Okay, so good afternoon, everybody, and welcome. Thank you so much for joining us today. I'm Dr. Rosandra Day Walker, and it is my pleasure to welcome you to our session titled Steer Your Career in the Right Direction, what you need to know as an early professional and also to ensure long-term success. This session is actually sponsored by the resident and recent graduate section of ACOM, and many of us, the panelists, well, all of us are either leaders within the group or members of the group as well or past presidents, and so it's really an honor to bring us together and to join you all and share our ideas to ensure the success and longevity of our specialty. So just to begin, and I want to thank Dr. Mullenix for putting this slide in here, one of the things that a lot of people, a sentiment that many of us share in this field is the diversity of career paths, and just to name a few, as you can see, where a lot of us end up serving or having different capacities includes, you know, hospitals and clinics, government agencies and the military, large corporations and small and medium enterprises, colleges, universities, as independent consultants, as part of medical groups and practices, factories, industrial sites, theme parks and resorts, entertainment, the entertainment business, law and safety enforcement, as well as professional sports teams, and this is not an exhaustive list, and we really like to start this conversation off with that because of the diversity of not only the panelists in the room but of all of you in this room as well, and so I think it's a very nice segue into introducing ourselves because we all have very diverse backgrounds and current paths that we would like to share with you as part of this experience. So I'd like to turn it over to Dr. Ross Mullenix to start. All right, I'll use this one, I think. Thanks, Ross. So we're just going to briefly introduce ourselves, give a little bit about our background just for kind of us to help with the context. So I am obviously in the Navy, 13 years out of medical school, but I'm only four years actually post-OEM residency graduation because I did a number of years with the fleet. So I have experience in the military and operational setting, medicine, Iraq health, admin, leadership side and also internationally. Board certified in both OCMED and PREVMED, and I have, you know, some of the extra things that many of you have as well, MRO, FMCSA certifications. I am assistant professor at USU, which is where I got my MPH, and I am pretty involved with ACOM, section leadership ambassador. I'm on a task force currently and a couple of other things. So go to the next slide. Okay, can you hear me better now? Sorry. Thanks. All right, so just to give a little bit more, you know, about what I did before OCMED, right? So I did seven years between medical school and going into occupational medicine. I started in general surgery. I did an internship there in San Diego. I went out with the Marines for three years as what we call a general medical officer in the Navy, and really it's basically occupational medicine, what I did. I didn't realize it at the time, but I loved that job. I went back to general surgery for two years before deciding that really wasn't the career path that I saw myself, you know, enjoying for the rest of my life. So I went back to OEM residency at Walter Reed, and then since then, I spent three years at Naval Hospital, Yokosuka, Japan, where perhaps the biggest thing I was involved in was running the COVID response for the whole region for the Navy, which was extraordinarily time consuming, but also very professionally rewarding. So now I'm at Naval Medical Center, Portsmouth, Virginia, which is one of the largest hospitals in the Department of Defense, and I'm the head of OCMED and the director for public health. And I'll turn it over to the next one. And I'm not sure if he mentioned it, but if he did, I'll just mention it again. He's actually our current and outgoing chair of the resident and recent graduates section, and we thank you for your service. So introducing Dr. Means next. Hi everyone. My name is Dr. Tamara Means. Just a little bit about my background. I do have an MD and a master's of health science and a master's of public health, so a lot of initials right there. At present, I'm currently assistant medical director at Vanderbilt University Medical Center, which is down in Nashville. Yeah, thank you. Thank you. There we go. Thank you. But I started my career at Meharry Medical College. Even better. I love it. Meharry Medical College is where I did my medical school. I did around a year over at University of Pittsburgh in Pennsylvania, and until I actually got to Pittsburgh, I didn't even know about occupational medicine. I didn't know it was out there. I found out randomly by talking to someone that knew about preventative health and occupational medicine and realized, you know what, that sounds like something I would be interested in. So once I found out about it, I was able to find a residency program at my medical school that I did not know was there, so I joined the occupational medicine residency program at my school and finished up there. I was able to find Vanderbilt University Medical Center by one of my rotations, actually. I did a rotation at their institution, got to see all the amazing things that we handle there, and I got to participate in that. So now that I'm here at Vanderbilt Medical Center, basically the key things as what I do on a day-to-day basis is I work in the occupational health clinic. We handle OSHA surveillance programs, resident education, and a whole bunch of various committees, including like workplace violence, wellness, and all that good stuff. So that's a quick summary of my background, and I will let the next one come up. All right. Thank you. Thank you. Okay, so just