Curiosity, connection, and career fit

For resident physicians preparing to enter the workforce, financial success may be less about choosing the highest-paying job and more about understanding personal values. That advice is chief among a list of tips and personal reflections shared by experienced panelists during the session, “Residency to Real Life: Economics, Career Transitions, and Finding Your Purpose in Anesthesia.”

Given the choice of pursuing fellowships in subspecialty training programs, joining private practice, or becoming part of a university-based practice, it’s important to think beyond compensation alone, said panelist Neal Campbell, MD, an Associate Professor of Anesthesiology at the University of Missouri-Kansas City.

“In my opinion, the process is really about self-discovery,” Dr. Campbell said. “Young physicians need to figure out who they are and what they value. I’ve found the work of Suzy Welch, a professor at NYU’s Stern School of Business and author of The New York Times bestseller 'Becoming You,' particularly helpful in thinking about this. Welch describes values as ‘life-organizing principles – the deeply held beliefs that galvanize our actions and decisions.’ Having clarity about those values can help physicians determine which work environments are most likely to fit who they are and what they want from the profession.”

However, Dr. Campbell emphasized that self-discovery is not a task physicians complete only once at the beginning of their careers.

“It’s a lifelong process. Who we are evolves. Our priorities change, and what we want from work may change along with them,” he said. “We must keep asking ourselves what matters to us and whether the way we’re working still reflects our values.”

That ongoing process, he said, can help physicians make more intentional career choices and ultimately find work that is personally fulfilling, professionally sustainable, and financially rewarding over the long term.

As newly graduated physicians enter one of the most competitive job markets in recent memory, the temptation of high-paying positions can be difficult to resist, said session panelist Amr Abouleish, MD, MBA, FASA. Dr. Abouleish, a Professor of Anesthesiology at the University of Texas Medical Branch in Galveston, said the biggest compensation package is not always the best first career move. 

One trend he has observed among newer generations of physicians is a stronger emphasis on work-life balance. Although previous generations often accepted long hours and extensive call schedules as part of the profession, today's graduates are more intentional about protecting personal time and family commitments. 

That shift has made locum tenens positions particularly attractive. These temporary assignments frequently offer high compensation, geographic flexibility, and schedules that allow physicians to work fewer weeks per year while maintaining a strong income. Despite those benefits, Dr. Abouleish advises young anesthesiologists against moving directly into locums work after residency. 

“Unfortunately, residents sometimes are attracted to the high dollar-value positions, such as locums right out of graduation. I'm against residents choosing that path to start because they need to get out there and become an attending, take care of patients in a setting where they have a group of people around them that they can rely on, and ask questions that help in decision-making as well as the care of their patients,” Dr. Abouleish said.

Although compensation is top of mind for many residents, others are more concerned with achieving work-life balance – or work-life integration, as fellow panelist Rebecca Margolis, DO, refers to it. Dr. Margolis is an Associate Professor of Anesthesia at the University of Southern California Keck School of Medicine in Los Angeles.

“I would start with the idea that there's no such thing as work-life balance in medicine or in other fields. I don't like residents to think that they are trying to strive for work-life balance, because it's really about work-life integration and knowing that some days work is going to consume your entire day, and other days, other parts of your life, community, family, and personal self-care, will consume it,” Dr. Margolis said.

Dr. Margolis tells residents to think of their lives as a collection of balls in the air, and the only ones that can't be dropped are the glass balls, such as your health and your family's health.

“When one of those glass balls is about to drop, you must switch and pick those up. And then there are rubber balls. And sometimes those rubber balls are work and sometimes the rubber balls are family,” she said. “You must know what’s glass and what’s rubber based on what's going on with your people, your work, and yourself.”

The session will also explore differences between academic and private practice careers in anesthesiology. Drawing on his own experience working in both settings, Dr. Campbell said that academic departments often have several complementary missions: providing excellent clinical care, educating the next generation of physicians, and advancing the field through research and scholarship. 

“Teaching, talking through the pros and cons of an anesthetic plan with trainees, and contributing beyond the immediate clinical encounter are often valued components of academic anesthesiology,” Dr. Campbell said.

Private practice, by contrast, is generally more focused on the clinical mission. Teaching and scholarship can certainly be present, but they are typically less central to the structure and purpose of the organization. 

“Neither model is inherently better,” Dr. Campbell said. “They simply tend to value different contributions from physicians. The best fit occurs when what a physician values in their work aligns with what the work environment values and rewards.”

The structure of the anesthesiology job market has also evolved, Dr. Abouleish said. Traditional physician-owned practices that offered partnership and equity opportunities have become less common as larger organizations have gained scale and administrative efficiencies. As a result, most graduates today are choosing among hospital employment, national staffing companies, or larger physician-led organizations rather than pursuing classic ownership-track partnerships. 

Those employment models each carry distinct advantages and drawbacks. Larger organizations may provide greater stability because physicians can often transfer among facilities if contracts change. However, Dr. Abouleish said that employees typically have less opportunity to share directly in a practice's financial upside compared with physicians who hold equity ownership. 

Although he remains a strong advocate for academic medicine because of its educational mission and personal rewards, he acknowledged that compensation in academic settings often changes more slowly and may lag rapidly evolving market conditions. Still, many academic centers have adapted recruitment strategies as physician shortages continue to affect staffing nationwide. 

“Ultimately, you need to consider how you find your mission. How do you find what's important to you in your life as well as the data pieces?” Dr. Abouleish said.

That’s a sentiment echoed by Dr. Margolis.

“Anesthesiologists make a good living, but there are a lot quicker ways to make money if that’s what you’re looking for,” she said. “People are attracted to a career in medicine for multiple reasons. But often there's meaning associated with it, such as being able to help patients care for families. That’s a meaningful thing.”

According to Dr. Margolis, that sense of purpose can become obscured during the intense years of medical training, when many residents operate in what she described as a constant "survival mode." As exhaustion accumulates, physicians may lose sight of the reasons they originally chose medicine. 

Research on physician well-being offers a hopeful message. Dr. Margolis cited a study showing that spending just 20% of professional time on work that feels personally meaningful can help protect physicians from burnout. Whether that means teaching residents, pursuing quality-improvement projects, practicing a subspecialty area, or engaging in a favorite clinical activity, identifying and nurturing that meaningful portion of one's work can have a significant impact on career longevity and satisfaction. 

"The beginning of your career is about figuring out what your 20% is," Dr. Margolis said. “Doing so can help physicians remain engaged, energized, and connected to their original purpose for entering medicine.”

Doreen Soliman, MD, Associate Professor of Anesthesiology and Residency Site Coordinator at University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, will moderate the session.