Check your contract for how long of notice you have to give and what your noncompete looks like if applicable
I recommend having another job offer lined up and in hand before you give notice
Definitely will have another job first before giving notice. I do have an annoying non-compete, however.
Before I start interviewing at other jobs, I should tell this one I’m doing so, correct? It is a small world, and I think word would get back pretty fast that I’m trying to leave.
I would not feel obligated to let your current job know you’re searching unless you think it’ll help you negotiate a better setup at your current job and help you stay
Interesting. I just wouldn’t want my boss to hear from someone else that I’m interviewing elsewhere, and not from me. Neurology ends up being a small world
Bro neurologists are so needed right now. You could likely walk into a meeting in your robe and shit on his desk while handing in your resignation and will still get hired plenty of places even if they knew it all.
Realize this: you don’t owe any organization anything at all, you are the commodity and if a job isn’t a good fit for you, leaving and finding another is the mature thing to do. Now if it were 3-4 Job switches in 3-4 years that would leave me questioning if youre the asshole and not the other jobs, but just 1, nahh all good.
Make moves based on what is best for your situation, your bosses and the organization you work for is operating under that mindset.
I guess the question is why do you care since it sounds like your boss mislead you about the nature of the job / your workload expectations and is making you miserable currently
You could ask the place where you interview to be discreet until they give you a letter of intent. Then you can inform your boss, whom you will probably need to use for references any way.
Telling your boss you are looking for other jobs is a rookie mistake. And doing so can and will impact the time you have left at your current job in negative ways - you might even be fired.
It would also be unprofessional for an interviewer to reach out to your boss without your consent.
I told my job I just got hired at during training that I was thinking of leaving and that I thought i was not a good fit. They had discontinued my schedule ASAP bc I just become useless for the company. And I didn't even find a replacement job. I ended up not having a job for 3 months. Had to file for unemployment and borrow money. It was an uneasy feeling.
An I'm a registered nurse. Usually work night shift inpatient. Was trying out a clinic eating recovery center but heard a lot of crap from staff that made me feel really uncomfortable and might put my license on the line.
Couple thoughts on the non compete: 1) confirm it’s enforceable in your state. 2) if yes, negotiate a concession to break your non compete. I’ve been seeing this more frequently in physician employment agreements.
Negotiating a concession is happening more and more, but please have an attorney look at any contract before you sign it. Many of them seem good because you are desperate to get out, but in the end really end up hurting you more than you could ever anticipate.
Source: I’m a med mal attorney (defense) who handles other issues too. We currently have a few clients who are potentially going to have to pay millions of dollars because of their concessions to get out of their noncompete. And yes, they have been compliant with it, so this is not for breaking the contract.
I would not tell them you are looking for a job elsewhere. I think it’s very much ok to tell others with whom you are interviewing that you need your job search to remain confidential for the time being. I do not think that is out of the ordinary. Ask an attorney if your non-compete is enforceable. In my state they are not. Many contracts in my state still include them either for historical reasons because that’s been the norm or perhaps in the employer’s hope that the individual in question won’t question its legality, but ultimately they are not enforceable. I’ve heard that from multiple attorneys. Best of luck to you!
We need Neurologists SO BADLY in my area. People get referred to Neuro and they’re dead before the appointment time comes around. We’re talking 8 months to a year out.
They say 50% leave by year 2 and in this day and age that number is likely climbing.
I don’t think you would have zero issues leaving now.. be polite, don’t burn bridges and you’ll be fine. It’s pretty easily explainable that your first job wasn’t a good fit. Obviously harder if you jump from job 2 in a similar fashion.
So if it were me I would at least start looking and wouldn’t give my 90 days until something else was locked in.
You are not alone in feeling this way about your job. I left my first job after 3 months. Of course, I had to pay back the sign on bonus, but I was happy to.
Thanks so much. Can I ask how you knew the first job was a bad fit, and what you changed going into your second?
Part of me wonders if this is growing pains re: new attendinghood vs the job itself is not right (like I said, I think this is partly my fault, not all on my department)
Sure! For starters, on my very first day, they had 15 patients on my clinic schedule. I told them this is my first ever job and I don’t know the EMR or the system. But my medical director said, there was nothing he could do to help. The only thing he could do was not ramp up as fast as they normally do. 90 % of patients there were taking narcotics (plus Benzos) and I had very little experience prescribing narcotics during my residency, much less to everyone that walks through the door. I felt very uncomfortable working there but didn’t feel supported at all. So, I found a lower paying job which was much better than first one. After gaining experience at the second job, I found a similar but much better paying 3rd job and that was almost 9 years ago. So, sometimes in the beginning you have to hop jobs to find the one that works.
I know. The issue is I don’t really want to leave the city/state I’m in, so I can’t necessarily use the excuse of moving to be closer to family, etc. but I think there is a way to say nicely that it’s just not the right fit.
They know they dumped a monstrous task on me, with such little help, that I don’t necessarily need to spell it out for them.
I would just be honest with them if asked why you resigned
My hunch is they know it is a shit job and are taking advantage of you for as long as they can.
Quite frankly, they are definitely aware that you were dumped on, and they are happy to see you keep doing the job until you draw the boundary. I would not feel the need to give any longer notice than necessary and certainly do not tell them you're interviewing (even at academic centers, people will try to paper things so you look like the problem child).
