New Peer Content May 2, 2022

Starting a new job is often a daunting prospect, whether just diving in for the first time after completing your training or transitioning to an unfamiliar place. With so many competing tasks, it may not be easy to keep everything straight. Ideally, you want to avoid letting things slip through the cracks, so it does not become an urgent issue, like: "I need credentials for satellite hospital A, and I’m on the schedule today to sign out cases there?” Or “I just found out I don’t have badge access to the morgue…and it’s Saturday…and I have an autopsy to do…” The New-in-Practice Committee compiled a handy detailed to do-to list with the onboarding process.

The onboarding process is highly variable between practice settings. For some, the process is nicely laid out and extensive, while for others there is practically none. Depending on the support services available, some of this process may have to be driven by you, at least in part. After accepting a new job, the first hurdle is setting yourself up to practice at the hospital(s). Set up involves:

• Having all of your records sent to the appropriate office
• Getting a medical license if you are changing states (start this process ASAP as it is often a limiting step that can take up to 6 months!)
• Getting credentialed at a particular hospital

Often, these procedures require case logs if you are directly out of training so, be sure to save these records. Different hospitals have varying requirements. Try to read through everything required and be proactive about obtaining all the materials needed. If not automatically done for you, be sure to set up a meeting with human resources before you start or within your first month to understand your benefits and set up important long term items such as retirement accounts, etc.

Once you are credentialed and legally ready to hit the ground running to sign out cases, there are a few things to consider before your first day:

• Will you get a badge before your first day or on the first day?
• Do you need physical keys for anything?
• Where will your office be?

To help ease into your new routine, and help those ‘Where am I moments’, try to, connect with someone at your new job willing to meet and help you out on the first day (and beyond). It is best to connect with someone who is also newer to the department as they have just gone through what you are about to (although, of course, this is not always possible).

What kind of microscope will you have/need is another important consideration if you are an anatomic pathologist. If you have particular needs for your computer or microscope, take care of this before starting as items can be requested as necessary ‘for the new person.’ Do not be afraid to ask for things you need to do your job successfully. Things to ask for include special lenses (60X or 100X if you are a Hematopathologist), polarizers if you will be signing out crystals, a camera if you will be doing a lot of tumor boards, Dragon software, and microphone, etc. You might find it challenging to ask for something once you’ve already started and may feel uncomfortable asking for things.

Once you’ve started, one of the next big tasks is that of introductions. Be friendly and go out of your way to introduce yourself to everyone from you colleagues, surgeons and radiologists you will interact with, PA’s, laboratory staff, administrators, etc. If you have trouble remembering names it is definitely worthwhile to make a list for yourself with some kind of helpful identifying information – ‘Janet, lab tech, helped me find the stain request form first day, for example. It is also helpful to collect contact information as well as share yours during these introductions.

In your first week be sure to ‘learn the culture’ of your new group. What is the acceptable turn-around-time for biopsies and resections? If you sign out transplant biopsies do the preliminary results need to be relayed to a coordinator? When should stains be ordered? When do people typically show up in the morning and leave at the end of the day? Do not come in at 9:00 AM if most folks are looking at cases by 7:30 AM!

If you will be interacting with residents and/or fellows in your new job make a point to sit down with the chief(s) to introduce yourself and find out what the expectations are and if there are any particular resident specific issues that may impact how you practice (for example, residents always have a block of lectures Wednesday morning so they will be late coming onto service). It is better to be aware of resident related potential issues before they become a problem.

This is by no means an exhaustive list of items, but rather serves to highlight a few important areas. We hope our new-in-practice to-do list will prove useful. Best of luck in your new position!

Dr. Butt is a new-in-practice thoracic pathologist who is part of a busy pulmonary consultation service at Mayo Clinic Arizona. She is the author of numerous book chapters and articles in pulmonary pathology. She is a member of the CAP New In Practice and Digital Content Committees and a past member of the Resident Forum Executive Committee. She can be found on Twitter @YasmeenButtMD.

All members of the 2020 New-in-Practice Committee contributed to this article.