Job Search Timing in OB GYN: Essential Guide for Future Attending Physicians

Understanding the Timeline: Why Job Search Timing Matters in OB GYN

The timing of your job search in Obstetrics & Gynecology is not a detail to “figure out later”—it is one of the most important strategic decisions you’ll make as you transition from OB GYN residency to your first attending role. Unlike the tightly scripted process of the obstetrics match for residency, the attending job search is more variable, more regional, and very much influenced by market cycles and institutional budgeting.

For OB GYNs, the physician job market is generally strong, but that doesn’t mean every job is good—or right—for you. Because most OB GYN positions involve call, surgical time, and long-term practice-building, your first job’s structure and location can shape your lifestyle, earning trajectory, and burnout risk for years.

This guide walks through:

• When to start job search planning in residency
• How the OB GYN job market works across regions and practice types
• A practical month-by-month timeline from PGY-2 through your first attending year
• How timing changes for fellowships, J-1/H-1B visas, and academic careers
• Common mistakes in job search timing—and how to avoid them

Whether you’re early in residency or just months away from graduation, you can recalibrate your timeline and approach to maximize options and negotiate from a position of strength.

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Big Picture: How the OB GYN Physician Job Market Works

Understanding how the physician job market operates will help you decide when to move.

1. Supply and demand in OB GYN

OB GYN remains one of the most in-demand specialties:

• High community need, especially in suburban and rural areas
• Increasing number of retiring OB GYNs in many regions
• Ongoing hospital pressure to grow L&D volume and gynecologic surgery lines

However, demand is not uniform:

• Urban coastal cities (Boston, San Francisco, NYC, Seattle) are highly desired; jobs can be more competitive, slower to open, and sometimes lower paying.
• Mid-sized cities and many community hospitals have a steady or urgent need; positions may be posted earlier and offer higher salaries and incentives.
• Rural hospitals and critical access facilities often recruit aggressively and may start contacting residents as early as PGY-2–PGY-3.

2. Hiring and budgeting cycles

Job search timing is influenced by institutional calendars:

• Hospitals & large health systems

  • Budget cycles often run July–June or January–December.
  • New FTEs (full-time equivalents) may be approved 6–12 months before a target start date.
  • Many want new grads to start July–October following graduation.

• Private practices

  • Smaller groups may move faster and hire closer to their immediate need.
  • Some will wait until late PGY-3 or even PGY-4 to firm up a position.
  • Others recruit early if they anticipate a partner retiring or leaving.

• Academic departments

  • Hiring can be slow due to multiple approval layers.
  • They may start exploratory conversations 12–18 months before your start date but finalize offers 6–9 months prior.

3. The “hidden” physician job market

Not every OB GYN position appears on job boards. Many open roles are filled through:

• Internal candidates (fellows, locums, per diem physicians)
• Word of mouth between department chairs and colleagues
• Recruiters who approach candidates directly
• Networking at regional and national conferences

This is why starting early—and letting mentors know your plans—is crucial. The earlier people know your interests (geographic, academic vs community, subspecialty, OB vs GYN balance), the more likely they’ll flag unposted opportunities for you.

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Ideal Timeline: From OB GYN Residency to First Attending Job

Below is a structured timeline assuming:

• You complete a 4-year OB GYN residency (no fellowship)
• You will start your attending job in July–October after graduation

If your path differs (fellowship, visas, gap year), we’ll address that later.

PGY-1: Foundation and exploration (no pressure yet)

Primary goals:

• Learn the field and figure out what you enjoy most:
  • High-risk OB? MIGS? General OB GYN? Ambulatory GYN?
• Pay attention to:
  • Your comfort with OB call and nights
  • How you feel about long cases vs clinic-heavy days
  • The academic vs community environment

What to do in PGY-1 about job search:

• Observe what your attendings do:
  • Who is in private practice vs hospital-employed vs academic?
  • Who seems satisfied with their work-life balance?
• Ask informal questions:
  • “How did you find your first job?”
  • “When did you start your attending job search?”

No formal applications yet, but early reflection will make later decisions faster and more targeted.

PGY-2: Clarify career direction and geography

This is when you should start thinking more concretely about your eventual attending job search.

