Your Career Guide
Surveying the landscape

Knowing who you are and what you want

Much of your success rides not on technical skill but on the behavioral and cultural fit between you and your work. Here's how to get it right.

By Deborah Grandinetti
Career Guide Editor

To find the right job in medicine, you've first got to know who you are. What revs your motor? What drives you to distraction? How hard do you want to work? What demands will family life place on you, and how will those demands mesh with a particular practice? What do you need from your work to thrive rather than struggle?

Until you know the answers, you're not ready to begin your search. Look at it this way: A career in medicine is challenging enough. The more your job turns you on, the easier it will be to put the unavoidable daily hassles in perspective. But if you're in the wrong practice situation, minor irritants will loom large. As frustration mounts, your performance can suffer, and your self-esteem along with it.

"It's commonly known among recruiters and industrial psychologists that success in a new job depends 20 percent on technical skill and 80 percent on the behavioral-cultural fit with the organization," says psychiatrist Gigi Hirsch, founder of MD IntelliNet, a Brookline, MA, consulting and placement company.

But fit isn't something that happens by chance. You have to make it happen, through a series of intelligent choices. The first step is a thorough self-assessment, followed by some market research to find out what the most attractive opportunities are really like for the people who work there.

In doing your self-assessment, five areas are key:

• Values: What motivates you? What would make you feel you were devoting your time and talents to something extremely worthwhile?

• Skills: What's your strong suit? Which strengths do you have that complement your medical skills? Are you skilled at something you don't enjoy doing? If so, you'll want to de-emphasize it so you don't gravitate toward something you won't like.

• Behavioral style: How do you approach problems, people, rules, and procedures? What kind of pace do you like to keep?

• Cultural preferences: Do you like the intimacy of small medical groups or the anonymity afforded by a larger organization? Are you a traditionalist, or an innovator who prefers a fast-moving, entrepreneurial culture?

• Lifestyle: Are you a family- and community-oriented person? An outdoor enthusiast who needs the right setting to pursue other passions? A travel bug who needs to take vacations on your own schedule?

There are several ways to approach your self-exploration. You can make this a do-it-yourself project, talk with someone you trust, or pay a career counselor or coach to help you. Anesthesiologist Jan C. Horrow found that simply talking to a longtime colleague crystallized for him what made him happiest at work. Others who made dramatic changes say they couldn't have done it without a coach.

Whichever route you choose, the object is to create a personal profile specific enough to help you focus your search, and then assess the resulting opportunities against that profile. Alternatively, you can use the information to create a position that's right for you.

To get started on your own, "ask yourself what the ideal nature of your work would be if you had no constraints whatsoever and anything were possible," says pediatrician Todd D. Pearson, director of the Center for Physician Renewal in Bellevue, WA. Pearson has used that question to good effect with many physicians. Your answer will help get to the essence of what you require to satisfy your need for meaningful work.

One way to zero in on your skills is to recall the work or volunteer experiences you've found most satisfying, and note the skills they required. If you look at a range of experiences, going back to jobs you held while you were in school, you may find a pattern—something you've always gravitated toward and been a natural at.

Look separately at areas such as job content, work relationships, job structure, practice culture, and overall organization, says psychiatrist Kernan T. Manion, principal at Work/Life Design in Concord, MA. If you've been practicing for a while, ask yourself what has and hasn't worked for you in each area for each job.

Consider supplementing your efforts with career self-assessment tools. These can give feedback on how you learn, relate to others, think, lead, work, and manage. You can purchase these tools from career counselors, or you can find some of them on the Web, including the Keirsey Temperament Sorter (www.keirsey.com ), the Myers-Briggs Type Indicator, and The Personal Interests, Attitude and Values scale and the Personal Insights Profile (www.ttidisc.com). There are also books like Career Renewal by Stephen Rosen and Celia Paul (Academic Press, 1998), which was written specifically for scientists, engineers, and medical professionals.

Once you're clear about what you need from work, think about how passions outside of medicine may shape your work needs. A doctor who has to commit to a specific schedule because of her children may not do well in a small group if her partners resent her lack of flexibility, says Judy Bee, a principal in the Practice Performance Group in Long Beach, CA.