Landing Your First Job: Contract Negotiations and Other Considerations

At the American College of Radiology (ACR) meeting in early May, the current shortage of radiologists was a hot topic of conversation among myself and many of my colleagues. This stands in stark contrast to a decade ago, when twice as many job seekers were available for every vacancy.¹

As a newly minted radiologist you may in fact find it relatively easy to land a position in today’s market. But in your eagerness to put your hard-earned skills to work, do not overlook the importance of knowing your negotiables and your non-negotiables—and not just as they apply to contracts.

For example, there are a few decisions you should make from the get-go, such as choosing between in-person work, hybrid work, and teleradiology. The conventional advice is for new attendings to avoid fully remote positions, as they need an “attendier attending” to show cases to and to help build their radiology repertoire—an opportunity that would be missed while working alone.

The post-pandemic era, however, has made hybrid work options a new reality, and radiologists can now work some shifts from home and some in the hospital. This can be a great option for new radiologists, especially those who have caregiving responsibilities, and who still need the help of veteran colleagues during the infancy of their career.

Another question to consider: Do you want to work in an academic or private practice setting? If you enjoy teaching and research, academics would certainly be an appropriate choice, but if you would rather focus more on clinical work, private practice is the way to go. Academics generally offers lower salaries but a better day-to-day lifestyle, while private practice typically affords higher salaries and more vacation time.

It’s worth noting that the lines between the two have substantially blurred in recent years; many academic programs now have clinical tracks and some private practices are affiliated with residency programs, providing opportunities to teach.

Interview the Employer

Once you’ve landed an interview with a promising prospective employer, it’s worth going beyond the basic interview to also speak with those who have left the practice as well as with junior attendings who may have joined the group recently. If your potential colleagues look miserable, there is a high chance that you will be miserable, too. If turnover is high, this should also set off alarm bells.

If you are looking to start a family, but there is no defined family leave policy, this could mean that the group is not used to, or particularly accommodating of, their radiologists taking extended periods of leave. Getting a well-rounded understanding of your prospective employer helps ensure that there will be no unfortunate surprises once you begin your job.

Contract Negotiations

Once you’ve landed a job offer, or two or three, it’s time to enter into contract negotiations. While the granular details of a contract can and should be reviewed by a lawyer, here, again, it’s important to know your negotiables from your non-negotiables—and not just over salary, healthcare insurance, and vacation time.

You may hear the words, “all our contracts are standardized,” but I have come to learn that many contract terms can still be modified. Indeed, the difference between landing a good job and a great one often comes down to the little things. For example, don’t be afraid to ask for a home workstation, an education fund, a relocation stipend, and/or a signing bonus.

If you fail to negotiate, you are leaving money on the table, money that could be used for your retirement, your children’s education fund, or even that vacation to Hawaii!