The backs of NYC cabs are collectively one of the most interesting crossroads where the human condition exists in its raw form. Truths are told, inhibitions tend to be quite diminished and choices people make are unfettered by interference from whatever cultural norms exist.

So, I think it was a fitting place to accept my first job as an EM physician. It was effectively an offer coming in the mail as I shook that hand in the back of the cab after our dinner, but I knew it was my first job. It was finally go time.

In the end, my decision was really made on a gut feeling. I always hate when people ask, “What’s your gut say?” What the hell does that really mean? It means that it’s not what your parents, family, spouse, kids, pet snake or every would-be complacent cell in your body wants. It comes down to this: Where do your dreams and your real world expectations for work align? Think back to when you decided to do this crazy job. Where did you see yourself in your dreams? Where will you be challenged and thrive? Only you can make that decision. If you aren’t happy, your family won’t be either. For me, US Acute Care Solutions (USACS) felt like the right decision, even though I knew that it was a harder decision to choose the travel life and start fresh in a new city. My dreams were essentially to move west, which aligned with the challenges of being a travel physician in various practice environments. I had already carefully weighed the pros and cons of each job option I had (which, luckily, was many). My gut took me to USACS.

We are lucky in our field. If you are competent (which you have to be to graduate!), a significant number of jobs await you. If you put in the work to interview, you will have multiple options. We are in high demand, and that is a great thing. With that said, your gut feeling needs to be heavily considered when you make your decision. We are all so very different and have different motivators to choose one job over another. So specific situations will apply to you personally.

I have realized some things in my first year out. Speaking in generalities, even though USACS is a leader in competitive packages, I have realized that financial motivators have actually had the least influence on my happiness in the past year. My most memorable moments over the past 12 months have had to do with quality of life related to proper time management, a great work environment that allows me to thrive and life experiences I have had since starting. Emergency Medicine has allowed me to pursue hobbies that I could never have done in any other job. This makes me happy. I feel that this pursuit of my happiness is well respected from within USACS. Most of you have significant debt, but I can guarantee you that the job you select, unless you are in certain really tight markets, will allow you to pay your loans effectively.

The first year has been an insane transition for me. My entire life completely changed. As I transitioned into attending-hood, I found that USACS was excellent in fostering a healthy environment for me. Much of this occurred on the front-end, as I was allowed to travel for many weeks without pressure before starting work. Funny enough, that traveling turned into personal blog entries that ended up opening up this writing position for USACS. USACS is a people company. The on-boarding process was smooth, questions were answered honestly and expectations and deadlines were clear. All the resources to make the transition are available for you to thrive.

Wherever you decide to work, do realize that you are entering a very strange year of transition, where much will be changing. Realize that your first job statistically is likely not your last one. Make a smart, calculated decision. Draw things out on a piece of paper. Do not shy from challenges.

Most importantly, listen to your gut.