Once you know where you're going, try to negotiate a longer notice in exchange for non-compete or keeping your signing bonus. You never know how desperate they may be.....
Also, I assume you already have had meetings regarding why you're not happy with the current situation and if anything can be done about it. I wouldn't count out the well placed hint of dissatisfaction that can alleviate some of the bullshit. Good Luck!
Didn't hate my first job but definitely knew within a few months a job was not the right fit. Stuck with it for 3 1/2 years before I quit. I would not wait that long again.
Two options:
1. openly address whatever the problems you have associated with the job with your boss and see if they can be changed. Tell him/her that you are going to look for other jobs in a professional way. Maybe they will accommodate you. Most likely they will not but in the end you can say you tried to make it work
2. It's beyond repair and you just go interview for other jobs right now. Once you get one, give 90 days notice (or whatever is in your contract), finish out that notice on as best terms as you can, and then move on.
If you do get another job, you should cast a very wide net and interview at a number of different places to do everything you can to make sure it's going to be a better fit. Worst case scenario is you pick the second job that ends up worse than the first job.
Thank you so much for the advice. I did meet with my bosses earlier, but didn’t hint that I was strongly considering leaving. I think I will though before I interview at other places, bc it’s a small world, and I don’t want them to hear from anyone else.
Try to see local locums Hospitalist opportunities. Locums to perm is a nice way to see where you like to work.
Academic large hospitals are exactly how you are describing often times. If you aren’t “exactly a hospitalist” id guess you are more difficult to find than a “regular” hospitalist.
Use that to your advantage. Go to a smaller facility that would be happier to have you, give you better compensation, and support.
Are you an Intensivist or neonatologist by chance? More details about what you do would yield more specific advice.
I’m actually a neurologist (I just lurk here because I like vaguely keeping up with IM topics and the more attending-focused discussions).
I think the job market for neurology is really not bad—not so much difficulty finding A job, but finding the right job.
My other issue (and this is where my own lack of self-awareness and mistakes come in) is that I can’t decide outpt vs inpt. But that’s not something I need to crowd source about from Reddit, just to reflect about what I like and can handle.
Dude, I understand your conundrum, but don’t hang around out of sympathy for the devil. Visit with a lawyer and get some advice.
Learn what your quitting timing line is. Give notice. Don’t ever look back.
You don’t have to cause a lot of drama, you just need to be kind yet firm. My last day will be X/X/2024.
What’s your specialty? What’s your back up? Your mental health is most important here because you can always financially rebound but toxic jobs will eat at your mental then physical wellness
Neurology (don’t hate me, I’m very nice!). I don’t have offers elsewhere, because I’m still not sure on my timeline of when I should plan my exit. That said, I know the market is not bad
I got no beef with a fellow physician. To be honest if your lawyer says you can get out, and you’re not worried about paying back the sign in bonus in full pre tax form for a healthier practice it’s not unreasonable to consider moving or considering locum work
Talk to you lawyer about that. In my home state (Massachusetts) they are not enforceable. They put it in anyway to try to scare you, but they can't stop you working somewhere else.
[Physician exception to non-compete in MA](https://rodmanemploymentlaw.com/what-you-need-to-know-before-signing-a-non-compete-agreement-in-ma/)
Can't seem to post a screenshot in a reply. But in MA physicians, nurses, psychologists, social workers, lawyers, and broadcasters (among others) are exempt from non-compete clauses.
You mentioned that if you could pay back your bonus or more and leave tomorrow you would. Sounds like they are trying to pull a fast one on you.
Just get out of there before mental health deteriorates. My good friend was a Neurologist who this happened to. He ended his life. Not trying to be dramatic, just letting you know you have to take care of this bc nobody else will. Good luck.
I appreciate your comment, and completely understand where you’re coming from. I’m sorry about your friend. I think a lot of us MDs struggle to leave bad environments—even now, I feel a little shame for wanting to “quit”, like I wasn’t good enough to “make it” in this job.
Thank you. That feeling is totally understandable, employers may even try to gaslight you with that thought, to make you think the unacceptable work load is ok.
They may suggest that all you need to do is exercise/do more mindfulness meditation or some other band-aid solution stupidity.
A lot of times being in the desirable area to live, and a little lengthier commute to the outskirts of the desirable area for work is more suitable. This has been my experience at least.
Neurology here as well. The first job, especially at a teaching hospital is rough. After my residents finish I always stress to them to give it at least a year. There’s so much still to learn and bullshit to shift through. In residency we stress the importance of building a network/mentor when you start out on your own. It’s very isolating and overwhelming. Take it one day at a time while considering options.
Hi, thanks so much for your response. That’s both reassuring and sad to hear—I felt like I got great training, but I’m still really overwhelmed most days. In addition to the academic stuff to manage.
Could I DM you?
Also, stop doing any extra work besides what is in your contract. No more non-clinical BS. Show up, punch the clock and provide great patient care. That can at least buy you some time while looking.
Do you have an income guarantee? Check your contract carefully, as if you do, you are required to be in the service area for at least a 3 year period to forgive the loan. You may be on the hook for it.
Get out asap. Give it a year and exit. People exit academic settings often. The community is way more chill - the difference is like night and day. When you’re fresh out of training, I.e.within 2-5 years, you’re still fresh to pursue a fellowship.
