Director’s Corner: How to Quit Your Job

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The best way to avoid a messy departure.

Dear Director,


I’m starting to look for a new job.  When should I tell my current medical director that I’m leaving? 

With the return of ED volume, I’m definitely seeing the job market improve and we’re seeing some movement of experienced docs go from one site to another, creating a domino effect of opportunity.  As jobs open up mid-year, we are seeing more and more sites looking to fill positions outside of the normal summer starting time.

Contractual obligations


Every director wants to know anytime one of our team members is thinking about leaving.  After all, it takes three to six months to recruit and credential a new physician at a minimum, so the more lead time you can give your director, the better off your group will be once you leave.

With that said, in your contract, there is a very clear statement about giving notice.  It’s likely 90 days.  That time period starts from the time you send your director written notification (email is fine) announcing your resignation.

Prior to giving your resignation, you should make sure that you have a signed contract with a clear start date and if you want to work without any interruption/time off, you should have begun the credentialing process for the new job. Credentialing takes at least 60 days, and usually 90.  If you’ve worked at numerous hospitals, it can even take longer.  While many people like the idea of having time off between jobs, you’ll want to make sure that your start date will allow you to pay the bills.

The reason the contract contains terms around exiting the group is to protect both parties.  I can’t (easily) terminate you quickly, which protects your ability to continue to earn income while you look for a new job and you can’t leave quickly, which protects the ED schedule by allowing management time to fill the shifts.


Why give more notice?

Although every decision to leave a job is based on the individual, often resigning comes down to just a few things: you have a better opportunity (career advancement or money), a lateral move, but the location works better for you (out of town, closer to home), you really don’t like your environment and just want out (boss, coworkers, environment).

I guess the risk of giving your boss a heads up that you’re looking for a new job could be held against you with a bad schedule or not being thought of as a team player, but there are also advantages for you.  I’ve known several docs (some of whom I’ve recruited) who were able to negotiate career advancement or more money once they told their current employer they were leaving and ultimately stayed at their original job, but with add-ons (money, title, responsibility, etc…).

Having a job offer in hand gives you more power to negotiate, but you still should have the conversation with your current employer before you sign a contract.

If you’re looking for a new job related to a particular location, giving your boss a heads up may open the door to their network of contacts.  My personal take is that if you’re going to leave anyway, I may as well help you and a professional contact by connecting the two of you.

If you really just want out of your current environment or to leave your current boss, having that discussion may allow for improvements to be made to the environment or the opportunity to clear the air with the boss.  They could be unaware of your issues and will respect you more for bringing them forward.  With that said, through the years, I’ve had a couple of people give me their resignation, clearly with an “F-U Mike” meant with it.

The reality is that if someone wants to be so petty as to penalize you with a bad schedule because you’re thinking about leaving, then that’s probably not a boss you want. Since leaving your site may leave your docs short staffed, even if you want to leave the boss, most people don’t want to intentionally hurt their colleagues, so any added notice will increase the likelihood that you are replaced in a timely fashion, and your colleagues won’t be picking up extra shifts for long.

Announcing your departure

I always leave it up to the departing doc about how and when to announce their departure. With 90-days notice, I feel like if you announce it too soon, you’ll be saying goodbye for what feels like forever. On the other hand, it shouldn’t be a secret when the schedule is released and you’re not on it.

Everyone’s a little different and it does depend a bit on when the first schedule that you’re not on goes out. Probably 30- to 45-days before your last shift is a very reasonable time to start letting your colleagues and nurses know you’re leaving.

Running through the finish line

Often, your last weeks will determine how you’re remembered by staff and colleagues.  This could be talking up the new job too much, talking negatively about the current ED, showing up late or calling out of shifts.  It’s important to finish like a professional.  This means not only showing up for and being productive on your final shifts, but completing your charts after your shift.

While an incomplete chart impacts billing and hurts your group a little, it really hurts you if there is a bad outcome and any potential litigation. Certainly, if you have administrative responsibilities, you’ll want to wrap them up and insure a transition to a new physician. (I’ve written about succession planning before, which is critical when it comes to transitioning admin or committee responsibility)

I’ve had docs that were leaving after failing a performance improvement plan do so well their last few months the group talked about how great they were.  I’ve had well-liked docs leave that did so little on their last month, people were happy to see them go.  What I shouldn’t need to remind people of — though it is effective — is that emergency medicine is a pretty small community.  I will likely serve as a reference for years, both officially and unofficially, so leaving on good terms is mutually beneficial.

Saying Goodbye

Goodbye doesn’t start when you announce your resignation. Somewhere in that last week or two, there may be some nostalgic moments.  There’s always turnover in EDs and I’ve seen going away parties range from a slap on the shoulder as you empty out your locker to happy hours a week after the last shift. It’s a great opportunity once you’ve left to email your colleagues and/or the staff to say thank you for the experiences.

As tempting as it is when you’re leaving on bad terms or just ecstatic to be gone, it’s not appropriate to make private matters public, but it’s always appropriate to say goodbye and thank you.   It’s also appropriate to use social media, particularly LinkedIn, to make a professional announcement of your transition.


A good bit of a medical director’s job revolves around staffing.  Part of my job is to make sure we have adequate physician coverage so I’m always making some guesses about who might leave, when and why, so I can balance the recruiting that I’m doing with actual job openings.  I currently have providers who are thinking a year or two ahead to retirement and others who are considering changing to part-time status.

Because they’ve come to me so far in advance, I’m able to plan my recruitment efforts and make sure we have appropriate staffing levels.  Each time someone gives me an early “heads up,” it’s usually because they don’t want to see their colleagues be short staffed and have to work “their” shifts when they leave.

While some people are approached about a job and make the decision to leave their current position in under a week, many others dip a toe in the water to see what’s out there and then over time, realize that change is inevitable.  For the doc who makes the decision seemingly overnight, it’s hard to give your current job a longer lead time.

However, if you’re the doc who is starting the search, once you are really looking at viable options, it’s time to consider letting your current employer know. Certainly, if your medical director is expecting you to move (spouse finishing fellowship), being honest and open about a timeframe will benefit you and the team you work with, and it doesn’t mean you won’t be able to stay in your current job if the situation works out that way.  Finally, if you have an administrative role, or you’re looking for a bigger role, you should give your boss more lead time.  It will take time to replace a department leader and there’s always the chance that the role you’re looking for can be created in order to keep you at the site.

At the end of the day, you only need to meet your contractual obligation.  However, your director and your colleagues will appreciate any additional notice you can provide. Even after making the decision to move on, it’s important to finish as a professional.


EXECUTIVE EDITOR Dr. Silverman is Chair of Emergency Medicine at VHC Health. He also taught a leadership development course for over a decade. Dr. Silverman’s practical wisdom is available in an easy-to-use reference guide, available on Amazon. Follow on Twitter @drmikesilverman

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