Job hunting? Cast wide net, read contract

Historically, the vast majority of senior residents and fellows in their first year following post-program training join an existing medical practice. But joining an established group practice is not the only option.

Many new physicians wish to remain in the academic or hospital setting, and some accept the great challenge of establishing their own medical practices. Regardless of the route you choose, it is up to you to guide your path -- and to understand the contract you sign when you reach your destination.

I have bad news and good news. The bad news is that many residency and fellowship programs do not have a career department to help you find a job. The residency or fellowship coordinator might maintain a list of alumni or tell you about job listings he or she is aware of, but it is up to you to identify career opportunities.

The good news is that there are numerous resources that can open the door to a plethora of options. Networking is the central way for residents and fellows to get their name known within their specialty's community. Medical conferences, meet-and-greets with attending physicians and social events are ideal opportunities for networking.

The Internet is a great resource for finding employment, as select Web sites are tailored specifically for doctors. Also, it is advisable to watch job postings in professional journals.

Another option is to get help from a physician recruiter who can locate specific employment opportunities in your medical field. No matter which resources you use, it is imperative that you start the process early to maximize the quantity and quality of opportunities.

So what happens when you get offered a job? Do you need a written employment agreement? Absolutely.

While a handshake between two parties may create a legally enforceable contract on television, I do not recommend that method of contracting. It is strongly suggested that the agreed-upon terms of your employment relationship be clearly stated in a written contract.

This document will govern the relationship between you and your employer and may be relied upon in the event of a misunderstanding. Therefore, the contract should incorporate all verbal representations to ensure that both parties understand the benefits each is entitled to and the duties each party is required to perform.

If you are not given an employment contract to review, you should request an agreement well in advance of your expected starting date.

So what key aspects should be included in the employment agreement?

There is no uniform, standard agreement for physicians who just completed residency or fellowship. But there are common provisions that exist in most employment agreements and should be completely understood before you sign the contract.

These provisions pertain to compensation, length of employment, grounds for termination, responsibilities and duties of both parties, liability insurance, covenants not to compete and partnership opportunities, as well as many others.

If you do not understand a provision, be sure to ask for clarification. Ignoring a provision merely because its meaning is unclear could lead to undesirable long-term effects.

If you are attentive to the details of your employment agreement, not only will you achieve contract terms that are more beneficial to you, but you also will confirm that both you and your prospective employer have the same intentions, leaving less room for confusion.

Naturally, I would recommend that you have an attorney review the agreement. That's not simply my own interest talking.

While medical school, residency, and fellowship prepare you to identify symptoms of illness, they do not train you to identify symptoms of an unhealthy employment agreement. You have conquered many obstacles to get to this stage in your career, and you do not want a contract term standing in the way of what you have worked so hard to achieve.

Since the agreement you sign will govern your professional existence for years to come, it is highly advisable that it be reviewed by an attorney with experience in business and health law.

Tax deadline extended

In the June 4, 2007, edition of this column, I wrote about how a law designed with Wall Street in mind, and further codified by the IRS, could affect physicians who receive deferred compensation. The rule, known as Section 409A, subjects all nonqualified deferred compensation plans to income inclusion at the time of deferral, unless they meet certain requirements under the statute and rules.

At the time, it appeared the deadline for compliance would be Dec. 31, 2007. But a subsequent regulation extended the deadline until Dec. 31, 2008. So you have extra time to review, or have someone review, any deferred compensation plans before Section 409A takes effect.