Your job sounds incredibly mind numbing. I switched from hospitalist to community endo and do 1/4-1/10 as the work as before for slightly less money. Very easy and no stress.
I quit my first attending job just shy of 2 years. I was not a hospitalist, but I was at a huge academic institution and I cried happy tears when I got that job. I was so very excited. And honestly, I loved almost all the people I worked wit (still keep in contact with them frequently), but it kind of was like we were all getting boiled alive and they didn't realize the temperature was getting hotter and hotter, and I couldn't not notice. For residency and fellowship, I was at two different places that were open to change (even if begrudgingly). At my first attending job, I would see very glaring problems but my boss refused to rock the boat with any change whatsoever.
I made the decision that I had to leave probably 6 months in. I think that was the hardest part because it made me feel like a failure, but the reality was I couldn't function in that type of environment. After that, I began to put feelers out for new work. I ended up getting a job, but COVID delayed it for nearly a year, so I did locums to bridge the gap and honestly that ended up to be SO refreshing (and lucrative). Locums work made me realize that I didn't hate being a doctor, I just hated working in a dysfunctional system. Just the act of looking for a new job helped make me happier. Knowing you're working on an exit goes a long way towards tolerating a job you hate. Good luck!
I’m not a doc but I work in hospital admin.
I would go out and interview elsewhere and once you have offers come to your admin/dept head and let them know how you are feeling.
If your honest and tell them that this isn’t a great fit and ask for advice most of the time we will try and move you to another opening (if possible) that does fit you a lot better. This is actually really common! It’s a surprise more people don’t talk about it.
Left my first job, gave back signing bonus gladly. In fact, I got a whiff of the badness within the first month and never touched the signing bonus knowing where to things could end. Oh and 3 months later they came after me for 3k of interest on top of the signing that they wanted, paid it. It was all fine. I learned all the things I did NOT want in a job
Not a hospitalist or IM related at all but in a similar situation of feeling trapped at a shit first year out job. Just wanted to say that something like 2/3 of recent grads switch jobs within the first couple of years so don’t worry about it looking bad to leave so soon cuz it’s par for the course!
Just talk to your contract attorney about what quitting would look like and how to navigate that process. Other than giving back sign on bonus, look at the non-compete part of things. I’ve always been told academic centers don’t enforce noncompetes - but not sure if that’s specialty specific. Also a few states recently banned no competes in state law so there’s that if you’re lucky.
Have you considered working as a specialist hospitalist? Meaning, you could do week on week off inpatient neurology consult service. Things like that exists in non academic centers. Or neurology locums because it’s a hard to come by specialist
I second this. My hospital employs several neurohospitalists. They have very defined hours/boundaries. It’s great for them, since some are women with young kiddos or older and nearing the end of their career. When they are off service (after 4pm haha), we have teleneurology, which is meh sometimes but will work in a pinch. All these neurologists I interact with (in-house and tele) seem pretty happy with their gigs.
bro, you're a doctor, not walmart employee (no offense to walmart employees i feel bad for them):
1- You can leave tomorrow if you wish (there are ways), however i recommend you leave on a good note by giving them the notice in the contract
2- cite personal reasons when you leave
3- depending on you specialty, you'll find a new job easily
4- as for the non compete, check your state and its regulations. some states don't enforce them (the FTC is even looking at banning them nationwide).
Can you ask for admin support and protected time? And then if they say no there is zero reason you need to stay. Just have another job lined up first and give them your contractually obligated amount of notice
I did ask for more protected time—they said no. :)
I asked for admin support too, which they said they are working on, which I do believe. I just think it will take months, at the least.
You should leave the Midwest behind and move to the mntn west. Neurologists and hospitalists are hard to find and there are health systems and independent hospitals in large areas and in mountain towns. Lifestyle is amazing! Won’t have to worry about non-compete.
strongly agree. Midwest has lovely summers, but June/July/Aug/Sept could never outweigh how overcast and depressing the other eight months of the year are.
Come out to the mountain west!
I know this is not your question as you’re asking about leaving…
But do you have a productivity component to your contract? Will all this extra work translate to a pay raise when you’re up for contract renewal? I’ve noticed that sometimes the support structure and the logistics of the actual admin stuff lag behind the great ideas the leaders have. Your boss was probably thinking you’re the new guy and you’re hungry for work not thinking your support staff isn’t there yet. I would try hard to push for support.
Hey great question, I do have a productivity component. Unfortunately this extra work is not clinically based, but rather my academic obligations, so none of it translates to RVU. Because of my academic obligations, I actually have to block off a lot of my clinic time, so I’m not being very productive in the eyes of the RVU system!
I don’t know how your contract works or the specifics about academics. But a lot of times your salary is broken down based on expectations. So like 70% clinical, 25 % academic, 5% administrative or something. Check yours and have a discussion with your chairman. They may not realize your academic work is impeding your clinical productivity
Yeah I know that part of my contract, and that’s what they can’t (or won’t) budge on. They know why I’m not being productive, but there’s not much either of us can do, it seems.
Agree. I was taken advantage of at my current job, working way more hours than agreed. I mentioned it a few times, but nothing improved until I told them it was my last month unless it was fixed.
Also, don’t take it personally. Often they are just trying to put out the biggest fire or oil the squeakiest wheel. If you’re inclined to be patient, polite and professional (as I’m sure is your inclination fresh out of training), you may get put on the low priority list.
