There is a certain point in residency that we all come to where nearly every single thing you do is automatic. You see the same spot of gum on the ground on the way in. Your bagel and fruit are the same bagel and fruit you have eaten for about 96 weeks (it’s still good, sure, but slightly nauseating at the same time). You have been turning out shifts in a dark winter holding on to whatever you need to get by. Your drive to work is a scene out of Groundhog Day. If you haven’t been there, I have questions about whatever Zen smoothed out the ripples in this time of your life.

The good news is that right about when you are at your breaking point, you start that ever-so-subtle drop toward the light at the end of the tunnel. It’s really small and far away at first. When you see it – and actually get yourself to believe that residency really does end – it is unimaginably relieving. For me and most of my colleagues, that time was right about when we were going into our final year. Of course, that apex of delight is quite ephemeral. Soon after the drone of monotony is killed by your approaching attending-hood, another interesting procession starts taking shape. Let’s call it: the questions.

It need not fill you with dread. Sit back and take a breath because you will certainly get a job unless you drastically or intentionally screw things up. The big questions first. Where will I live? Where will I work? Each of us is like a game of Tetris with different respective blocks that need to fit in certain places. Some of us have kids that need to ideally be in one place, all of us have families to consider and some of us are set to roam the globe. At one year out, what you need to think about are the bigger questions: What is best for my family? What is important to me? I literally looked at a map and thought, “Well, where am I going?” You need to figure out these bigger questions because they beget smaller questions and eventually, answers.

Getting a job can be quite a lot of fun, believe it or not. You need to start familiarizing yourself with the terms that will be thrown your way. What is a democratic group? What is an independent contractor? Remember that you have resources. Speak to your administrators about what these terms mean, or use our incredible academic organizations, such as EMRA, to begin acquiring the knowledge that will help you navigate the road to your first job.

Know this – with even the smallest amount of exploratory effort, you WILL be pursued by a veritable snake pit of head-hunters dangling lovely signing bonuses and hefty hourly rates in front of you. Your best defense against toxic contracts is arming yourself with knowledge. Review this link – I believe it is the most comprehensive one-year-out primer available.