some housekeeping. If anybody wants a seat, there are three empty seats right up front if you'd like to come up and have a seat. Oh, four seats, actually. Four seats. Anybody want to have a seat? Talking to you in the back. We see you. There you go. There you go. And while we do that, a show of hands, how many of you are currently in residency? Oh, that's beautiful. Okay. Okay. How many of you, is this your first? Well, let me see. Yeah, your first residency, not your second. Okay. You only did maybe a preliminary year, and then this has been the track. Wow. Okay. And then it sounds like most of you, it's your second residency. You did something else before that. Let me hear, shout out some of the specialties that are represented. Do we have internal medicine? Let's see some hands. Okay. Family medicine. Surgery and surgical specialties. All right. My recovering surgeons. Yes. Great. Anesthesia. OBGYN. Hey. Dermatology. I figured I'd try. It's okay. No, they're happy where they're at. That's fair. Okay. Okay. Okay. Great. What is it? Pediatric. Yeah, that's okay. Okay. Welcome. We'd love to have you. Okay. What haven't I said? Radiology. Radiology. Okay. Oh, really? We have radiology. Nice. That's fun. Okay. PM&R. PM&R. Fantastic. All right. So I think, you know, it does really stand to show that we're very accommodating. And then how many of you are maybe making a mid-career shift? You were in practice for some years and you saw the light and said, you're going to come on over here, right? Okay. Well, welcome. We're happy to have every last one of you. Anybody in here a program director or an educator teaching future residents? Fun. 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Oka course that is offered, and you have to pass the test and everything to get certified. But it does open up, similar to DOT, I think, a very commonly sought-after credential, and in many cases, required for the job. So it's a course related to drug testing reviews. Yeah, and I can speak from an academic institute side. So we have a lot of people that come in for MROs or urine tests, things along those lines. We have that pretty much almost every day. Some of the times, you'll get a specific one where there's cause, for cause. And then other times, people have scheduled ones. But usually, every day, there's someone coming in for a urine test. So just thinking about that from a, I guess, financial aspect, that's a lot of people requiring MROs, activities, and your skills. So doing that, I think, is definitely very useful. And I know a lot of people that do have that certification that have their own side business, as he mentioned. They've been able to branch into other things with that certification. So those are all kind of things that you should consider when you're looking into these different areas. Did you want to add? Sure. So yes, to be specific, so as they alluded to, the medical review officer is a physician who is tasked with reviewing typically non-negative drug screen results, which could be in the form of urine, hair, blood, nails, et cetera. And basically, your job is to verify whether they are, if it's due to some valid medical reason. For example, drug tests come back positive for opioid medications every day. And some people have valid prescriptions for it, and others do not. And so it's part of your job is to evaluate that and make a determination. Of course, this has implications on people's livelihoods. And so it does require some training. There are two courses that I know of available. One is, I think, affiliated with ACOM, and then there is another one through the MROCC. If anyone knows of any others, feel free to let us know. But I know of those two mainly. And it's another certification that can make you a more marketable job candidate. And some people actually make a career off of just serving as an MRO, either independently, as a consultant or a contractor, or as an employee for huge, or not even doesn't have to be a huge corporation, but another company. And it pays well. OK. I want to circle back to this one, if that's OK, at the end. And I want to get into the job search, interviewing, and contract negotiations. So I want to bring back Dr. Ibushi for a very riveting presentation on this aspect. Thank you. OK, everyone. So now we're going to talk about the job search, interviewing, and contract negotiations, something I'm very passionate about. So a little bit about my background, or the different sort of jobs I've held. So right after residency, my first job out of residency was working as a medical director at Concentra in Las Vegas. That was interesting. So I went to, I did my ACMED training at Meharry Medical College in Nashville. Thank you. And OK. And I have no financial disclosures. So like I said, I did my first, my first job outside of residency was at Concentra. So your bread and butter, ACMED, and of course, some urgent care. And after that, I worked at another urgent care briefly. And then I went into corporate. I worked at Tesla for a year. And then after that, I went into contracting. I became an independent contractor, did a couple of jobs. And we'll get into that later. And before I got into my present position at Ramstein in Germany. So the objectives of this part of the presentation is, of course, talking about getting prepared to get a good job offer, how to navigate contracts and negotiations and red flags, how to look into employment opportunities, and of course, best advice from our recent grads here. So my first slide, for all residents, of course, the most important thing is preparation. Getting prepared is everything. Of course, planning is everything. I always say when, in those final few months of residency, you should be thinking about what kind of ACMED or do I want to practice. As we mentioned in our very first slide, there are different types of