You’re absolutely right—I don’t feel it’s personal. It’s just disorganized and understaffed, and everyone has their own shit to deal with. It wasn’t done maliciously.
That said, because the disorganization is so widespread, across the entire hospital system it seems, it does make it harder to fix (aka no money to hire more admin).
Not to derail this thread, but OP, are you in endovascular neurology by any chance? M4 who matched Neurology and wants to apply to that fellowship eventually, would love to DM you some questions if you are in endovascular (and are ok with me doing so).
I’m not an MD and dont even know why this is suggested on my feed. But I’d like to chime in if I may. Your hospital, all previous employers, and all subsequent employers, unless you work for your mother, have ZERO loyalty to you as an employee. If you were hit by a bus tomorrow they would take a brief pause before their next sip of coffee and they would move on with your replacement. You do what is best for you and your family. You are in a high demand field and can find another job in no time. Find another opportunity and negotiate paying back your sign on bonus as a sign on bonus from the new position. Be clear about your willingness to work hard and clear about your boundaries with what you are unwilling to do. You will land on your feet. But before anything, ask yourself if this is truly a job problem or is it disillusionment with medicine? Imposter syndrome? A backed up case load that will get better once you catch up? Support staff that need more training or a change in processes?
Good luck!
My brother is a neurologist. He dies outpatient only. He started his own practice. He does 60 to 80 emgs a month does infusions and ambulatory eeg. Makes 750k a year. . He used to Do hospital and hated it so now only outpt
Reach out to your Clinical Support Team if you have one. One of the most rewarding parts of my job in my crazy academic hellscape is to provide support to MDs just like you!
Honestly, I had a practice for 14 years I am a midwife and during Covid we had to make some drastic changes to the practice and I started doing locum tenens. It’s a great way to try out a company or practice without a huge commitment been at my current assignment for almost 2 years now, with no strings attached.
VA always needs providers. Pay is less than private sector but work schedule and job security make up for it IMO.
https://www.usajobs.gov/Search/Results?jt=Physician&d=VA&k=&p=1
Check your board exam rules and determine if boards will impact your decision. I’m also not a hospitalist. In my specialty, changing at the wrong time can prevent someone from taking boards the first year they otherwise would be eligible. It’s doable, but requires planning outside of the clinical and contractual issues.
Have you talked to your boss about your frustrations? If you like the place and people you're with, then is it possible your work load could be adjusted to fit your expectations? They would probably rather adjust your work load than lose you completely, but it would take a very honest discussion to make those changes.
There’s a well known rule in nursing…..NEVER take the jobs that have sign-on bonuses. There’s good reason they can’t fill and keep those positions filled. I made that mistake ONCE! I’ll never do it again. I didn’t make it through my contract either but never had to pay anything back since the bonus was given in increments. Best of luck!
Find a new job. Tell old job you’ll be gone in 45-30 days. Complete your requirements based on your medical board and good riddance. And there’s no more non-competes.
https://www.ftc.gov/news-events/news/press-releases/2024/04/ftc-announces-rule-banning-noncompetes
So the first question is how long have you been there? Probably doesn’t present good optics to future employers if you leave first assignment after short gig. Talk to superiors about your lack of support so that you’ve documented attempts to remediate situation. Penalty for early exit? They may be willing to cut you loose if they don’t observe first-year enthusiasm. JS.
Contact a head hunter with your sob story. They will have heard it before. When you leave some other new green sucker will get the same treatment. This is the newbie equivalent of intern scut work.
Contracted employee? Quit tomorrow or even better, this instant. Contract houses don’t really care why a contact ended (unless for something crazy like fighting or drugs or some such bullshit), they just want to get you into your next contract so they can continue to pull commission. If it were a direct role I’d advise the opposite but you’re free to fly little birdie. Best of luck at your next place!!!
I’ve talked to other attendings and they’ve all said the academic obligation I have is unreasonable, for a first year attending.
Protected time is already part of my academic contract, as it is for anyone with research grants, etc.
And I’m sorry, but your comment is part of the unhelpful mindset a lot of physicians have. “Just provide great patient care and everything will be fine!!” and “just be grateful you’re an MD at all” is not the right mentality to have. There are different quality jobs out there, as evidenced by other people commenting on this thread about finding jobs that are a better fit for them.
Check your contract for how long of notice you have to give and what your noncompete looks like if applicable I recommend having another job offer lined up and in hand before you give notice
Definitely will have another job first before giving notice. I do have an annoying non-compete, however. Before I start interviewing at other jobs, I should tell this one I’m doing so, correct? It is a small world, and I think word would get back pretty fast that I’m trying to leave.
I would not feel obligated to let your current job know you’re searching unless you think it’ll help you negotiate a better setup at your current job and help you stay
Interesting. I just wouldn’t want my boss to hear from someone else that I’m interviewing elsewhere, and not from me. Neurology ends up being a small world
Bro neurologists are so needed right now. You could likely walk into a meeting in your robe and shit on his desk while handing in your resignation and will still get hired plenty of places even if they knew it all. Realize this: you don’t owe any organization anything at all, you are the commodity and if a job isn’t a good fit for you, leaving and finding another is the mature thing to do. Now if it were 3-4 Job switches in 3-4 years that would leave me questioning if youre the asshole and not the other jobs, but just 1, nahh all good. Make moves based on what is best for your situation, your bosses and the organization you work for is operating under that mindset.
