Sign your name on the dotted line
Listen to that small, still voice
Do your homework
Show some class after the interview
But don’t wait until that letter to strut your stuff
Make like a Boy Scout
Turn the interview into dialogue
Recognize when you need some extra help
Pitch your niche
Put yourself out there
Do a walkabout
In the grand scheme of things, it’s easy to forget the small steps
that lead to more lasting endeavors. Childbirth, the fax machine, Schumann’s
symphonies—tiny bridges all, barely remembered once in the throes
of teenage offspring, e-mail, Wagner and Mahler. But they’re necessary
Such is the process of finding a job. Once you’ve launched your
career, it’s hard to remember all the steps you took to seek employment.
Like a Las Vegas newlywed, waking up to find a ring on your finger, you
may find yourself wondering, “How did I get here?” But it’s
actually not that complicated to trace back through each of the small
but essential steps that link the end and beginning of your job search.
You have a job offer and you accept. Simple enough.
But there’s more than one way to say “yes.” Equally
important, there are several ways to say “no.”
When you get a job offer, respond within five to seven days, regardless
of whether you’re accepting or declining the offer, says Michael
S. Brown, MD, president and medical director of Yellowstone Pathology
Institute, Billings, Mont. “You can’t string groups along,”
says Dr. Brown. Groups may have two or three other candidates in mind
in case you decline, and they should be free to pursue those pathologists
if you don’t accept their offer.
Accept or decline by phone, with a personal conversation, though you
can always follow up with a gracious letter, thanking them for the opportunity
to join the group. That’s another way of saying, don’t rely
on a letter, e-mail, or voicemail message, regardless of how tempting
it is to avoid a strained conversation about your decision. “You’ve
got to be upfront and honest about why you’re declining that position:
You’ve found another job that you like better. Or, there was a problem
with something in their practice that you just didn’t feel comfortable
with,” he says. In the latter case, the group may even be willing
to make a change.
These conversations can be sticky, Dr. Brown acknowledges, especially
for those who have found several practices they like. He found himself
in that very position nearly five years ago, just before he started at
Yellowstone Pathology, a disclosure that can rouse equal portions of envy
and interest, along the lines of “Lucky bastard—I should probably
listen to his advice.” “I really liked three different practices,
and when I had to call them [the other two] and tell them I wasn’t
coming, they just couldn’t understand why. It made me feel bad,
too—I felt like I was letting them down. But you’ve got to
be honest with yourself and honest with them. And certainly if there’s
a problem with their practice, one they don’t realize they have,
maybe you can help them change that, even if you’re not going there.”
The five- to seven-day rule can be hard to follow for those fortunate
enough to be weighing several offers. “What a great position to
be in,” Dr. Brown says. “I think it’s perfectly acceptable
to ask for more time.” Some groups may dole out only another week
or so, or may try to pressure you to respond right away. At that point,
you’ve got to think fast, do some speedy soul-searching, and be
prepared to make your decision quickly.
It can also help to take another step back. Dr. Brown suggests setting
up a timeline when scheduling interviews. Find out when the group plans
to hire and what their start date is. What’s their deadline for
making a decision and having a contract signed? “Then you can try
to schedule your interviews a bit better, to work out to all of those
Sign your name on the dotted line.
Before you say “I do,” you’ll get a contract, the professional
world’s version of a prenup agreement. Look it over. Very carefully.
“Look at the terms of the contract, whether it mentions anything
about partnership,” Dr. Brown says. A contract should list the group’s
expectations for the prospective hire. If that information isn’t
in the contract—and often it isn’t, says Dr. Brown, because
many groups use a basic, standard contract—you’ll need to
get another form of documentation that states, essentially, “We’re
going to hire you, and here’s what we expect you to do.” The
contract should match the discussions and agreements made during the interviews.
Also look to see whether any type of buy-in is required to become a partner,
and be on guard against noncompete clauses. In some states, Dr. Brown
notes, the supreme courts have upheld such clauses.
Dr. Brown strongly recommends having a health care attorney review the
contract. This simply isn’t a pathologist’s strong suit, nor
does it need to be. “You spent the last four, five, six years training,
and not involved in business deals, so you need to hire an expert. It’s
worth spending a little money to have somebody look it over and make some
recommendations. Have them highlight anything that may cause problems
in the future.”
