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What New Physicians Worry About Most

June 26, 2019

What New Physicians Worry About Most

By Debra Wood, contributor

As final-year medical residents approach the end of their formal training, a number of concerns bubble to top of mind. Despite years of training and overcoming numerous challenges to get to this point, the transition to one’s first professional practice can still hold some uneasiness.

Respondents to Merritt Hawkins’ 2019 Survey of Final-Year Medical Residents, conducted in March 2019, noted several factors are causing new physicians angst.

8 Top Concerns of Final-Year Medical Residents

1. Compensation

Forty-three percent of the responding final-year medical residents expressed being very concerned about earning a good income, with 45 percent saying they were somewhat concerned about it. Seventy-five percent of the residents considered a good financial package important when evaluating opportunities for a first job after residency.

“Income is always important,” said Jeffrey I. Kakish, MD, MBA, a healthcare executive in the department of academic medicine at Merritt Hawkins, a leading physician search and consulting company. “But I think residents’ main goal is to find an opportunity close to home as well as giving a significant income to pay off student loans and to build a career and a family around it.”

The survey authors noted that residents may be feeling more insecure financially than they have in the past due to the evolving nature of physician reimbursement, which is shifting away from fee-for-service models and toward fee-for-value models.

2. Medical school debt

Student loan debt was very concerning to 38 percent of the survey respondents, with 26 percent noting they are somewhat concerned. Forty-two percent reported they owe more than $200,000.

Julie Fresne, senior director of student financial and career advising services at the Association of American Medical Colleges (AAMC), recommended new physicians check into an income-driven repayment plans. The “Pay as You Earn” and the “Revised Pay as You Earn” plans have good conditions, she said. The payment will not exceed 10 percent of the person’s income.

“These programs are designed so that every student loan borrower has a manageable payment,” Fresne said. “Physicians often pay on time or early and have very low default rates.”

Working in public service or for a not-for-profit, physicians may be eligible for loan forgiveness.

The AAMC FIRST (Financial Information, Resources, Services, and Tools) Program offers financial resources.

3. Availability of free time

One out of every three final-year residents (33 percent) cited being very concerned about availability of free time, and 55 percent were somewhat concerned. This high level of concern may be due to the growing awareness of physician burnout and wellness issues.

“As a new physician, you’re investing time, energy and effort to build your career,” said Gabriela Cora, MD, MHA, MBA, DFAPA, president and CEO of Executive Health & Wellness Institute in Miami. “However, working 24/7 does not make you better. You can have what you want, but not all at once.”

Cora recommended new physicians build into their schedule time to do things they enjoy, saying, “Planning ahead is important.”

Amaryllis Sanchez Wohlever, MD, of Winter Park, Florida, author of Recapturing Joy in Medicine, said she reminds new physicians that they are human and have human needs. She encourages residents nearing completion of their training to stay connected with family, friends and physicians who have helped them.

Cora also expressed how important relationships are and to prioritize spending time with others, adding that those experiences with other people and the community can make one a better physician.

4. Insufficient practice management knowledge

Not knowing enough to manage a practice was reported by 23 percent of the residents as being very concerning and for 54 percent somewhat concerning. Additionally, 20 percent indicated being very concerned about dealing with payers, while 52 percent were somewhat concerned.

“While in residency, physicians are not really taught how to work with external partnerships or payers,” Kakish said.

Those concerns may contribute to why 45 percent of the respondents said they would be open to becoming a hospital employee, the highest percentage ever. Kakish said that hospital positions often appeal to new physicians due to work–life balance and because hospitals offer security.

5. Malpractice

Professional liability was very concerning to 18 percent of the residents and somewhat concerning for 57 percent of them. Sixty-eight percent consider locating in a low malpractice area as very or somewhat important.

Another bonus with hospital employment is that it usually comes with malpractice insurance coverage.

6. Ability to find a practice

Only 16 percent of the surveyed residents were very concerned about their ability to find a practice. In fact, 45 percent of the new physicians noted that they have received 100 or more job solicitations during their residency. Questioning whether they are making the right choice is common. Ninety-two percent had been contacted at least 10 times by recruiters for a first job after residency.

“A main goal is to find an opportunity they are comfortable with and close to home,” Kakish said.

7. Second thoughts about their career path

This year’s group of new physicians expressed some career trepidation. The survey found 21 percent of U.S. medical graduates would not choose medicine if they had to do it all over again. If any prefer to try something different, the current healthcare environment offers a multitude of opportunities for physicians not wanting a traditional practice.

“There are different avenues you can take with your medical background,” Kakish said. “That opens up new career opportunities.”

8. Readiness to practice

The good news is that the survey found only 5 percent of final-year residents were very concerned about dealing with patients and 12 percent expressed insufficient medical knowledge.

Yet, transitioning from a leadership position as senior resident to being a newbie physician may concern residents, Cora said.  

“Once you start, whether solo practice or joining a group, you will be the rookie in that group,” Cora said. The survey researchers noted that most new physicians can expect to find adequate support from their peers, especially in hospitals and group practices.

For more insights on the career plans and practice perspectives of graduating medical residents, download the full survey:  2019 Survey of Final-Year Medical Residents

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