occupational medicine. You can do clinical ACMED. You can do academic corporate medicine. You can start your own practice. There's so much variety that you can do. But you have to think about what kind of career are you interested in. And of course, take the electives needed to be successful in that. I think I did the OSHA elective, which was great. And there's NIOSH electives. If you're interested in informatics, whatever it is you think you want to do, there's an avenue. And there's someone that can talk to you about how to do that. So first things first, of course, graduate. Complete all the things you need to do, your rotations, your thesis, finish strong. Prepare for your board exam, as we talked about the different ways and things you can do for that. Board exam planning. Get your letters of recommendation. Get organized. Organize your CV, your research work, everything that you've ever done. Start getting that together as you prepare so you can graduate successfully and move on. Then, of course, things to think about. Review your financial obligations. Of course, a significant part of your future, which I'm still working on, is your debt management. Some of us don't have loans, if you're lucky. But think about those things. And of course, when you're applying for a job, I also say think about pre-employment screenings. So you're applying for a job right now. You have to think about things like your vaccinations. Do you have all the things you need to be ready? Should you get hired and need to get those things done? Think about the fact that you'll have to have an exam or drug screening or something like that. So keep that in mind. Of course, you have your required certifications, your ACLS, BLS, ATLS. Think about health insurance plans, plans for what you'll do when you graduate from residency, your personal finances. Plan your time off and your vacation days and all of that. And even daycare options, if you have children, when you're doing your job, planning for your job search. So when do you start looking for a job now? As soon as you have an idea where you want to go and what type of OCMED you'd like to practice. There's a lot of opportunities out there, but certain things are quite competitive. So the earlier you prepare, the better. You might be interested in fellowships, not just looking for a job. There's EIS fellowships if you want to spend time, which is the epidemiology service. There's also, some people want to get into pain fellowships, addiction fellowships. You can work at the CDC. So start planning early. These are other options you can do if you don't just want to go straight into clinical OCMED like some of us did. How many jobs should I apply to? How many jobs do you all think you should apply to right out of residency? Anyone want to give me a number? How many say 10 or above? Raise your hand. 20? Five? Five, okay. Yeah, so like I said, it depends on your application as a whole. When I was getting out of residency, like I said, I rotated through Concentra and OSHA. I did a couple of electives. So I applied to two jobs, and Concentra came about because I'd spent some time there. So that was good, but that was lucky for me. But other times, depending on if you have geographical specifications where you want to go, then yes, you should apply to as many jobs that you can. Thinking about, of course, things like your finances, your family, if you want to expand geographically and things like that. So know yourself is what I say. Know exactly what you want to do. Spend some time thinking about that and then go after the opportunities for that. Now, something I found here at this AECOM, I think there's a new heat map that AECOM website just launched, which I think is fantastic, because I didn't really have that. I remember when I was first coming into AACMED, I'm a reformed urologist, so my first residency was urology. And at that time, you just applied to, when you were finishing up, you just applied to certain urology positions. But I remember my friends were like, oh, you should get on LinkedIn. I said, but what? I didn't see the, I was like, LinkedIn, why? I think LinkedIn is for business and things like that. But to be honest, now the job search is so diverse. Yes, if you can, I would sign up for job boards. And I think this AECOM heat map is really good because I didn't have something that had a place I could go and you could find all the AACMED jobs in a certain area, in the geographical area, learn about how much average salary is in that area. So I would go on the AECOM website and look into that, into the heat map. I think it's really good. And yeah, so that's part of early planning and of course, the benefit of coming to this conference. So that would be downstairs on the fourth floor. I encourage you all to go and look at that. So interviews, okay. So the next step, of course, when you're applying is you get called in for an interview. These are the four things I always say, practice, prepare, research. So practice makes perfect, of course. So spend a lot of time going over sort of your questions and how you want to answer the interview questions. Prepare as if it was a real interview. Review your answers to specific questions. They always ask you, tell me about yourself and those common questions. So have practice talking about that. I always say have copies of your CV and personal statement and transcripts somewhere and research the place you are going to thoroughly. That's really important. I've made a lot of mistakes. I always talk about knowing where you're going and because it's so much, it's nice when you have an interview and you get into a topic and then it takes up a lot of time because you're well prepared and then you know that they will hire you. So I always say hiring decisions are made in the first 30 seconds of the interview. The balance of the time is