Key decisions to explore:

1. Academic vs community vs private practice

   • Academic:
     • More teaching, research, complex cases
     • Often lower base salary, stronger benefits and academic culture
   • Community/hospital-employed:
     • Mix of OB and GYN, more volume, stable salary
   • Private practice:
     • Potential for higher income with partnership
     • Greater business and administrative involvement

2. Geographic preferences

   • Target 2–4 regions or metro areas, not just one city
   • Consider:
     • Family, partner’s career, schools, cost of living
     • State malpractice environment and OB liability premiums
     • Proximity to tertiary centers and subspecialty support

3. Fellowship vs generalist practice

   • If fellowship is likely (MFM, Gyn Onc, REI, MIGS, FPMRS):
     • Your attending job search shifts to the end of fellowship.
   • If uncertain, talk with multiple faculty in potential subspecialties by mid-PGY-2.

Concrete actions in late PGY-2:

• Draft a simple CV (you’ll refine it later).
• Attend at least one career or specialty conference and visit job booths.
• Have a frank career discussion with:
  • Your program director
  • At least one mentor whose career path you admire

You are not applying yet, but by the end of PGY-2, you should know:

• The general type of practice setting you want
• A short list of geographic areas you’d consider

PGY-3: The critical planning and early application year

For most residents who will practice as general OB GYNs after residency, PGY-3 is when you should actively begin your attending job search.

Early PGY-3 (July–November): Preparation and networking

1. Polish your professional materials

• CV:

  • Include education, training, research, presentations, leadership roles.
  • Highlight OB GYN-specific experience: surgical case volume, L&D responsibility.

• Cover letter template:

  • One base version you can tailor to each job.
  • State:
    • Training program
    • Expected graduation date
    • Practice type and geographic preferences
    • Why you’re interested in their organization/region

2. Clarify your “non-negotiables” vs “flexible” items:

• Non-negotiable:

  • Geographic constraints (partner’s job, family responsibilities)
  • Type of practice (must be hospital-employed, must have Gyn Onc support, etc.)
  • Minimal OB or GYN volume you’re comfortable with

• Flexible:

  • Start date within a few months
  • Exact call schedule structure (Q4 vs Q5, for example)
  • Mix of OB vs GYN within a certain range

3. Start networking deliberately

• Tell your program leadership your plans:
  • “I’d like a hospital-employed OB GYN position in the Southeast, starting August after graduation.”
• Email trusted attendings:
  • “If you hear of opportunities in [regions], I’d love to be considered.”
• Go to regional and national OB GYN meetings:
  • ACOG District meetings, national ACOG, subspecialty society events.
  • Visit recruiter booths; collect cards; briefly introduce your interests.

Mid PGY-3 (December–March): Start applying—earlier than you think

This is prime time to move from “planning” to active applications, especially if you have specific geographic needs.

Why you should start now:

• Many hospital systems recruit 9–12 months before your start date.
• Academic departments often move slowly; initial conversations may start now, with offers later in PGY-4.
• Desirable metro areas may fill their limited positions early.

Concrete steps:

1. Identify job sources:

   • Large health system and hospital websites
   • National job boards (e.g., ACOG Career Center, general physician job sites)
   • Email from recruiters and agencies
   • Word-of-mouth leads from your mentors

2. Send initial inquiries:

   • For posted jobs:
     • Apply through formal channels and email a short note + CV to the listed recruiter or department chair.
   • For desired regions without posted jobs:
     • Email OB GYN department chairs or medical directors:
       • Introduce yourself, note your training and timeline, and ask if they anticipate hiring.

3. Begin informal and formal interviews:

   • Many first conversations are via:
     • Phone or Zoom
     • Informal “get to know you” calls with chairs or recruiters
   • Have a standard set of questions ready:
     • Call structure and coverage
     • OR block time and surgical mix
     • Composition and age distribution of the group
     • Support services (MFM, anesthesia coverage, NICU level, hospitalist OBs)

Late PGY-3 (April–June): Narrowing options and site visits

By late PGY-3, you should have several active leads if you are targeting a typical July–October post-graduation start.

Your goals in this phase:

• Move from broad exploration to serious contenders
• Schedule in-person site visits for your top 2–4 choices
• Start comparing offers and practice cultures

Site visit timing considerations:

• Plan around your call schedule and major rotations.
• Many programs will:
  • Allow use of vacation time or professional days for interviews
  • Require advance scheduling—coordinate early with chief residents and program leadership.