If things don’t add up, then what? That’s your call. Will
you be able to live with the problem if the group says they won’t
negotiate the issue? Or is it a deal-breaker? Remember, Dr. Brown advises,
“You’re just starting out in your career, you may have time
to grow, and you can always change jobs. You need to choose your battles
If you want to negotiate a contract, first make sure you even have the
option. Some groups will present you with a nonnegotiable contract, as
if you were buying a Saturn, and your only option is whether to sign.
Listen to that small, still voice.
Before becoming enmeshed in legalese, spend some time listening to your
gut. Dr. Brown is the first to admit that much of the job search is neither
logical nor pragmatic. It’s important, he says, to pay attention
to your feelings. “So much of this is visceral. You have to trust
your instincts.” Say you ask the practice for additional documentation
confirming agreements made in the interviews but absent from the contract
they sent to you. If they decline, what do you do? “They may tell
you it’s not a big deal, and it’s something that you shouldn’t
worry about,” Dr. Brown says. And that leaves you to rely on your
“You can ask yourself, ‘OK, do I feel comfortable with this
answer, and have I met enough people in the group to feel that everyone
there is happy? Do I still want to join the group?’” says
Dr. Brown. “Or does that raise another yellow flag, enough to make
you say, ‘Wait a minute, maybe I shouldn’t join this group?’”
Each step offers a red light or green light—and a chance to check
your reactions. After each interview, for example, ask yourself if you
want to work with the people in the practice. That’s also a good
time to weigh other questions: Is this a good location for you? How does
the group interact with the hospital and other medical staff? Can you
handle the workload? Can you grow in the practice? Will you be working
9 to 5, slapping glass, as Dr. Brown puts it, stifling your chances to
develop other areas of expertise? Will you be able to grow outside your
job as well, or will the job always supersede your personal life?
Do your homework.
Other questions to consider are: Is the group stable? Have they had a
lot of turnover recently? Have they fired a lot of people? Is it a group
that hires young people right out of training and churns through them,
without making any of them partners? Will you be bored in the job? Do
you fit into the group’s culture? Do you fit into the medical community’s
“If you want to find out about the group, consider calling other
pathologist groups in that locality or region,” Dr. Brown says.
“Ask them about pathologists in that group, and ask if they’ve
noticed any problems. Call the surgeons, oncologists, other medical staff.
You want to do your homework.”
Show some class after the interview.
Follow up with a letter. “Do not wait,” Dr. Brown says. Write
the letter the day after the interview, and send by the next day. State
your appreciation for having the interview and for the chance to meet
members of the group. And then remind them of your attributes, letting
them know what you can bring to the practice.
But don’t wait until that letter
to strut your stuff.
The interview is not a time to be cocky. Nor is it a time to be too laid-back.
But it’s also not a time to sit passively or otherwise adopt a Midwestern
You don’t need to do anything fancy. Know your skills, and be able
to convey what you can do. Show that you’re willing to learn, that
you’re motivated and capable of performing the tasks the job requires.
Have an extra copy of your CV handy. And it’s not a bad idea to
tote a few recent journal articles with you. “Not People magazine,”
Dr. Brown says. Your reading material may even come up in the interview.
“If they’re asking you, ‘What’s new in pathology?’
you may be able to say, ‘I was just reading the Archives of
Pathology and it had this interesting article.’ And that may
spur some good discussion.”
Skills alone will not get you hired. You heard right. That’s so
scary, and so true, it bears repeating. “The person who gets the
job is not the person who’s the most qualified, but rather the person
who gives the best interview,” Dr. Brown contends. “You need
to show your ability to get along with others, and you need to show confidence
What you shouldn’t show is too much sartorial creativity. “Now
is not the time to make a bold statement in your dress,” he says.
That means a suit—either skirt or slacks—or a dress for women,
and a suit—or, at the very least, a sports coat and tie—for
men. Suits, for both genders, are the wiser choice, in Dr. Brown’s
opinion. “It looks like you’re there for business.”
Make like a Boy Scout.
Be prepared, in other words. Arrive for your interview 30 minutes early,
which will give you time to get lost, find your bearings, and then sit
down and try to relax—because you will be nervous.