used to justify that decision. So be prepared when you go in with your appearance, how confident you feel. The more you are prepared, the more confident you will be. The most qualified person for the job won't get the offer if you interview poorly. So spend a lot of time, if you can, practicing your interview. People always remember how they felt when you spoke and they will assess your compatibility with the program or the job and the strengths and weaknesses of the company. Again, thorough preparation is important. Just more things about interviewing. Be yourself, smile, know yourself, know the points that you can be confident about. Be humble, but be confident. Speak clearly, articulate yourself, be polite. Of course, don't be late, arrogant, shy, or have no questions. Always have one or two questions to ask at an interview and be well-groomed because your personal appearance is important and be kind and nice to everyone. If you actually go into an interview now, most interviews are telemed interviews, so that's also interesting. I prefer those. You saved my traveling, but yeah. So be ready for that. So this is just a slide talking about appearance, which business formal, look like a professional, successful physician when you go for your interviews. Just some more about, I always say you should have a top five plan, which is when I go into every interview, I always have five things I want the employer to know about me. And these five things should answer what makes you a good candidate and what makes me or what makes you unique. So if you have those five things, usually most questions they ask you, you can answer. For interviewing, when you accept a client, when you accept a place to interview, I would say rank your needs and wants in order of what's important to you before you accept an interview. At the end of these interviews, make sure you compare your scores. How did you feel after every interview? And don't forget to send thank you notes and letters to your interviewers. These are some important websites to go on for, if you're looking for a com jobs, like I said, I would look on the AECOM website and the ABPM website. Of course, the PrevMed websites. There are a lot of things that are very helpful on these websites. I would go to them when I'm doing my job search. So the next thing is, next thing is employment negotiations. Very, very important. So when you first get your job offer, they'll give you, usually there's a number posted or not, and the base salary and things like that. And I say you should always, always, always negotiate. Never accept the first number you get. I say that because I accepted the first number that I got. I was just so happy to get a job. I didn't even question anything. I was like, oh, this is great. I didn't have money, so I was happy to go anywhere. That was a mistake. But I learned quickly after talking to other people that I'm sure they were so happy. I just said yes. I didn't negotiate. I didn't ask for anything. I didn't really read my contract. So that's why I love telling people to not do that. So always, the first number they give you is not even close to what you could get. I learned, yeah, I still think about that, actually. I left a lot of money on the table, but that's fine. So when you get, let's say they offer you, I'll be generous and dream and say they offer you $400,000. I don't think they will. But if they do, always say thank you and talk about, try to go up by a certain amount of money and see what they say. Because it's very difficult to talk about the salary portion of when you have an interview, but it will happen, so be prepared for that. And the way I look at numbers that I, if I wanted to talk about a number is, of course, doing a lot of research in the area that you're going to, cost of living. There's several websites that talk about certain numbers and amounts of money that you want to bring up when going for a job. So I don't know if we have time after this, I can go more into that. So the components of a salary I'm mentioning here, there's the base salary. You should always ask about a bonus and ask how they calculate that bonus. It can be based on RVUs, clinical visits, CPT codes, and others. Sometimes some jobs have tiered bonus structures. And of course, like Rosandra was talking about, if you have other duties like MRO, DOT, you can negotiate around doing those things as well. Last thing is contracts. So congrats on getting your job offer. When you do, it's very, very important that you look over that contract. And I always recommend a lawyer looking over it as well. Like I said, the first time, my first job, I didn't do any of these things. I was just happy to have a job. And it was a mistake, of course, because sometimes you get tied into things when you sign contracts. Sometimes they are non-competes and things of that nature. So it's very important to read your contract. Know, I would say know what you want to do in case you need to leave a job for whatever reason. So it's important to ask about what happens or what will happen if I have to leave this job before the contract is over. So, and then look at things like time off. Do you get money for CME? Do you get funding for those things? Are there restrictive covenants or non-competes? And the tax structure as well. So again, I would get a lawyer to look over these things every single time, no matter how small you think it is. It's always beneficial to do that. These are just more things to negotiate on. If they can't give you more money, maybe you can get more benefits. You can negotiate time off. You can negotiate your retirement. If you can buy into the practice, and also insurance as well. Everything is negotiable, and you should always negotiate. And let's see. So yeah, I put more things here. You can negotiate wardrobe, travel between sites, negotiate if you