During site visits, assess:

• Culture:
  • How do partners interact? Do they speak positively about leadership?
• Operations:
  • Clinic support, L&D staffing, EHR, surgical scheduling.
• Lifestyle:
  • Typical weeks on L&D vs clinic vs OR
  • Realistic call burden and how post-call time is handled

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PGY-4 and Beyond: Offers, Contracts, and Final Timing

Early PGY-4 (July–October): Finalizing offers

By early PGY-4, most non-fellowship-bound OB GYN residents should:

• Have completed at least 1–2 site visits
• Be in serious discussions with multiple potential employers
• Start receiving or requesting written offers and contracts

Why this timing matters:

• Having offers in hand by the first half of PGY-4:
  • Reduces anxiety about the future
  • Gives you leverage to negotiate terms
  • Allows sufficient time for credentialing, licensure, and relocation planning

If you reach October–November of PGY-4 without strong leads and you are not geographically restricted, you’re not “too late,” but you should:

• Increase your search radius to more regions and settings
• Tap mentors aggressively for leads
• Be flexible on start dates or practice structure if needed

Contract review and negotiation

Contract negotiation is where job search timing directly impacts your power:

• If you start late and have only one offer:
  • Your leverage is limited; you may feel forced to accept less favorable terms.
• If you start early and have multiple offers:
  • You can politely leverage other options to improve salary, call distribution, or support.

What to do when you receive a contract:

• Never sign immediately.
• Engage a healthcare or physician contract attorney, ideally one familiar with OB GYN in your state.
• Specific issues for OB GYN to review:
  • Malpractice coverage and tail coverage responsibility
  • RVU expectations and productivity bonuses
  • OB call schedule and expectations for C-section availability
  • Non-compete radius and duration, considering your long-term plans

This review and negotiation process can take 2–6 weeks or longer, especially in large organizations. Starting early gives you that time without jeopardizing your start date.

Mid–Late PGY-4 (November–May): Licensure, credentialing, and Board prep

Once you sign:

• Begin state medical licensure immediately (can take months).
• Start hospital privileging and payer credentialing:
  • The employer usually initiates this, but you must provide extensive documentation.
• Confirm:
  • Target start date
  • Orientation schedule
  • Relocation timelines

Simultaneously, you are:

• Preparing for ABOG written boards (and eventually oral boards).
• Finishing residency responsibilities and leadership roles.

Having your job settled by late PGY-4 frees mental space for board prep and a smoother transition.

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Special Situations: How Timing Shifts for Different Paths

1. Fellowship-bound OB GYN residents

If you are pursuing fellowship (MFM, Gyn Onc, REI, MIGS, FPMRS, Complex Family Planning), your attending job search timeline generally shifts to the end of fellowship, but planning still starts earlier.

• During residency:

  • Focus on the obstetrics match for fellowship and strong applications.
  • Use the same exploration principles to understand long-term career goals.

• During fellowship:

  • For a 3-year fellowship:
    • Start serious attending job search in early 2nd year.
  • For a 2-year fellowship:
    • Start serious search in late 1st year or very early 2nd year.

Many academic and tertiary centers will contact fellows 12–18 months before completion for subspecialty positions. Community and regional hospitals often recruit MFM and Gyn Onc well before graduation due to high demand.

2. International medical graduates and visas (J-1 / H-1B)

Visa status significantly affects when to start job search planning.

• J-1 waiver positions:

  • Typically concentrated in rural or underserved areas.
  • Many states have annual caps and early opening dates.
  • You should:
    • Start exploring J-1 waiver options at least 18–24 months before graduation.
    • Contact attorneys and potential employers early, as the paperwork and timing are rigid.

• H-1B positions:

  • Fewer employers offer H-1B due to cost and complexity.
  • Start your search earlier than US grads—ideally early in PGY-3—focusing on employers known to sponsor H-1B.

In either case, your question is not just when to start job search but which employers can meet your visa needs. Starting early gives you time to adjust your geographic expectations if needed.

3. Academic careers with research focus

If you aim for a research-heavy academic career:

• Begin conversations with potential mentors and department chairs as early as PGY-3.
• Consider:
  • Additional research training (e.g., MPH, clinical research fellowship)
  • Securing protected time and startup support in your contract

Academic OB GYN positions can take longer to design and approve, so you may need more time between initial contact and finalized offer.

