We have all been hearing for the last few years about how tough the job market is for graduating cardiothoracic trainees, and as a result I was very concerned about finding a good position that would allow me to start the career that I want. Below I have outlined my job search, but first I’ll highlight a few pointers that I’ve learned along the way and from others.

I feel that the key to finding most jobs are personal relationships, and thus networking with prospective employers has to be the number one priority for any resident. This should start early, not just at the January STS meeting the year you graduate. Plan out where you may want to work and introduce yourself, or have someone else introduce you to those division chiefs. Even if you are a general surgery chief resident, if you want to come back to the geographic area of your training after fellowship, make those contacts early. Go to local surgery society meetings, send cover letters, talk to your chairman, talk to family friends. I think that you have to utilize every resource that you have, because you’ll never know where the opportunities may come from. The toughest thing is getting your foot in the door to interview, and once that’s done, you’ve increased your odds incredibly for that position. I would also look for the job that you want, not just for the job that is available. We have all seen a lot of early turnover in junior attendings in both academic and private practice because the jobs were not what they wanted. The most important thing throughout the process is to be honest with everyone about your goals and your intentions. Your goals may change in the process, and I think that that is ok, but the field of CT surgery is very small, and you never want to burn any bridges.

I started talking with my senior staff about jobs during my first year of CT training. I let them know what I was interested in (Academic General Thoracic) and where I was interested in going (Midwest preferably). I had entertained the thought of looking for a job solely based on location and income (maybe sacrificing academics and even considering practices that had a mix of cardiac and thoracic). After a long discussion with my wife regarding our goals, we agreed that I should look for the right job that made me happy, that allowed me to meet my career goals, and that also was in a location that allowed us to enjoy ourselves and start a family. My home institution in Seattle was interviewing to fill a spot for an academic thoracic surgeon. I had initially not planned on looking to stay, but after spending a year in the Pacific Northwest, my wife and I had both fell in love with the area and could envision ourselves staying. I asked for an interview and had one, more than a year prior to my finishing fellowship, because they were interviewing other candidates that early and I wanted to make sure that they knew that I was interested. I learned a lot from the interview about my institution, and I realized that what I had looked for in a great training program didn’t necessarily correlate with what I was looking for in a great program to be a junior faculty.

This early interview forced me to look at other programs that summer, a full year before I graduated. I wanted to see what else was available and didn’t want to be offered a position without having looked at 2 or 3 other options. At the May AATS meeting 14 months prior to my graduating, I was asking some of my mentors from other institutions about potential positions. The chief of cardiothoracic from my general surgery program introduced me to the chief of an academic program looking for junior faculty for the following year. The program was in the South and was not the ideal location, but the university had a lot of opportunities to build a practice. I didn’t hear back for a few weeks after sending my CV and cover letter, and was getting nervous. Luckily, a junior faculty member knew the chief well from his general surgery days and called on my behalf. I was offered an interview shortly thereafter. I was brought down and met with my future potential “partners” over a 24 hour period. The job itself had both clinical and research opportunities but was in a location that neither I nor my wife had ever lived in and we had no family or friends nearby. I liked the position, but also, I learned a lot of new questions to ask my home institution about.

I was hoping to interview at one more location, and had emailed a division chief at an academic program on the East Coast. I had heard about the position through the grapevine and had sent an email and CV to the division chief, but also had a faculty member who knew him send a separate email on my behalf. I was excited about that interview, but while waiting to hear back I was contacted by my recently graduated senior fellow about a potential position at his new institution, which is in the Midwest. I was born and raised an hour away and was excited about being near family. I went to the interview in the Midwest, armed with the knowledge of two prior interviews to ask about the academic opportunities that I was interested in. I enjoyed the interview and felt that I fit well with the group. Prior to me setting up and going on my third interview, my home institution had expressed interest in having me stay. A month prior, I had told my faculty that I was very confident that I would stay after my first two interviews, but when the final opportunity presented itself, I felt that I had to go. I was told my by faculty that they were going to have to interview other candidates also because they didn’t want to wait for me and lose out on other excellent candidates. I had pangs of fear that I would lose out on my home institution’s position and not be recruited by the other places that I was looking at, but I stuck to my plan of looking at least 3 institutions, and in the end signed with the final place, where I had both the academic opportunities, but also the family ones as well. The East Coast position that I was waiting to hear from never contacted me again. I heard through the grapevine that they were hiring someone else.

I found all three interviews through different sources, but they were all through personal relationships. I had sent out 8-10 cover letters and CV’s to other academic institutions that posted jobs on CTSnet. I never heard back from most of them, despite even a follow up email. I’ve heard that sometimes division chiefs will get 50+ CV’s within 48 hours of posting a job on CTSnet, and that this limits their ability to sift through these applicants. I didn’t utilize the STS Career Connections service which seeks to connect institutions with trainees, but I think that that is another valuable tool. I think that the personal relationships make for the best resource, and that once you get the interview, you’ll have at least a 20-33% chance of getting that job (if they’re interviewing 3 to 5 candidates). The interviews are harder to come by, but once you’ve got them, the odds are much better than when you’re interviewing for residency or fellowship. I hope that this has been helpful, please feel free to contact me with any questions.

– Rishi Reddy