are going to have any ancillary workers, how many people work for you, the type of EMR you use, scholarship time, community support. You can even talk about getting housing. I mean, I've heard there's so many things about negotiation. And again, at the end of this talk, I can answer and tell you some of the things that I have negotiated in my contracts. You should always think about cost of living. That's very important. Things like state income tax, medical licensure tax, how much does it cost to be licensed? Oh yes, when you're graduating, think about how much you will pay for getting licensed, and how long it takes. I'm licensed in seven states, and I think Las Vegas was the hardest one, because you have to take an exam. And Texas also takes time as well. What was the easiest place for any of you to be licensed? I think Delaware or something. Wisconsin. Oh, Wisconsin, yeah. Because if you want to work for the military, you just need one license. I wish I didn't get all those licenses, but there are stories for why I did that. But yes, because you have to pay to renew those, so it's quite expensive. So you can get one or seven. Okay, so now, thank you all for listening to that, and we'll get some pearls of wisdom from the rest of the panel. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Great. There you go. All right. Hi, Steven. Hi. Yes, and one of the things that she sort of mentioned, she said be proud of yourself and what you've already accomplished is that, let's say you're switching from another specialty, for example, all of that experience that you have does contribute to your success. That's one of the things that helps make you special and helps you define your niche, usually. Don't be afraid to highlight what previous work you've done, even if you think, or you somehow think it might not be applicable to op-med. Trust me, it probably is. High chances. For example, I did ears, nose, and throat otolaryngology before coming to occupational medicine, and so my surgical skills come in handy because most people don't like doing the lacerations, and if there's anything that has to do with a nose or an ear, it's a black box to most people, and so it comes my way. Dr. Means, what are your keys to success in one minute? All right, so I'll be real quick. The main thing that multiple people have said already up here is focus on the life that you want. What do you want? Incorporate that and find a way to get it because without a vision going into these interviews, you're gonna get whatever they take. Other things is just remain grateful. It's a long journey. Remember those days when you're really sick of your patients and you just want to be like, oh my goodness. Remember why you went into this specialty. Remember what makes you happy to do medicine because not everyone gets to do what we do. Keep an open mind and be creative. Those pivot changes, they happen. That's part of life, and sometimes they create amazing opportunities. Failure is part of the process, and I do say failure in quotes because what you think at one point in your life is something that went bad and that might be the best thing that happened to you. And find your balance and what keeps you happy and excited to do what you do. Great job. I know, right? I think this is you. Thank you. Thank you. Thank you. Thank you. Thank you. Okay. Dr. Mullinex. Yeah, so just a couple things that I think have been helpful for me is number one, I think you have to really be intentional about planning and doing some research for your future. I don't mean just in the next year, but I try to think at least 10 years out, right? Planning what, at least making sure that I'm aware of what the options are, and then knowing what wickets I need to hit to make sure that I'm set up for success if I wanna be able to pursue those options in the future. And so I can work on building the skill sets I need that I may not have today. Where do I need to be maybe in five years if I want that job in 10 years? Because I think it's really important that everyone is familiar with the ACOM competencies, right? So there's 10 of them. One of them is clinical, and there are nine others. And I think that is something that can really set you apart. I think when you do those things very well, things like risk communication, public health emergency management, right? You know, administration and leadership. So that helps you be prepared for opportunities as they come up. And I think you gotta be really willing to step outside the box. I see 10, I oversee 10 other positions in my current role, and I'm sometimes frustrated that opportunities come up and I pass it out and I get no takers, right? But I think if you really wanna set yourself up for success, you gotta be able to do things out of your comfort zone, build the skill sets and take advantage of opportunities even when they're difficult. And the last thing is I would definitely get a mentor or two or three or five, right? So it's important to talk to the people that have been there before and done that. You know, for me, I obviously seek out some people in the military. I also utilize ACOM's mentor program, which I would definitely encourage everyone to use, even if you're just a medical student, right? You can get some really good gouge from people that have walked in your shoes years ago. So thank you. Awesome, thank you. And I especially like your last tip, which is try to have fun and enjoy what you do, both inside and outside of work. And to give another plug for that mentor program, again, I'm N of one, but I will say that the one mentor that I did sign up for, she was the person who ended up giving my name to my current boss who ended up recruiting and hiring me. So it's real. And so very quickly, I'll give you a few keys. You've heard them say it, maintain balance and wellbeing. And one thing I like