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Viewpoint
September 23, 2024

How to Choose the Best Job for You

Author Affiliations
  • 1Cardiovascular Associates of America, Celebration, Florida
  • 2Massachusetts General Hospital, Boston, Massachusetts
  • 3Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2024;184(11):1285-1286. doi:10.1001/jamainternmed.2024.3589

Front-line physicians looking for a new clinical role have never had more employment choices, including academic medical centers, nonprofit and for-profit health systems, single-specialty and multispecialty private practices, innovative value-focused practice models, and virtual-first clinics. On the other hand, the US faces a clinician burnout and job dissatisfaction crisis, which, along with rising rates of clinician turnover and retirement, poses threats to clinician health and to clinical quality.1 In evaluating prospective jobs, clinicians often focus on work responsibilities, work-life balance, salary, reputation, and location but may not adequately investigate other important aspects of their prospective job and employer.2 This Viewpoint provides practicing clinicians who are considering choosing a new employer with guidance about questions (Table) relevant to evaluating 3 key organizational characteristics: governance, rewards systems, and culture.3

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1 Comment for this article
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Objective self-appraisal and who you will be with are most important
Paul Schmied, BS | Independent Researcher
Choosing to enter a profession requires making a commitment. Achieving certification and approval to practice a profession, requires knowledge and skills. Being truly successful in a career requires not just competence but also alignment with your personal aptitudes and interests. A career is what you do for a lifetime, not who you do it for, or where. It should be a reflection of who you are.

Every doctor has a different set of aptitudes and instinctive interests. Do you truly know what your instinctive interests are, or have you been working to only improve
and do what you have been told by others that you are good at? Do you define professional success by income and security, or accomplishments and relationship ? Is this how you define personal success?

I know from experience in my profession that the areas in which I had the strongest skills, did not match what gave me the greatest satisfaction. I was excellent at analysis, diagnostics and system design which paid well I got the greatest satisfaction from learning to mentor and educate others one on one, which didn't. While I could coordinate and manage large complex projects, I found that enjoyed solving the often-ignored operational problems that directly affected the users of those systems, more than designing those systems.

I did NOT discover this where I first imagined I wanted to work. I wanted to be in aerospace and wanted to work for Rockwell in California or Northrop in Virginia . Their organizations, objectives, management, pay scales and locations were near-perfect fits with what I wanted. Nine employer changes later, without ever moving from the midwest, I did projects for large and small hospitals, schools, governments, banks, an advertising agency, a shipping and a telecommunications company. I found greatest personal and financial success as an employee of a large national real estate company- in a position that I wasn't hired for.

The aspects of a company that you can analyze as an outsider- its organization, reward and culture are all arbitrary and will change, dynamically and unpredictably over time.

Every client and every employer had a different structure and culture. These had no significant effect on the work that I did, how I did it, or its quality. What did were individual people with whom I worked- co-workers, supervisors and subordinates, none of whom were known to me beforehand. Several of these employers underwent unpredictable corporate reorganizations and meters that radically changed the culture.

The best guide to finding out whether a company you are interested in working for is a good fit -today - are employees, present and recent past, who have positions similar to what you want. They, not their managers, can give you more insight than any organization analysis can. If they enjoy their jobs and have interests compatible with yours, chances are good that you will enjoy working there - for a while - until doing that job makes you evolve.
CONFLICT OF INTEREST: None Reported
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