Searching for a Job: A Survey of Hand Fellowship Applicants and Current Hand Surgeons.

Background: Core curricula do not include courses on how to find employment after hand fellowships. Little data exists in literature regarding job selection in hand surgery. This study's purpose was to provide information to future hand surgeons on ways of finding a job that meets their expectations and to elucidate factors that should be considered before deciding on a hand practice. Methods: A web-based survey asked hand fellows and fellowship applicants how they were searching for employment, the kind of practice they sought, expectations about hours, call, salary, possible niches, and importance of location, research, and passive income. A second survey was sent to hand surgeons. Statistical analysis determined how fellow expectations differed from reality. Results: Prospective hand surgeons completed 96 of 270 (36%) surveys and hand surgeons completed 63/107 (59%). Most prospective hand surgeons utilize word of mouth, mentors/faculty to search for employment, whereas most surgeons received connections through residency, friends/ family, or cold calling. The niches that prospective hand surgeons planned to bring to their practice differed from those of practicing surgeons. Expectations of call matched those of practicing hand surgeons, with most expecting to work 50 to 60 hours per week. For prospective surgeons, location and passive income were important but research was less so. Most hand surgeons have passive income and indicated low research participation. Conclusion: Minimal training in job selection has been cited as a reason for changing jobs. The applicants' and fellows' expectations on call, work hours, passive income, and research were similar to hand surgeons, but the niches they hoped to fill differed, perhaps indicating those may not be possible in actual practice. This study provides perspective on what practice as a hand surgeon is like and things to consider when job searching.