You’ve good reason to be nervous. Who knows what they’ll
throw at you during the interview? Dr. Brown tells the story of a friend
who interviewed at a large laboratory: He walked in the door and met the
receptionist, who gave him two trays of slides, pointed him to a room
and said, “Go in there and write down your answers—you’ll
meet somebody later.” Dr. Brown’s friend turned around and
Certainly it makes sense to check your gut instincts in a situation like
that. But also be aware that interviews are as varied as snowflakes. “You
shouldn’t be angry or frustrated or offended if they do happen to
give you a tray of slides and say, ‘We’d like you to look
at these,’” Dr. Brown says. Of course, you can always refuse
to take a test—but he doesn’t recommend it. “Some groups
may want to see how you perform under pressure. Perhaps they want to see
what your pathology acumen is.”
You may be grilled by the head of the group alone, without meeting anyone
else. Other interviews may feel more like a round robin, where you may
meet every member of the group, but only briefly.
Can you ask what kind of interview is planned? It’s reasonable
to inquire what you can expect on the day of interviewing, Dr. Brown says.
But avoid specific questions, such as, “Are you going to give me
Ideally you’ll have an opportunity to meet with a number of the
group’s members over the course of several interviews, which will
give both sides a chance to evaluate the fit. But if that doesn’t
happen, for whatever reason, ask to meet others in the practice. “I
wouldn’t feel comfortable joining a group without meeting at least
a majority of the people you’re going to be working with day in
and day out,” Dr. Brown says.
Just as interview formats vary, so do the questions that will fly your
way. Be prepared for these popular queries:
- Why should we hire you?
- Tell us about yourself.
- Where do you see yourself in five years?
- Why do you want to work here?
- What is your involvement in organized medicine?
- Are you keeping up with the literature?
- What conferences have you attended or given?
- What is your fellowship/area of expertise?
- What is your experience/expertise with information systems? Courtroom
testimony? Laboratory inspections?
- Have you published?
- Have you had any teaching experience?
Don’t just expect these questions—practice answering them.
Have a colleague, friend, or spouse ask you these questions, and work
through your answers. “That’s a lot different than looking
at a list and saying, ‘Yeah, they’re going to ask me about
this,’” Dr. Brown says. It’s the difference between
hemming and honing, and, perhaps, being hired or not.
These questions imply a neatness and order that rarely exist in real
life. You may want “to grow,” and you can ask about growth
opportunities in the interview, but it’s hard to know, especially
early in your career, where you might be headed. It’s a little like
looking at a dismal city block and wondering if the blight is permanent
or merely awaiting gentrification.
Sometimes you only know after several jobs, or after tucking a few years
of experience under your belt. Do the best you can, Dr. Brown advises,
and start by taking the time to do some genuine soul-searching, exploring
your priorities. Then, even if you can’t answer the questions fully,
you can say, “In five years I think I want to be here, but I’m
not entirely sure.”
Turn the interview into a dialogue.
You’re trying to find the best fit, and not simply nab a job. That
means you can, and should, ask questions of the group, including:
- What are the responsibilities of the position?
- Is there an educational stipend or allotment?
- Is there time for educational activities, such as going to national
- Is this a partnership track, or will I simply be an employee?
- How will things be for me here in two, three, five years?
There are other questions to ask, including those about vacation and
salary, but proceed with caution. “It’s a touchy situation,”
Dr. Brown says. Let the group take the lead. Some will state the salary
right away, while others may make no mention at all. At some point you
might need to raise the issue if they don’t—but it will be
easier to do it at a follow-up interview, once you’ve gotten to
know the group a little bit better.
Some questions beg to be turned-over tables. Ask the group where they
see themselves in X number of years. And once you’re asked your
views about the future of pathology, ask them the same question. “That
will give you a good gauge of whether the group is engaged in the overall
climate of pathology,” Dr. Brown says. “They’re not
just isolated in their hospital, doing their day-to-day thing, with no
idea of what’s really going on and where things are moving in the
Recognize when you need some extra help.
The goal of the job search is to find a good match—many people,
quite reasonably, compare it to finding a mate. So it shouldn’t
be surprising if you don’t click with everyone.
But—how to put this delicately?—maybe you are messing up.
And maybe, just maybe, you’re making an unintentional, easily correctable
mistake during the interview process. “Yeah, certainly some people
have better interpersonal skills and interview skills than others,”
Dr. Brown acknowledges.
The key is to practice. Practice as if you want to get to Carnegie Hall.
Practice interview questions with someone you trust, and then team up
for an honest critique. And try to get a few interviews under your belt,
especially if you don’t feel comfortable with the process. It might
be smart to schedule your earlier interviews with groups that you’re
less interested in, and save the more compelling ones for later, once
you’ve learned how to deal with the tough questions.
Pitch your niche.
