Liana Tedesco, MD
May 19, 2025
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Starting the job search is an exciting yet challenging journey. Picking the wrong environment or employer can significantly impact your quality of life and lead to an early career change. No matter the specifics (academics vs private, urban vs rural, etc), I think we are all looking for a job with work-life balance and opportunity for professional growth. While the perfect job may not exist, it’s crucial to be mindful of certain “red flags” that could signal trouble down the road.
Here are some things to look out for when seeking your first (or next) job:
1Unclear Job Description or Expectations
A vague or overly broad job description can be a major red flag. If the responsibilities and expectations for the position aren’t clearly outlined, it’s a sign that the organization may not have a well-defined role for you. You will want to ask questions like, what types of cases you’ll be handling (e.g., general orthopedics vs. subspecialties like spine, sports medicine, or hand); How is the call schedule structured; what are the expected clinic hours; how will I obtain OR time; what are the opportunities for academic and/or research involvement (if that’s important to you). Suppose the job description is murky or changes during the interview process. In that case, it may suggest disorganization or a lack of understanding about the role, leading to frustration and later challenges.
2High Turnover Rates
In any profession, a high turnover rate should raise some red flags. If several surgeons have left the practice in a short period of time, ask why. If you are filling a role that someone left after less than 3 years, ask to speak with that person directly. Turnover can indicate problems like poor management or workplace culture, unreasonable workload or expectations, or lack of work-life balance or limitations in support.
3Ambiguous Compensation and Benefits
We have all worked very hard, over many years, and as such, should be compensated accordingly. If the salary and benefits package seem unusually low or significantly below industry standards, it could be a red flag. The same could be said for a salary that is significantly higher than the industry standard – there is often a catch. Be sure to research average compensation for orthopedic surgeons in the region and specialty. Understanding the benefits, such as retirement plans, health insurance, paid time off, and malpractice insurance, that a group offers is critical as well. Along these lines understand the cost of living in the area as that can impact financial considerations.
4Unreasonable Workload and Call Schedule
We all know that this is a demanding job. However, the workload you are being asked to cover should be manageable and reasonable. If an employer is expecting you to cover an excessive number of patients, surgeries, or on-call shifts, it can lead to burnout and negatively affect your personal life. Make sure to have a clear idea of their expectations of you. Some red flags in this area include excessive on-call hours or mandatory weekend shifts with little flexibility or a lack of coverage or support. It’s important to discuss call schedules, workload expectations, and ancillary support early on to ensure they align with your personal preferences and lifestyle.
5Poor Communication and Transparency
Communication is key to a successful working environment, especially in surgical subspecialties, where collaboration is essential. If you notice poor communication during the interview process or a lack of transparency about important details like practice protocols, team structure, or organizational goals, it could indicate future challenges in the workplace. If there are communication breakdowns early on, it’s unlikely to improve once you’re hired.
6Lack of Professional Development or Growth Opportunities
In a competitive field like orthopedic surgery, professional development is vital for staying current with the latest techniques, technology, and best practices. If a potential employer doesn’t seem interested in supporting your ongoing education or doesn’t offer opportunities for career advancement, this could limit your growth as a surgeon.
Watch for signs such as:
- No mention of continuing medical education (CME) support or funding
- Lack of mentorship opportunities
- Limited scope for specialization or advancement within the practice
A good employer should foster an environment of learning and growth, allowing you to sharpen your skills and expand your expertise over time.
7Unprofessional or Hostile Work Environment
During interviews, try to gauge the atmosphere and culture by observing how the team (everyone from the office staff to the OR nurses to the partners) interacts and whether the environment feels collaborative or tense.
8Overemphasis on Production or Profit Over Patient Care
Any organization/practice that prioritizes profits over patient care should raise red flags. If a prospective employer seems to be overly focused on production numbers, billing quotas, or RVU goals to the detriment of quality patient care, it can result in moral and ethical conflicts down the line.
9Lack of Support Staff or Resources
Adequate support from medical staff, administrative teams, and resources is vital to ensure smooth operations and excellent patient care. If the necessary infrastructure isn’t in place, such as qualified nurses, surgical assistants, or administrative support, it could create unnecessary stress and hamper your ability to perform your duties effectively. Make sure to ask about the size and experience of the support staff (office coordinators, ATCs, RNs). You will also want to clarify the availability of necessary surgical instruments, technology (i.e,. robots, microscopes), and facilities (i.e., surgery center, clinic sites). Without proper support, your job can quickly become overwhelming, and patient outcomes may be negatively affected.
The process of finding the right orthopedic surgery job can take time. Be patient and careful with your decision-making. While it’s tempting to jump at the first opportunity that comes your way, it’s important to thoroughly evaluate potential opportunities for any red flags that could jeopardize your professional well-being and career development. By being aware of these warning signs, you can ensure that your next job not only aligns with your career goals but also provides a positive and sustainable working environment. This won’t be the same for everyone, and that is okay! After all, your professional happiness and success depend on finding the right fit for you!
DISCLOSURES: Dr. Tedesco This individual reported nothing to disclose.
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