After seeing some of my JMOs struggle with the peaks and troughs of the job hunt season, I thought it might be useful to share some of my experiences. My hope is that my experiences might normalize the angst, disappointment and dejection for some and give hope to those who think that their future is lost, because they didn’t get the job they wanted the first time around. (It isn’t supposed to reflect negatively on any individual, hospital or college).
When I was a JMO I was totally naïve and optimistic. I was one of those junior doctors, who flew through life, never failing at anything. In fact, studying medicine caused me considerable angst because I wasn’t able to get the number 1 mark or win prizes (even though my overall marks were perfectly fine). My self-esteem was built on comparing myself to others. That is, it was on very unstable ground – one minute, “I’m definitely the greatest”. Next, “I’m the worst person ever. I should just quit” etc. To top this off I had a healthy sense of entitlement. In any meritocracy, I deserved to be amongst the best, in the most prestigious and competitive inner city jobs and I harbored considerable resentment when my expectations weren’t fulfilled (which was often, since I am also a very negative person with a pathological skill in finding reasons why I am falling below expectations).
You should also know that (other than the interview to get into medicine) prior to my first job hunt season as a JMO, I had never done an interview. Being proactive enough to realize this deficiency, I attended an interview trainer weekly for about 4 months, at a cost of $300 per session. In this time I went from being clueless AF – i.e. thinking “I want to come to this place to work, because it sounds like a cool place and is near my home” or “I am good at stuff, so hire me” were totally legitimate answers, to being a decent and very well prepared interviewee. I wrote lists of my qualities, spelled out my goals, wrote example after example to illustrate my qualities and I recorded it all on my iphone, so I could play it back, see if I could fix that monotone, get rid of that maybe or lengthy pause. I went through the torture of being videoed so I could see all of my destructive, self effacing mannerisms. My CV was checked and checked again by at least 5 or 6 people and all agreed that my CV was solid. When I filled in the boxes on the erecruit website I labored over every single word and I preinterviewed at every possible location. If effort was the key to success, then I was certainly entitled to it!
However, soaring heights were not in my fate! Perhaps the wild flapping of a frightened chicken better reflects my level of success. I applied to at least 13 jobs and only got 3 interviews. Only 1 of these was in an inner city hospital. Many of my colleagues were similarly disappointed, whilst others had 6 or 7 interviews (or in 1 case, 11!). Then on interview day, I performed reasonably. At least, I thought I did my interview practice justice, despite nerves. I really fell apart on 1 question and unfortunately it was at the interview for the prestigious inner city hospital. Anyway, the whole emotionally exhausting and disappointing experience resulted in me remaining at my home hospital, which was my last preference. Should I be ashamed to tell you that I cried bitter tears that evening over the phone to one of my previous registrars? I bemoaned the lack of meritocracy: “So and so is going to this inner city hospital and they are no better than me! No-one even gave me a chance!”
I know my faults contribute to my middling success (I am a quiet, socially anxious person who struggles to please. I have never had the knack of “sycophancy”. I have never been popular). However, my first job hunt season (and subsequent ones have only confirmed this) showed that medicine is not a meritocracy. Individuals and particular institutions strive to achieve meritocracy, sure, and certain departments are more systematic in their selection process. But there are certain tacitly accepted rules. We all know that internal candidates are more likely to be hired for certain jobs, a nepotism medicine is strangely proud of. If you are the internal candidate who is rejected, you were probably unlucky enough to piss off someone powerful, for reasons potentially frivolous (including unintentional implicit bias). On the other hand, when external candidates are hired the hiring seems to go in unofficial networks (people from hospitals A, B and C are more likely to get hired within A, B or C). If you are hired from outside A, B or C, a powerful doctor within your institution may have recommended you in an informal phone call or you may have a relative, spouse or some other connection within A, B or C. Who of us do not know of a well liked PGY3 who got onto a program, whilst highly qualified PGY6s languish in unaccredited jobs? In a practice, which is equally frustrating, it is expected that we will interview for jobs for which the candidate has already been chosen (often internally or following preinterviews) and the interview itself is just a pretense to please bureaucracy. Needless to say, this is all very hard when internships are allocated randomly. Imagine how difficult it must be to come from a rural location. Your mountain to a training position in a tertiary centre is that much steeper.
That said, I did not start this story to bitch and moan about the failings of our job selection system. I just want to put it out there that the job selection period is emotionally fraught for many of us and that the job selection system really isn’t fair. You and I, we cannot control the systemic issues facing us. Yet when I was more junior, I spent a lot of energy feeling like a reject and a failure. At other times, I raged against the system, feeling resentful and bitter. However, in hindsight, I am no worse off for falling off the path of inner city hospital glory. I trained at an excellent tertiary centre. I got into the advanced training program I wanted. I even emailed a lovely fancy inner city hospital doctor for advice about fellowship plans and she told me it mattered not whether I had worked at a fancy inner city hospital. Rather, I had to do a PhD (ha haaaa). Many of my friends went to rounds 2 or 3 looking for jobs each year, yet now they are on their training programs of choice. Colleagues who were awful, malicious, selfish or otherwise terrible and got inner city jobs got their comeuppance. None of this makes it easier to have your well laid plans up turned, to have to go back to the drawing board and choose a different specialty, spend a year in gen med, on research, locuming… None of this makes it easier to deal with a system that isn’t fair every year. But since we can’t change the system (except in frustratingly parkinsonian steps) I want to try to help you through it by putting your struggles out there, by normalizing the misery of it and by reminding you that unexpected paths may lead to excellent places.