Weigh your experiences—are you well prepared for the groups or
jobs that interest you? If a group needs help with management or administrative
issues, for example, and you don’t have experience in those areas,
“You need to hurry up and get some, so that you can at least say,
‘I’m learning this, and I’ll continue to learn this,
and I can fill this need for your group,’” Dr. Brown says.
Obviously, AP/CP board certification will make you more marketable—Dr.
Brown reports that nearly 70 percent of hires in recent years have been
combined AP/CP trainees. Fellowships can also give you an advantage. Dermatopathology,
hematopathology, and cytopathology are hot tickets, and younger residents
may want to consider molecular pathology.
Consider advanced management training, or developing an expertise in
new technology. Dr. Brown says he sold his group on flow cytometry. Yellowstone
Pathology was interested in setting up a flow lab but didn’t know
how to do it. Dr. Brown knew how, and made his pitch for doing so. “They
were very interested in that, and they needed a hematopathologist, and
that was one of the things that clinched the deal.”
“It’s important to be realistic about your abilities and
whether you’re going to be able to accommodate the needs of the
group that you’re interested in,” Dr. Brown says. “But
also remember that the first few years are where you’re actually
going to learn more about practicing pathology than you did in your training.
You still have a lot of opportunity to improve in areas that you may be
Put yourself out there.
There’s no substitute for networking. “No matter how many
credentials you have or how qualified you feel you are, people still are
more willing to listen to you if you have some sort of personal connection.
You can be one of the best technical, scientific pathologists in the country,
but if you don’t have some good connections, it’s going to
still be harder for you to find the job you want.” But don’t
ignore journal advertisements—they’re not the sign of desperation
many believe them to be, says Dr. Brown. Indeed, many institutions, including
most academic ones, require such job listings.
Advisors, program directors, and other connected faculty members have
a lot to offer. Locum tenens is a superb way to connect with a group.
So are personal references and local, regional, and national meetings.
Cold calls also work. “I actually did a lot of cold-calling when
I was looking for a job,” Dr. Brown recalls. Some prefer to write
a letter first, then follow up with a phone call; Dr. Brown favors the
opposite approach. “If you send a letter, that may just get shuffled
in with the rest of their mail that’s been sitting on their desks
for a couple of weeks.” Calling first, however, will help them spot
your followup letter when it arrives. “It may give you that slight
advantage that may be just enough to get you in the door for an interview.”
Once you’ve made initial contact, keep in touch. Write letters
to the group periodically. Don’t feel like you need to draw attention
to your letters by sending them overnight—any large envelope will
In your cover letter, note that your CV is enclosed and list your training
and skills. “Do not send out a form letter,” Dr. Brown warns.
“Your letter needs to be very personalized and state why you want
to work with this group, why you want to live in this region, and what
interests you have that draw you to that particular group.” Also
let them know when you’ll be available, even if it’s 18 months
out. Include three to five references—but ask them first. “You
want to get someone who can give you a glowing recommendation, not necessarily
just the biggest name at your institution.”
Follow up your cover letter within two weeks, by phone. Ask them if they
have any questions for you. It’s common to be asked why you’re
interested in a group. Is it the group’s size? The practice’s
focus on certain areas of pathology? The relationship to a particular
institution? “You should be prepared to give some specifics,”
Dr. Brown says.
This is not the time for you to ask questions—unless, of course,
they ask you if you have any. Generally, however, your questions are best
saved for the interview.
Do a walkabout.
Dr. Brown recommends some form of soul-searching as the first step before
plunging into interviews.
You need to answer, as best you can, questions such as, What kind of
practice are you interested in? Where do you want to live? What type of
group do you want to join? What size group appeals to you? Do you want
a single- or multispecialty group? Does the military offer what you want?
What about a large commercial laboratory? Do you want to be employed by
a hospital? Does academia call you? Or does a community practice speak
to you instead?
“You need to step back and look at yourself, and ask, What are
my strengths and weaknesses,” Dr. Brown says. “It’s
a soul-searching process, and it’s a challenge.”
But it’s also how you find a satisfying job—question by question
and step by step, until you’ve crossed that bridge.
Karen Titus is CAP TODAY contributing
editor and co-managing editor.
Dr. Brown’s thoughts on finding a job in pathology were
shaped by his own experience and his interaction with other young pathologists
in the workforce, in particular Susan Wheaton, MD, and Kim Collins, MD,
with whom he wishes to share the credit.