about, or let me say, like I love about occupational medicine is that you actually can maintain balance. I think maintaining balance might be the norm and not the exception here. And so of course we have the lowest rates of burnout and that's because a lot of the times we're in, most of the time, not all of the time, but a lot of the time we are in situations that afford us a lot of flexibility and autonomy and time. Time to do things outside of work, to pursue our own other passions or side hustles, if you will. I mean, I bet if you asked a lot of people in the next room, what else they have going on, they'll tell you two, three, four different sidelines. So build relationships, key. Build relationships no matter what, one, because you're a human being and we are relational human beings, but also because in this realm, it is so important. And you would be surprised or not at one, just the breadth of knowledge, wisdom, and experience that people have here, as well as the opportunities that they might put you onto that you had no idea otherwise existed. And another thing that someone said last night and I've heard it before is, they jokingly, facetiously say, be nice to everybody here because we all end up being each other's boss at some point. And that's real. It alludes to the fact that we almost sort of rotate through a lot of the same or similar positions around the country and internationally, and or we end up recommending the next person who ends up taking our spot when we feel we're done and we're ready to move on to the next thing. So yes, build your relationships, find your niche and be adaptable. There are a lot of niches within occupational medicine. I mean, you see us, we're all over the place. We're doing social media, we are building, we're entrepreneurs, we are consultants, we are employees, we are contractors, we are employed, et cetera. So find your niche and be adaptable because things are changing. Use your platform to make a difference. I think another really special thing about our specialty is that we can affect people on both an individual and a population level. That is the power that we hold. It is a privilege. And so a lot of times we are the only advocate that a lot of our patients have because they might not have a primary care doctor in the community. When they come to see you for that injury, you are the one. And so remember to use your platform or try to use your platform to make a difference, even if it is just for one person because you are taking care of people. Yes, they are workers, but at the end of the day, they are people, they are brothers, mothers, fathers, sisters, friends, and they are your co-neighbors in this world. And always do the right thing. Always do the right thing. It's easy. It feels, sometimes in the moment it might feel harder, but it's actually the easiest thing in the long run. And in this space, we interface with a lot of different people, especially if you go into certain spaces. And you can end up being put sometimes in positions that almost feel like they conflict with your medical training and your Hippocratic Oath. But remember what you came to do. You came to help and heal, so always do the right thing and stay on the right side, okay? And then finally, stay curious. Things are constantly changing. I mean, you know, we're in the fourth industrial revolution. The future of work conversations are happening. What's gonna happen with robotics? What's gonna happen with AI? If anybody's using chat, GPT. And what does that mean for the worker? What does that mean for you? Stay curious, stay open to new knowledge so that you can ride the wave on to the next, the next interesting thing, okay? And so with all that being said, I would love to open it for a question and answer. The microphone is right here for anyone who has any questions. Thank you so much. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. I would like an example of a potential pitfall that fellow residents could potentially fall into when dealing with contracts. So I will tell a story. I interviewed at Kaiser Permanente in the Bay Area. I liked it a lot. I did a lot of other interviews as well, but I liked them the most. So they gave me a contract and I read it. And their contracts at Kaiser, for those that have never interviewed or talked to them, they're very straightforward and they're very detailed in the sense that all the words they put on there are pregnant. So what I did not know is that they're pregnant with meaning which means that you can just have one page of a contract. So I read to the bottom, I saw you can sign, and then they had a next button. And so I thought, oh, they want me to sign on every page of the contract. This must have 50 pages. This is gonna be awful. So I signed and next, and they said, thank you. So for those that are gonna deal with contracts that have never done it before, know that a contract can just be one page. I am happy with my choice. I am so thankful to Kaiser, and I'm looking forward in two months to working there. Thank you. Thank you. I like that. Thank you. So yes, the importance of actually reading the contract and if you have the funds, get a lawyer to read it because they got lawyers to write it. Hi, I'm Lisa Shaw. I'm actually with the military, but I did have a question for some of the red flags follow up because that's something that we don't normally get training in and I feel like it's like signing our life away. So what are the red flags that we should be looking out for? When you're talking about job interview and things like that? Oh, just contracts. Well, one of mine honestly was, I'll just mention one since we have short on time, but one of the things I realized was they wanted me to sign that contract very quickly. They gave me a week and pushed it to that week. Like, oh, do you know, it's fine. We can discuss it