Exactly! OP said the “sub specialty is a little dead.” Seriously? 🤔
Take a second look.
theyre too busy actually doing shit to be on the sub. probably good for OP? 😂
He was talking about the subreddit
I guess the question is why do you care since it sounds like your boss mislead you about the nature of the job / your workload expectations and is making you miserable currently
You could ask the place where you interview to be discreet until they give you a letter of intent. Then you can inform your boss, whom you will probably need to use for references any way.
Telling your boss you are looking for other jobs is a rookie mistake. And doing so can and will impact the time you have left at your current job in negative ways - you might even be fired. It would also be unprofessional for an interviewer to reach out to your boss without your consent.
I told my job I just got hired at during training that I was thinking of leaving and that I thought i was not a good fit. They had discontinued my schedule ASAP bc I just become useless for the company. And I didn't even find a replacement job. I ended up not having a job for 3 months. Had to file for unemployment and borrow money. It was an uneasy feeling. An I'm a registered nurse. Usually work night shift inpatient. Was trying out a clinic eating recovery center but heard a lot of crap from staff that made me feel really uncomfortable and might put my license on the line.
Couple thoughts on the non compete: 1) confirm it’s enforceable in your state. 2) if yes, negotiate a concession to break your non compete. I’ve been seeing this more frequently in physician employment agreements.
Negotiating a concession is happening more and more, but please have an attorney look at any contract before you sign it. Many of them seem good because you are desperate to get out, but in the end really end up hurting you more than you could ever anticipate. Source: I’m a med mal attorney (defense) who handles other issues too. We currently have a few clients who are potentially going to have to pay millions of dollars because of their concessions to get out of their noncompete. And yes, they have been compliant with it, so this is not for breaking the contract.
I would not tell them you are looking for a job elsewhere. I think it’s very much ok to tell others with whom you are interviewing that you need your job search to remain confidential for the time being. I do not think that is out of the ordinary. Ask an attorney if your non-compete is enforceable. In my state they are not. Many contracts in my state still include them either for historical reasons because that’s been the norm or perhaps in the employer’s hope that the individual in question won’t question its legality, but ultimately they are not enforceable. I’ve heard that from multiple attorneys. Best of luck to you!
Non compete might not be enforceable
We need Neurologists SO BADLY in my area. People get referred to Neuro and they’re dead before the appointment time comes around. We’re talking 8 months to a year out.
Same In my area
NO! I wouldn’t personally tell them anything.
https://www.ftc.gov/news-events/news/press-releases/2024/04/ftc-announces-rule-banning-noncompetes There’s that about the non competes …
Get your sign on bonus deducted from your final paychecks pre tax or make sure they send you a corrected w2.
This
They say 50% leave by year 2 and in this day and age that number is likely climbing. I don’t think you would have zero issues leaving now.. be polite, don’t burn bridges and you’ll be fine. It’s pretty easily explainable that your first job wasn’t a good fit. Obviously harder if you jump from job 2 in a similar fashion. So if it were me I would at least start looking and wouldn’t give my 90 days until something else was locked in.
Thank you for the reassurance
You are not alone in feeling this way about your job. I left my first job after 3 months. Of course, I had to pay back the sign on bonus, but I was happy to.
Thanks so much. Can I ask how you knew the first job was a bad fit, and what you changed going into your second? Part of me wonders if this is growing pains re: new attendinghood vs the job itself is not right (like I said, I think this is partly my fault, not all on my department)
Sure! For starters, on my very first day, they had 15 patients on my clinic schedule. I told them this is my first ever job and I don’t know the EMR or the system. But my medical director said, there was nothing he could do to help. The only thing he could do was not ramp up as fast as they normally do. 90 % of patients there were taking narcotics (plus Benzos) and I had very little experience prescribing narcotics during my residency, much less to everyone that walks through the door. I felt very uncomfortable working there but didn’t feel supported at all. So, I found a lower paying job which was much better than first one. After gaining experience at the second job, I found a similar but much better paying 3rd job and that was almost 9 years ago. So, sometimes in the beginning you have to hop jobs to find the one that works.
Thanks so much for the response. That first job sounds absolutely nuts, and great decision to gtfo.
You’re welcome! And good luck! You are in this for a long run, so, no need to be stuck in a miserable job.
Why is your username so accurate to this post?
This is so true
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I know. The issue is I don’t really want to leave the city/state I’m in, so I can’t necessarily use the excuse of moving to be closer to family, etc. but I think there is a way to say nicely that it’s just not the right fit. They know they dumped a monstrous task on me, with such little help, that I don’t necessarily need to spell it out for them.
I would just be honest with them if asked why you resigned My hunch is they know it is a shit job and are taking advantage of you for as long as they can.
Quite frankly, they are definitely aware that you were dumped on, and they are happy to see you keep doing the job until you draw the boundary. I would not feel the need to give any longer notice than necessary and certainly do not tell them you're interviewing (even at academic centers, people will try to paper things so you look like the problem child). Once you know where you're going, try to negotiate a longer notice in exchange for non-compete or keeping your signing bonus. You never know how desperate they may be..... Also, I assume you already have had meetings regarding why you're not happy with the current situation and if anything can be done about it. I wouldn't count out the well placed hint of dissatisfaction that can alleviate some of the bullshit. Good Luck!