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Common Mistakes in Job Search Timing—and How to Avoid Them

Mistake 1: Starting the attending job search too late

Many residents assume they can wait until PGY-4 to think about jobs. This often leads to:

• Fewer offers
• Less geographic choice
• More pressure to accept a suboptimal position

Avoid it by:

• Starting active exploration and outreach in mid PGY-3.
• Aiming to have at least a couple of serious prospects by the start of PGY-4.

Mistake 2: Being overly rigid about location too early

It’s reasonable to have geographic preferences, but being fixed on a single neighborhood in one major city can drastically limit options, especially if you’re searching late.

Better approach:

• Define a primary target region and 1–2 backup regions.
• Start early in your preferred region; if options are limited by early PGY-4, expand your search.

Mistake 3: Ignoring the importance of informal networking

Relying only on posted jobs misses the hidden physician job market—openings that never make it to public boards.

Instead:

• Talk openly with mentors from PGY-2 onward about your career interests.
• Attend OB GYN conferences and engage with recruiters and faculty.
• Let fellowship and senior residents know what you’re looking for—they often hear about upcoming needs first.

Mistake 4: Underestimating contract review time and complexity

Some residents assume they can sign quickly once an offer arrives, only to be surprised by complex malpractice, tail coverage, and non-compete provisions.

Avoid it by:

• Building at least 4–6 weeks into your timeline for contract review and negotiation.
• Identifying a qualified contract attorney before your first offer arrives.

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Putting It All Together: A Simplified Timeline Snapshot

For a generalist OB GYN resident (no fellowship, no visa issues):

• PGY-1:

  • Observe practice types and career paths; no active job search.

• PGY-2:

  • Clarify long-term interests (academic vs community vs private).
  • Narrow down geographic preferences.
  • Build a preliminary CV and meet with mentors.

• Early–Mid PGY-3:

  • Polish CV and cover letter.
  • Start networking and exploring specific organizations and regions.
  • Start initial outreach and informal interviews (phone/Zoom).

• Late PGY-3:

  • Apply broadly to interesting positions.
  • Complete first round of site visits.

• Early PGY-4:

  • Conduct remaining site visits.
  • Receive offers and start contract review and negotiation.

• Mid–Late PGY-4:

  • Finalize contract.
  • Complete licensure and credentialing.
  • Prepare for boards and plan relocation.

This spacing gives you the best chance to match your job to your priorities, negotiate effectively, and transition smoothly from OB GYN residency to your attending job.

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FAQs: Job Search Timing in OB GYN

1. When should I realistically start my attending job search as an OB GYN resident?

For most residents going directly into practice after OB GYN residency, you should:

• Start serious planning and networking in early PGY-3
• Begin active applications and interviews by mid PGY-3
• Aim to have at least one strong offer in hand by early PGY-4

Starting earlier is even more important if you are geographically limited, need visa sponsorship, or are targeting highly competitive metro areas.

2. Is it bad if I don’t have a job lined up at the beginning of PGY-4?

Not necessarily, but by early PGY-4 you should at least:

• Be in active discussions with multiple employers
• Have completed or scheduled site visits

If you reach late PGY-4 with no strong leads, broaden your search area and practice type, and ask your program leadership and mentors to help connect you with recruiters or colleagues in regions of need.

3. How far in advance do hospitals and practices usually hire OB GYNs?

Typical ranges:

• Hospitals and large health systems:
  • Often recruit 9–18 months before desired start date.
• Private practices:
  • Timeframe varies; some hire 6–12 months ahead, others closer to need.
• Academic departments:
  • Conversations can start 12–24 months before start; offers often finalize 6–12 months ahead.

Because these ranges overlap and are not standardized, starting early gives you more options and flexibility.

4. Should I take the first offer I receive, or wait for more?

You do not need to accept the first offer you receive. Ideally, you should:

• Compare at least 2–3 offers when possible
• Consider:
  • Compensation and benefits
  • Call schedule and OB vs GYN mix
  • Culture, location, support resources, and long-term growth

If you receive a strong offer but are still interviewing elsewhere, be transparent about your need for a reasonable decision window. Most employers understand that residents are exploring several options, especially when they begin their attending job search at an appropriate time.

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Planning your OB GYN residency-to-attending transition with clear timing in mind will help you move from uncertainty to a deliberate, informed career launch. The earlier you understand the physician job market and structure your job search process, the more likely you are to land in a role that fits your professional goals, family needs, and long-term well-being.