later. Just sign and we can make adjustments later. Don't sign anything unless you already pushed the next button. If till you finish like all your questions, because there's not a next time. Okay, so if they're pushing you to hurry up and sign, like you only have a week to review, they're not really giving you, they're giving you vague answers when you're asking questions. Those are the red flags. And if you have a feeling in the back of your head that something's red, then go with that gut. Yes, what she said is really good. And another red flag, it's just more of when you're a new grad, you're really, I think new grads are really vulnerable to just, you know, you're getting this new job, they've given you this contract and they can look like a lot of money and things, but it's really important, I think, one, besides, you know, reading the contract, getting a lawyer, just if you can, talk to us like that mentorship piece is important. Make sure you're talking about just what certain things mean. One of the mistakes that I made, I would say a red flag is like, there's this one time I signed up for this, like I wanted to make some extra money and when I was a medical resident, I had moonlighted for one of these jobs where you make money to do physical exams. So I said, okay, while I was doing my main job, I would sign, they had posted this job somewhere online and I said, oh, I could see patients and I signed the contract, I read the contract, but then I found out later after I signed the contract that the contract I signed was actually not with the company but it was with a subcontractor and she had a non-compete of three years. So I didn't, so I think this year is when I can finally not do that same kind of job because I didn't know what I was signing when I signed it because I thought it was a small thing. So always know what contract you're signing, who is the person, are they the actual company, are they the subcontractor or a contractor because then you could be employed for someone that's not even the company that you thought it was, which is why I'm very big on getting lawyers to read because of course we are intelligent, we can read things, but sometimes if you don't know the meaning behind something or what's in something, so really try to make sure you understand whose contract you're signing. No, I'm gonna let the next person ask and then Ross will probably take the next answer. So pay attention to the wording in your contract. So if you don't know what it means, look it up, ask somebody, ask one of us, get on the ACOM community board and ask, what is a non-compete, what is this, what is that? Yes, so can we take the next question? Yeah, sure, thank you. So you all mentioned how a lot of different opportunities out there in occupational medicine. I think, Rosandra, you specifically mentioned the fractional medical director positions that you hold. The question is, how do you find these? Is it just networking or is there a place where you find them? I mean, so you have a lot of different opportunities, how do they come up? So to quickly name a few, obviously networking here, the exhibitor booth, there are a lot of jobs there and a lot of companies that also have their own job boards. Just to name a few, not that I have an opinion on them or anything, but I know Premise is here, Concentra is here, Select Medical is here. Last year, I think the CIA was here. The military is here, everybody is here. And then when you go to these section meetings or you sit in these rooms with each other, people tend to tell you what's out there that may not be published. There is a job board on the ACOM website as well. And what else can you offer? Other job boards? Where else do you find those jobs? Yeah, I agree that I think networking is huge, particularly in this field. But I know, yeah, I'm in the military, so I go where I'm told. But I know that others have had a lot of success with Medlock Consulting, right? That's well known in OCMED, kind of a recruiter headhunter and is very experienced in placing OCMED types in OCMED jobs. That was what I was thinking. Medlock Consulting is another one, who was a company started by someone who has since passed, but she's been with our group for years. And a lot of people who are senior in this organization actually got their first, second, or third jobs through that company. And I mean, LinkedIn. I mean, you can still go online. I think I've met people. If you can think it and you want to work there, and you never know, there could be an OCMED position or you could create one or market yourself. You could consult. There are so many avenues you could do. And then you get the, this is where you network and talk to other people about how did you get into this thing and that thing. So you can even Google. I mean, again, I finally have a LinkedIn, but yeah, LinkedIn is good too, so. And then all of the job positions won't necessarily say occupational medicine, okay? So remember to think outside of the box. Sometimes these companies who are completely non-medical, like your big tech companies and whatnot, they're just looking for someone with MD experience or DO or APP experience that can speak to the health side of things because health is a big business or they need safety and health for their actual employees. So think outside of the box. You can go to the actual website for Apple, for example, and see what they have available, et cetera. Okay. Next, thank you. Next question. Hi, guys. I'm Max. I'm a resident. Wait, what time is it? One second. The actual official time has concluded. So if you need to step out, please feel free to. But I think we'll stay another five minutes to answer a few more questions in this break time. Right? It's a break. Okay. All right. So we'll just let these people exit real quick and take your questions. Speak loud. Hi, I'm Max. I'm