be willing to add a good candidate at any time if the fit with the practice is good. Be considerate on the phone, and ask to speak to the managing partner of the group. If you are unfamiliar with a particular locale, call up another specialist (medical oncologist, surgeon, urologist, etc.), explain that you are exploring opportunities in the area, and ask him or her about radiation oncology groups in the area—you often will get insights not available otherwise about a practice’s reputation and community standing.

The Curriculum Vitae (CV)

The CV is often the first major interface between you and your prospective employer. First impressions are significant, so make this one count. Keep in mind that employers often are deluged with CVs, so making yours stand out from the pack will go a long way toward getting you that interview you are seeking.

First, make the CV organized and concise. Make it easy to read— remember that the reviewer’s eyes will probably be over age forty and thus not a big fan of tiny fonts. Don’t be afraid of using a bit of color—it implies to the reader that you have prepared the document just for him or her. We are not talking “circus” here; we are talking “stylish.” Speaking of color, don’t forget to embed a good color photo of yourself in the CV (head and shoulders shot) near the top of the first page—it will not only set your CV apart, but will help the reviewer put a face with a name when he meets you.

Make your CV current, and be sure your contact information is easily identifiable and current—including e-mail addresses and cell phone numbers. Include items the employer is interested in— not only the usual demographics and training history but other items that differentiate you—research accomplished, papers presented or published, honors and awards received, what your specific areas of interest are, unusually comprehensive training or achievements (pediatric radiotherapy, brachytherapy, stereotactic radiosurgery, radiopharmaceutical delivery, etc.).

Your prospective employer also wants to know what makes you a “real” person—potential recruits are not only being evaluated in terms of sheer competence but also as to whether or not they will fit into the “corporate and social family” of the practice. What do you like to do outside work hours? Have you been involved in your community during or after training?

Be sure you attach a personalized cover letter with each CV you send out, addressed to the lead physician, senior partner, or hiring contact who will be interviewing you. Finally, be sure to PROOFREAD both your CVs and cover letters—nothing will torpedo your chances of getting an interview faster than sloppiness here. The interviewer in Topeka will not take kindly receiving the cover letter you intended for Toledo.

Getting the Interview

A week or two after sending out your spiffy CV and cover letter, place a phone call to the addressee. Express your interest once again in his or her practice, and bring up any local connections to the area if you have them—interviewers are much more likely to offer an interview if they know the interviewee is motivated to move to their area by other forces—family, love of the sea or mountains, or whatever. Be flexible on times to come for the interview, and offer to come on your own nickel—this once again is viewed as an expression of true commitment from the interviewer. If you are going to be in the area anyway for some other reason, don’t hesitate to mention that fact, and ask if you can stop in while you are there. The interviewer will be more likely to invite you for an interview and tour, as you cost him nothing, and at the same time, this will give you an opportunity to work your charms face-to-face. If you are traveling out of town, it is certainly appropriate for you to ask whether or not you should bring your spouse, but by all means, leave the kids at home for the first visit.

Preparing for the Interview

Know what you want. You should think about this long before your arrival for the interview. Are you looking for a full-time or part-time position? Do you want to work in a large group or small group? A hospital-based or freestanding facility? Are you willing to see all patient referrals, or are you hoping to focus your practice on certain disease sites or patient populations? What are your strengths and weaknesses? Think about this ahead of time—you WILL be asked. Be honest with yourself and your interviewer. Do you need time for research activities, military commitments, or other activities? Are you looking for a partnership track, or do you prefer an employment model? What minimum vacation time are you willing to accept? Do you expect to rotate between different clinics in the practice, or are you only willing to practice at one site? Does your family have any special schooling, medical, or spousal employment needs that might impact your work location or schedules? A clue here—be flexible. By the same token, don’t be wishy-washy—if you have specific needs and desires, it is best to bring them up at the interview. If there are any insurmountable hurdles, both you and the interviewer can save yourselves time and trouble down the road by being frank.

Get a background on the practice before you arrive. The Internet is an amazing tool—use it! Practice Web sites can provide a wealth of background information about the structure, geography, composition, and philosophy of the group. Your host will be impressed that you took the time to look them up ahead of time as well. Know the names of all the doctors in the group before you arrive. Be aware of all the current practice locations of the group, and if you have the time before the interview, drive by the locations to get a better feel for the area.

Ask for an agenda. A few weeks before your visit, ask the office you will be visiting to provide an agenda for the day of the visit. This not only gives you an expectation of how long you will be at the interview and who you will be meeting but also gets the interviewer thinking about how best to organize your visit. You might ask if there are any tumor boards on the day of your visit—visiting and participating in a tumor board not only gives you a feel for the local medical community but also gives you a chance to show off your acumen and social graces to your interviewer.

Travel costs. Unless you have already volunteered to visit at your own expense, you can diplomatically ask about the practice’s policy on reimbursing travel costs for the interview. In most cases, the question is expected, and the interviewer will not think less of you for asking. If he says “no” to any reimbursement, chalk the cost up to the price of honing your interviewing skills. If the potential employer is really interested in you, however, he or she will usually be more than willing to cover at least a portion of the costs. If a follow-up interview is offered to you, the practice will usually pay for the travel expenses related to that second visit.

Ask to visit on a Friday or a Monday. The advantage of scheduling your interview at the beginning or end of the week is that you can spend a day or two on your own, or with a realtor, exploring the locale over the weekend. Try to get an overall flavor for the environment, housing market, school situations, area demographics, recreational activities, etc. This will require less weekday time away from your current practice or residency for the interview process and may save you (or your appreciative host) big bucks on the airfare with a Saturday night stay.

