In your words

Why I’m working less than 30 hours a week after residency

I wanted to earn a solid income but find a position that would give me the work-life balance I craved. Here’s how I found the right job.

Adil Manzoor, DO
Contact amanzoor
Topics

Residency is ending. What do I do now?

It’s a question many trainees have trouble focusing on as they deal with the day-to-day challenges of residency. Some push it away, hoping for the right opportunity to come along.

Every physician has different priorities for their first job after residency. In my case, I wanted to earn a solid income but find a position that would give me the work-life balance I craved. In the end, I chose a 28-hour per week urgent care position. Here’s how I found the job that was right for me.

The dilemmas

I’ll be finishing my internal medicine and pediatrics residency this year. My wife and I are expecting our first child in August and want to move closer to our family. She’ll be taking unpaid maternity leave for at least five months and is on my health insurance.

With the end of my residency, our coverage will be eliminated, but we need insurance now more than ever. Not to mention that we support both of our parents’ mortgages.

With stress mounting, we realized that the first step would be to understand our finances. To do that, we hired an independent financial advisor who analyzed our spending habits and created a financial plan with advice specifically tailored to our goals. The financial plan gave me a good guideline for what I’d need to earn.

The job opportunities

The next step was to find available jobs.

I used physician staffing agencies, which were fruitless. None could find the right fit for me in the state of New Jersey, which is already filled with physicians.

I wanted to do primary care and the offers were terrible, with low salaries and mind-boggling requirements. One contract required physicians to take call once a week. Another specified a patient load of 25-30 per day, with compensation tied to patient satisfaction scores.

I didn’t want to work 40-hour-plus weeks. I wanted to work a few days a week so I’d have free time to study for boards, pursue my hobbies, bond with my family and work on creating a direct primary care practice.

I pitched my idea to my colleagues, who thought this sounded like an impossible dream.

But I persisted and figured out a way to get exactly what I wanted.

Finding a niche

I learned that urgent care was the most ideal job for my plan. I had moonlighted with an urgent care since my third year of residency and choose to stay with the company.

As a resident, I received a $70/hour contract with a bonus potential to make up to $100/hour. Post-residency, they offered several choices: 28-hour full time, 35-hour full time, and 40-hour full time, each paying $105-$110 an hour.

These jobs came with full benefits, including two weeks of paid vacation and CME.

My employer also will pay for all re-certifications, which in my case includes BLS, ACLS, PALS and NRP. The offer included a signing bonus of up to $15,000, retention bonuses and up to $15,000 in loan assistance.

To top it off, the company offered free care to my family in any of its 79 urgent care facilities. No primary care job could match this. I negotiated a higher base salary, a higher sign-on bonus and a $5,000 moving bonus.

Running the numbers

The 40-hour week salary would net a minimum of $228,600/year. I’d earn $200,200 working a 35-hour week or $152,880 for a 28-hour week. I chose a 28-hour full-time position with a potential productivity bonus that could push my wage up to $135/hour.

I can meet the minimum requirement by working two 14-hour shifts. The beauty of this contract is that there is always need for coverage and I’ll be able to choose my own schedule.

The lesson from my experience: Don’t just rely on what your recruiters tell you. Use them to find open positions, look at more than one employer, compare offers and negotiate directly.

Most important of all, ask. Asking for what I wanted is what made my “impossible dream” a reality.

Related reading

Tips for negotiating your first salary after residency

I tried capitated primary care, and it reversed my burnout

Is locum tenens work right for you?

Write for The DO: The DO is seeking essays and opinion pieces written by DOs, medical students and health care professionals who embrace the patient-centered philosophy of care. Learn more about how to submit here.

More in Lifestyle

Confronting burnout and moral injury in medicine

Regarding burnout in medicine, “I knew there was more to the story than the frustration of dealing with administrative obstacles,” writes Jerry Balentine, DO.
Nearly 70% of doctors in their 40s want to retire in their 50s or early 60s, survey reveals

Medscape report finds that physicians, on average, would like to save $3.9 million to feel comfortable retiring from medicine.

6 comments

  1. Thomas John D'Amico, DO

    Unlike most of my colleagues, have your priorities correct. As a Hospitalist, I work 15 11 hour shifts per month which is considered full time. I’ll be cutting back to a, “part-time-plus” plan after my student loans are paid off.

    Let some other person wind up with marriage problems and with their kids on crack!

    For myself, l’m too busy with date nights with my wife, reading my daughter 1000 books before kindergarten and teaching my son Latin and Math.

    Reply

    1. Adil Manzoor

      This response is to this comment & comment below:

      This is just one track for a graduating resident to get her/his feet on the ground without committing to a lifestyle or a job, especially those who want to go into Primary Care, which I plan to do.

      Plus gives one time to really study for their boards, especially those who train in dual-specialties, such as Medicine-Pediatrics.

      Reply

  3. Eliane Biester

    Hey Dr. Manzoor,

    This article is a fresh of breath air. I am currently in my second year of medical school. I can become very inflamed when I think about the hours we will need to work in residency and how corporate offices and companies can control our lives. Medical school and healthcare in America is a business and a broken system that I willingly subscribed. My mother is a family physician in a rural town. She works 3-4 hours per night charting away and is requiring to see 22-24 patients per day. This is what I want to avoid for my own life and why I debated not going to medical school for my entire existence. I cannot do what she does. I simply refuse to work away my life.

    My biggest fear is not finding a work/balance in this career path. I am thankful that I see that it is possible if I seek the right opportunities and that we can find pockets of hope within the broken system.

    Reply

    1. Adil Manzoor

      Definitely look into DPC Elaine. The only reason I have chosen to work this many hours is so that I can build a DPC practice where I can truly focus on providing good patient care to the underserved and the uninsured without insurance companies controlling anything. With this method, I am truly able to get patients involved in collective decision making. Also, am starting a Nonprofit in NJ to do street Medicine and help provide acute urgent care and primary care services to the more than 8,000 homeless in the state (at least that’s the goal)!

      Working the aforementioned hours has allowed me the freedom to truly focus on helping those who are in need.

      Please reach out to me at anytime with questions.

      Reply

  4. Twyla

    I am glad that this article really speaks to the desires I want in my career in medicine– being able to provide excellent care to patients without working my soul and body into the ground by sacrificing my well-being. Thank you Dr. Manzoor ! My thoughts also very similarly align with Eliane! I am about to go into my first year of medical school!

    Reply

Leave a comment Please see our comment policy