First, be clear about what you want at this point in your career. Are you looking for a position that will give you the broadest opportunity for experience? Is limited call time a critical issue for you? Are you looking to settle down long term, maybe becoming a partner or preparing to purchase a practice? Are you a big city person? Maybe you prefer a more rural setting for raising a family. Think about your career over the next five years, bearing in mind that you don't have to spend your whole life in one location. Whatever feels right to you at this point in your life and your career, have in mind what would be the "best job" for you.

Ask yourself these questions:

• What motivates me?
• What do I find most satisfying about my work?
• What are my strongest skills (both personally and professionally)?
• What do I dislike? If these are areas where I have strong skills, how do I de-emphasize those skills?
• What kind of lifestyle is important to me? (family oriented, outdoor recreation, theater or other fine arts, flexible schedule, etc.)
• What kind of pace do you like in your work? In your personal life?

When you have answered these questions for yourself, consider what kinds of practice and living environments would make the best fit for you.

In general, small to mid-sized communities, particularly those with only one hospital, tend to have higher reimbursements, less managed care, less competition, and a lower cost of living. This can allow you to earn substantially more with lower overhead and expenses, creating the opportunity to accrue substantial savings while enjoying a good standard of living. Additionally, many physicians find great professional and personal satisfaction as part of a community where they are really needed. And many smaller communities are within an hour or so from larger metropolitan areas.

Even if you feel strongly about one particular state or location, consider surrounding states and areas. The more flexible you are about where you are willing to locate, the more options you will have in making your career choices. Be willing to visit a new area. You may be delighted with what you find.

Competition for the better jobs can be intense. You need to be prepared when opportunities arise, and you need to pursue them aggressively. Have your CV ready to go, and update it regularly (see Creating a Winning CV). Learn everything you can about the position. Make yourself available for interviews. Prepare for the interviews thoroughly (see Interviewing with Confidence). Contact your liaison immediately after each interview to strategize your follow-up and begin salary negotiations.