Think ahead of time about how you would see yourself fitting into this particular practice setting. Do you provide a skill set that complements and reinforces those already present in the practice? Do you provide a new skill set to the practice that presents a new opportunity for them?

The Site Visit

Okay, you have wrangled yourself an interview, and the day has come. Let’s spend just a moment talking about that first visit. After your CV, this is the next big chance to make a favorable and lasting impression. Most of what follows should be obvious, but with over thirty years of experience as interviewers, we know otherwise: you would be surprised at what we have seen floating through our doors through the years.

First, arrive the night before, and get some rest. This removes the anxiety of worrying about missed flights, trees down on the road, or any other vagaries of nature trying to keep you from your destiny. Buy a new suit or dress, and polish your shoes. If your clothes get wrinkled traveling, get them ironed. Get a haircut (or elegant coif),! Your appearance at this point is critical to projecting a professional and conservative image. Now is NOT the time to express your individuality in exotic dress or devotion to the body images of the latest punk rock bands. Your interviewer will be regarding you as a potential ambassador for his practice to the community, so play your part.

Arrive early for your appointment. As a corollary to the early arrival, know directions to the interview site in advance. An early arrival not only sets a positive tone for your punctuality but also gives you a chance to meet the front office staff. These folks are often asked their opinion of interviewees after the fact, so be on your best behavior with them also—like the best sergeants in the military, they can make or break your day. Appear eager and upbeat.

Bring business cards. Most residents forget about this, but it is another great way to differentiate you from the pack and is not expensive to do. Your interviewer will be impressed with your detail-oriented personality. Present these cards liberally to the staff in the front office, as well as the other physicians and partners you meet.

The Interview

When first meeting your potential employer, introduce your- self while looking him in the eye and offer a firm handshake. Address him by name. The interview process is extremely variable depending upon the practice, but at some point in the day, you will probably have a one-on-one meeting with either the senior managing partner or the clinician in the group assigned to screen potential new recruits, a tour of the facility, and an opportunity to meet the rest of the staff. Keep in mind that the interview is a two-way process—the interviewer will be trying to showcase his practice nearly as much as you are attempting to showcase yourself. Be prepared in advance with a list of questions you have about the practice, and expect to be asked questions about yourself and what you are looking for in a practice.

Questions you might be asked: Common items include your experience with specific procedures and clinical situations, about your short- and long-term goals, about how you think you might best fit with the group (and what you bring to the group), about what you value most (time off, money, camaraderie, etc.), where you expect to be in five years, when you will be ready to make a decision on accepting a practice offer, etc.

Questions for you to ask: There is no standard list of questions to bring up, but the following topics might be useful: expected clin- ic assignment and duty responsibilities, local referral patterns, equipment availability and treatment planning procedures, patient follow-up policies, other specialist availability, routine tumor board, pediatric cancer conferences, and cancer committee availability, research opportunities, partnership track, etc. Ask how you can best help the practice grow and flourish.

Questions about the practice: If given the opportunity, spend some time with other group physicians (if any), to get their flavor of the practice. You are trying to get the “pulse” of the practice—energy, harmony, discord, outlook, plans, market dominance, and other unique issues. How many physicians are there, and how many are to be added? Are you replacing someone who is leaving, or are you part of an expansion process? If anyone has left, why? As an aside, I would note the names of physicians who have left and later follow up with a phone call to them to get their side of the story as to why they left and the health of the practice. There may be perfectly reasonable explanations for folks leaving, but beware of practices that have a steady stream of junior associates who leave after just a few years—there are unfortunately some practices that just seem to hire and fire junior staff chronically, thus keeping their personnel costs down while never having to offer partnerships. Let the buyer beware.

Spend some time with the physicists, dosimetrists, and technical staff as well. Having a look through patient charts and port films can give you a flavor for the group’s patient treatment philosophy and sophistication. If given the opportunity to sit in on chart rounds, do so. If the practice has multiple locations, and if you have the time, ask if you might stop in to take a quick look at them as well. This is especially important if you find you are being considered for a clinic other than where you are being interviewed.

What not to mention on the first visit: There are a couple of items you should NOT bring up at the initial interview. The first is salary. Salary will usually be brought up at a second interview and, in general, should not influence your decision about choosing the right practice anyway. A few dollars difference between one practice and another will mean little to you in the long run if the work environment is not fulfilling professionally. Another topic to avoid is discussing all the other practices you are interviewing with (unless you are asked directly). Bringing these up leaves the impression that you are not focused on any particular practice, but rather are just “job shopping” for better money or benefits— these candidates are felt to be focused on self-interest rather than the real practice opportunity. Remember, this interview is aimed at showing the potential employer just how valuable you can be to him, NOT how valuable he can be to you. In a similar vein, the initial interview is not the best time to bring up all the special needs you or your family have (unless asked)—these will usually be brought out at a second interview, should you be offered one.

Follow up after the Interview

Upon return home, be sure to follow up with a thank you card or e-mail to the interviewer. You might wish to sit down and make a profile of the practice while it is fresh on your mind—pros, cons, impressions, and the like. Make phone calls to former employees and staff, referring physicians including medical oncologists and surgeons, and perhaps even competitors (limited value).

If the practice is interested in you, they will usually be in contact within a few weeks to arrange a second visit. At this time, specific needs and financial offers will be ironed out. Items to clarify would include salary and vacation time, as well as health benefits and malpractice insurance coverage. It would also be a good time for you and your spouse to look more closely at housing opportunities. It would be wise to get an attorney familiar with medical practice contracts to review the written contract you are offered in detail. Specifics on contracts will be covered in more detail in the next chapter. You will be expected to give the offering practice a final acceptance or refusal notification in writing within a few weeks.

Congratulations on being offered the job you want and now the new adventure starts!