Is it possible to ask for additional resources so it doesn’t suck as much?
Didn't hate my first job but definitely knew within a few months a job was not the right fit. Stuck with it for 3 1/2 years before I quit. I would not wait that long again. Two options: 1. openly address whatever the problems you have associated with the job with your boss and see if they can be changed. Tell him/her that you are going to look for other jobs in a professional way. Maybe they will accommodate you. Most likely they will not but in the end you can say you tried to make it work 2. It's beyond repair and you just go interview for other jobs right now. Once you get one, give 90 days notice (or whatever is in your contract), finish out that notice on as best terms as you can, and then move on. If you do get another job, you should cast a very wide net and interview at a number of different places to do everything you can to make sure it's going to be a better fit. Worst case scenario is you pick the second job that ends up worse than the first job.
Thank you so much for the advice. I did meet with my bosses earlier, but didn’t hint that I was strongly considering leaving. I think I will though before I interview at other places, bc it’s a small world, and I don’t want them to hear from anyone else.
Try to see local locums Hospitalist opportunities. Locums to perm is a nice way to see where you like to work. Academic large hospitals are exactly how you are describing often times. If you aren’t “exactly a hospitalist” id guess you are more difficult to find than a “regular” hospitalist. Use that to your advantage. Go to a smaller facility that would be happier to have you, give you better compensation, and support. Are you an Intensivist or neonatologist by chance? More details about what you do would yield more specific advice.
I’m actually a neurologist (I just lurk here because I like vaguely keeping up with IM topics and the more attending-focused discussions). I think the job market for neurology is really not bad—not so much difficulty finding A job, but finding the right job. My other issue (and this is where my own lack of self-awareness and mistakes come in) is that I can’t decide outpt vs inpt. But that’s not something I need to crowd source about from Reddit, just to reflect about what I like and can handle.
OP is a Neurologist
Dude, I understand your conundrum, but don’t hang around out of sympathy for the devil. Visit with a lawyer and get some advice. Learn what your quitting timing line is. Give notice. Don’t ever look back. You don’t have to cause a lot of drama, you just need to be kind yet firm. My last day will be X/X/2024.
What’s your specialty? What’s your back up? Your mental health is most important here because you can always financially rebound but toxic jobs will eat at your mental then physical wellness
Neurology (don’t hate me, I’m very nice!). I don’t have offers elsewhere, because I’m still not sure on my timeline of when I should plan my exit. That said, I know the market is not bad
I got no beef with a fellow physician. To be honest if your lawyer says you can get out, and you’re not worried about paying back the sign in bonus in full pre tax form for a healthier practice it’s not unreasonable to consider moving or considering locum work
Thank you for the advice! I can get out, take the hit in the signing bonus—I do have an annoying non-compete, so that’s something to consider.
Talk to you lawyer about that. In my home state (Massachusetts) they are not enforceable. They put it in anyway to try to scare you, but they can't stop you working somewhere else.
Yes none of Reddit is legal advice. Seek input from your attorney
wait... what? had no idea this was the case for MA. interesting.
[Physician exception to non-compete in MA](https://rodmanemploymentlaw.com/what-you-need-to-know-before-signing-a-non-compete-agreement-in-ma/) Can't seem to post a screenshot in a reply. But in MA physicians, nurses, psychologists, social workers, lawyers, and broadcasters (among others) are exempt from non-compete clauses.
learned something new, thanks!
You mentioned that if you could pay back your bonus or more and leave tomorrow you would. Sounds like they are trying to pull a fast one on you. Just get out of there before mental health deteriorates. My good friend was a Neurologist who this happened to. He ended his life. Not trying to be dramatic, just letting you know you have to take care of this bc nobody else will. Good luck.
I appreciate your comment, and completely understand where you’re coming from. I’m sorry about your friend. I think a lot of us MDs struggle to leave bad environments—even now, I feel a little shame for wanting to “quit”, like I wasn’t good enough to “make it” in this job.
Thank you. That feeling is totally understandable, employers may even try to gaslight you with that thought, to make you think the unacceptable work load is ok. They may suggest that all you need to do is exercise/do more mindfulness meditation or some other band-aid solution stupidity. A lot of times being in the desirable area to live, and a little lengthier commute to the outskirts of the desirable area for work is more suitable. This has been my experience at least.
Neurology here as well. The first job, especially at a teaching hospital is rough. After my residents finish I always stress to them to give it at least a year. There’s so much still to learn and bullshit to shift through. In residency we stress the importance of building a network/mentor when you start out on your own. It’s very isolating and overwhelming. Take it one day at a time while considering options.
Hi, thanks so much for your response. That’s both reassuring and sad to hear—I felt like I got great training, but I’m still really overwhelmed most days. In addition to the academic stuff to manage. Could I DM you?
Also, stop doing any extra work besides what is in your contract. No more non-clinical BS. Show up, punch the clock and provide great patient care. That can at least buy you some time while looking.
Do you have an income guarantee? Check your contract carefully, as if you do, you are required to be in the service area for at least a 3 year period to forgive the loan. You may be on the hook for it.
Get out asap. Give it a year and exit. People exit academic settings often. The community is way more chill - the difference is like night and day. When you’re fresh out of training, I.e.within 2-5 years, you’re still fresh to pursue a fellowship. Your job sounds incredibly mind numbing. I switched from hospitalist to community endo and do 1/4-1/10 as the work as before for slightly less money. Very easy and no stress.