a resident at UCSF. I'm just curious how you guys went about talking to employers where- I can't hear him. One second, guys. You can just go. I've heard from a lot of people that often jobs will say, they want five years of experience. And how did you go about talking to those types of employers when you may not have had that experience yet, but you're still interested in that job? Okay. I think it was the Nyla Medlock who said, those resident years you were working, that counts as experience. Okay? First and foremost, don't let anyone tell you otherwise. What else do you guys want to add to that? Those resident, how many years of residency did you do? Have you done so far in your life? Three, including recurrent. Three, so you just need two more? Okay. She's very right on that. But the other thing I would say is, it never hurts to reach out. You can reach out and be like, hey, this is where I am with my stuff. I'm really interested. If anything changes, let me know. Somebody told me that those things they put on the job description, they are suggestions, not requirements. And so if you have some other experience that you can sell, that would maybe supersede that extra year. Like, oh, I did this really amazing thing a few years ago. You would be surprised what would actually make you a more marketable person. Anybody else? Very true. Yeah, and I still say, like, if you see that job that says five years experience, and as they've both said, you have that three years, still apply for the job. And if they do call you, then talk about, like she said, the things that you have experience in. Because most of us have already a previous life, a previous type of thing that we've done. And even research experience, you could have been the head of your, anything, anything that shows your leadership skill and your competencies that you can do, then talk about that. I mean, my first job out, I was a director, and it just depends on how you can negotiate that and show people what you can do. And if they're into it, then you'll get hired. I'm sorry, Ross. Go ahead, next question. So not so much a question as kind of a shared experience that to pass on. I had a signing bonus with my current contract, which was fantastic. But I'm, and I'm sure this varies a little bit state by state, but in Pennsylvania, my signing bonus was actually a loan that was then forgiven over the course of my employment. So what they did was, you know, my setting bonus is X number of dollars, and there was an interest rate attached to that, which was 6%. And then they forgave that loan without having to pay it over the course of my five-year contract. This caused a couple of things. One, it means that if I leave, I potentially have to repay the balance of that loan, right? The other thing is that because it's a loan, my wife, who I have a very strong relationship with, has half of that loan, right? And so while we were able to use that to buy a house and then use the down payment for our house, which is a fantastic use of signing bonuses, and I strongly recommend it if anybody's interested in that, just be aware that that is a potential implication of the use of those funds. And of course, as that loan gets forgiven, you are taxed, potentially, on that unexperienced income, because you have been forgiven the additional interest on the loan as well. People are smart, thank you. See, there's a lot of business-minded people in here. Mm-hmm. On your signing bonus, or how's that going to work? I honestly, I don't want to, like, that was several years ago now, so I don't want to come to the example for you. But I will say my company had a very positive relationship with me about it. They disclosed all that to me ahead of time. All right, last question. And then we have to leave. So Scott Wallace, USU's program again, as well. The uniform didn't give it away. So one of the other things I've been wondering here is I've seen a lot of people do it. Everyone wants to find a job. And I haven't seen as many of the resources, basically, on how to be your own boss. A lot of people eventually get into sort of consulting. And I know some people run their own private practice. But through medical school, residency training, maybe it's because of the military. And even here, I've seen very little on how to establish and run your own private practice in those pieces. Have you all seen any good references or resources like that or other networking for how to really set it up so you can be your own boss or get people to work for you? Yeah, I will say there is a private practice section within ACOM. I'm not a member of it myself, but that's probably a great resource. That's a great resource. And also, just doing research online, you can join actual business organizations outside of. There are medical business organizations that talk about practices within this ACOM group itself. Of course, like the finance, there's a private practice section. We actually had a meeting yesterday. So just networking, you can reach out to us and email us, and we'll give you that information. I just want to add one last thing. I do recommend for all of you, the higher you go, to really get a lawyer and a tax person. No, the reason I say that, not just reading your contract, is if you do get into hiccups or problems, then at least you can get out of them. It's not just impossible. With a good lawyer, you can sort of get out of any problems that you've gotten. So please reach out to any one of us if you have more questions. Thank you. Thank you all. Thank you so much. I hope you enjoyed and learned something. And feel free to reach out to us after this to get more information.

panel discussion

career guidance

occupational medicine

diverse career paths

job search process

contract negotiation

work-life balance

building relationships

private practice

professional networking