Bring extra copies of your updated CV and look sharp. Shine your shoes. Is it time to replace the suit you used to apply for residency?
Send a thank-you note or e-mail to the person(s) you interviewed with. If possible, do this within three days of your visit. It’s an important step in the process, yet this simple task often is overlooked. Remain in contact with the HM programs you are most interested in. Think about a follow-up visit or phone call to address any unanswered questions.
January-March
Hopefully you will have one or more offers by now. This is the time to negotiate a contract and accept an offer. Review the contract carefully and don’t hesitate to ask for clarification of unclear points. Some applicants prefer to have a lawyer review the contract prior to signing (see “The Art of Negotiation,” December 2008, p. 20).
Register for your board examination. Most specialties, including internal medicine, family medicine, and pediatrics, as well as board exams for osteopathic medicine, have registration deadlines in February. Given the significant cost of applying for these exams, it pays not to be tardy, as late fees can set you back hundreds of dollars.
Apply for state medical licensure. This process varies by state, but it can take several months to complete, especially if you are applying in a state other than where you trained. For example, California recommends starting the application process six to nine months in advance. International medical graduates who require a work visa need to ensure their paperwork is processed in a timely manner.
Each hospital is different, but applications for hospital credentialing generally means filling out a mountain of paperwork. Most hospitals will perform a thorough background check, so don’t be surprised if fingerprinting is required. The hospital or hospitalist group usually helps new hires navigate through this process, which can take several weeks or even months.
April-June
Moving to a different city or state can be exciting—and stressful. Start talking to hospitalists at the facility where you will be working to get a feel for the city and recommendations for places to live. Revisit the location to become more familiar with the surroundings. Some hospitals are very helpful; some provide new hires with a real estate agent. Moving expenses often are covered as a condition of employment, but it depends on your contract.
Consider taking a vacation to either further explore relocation options or to simply relax. If you have followed the recommendations outlined in the previous months, you should have time to unwind as your residency comes to an end. Some future hospitalists like to use this time to intensify board review; others cringe at the thought.
Transitioning from resident to hospitalist is no easy task, and it shouldn’t be taken lightly. It’s not a one-month process, either, so planning is essential. Although it might seem to be a daunting journey, it’s very rewarding in the long run. TH
Dr. Grant is a hospitalist at the University of Michigan Health System in Ann Arbor. Dr. Warren-Marzola is a hospitalist at St. Luke’s Hospital in Toledo, Ohio. Both are members of SHM’s Young Physicians Committee.
Thank you very much for the suggestions and advice and the timeline.