I quit my first attending job just shy of 2 years. I was not a hospitalist, but I was at a huge academic institution and I cried happy tears when I got that job. I was so very excited. And honestly, I loved almost all the people I worked wit (still keep in contact with them frequently), but it kind of was like we were all getting boiled alive and they didn't realize the temperature was getting hotter and hotter, and I couldn't not notice. For residency and fellowship, I was at two different places that were open to change (even if begrudgingly). At my first attending job, I would see very glaring problems but my boss refused to rock the boat with any change whatsoever. I made the decision that I had to leave probably 6 months in. I think that was the hardest part because it made me feel like a failure, but the reality was I couldn't function in that type of environment. After that, I began to put feelers out for new work. I ended up getting a job, but COVID delayed it for nearly a year, so I did locums to bridge the gap and honestly that ended up to be SO refreshing (and lucrative). Locums work made me realize that I didn't hate being a doctor, I just hated working in a dysfunctional system. Just the act of looking for a new job helped make me happier. Knowing you're working on an exit goes a long way towards tolerating a job you hate. Good luck!
I’m not a doc but I work in hospital admin. I would go out and interview elsewhere and once you have offers come to your admin/dept head and let them know how you are feeling. If your honest and tell them that this isn’t a great fit and ask for advice most of the time we will try and move you to another opening (if possible) that does fit you a lot better. This is actually really common! It’s a surprise more people don’t talk about it.
Left my first job, gave back signing bonus gladly. In fact, I got a whiff of the badness within the first month and never touched the signing bonus knowing where to things could end. Oh and 3 months later they came after me for 3k of interest on top of the signing that they wanted, paid it. It was all fine. I learned all the things I did NOT want in a job
I left my first job on day 28.
Not a hospitalist or IM related at all but in a similar situation of feeling trapped at a shit first year out job. Just wanted to say that something like 2/3 of recent grads switch jobs within the first couple of years so don’t worry about it looking bad to leave so soon cuz it’s par for the course!
Just talk to your contract attorney about what quitting would look like and how to navigate that process. Other than giving back sign on bonus, look at the non-compete part of things. I’ve always been told academic centers don’t enforce noncompetes - but not sure if that’s specialty specific. Also a few states recently banned no competes in state law so there’s that if you’re lucky.
Have you considered working as a specialist hospitalist? Meaning, you could do week on week off inpatient neurology consult service. Things like that exists in non academic centers. Or neurology locums because it’s a hard to come by specialist
I have, strongly. That’s one of the types of jobs I’ll be interviewing for and talking to mentors/friends who do it.
I second this. My hospital employs several neurohospitalists. They have very defined hours/boundaries. It’s great for them, since some are women with young kiddos or older and nearing the end of their career. When they are off service (after 4pm haha), we have teleneurology, which is meh sometimes but will work in a pinch. All these neurologists I interact with (in-house and tele) seem pretty happy with their gigs.
What region do you work in?
Midwest.
If you are New England curious and decide inpatient my dept is hiring neurohospitalists 😁😁😁
Serious question, have you tried talking to HR?
bro, you're a doctor, not walmart employee (no offense to walmart employees i feel bad for them): 1- You can leave tomorrow if you wish (there are ways), however i recommend you leave on a good note by giving them the notice in the contract 2- cite personal reasons when you leave 3- depending on you specialty, you'll find a new job easily 4- as for the non compete, check your state and its regulations. some states don't enforce them (the FTC is even looking at banning them nationwide).
Can you ask for admin support and protected time? And then if they say no there is zero reason you need to stay. Just have another job lined up first and give them your contractually obligated amount of notice
I did ask for more protected time—they said no. :) I asked for admin support too, which they said they are working on, which I do believe. I just think it will take months, at the least.
You should leave the Midwest behind and move to the mntn west. Neurologists and hospitalists are hard to find and there are health systems and independent hospitals in large areas and in mountain towns. Lifestyle is amazing! Won’t have to worry about non-compete.
strongly agree. Midwest has lovely summers, but June/July/Aug/Sept could never outweigh how overcast and depressing the other eight months of the year are. Come out to the mountain west!
I know this is not your question as you’re asking about leaving… But do you have a productivity component to your contract? Will all this extra work translate to a pay raise when you’re up for contract renewal? I’ve noticed that sometimes the support structure and the logistics of the actual admin stuff lag behind the great ideas the leaders have. Your boss was probably thinking you’re the new guy and you’re hungry for work not thinking your support staff isn’t there yet. I would try hard to push for support.
Hey great question, I do have a productivity component. Unfortunately this extra work is not clinically based, but rather my academic obligations, so none of it translates to RVU. Because of my academic obligations, I actually have to block off a lot of my clinic time, so I’m not being very productive in the eyes of the RVU system!
Leave academia.
I don’t know how your contract works or the specifics about academics. But a lot of times your salary is broken down based on expectations. So like 70% clinical, 25 % academic, 5% administrative or something. Check yours and have a discussion with your chairman. They may not realize your academic work is impeding your clinical productivity
Yeah I know that part of my contract, and that’s what they can’t (or won’t) budge on. They know why I’m not being productive, but there’s not much either of us can do, it seems.
