Navigating the Job Hunt During COVID-19: Challenges and Opportunities

The health care system has historically been unaffected by, if not “immune” to, recessions; people have continued to seek medical care during tight times.¹ However, with decreases in nonurgent surgeries and other revenue-generating procedures during the COVID-19 pandemic, America’s hospitals and health care systems have experienced significant financial losses estimated to average $50.7 billion per month.² While trainees have, in some ways, been protected from the financial fallout of being furloughed or having our salaries cut, we have had to face other consequences, the most striking of which are challenges to finding new employment. Many academic medical centers and private practices have publicly announced hiring freezes, some of which will remain through the end of the academic year and beyond. This has transformed the job field for fellows planning a career in academic hematology/oncology. Currently, less than 5 percent of hematology/oncology job listings on the New England Journal of Medicine Career Center are true academic posts.²

Thus, options are limited for fellows (and residents) interested in academic medicine or a particular subspecialty. New graduates may turn to private or affiliate jobs, a career in industry, or practice in alternative subspecialties to ensure solid employment as of July 2020.

Additionally, department needs may have changed since the COVID-19 pandemic. Clinical work, to make up for revenue lost during COVID-19, is likely to be more valued than research, education, or administrative time to ensure financial solvency at a larger enterprise level. Inpatient workload and flexibility may also be higher owing to the restructuring of hospital services. These factors will likely play a role in any possible changes to previously agreed-upon job descriptions. More concerning are reports of fellows having job offers rescinded or contracts delayed because of financial setbacks at the hiring institution. For these fellows, no structured safety net exists, and they have had to search for alternative job opportunities, take time off, or find a way to fund an extra year of fellowship.

The effect of the current shortage of academic hematology oncology jobs on next year’s job market remains uncertain. In the event that academic centers have achieved the financial stability to be able to hire faculty, the limited number of spots that open up may have a larger pool of contenders, as many graduating fellows may extend their training or take temporary jobs while waiting for a position that is more aligned with their career goals. These concerns have current second-year fellows reconsidering extending their training as a buffer against any long-term effects that COVID-19 may have on the job market.

One rising third-year fellow noted, “One of my mentors told me that I should consider a fourth year of fellowship because there would likely be only a few jobs available by the time I graduate.” The concern for future waves of the pandemic and uncertainty about the length of hiring freezes has given both faculty and trainees pause with regards to the future of the hematology oncology job market. Overall, trainees may experience increased anxiety and a lack of autonomy, as many of the driving forces of this issue are out of our control. As one trainee said, “I don’t think there is much that trainees can do right now because of the economy.”

While we cannot control the economy, there are a few things we can do to adapt and improve our visibility as opportunities appear. Given the uncertainty facing graduating or rising third-year fellows, networking and flexibility are extremely important. Face-to-face networking, often done at major conferences, will look different this year with the transition of international meetings to virtual formats. While less contemporary, this will allow for alternative methods of networking such as the use of social media. Trainees can use online platforms like Twitter to join conversations in their field of interest, identify and establish contact with prospective institutions and mentors, and highlight their work and career interests. Fellows can reach out to prospective mentors and institutions with a succinct cover letter and CV to show their interest, after which they could consider a video meeting or phone call. Ideally, a fellow’s mentor(s), program directors, or institutional leaders could reach out and provide guidance and support during these uncertain times. Even if there is a current hiring freeze, fellows can establish contact with various institutions and then revisit with them periodically. Set up short video or phone meetings with faculty you or your mentors know as a way to learn about the institutional culture and whether the place would be a good fit. Regardless of whether their institution is hiring, this will allow you to cultivate your networking skills, make connections, and potentially gain insight for your own career development.

In addition to networking, career flexibility will be important in this setting. Fellows can take this time to reflect on their career goals and overall values as they pertain to their ideal work and personal life. Make a list of priorities, such as subspecialty type, income, clinical and administrative load, research time, geographic location, and institutional culture. While all of these factors are important, prioritize which ones are deal-breakers. Additionally, when negotiating a contract, make sure that it highlights which changes are related to COVID-19 and whether those will be temporary and renegotiable. Be sure to emphasize any special roles you may have played in your institution’s COVID-19 response as they may be desirable to hiring institutions. For more detailed advice on navigating the job market, please read “Run a Marathon on Rolling Hills – Career Transition in the Pandemic Era,” written from the point of view of postdoctoral scientists Dr. Cai and Dr. Zheng.

While we are in a period of uncertainty for fellows interested in pursuing academic medicine, this can also be a period for important personal growth. This is a time when fellows can reflect upon their overall vision for their lives and what kind of career would be fulfilling. Remaining focused on your ultimate goal and values may allow you to find opportunities in unlikely places.

1. Hiles DRH. Health services: the real jobs machine. Mon Labor Rev. Nov 1992;115:3-16.
2. Hospitals and health systems face unprecedented financial pressures due to COVID-19. American Hospital Association. May 2020.
3. New England Journal of Medicine Career Center. N Engl J Med. Last accessed May 27, 2020.