Original Article

And Now, Please Sign on the Dotted Line: Teaching Residents About Professional Life After Residency

Authors: Sherine Salib, MD, Victoria Valencia, MPH, Alejandro Moreno, MBBS, MPH

Abstract

Objectives: Despite possible long-term repercussions, few training programs teach their residents about the business of medicine. In particular, certain contractual issues can adversely affect a young physician’s career mobility.

Methods: We designed a business-of-medicine curriculum and used a survey to determine whether the curriculum satisfied attendees’ perceived knowledge gaps about the topics covered in the course, which included four key contractual matters: physician employment contracts (including restrictive covenants), malpractice insurance, job search, and interviewing skills. We used a postsurvey in 2015 and added a presurvey for the course in 2016. The same content was delivered in a 1-hour conference to internal medicine residents attending a regular noon conference series in 2015 and a regional academic meeting in 2016. Survey data are presented in terms of descriptive statistics. We used χ2 tests for comparisons of pre- and post-Likert scale survey data.

Results: Of 108 residents, 50 returned the surveys for an overall response rate of 46% across the 2 years of the course. Overwhelmingly, residents found the conference to be beneficial to the understanding of the four key contractual matters, with each topic having a statistically significant difference in perceived knowledge between the pre- and postconference questionnaires (P < 0.001). The majority of the residents indicated that they wanted to learn more about business-of-medicine topics, in particular financial challenges (76%) and job opportunities (68%).

Conclusions: Our results confirm that our curriculum is effective in increasing the residents’ perceived understanding of restrictive covenants, malpractice insurance, negotiating skills, and job search. Our results also demonstrate that residents have a desire to learn more about job searches; negotiating skills; and contractual issues, including restrictive covenants and malpractice insurance.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Falvo T, McKniff S, Smolin G, et al. The business of emergency medicine: a nonclinical curriculum proposal for emergency medicine residency programs. Acad Emerg Med 2009;16:900-907.
 
2. Gunderman RB, Tawadros AM. Business education for radiology residents the value of full-time business educators. Acad Radiol 2011;18:645-649.
 
3. Holak EJ, Kaslow O, Pagel PS. Facilitating the transition to practice: a weekend retreat curriculum for business-of-medicine education of United States anesthesiology residents. J Anesth 2010;24:807-810.
 
4. Committee on Medical Liability and Risk Management., Gonzalez JL. Policy statement-professional liability insurance and medicolegal education for pediatric residents and fellows. Pediatrics 2011;128:624-629.
 
5. Dhaliwal G, Chou CL. A brief educational intervention in personal finance for medical residents. J Gen Intern Med 2007;22:374-377.
 
6. Salib S, Moreno A. Good-bye and good luck: teaching residents the business of medicine after residency. J Grad Med Educ 2015;7:338-340.
 
7. Cirocco WC. Restrictive covenants in physician contracts: an American Society of Colon and Rectal Surgeons’ Survey. Dis Colon Rectum 2011;54:482-486.
 
8. Paterick TE. Physicians in transition: practice due diligence. J Med Pract Manage 2013;28:385-387.
 
9. Satiani B, Nair DG, Starr JE, et al. Essentials of negotiating for employment in a changing environment. J Vasc Surg 2014;60:253-259.
 
10. Snelson EA, Moore CE. Contracts: making the transition from residency to work, work for you. Clin Colon Rectal Surg 2011;24:109-115.
 
11. Austin MG, Grosack M. What you should know about restrictive covenants in health care. Healthc Financ Manage 2013;67:92-96.
 
12. American College of Physicians. Physician employment contracts. https://www.acponline.org/system/files/documents/running_practice/practice_management/human_resources/employment_contracts.pdf. Accessed January 1, 2017.
 
13. Berkenbosch L, Schoenmaker SG, Ahern S, et al. Medical residents’ perceptions of their competencies and training needs in health care management: an international comparison. BMC Med Educ 2013;13:25.
 
14. Satiani B. Business knowledge in surgeons. Am J Surg 2004;188:13-16.
 
15. Shaffer R, Piro N, Katznelson L, et al. Practice transition in graduate medical education. Clin Teach 2017;14:344-348.