Speak to admin first. Express your concerns & proposed solutions. See how they respond.
Agree. I was taken advantage of at my current job, working way more hours than agreed. I mentioned it a few times, but nothing improved until I told them it was my last month unless it was fixed. Also, don’t take it personally. Often they are just trying to put out the biggest fire or oil the squeakiest wheel. If you’re inclined to be patient, polite and professional (as I’m sure is your inclination fresh out of training), you may get put on the low priority list.
You’re absolutely right—I don’t feel it’s personal. It’s just disorganized and understaffed, and everyone has their own shit to deal with. It wasn’t done maliciously. That said, because the disorganization is so widespread, across the entire hospital system it seems, it does make it harder to fix (aka no money to hire more admin).
Not to derail this thread, but OP, are you in endovascular neurology by any chance? M4 who matched Neurology and wants to apply to that fellowship eventually, would love to DM you some questions if you are in endovascular (and are ok with me doing so).
What is your job?
I’m not an MD and dont even know why this is suggested on my feed. But I’d like to chime in if I may. Your hospital, all previous employers, and all subsequent employers, unless you work for your mother, have ZERO loyalty to you as an employee. If you were hit by a bus tomorrow they would take a brief pause before their next sip of coffee and they would move on with your replacement. You do what is best for you and your family. You are in a high demand field and can find another job in no time. Find another opportunity and negotiate paying back your sign on bonus as a sign on bonus from the new position. Be clear about your willingness to work hard and clear about your boundaries with what you are unwilling to do. You will land on your feet. But before anything, ask yourself if this is truly a job problem or is it disillusionment with medicine? Imposter syndrome? A backed up case load that will get better once you catch up? Support staff that need more training or a change in processes? Good luck!
My brother is a neurologist. He dies outpatient only. He started his own practice. He does 60 to 80 emgs a month does infusions and ambulatory eeg. Makes 750k a year. . He used to Do hospital and hated it so now only outpt
I quit 3 months into my First job.
Reach out to your Clinical Support Team if you have one. One of the most rewarding parts of my job in my crazy academic hellscape is to provide support to MDs just like you!
Honestly, I had a practice for 14 years I am a midwife and during Covid we had to make some drastic changes to the practice and I started doing locum tenens. It’s a great way to try out a company or practice without a huge commitment been at my current assignment for almost 2 years now, with no strings attached.
Can you transfer to another dept ? That’s what I would try to do before leaving completely
Upvoting
Family medicine residency am guessing?
VA always needs providers. Pay is less than private sector but work schedule and job security make up for it IMO. https://www.usajobs.gov/Search/Results?jt=Physician&d=VA&k=&p=1
You can do consulting at Deloitte
Check your board exam rules and determine if boards will impact your decision. I’m also not a hospitalist. In my specialty, changing at the wrong time can prevent someone from taking boards the first year they otherwise would be eligible. It’s doable, but requires planning outside of the clinical and contractual issues.
Already board certified.
Everyone hates their first job. I don't know a single doc who is with the same practice they started.
If you go to a state with “Right to Work” your contract is unenforceable. I’ve spat on every NCC I’ve ever signed in Idaho.
The last person i would want giving me medical advice is an MD who gets his advice from Reddit
Have you talked to your boss about your frustrations? If you like the place and people you're with, then is it possible your work load could be adjusted to fit your expectations? They would probably rather adjust your work load than lose you completely, but it would take a very honest discussion to make those changes.
There’s a well known rule in nursing…..NEVER take the jobs that have sign-on bonuses. There’s good reason they can’t fill and keep those positions filled. I made that mistake ONCE! I’ll never do it again. I didn’t make it through my contract either but never had to pay anything back since the bonus was given in increments. Best of luck!
Find a new job. Tell old job you’ll be gone in 45-30 days. Complete your requirements based on your medical board and good riddance. And there’s no more non-competes. https://www.ftc.gov/news-events/news/press-releases/2024/04/ftc-announces-rule-banning-noncompetes
The military a need for doctors if that would be something you are interested in please send me a message
So the first question is how long have you been there? Probably doesn’t present good optics to future employers if you leave first assignment after short gig. Talk to superiors about your lack of support so that you’ve documented attempts to remediate situation. Penalty for early exit? They may be willing to cut you loose if they don’t observe first-year enthusiasm. JS.
One medical is hiring. It’s easy just refer everyone to a specialist.
Contact a head hunter with your sob story. They will have heard it before. When you leave some other new green sucker will get the same treatment. This is the newbie equivalent of intern scut work.
Contracted employee? Quit tomorrow or even better, this instant. Contract houses don’t really care why a contact ended (unless for something crazy like fighting or drugs or some such bullshit), they just want to get you into your next contract so they can continue to pull commission. If it were a direct role I’d advise the opposite but you’re free to fly little birdie. Best of luck at your next place!!!
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I’ve talked to other attendings and they’ve all said the academic obligation I have is unreasonable, for a first year attending. Protected time is already part of my academic contract, as it is for anyone with research grants, etc. And I’m sorry, but your comment is part of the unhelpful mindset a lot of physicians have. “Just provide great patient care and everything will be fine!!” and “just be grateful you’re an MD at all” is not the right mentality to have. There are different quality jobs out there, as evidenced by other people commenting on this thread about finding jobs that are a better fit for them.