7 Job Red Flags That Could RUIN Your First Year as an Attending
Jan 2, 2026
5 min read
1🚩 No transparency about schedule or shift load
If they can’t clearly tell you:
How many shifts you work
How long they are
Who covers nights
How holidays rotate
…then guess who’s getting stuck with all the nights and holiday shifts? 🫵
Ask directly: “What did your newest hire work their first 6 months?” You want real numbers — not a vague “it depends.”
2🚩 High turnover that no one wants to talk about
If the group has a revolving door of attendings — The call is coming from inside of the house..
Replacing multiple docs in the last year
When you ask why the last doc went and get “Uhh… lots of changes… leadership is re-evaluating…”
3🚩 The pay is too good to be true
If they are paying you hand-over-fist to get you to sign, they are paying you for something alright…
Find out how much the neighboring hospital in the city is paying for comparison
Rule of thumb - academic jobs pay less (trade off with residents doing some of your work). Rural hospitals pay more (to convince people to move further from their cities). Popular cities pay less (lots of doctors want to work in NYC).
If the job was truly that rich, ask yourself, why did the last guy leave?
4🚩 RVU targets that make zero sense
If the hiring medical director can't explain to you in simple terms what goes into RVU calculations and payouts, means they don't plan on paying out much.
The Medical Director is solely responsible for being a liason to the finance department for RVU calculations. If the Med. Dir. can't verify for you, no one will be able to.
This may be intentional, or more likely unintentional. Either way, don't let the math scare you. If you are thinking it doesn't make sense, other docs all probably sat in your seat and thought the same thing. If they can't explain it, means it is going to be a hellish conversation to discuss in any future meetings.
5🚩They want you to sign fast
A great job will never rush you. But a bad one? They’ll say things like:
“We really need an answer by Friday.”
“The offer changes if you wait.”
“Everyone else signs right away.”
Take your time. Ask more questions. Talk to the actual docs currently working there.
6🚩 They have no established backup for Obstetrics.
No matter where you are planning to go, the department should have a simple codified procedure on what to do during cases of emergent labor and delivery. This is a simple way of gauging if the department leadership has your back or not.
Even if it is to stabilize and transfer, that number and pathway should be established long before you get there.
Because Tocolytics and Duct Tape is not a plan..
7🚩 Contract details that feel sketchy
There is a lot in the physician contract that is boiler plate and routine. Although, you should be on high alert if you see:
Non-compete that covers an entire large city or state (many times these are non-enforceable regardless).
No clear termination clause.
Important promises are NOT in writing.
You are going to want to not ask tough questions and want to be the nice applicant and agree to "handshake" deals. Just remember that if it's not in writing, it doesn't exist.
********** Final Takeaway **********
You worked too hard (at least 15 years) to not land a job that you love. A great offer isn’t just about the money. Do what you love and find a job that give you:
A schedule that supports your life
A culture that respects physicians
Pay that actually makes sense
A contract that protects you
You CAN have it all, and in-fact, in every other industry 15 years buys you at least that. Your first year as an attending should be exciting, not terrifying. Look out for the signs — and choose a job that lets you Just DO MD.
