Switching Jobs Safely: Timeline for Resigning, Negotiating, and Start Dates

The most common mistake physicians make when switching jobs is moving too fast.

You do not resign first. You do not negotiate last. And you definitely do not trust start dates until the ink is dry and credentialing is underway.

Here is the correct, safe sequence—month by month, week by week, right down to when you send which email.

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6–9 Months Before Your Planned Start Date: Quiet Prep, No Sudden Moves

At this point you should be thinking, not acting loudly.

Step 1: Define your “must‑haves” and “never‑agains”

Before you talk to a single recruiter, write this down:

• Minimum base salary and target total comp (base + bonus + call pay)
• Schedule boundaries (clinic hours, call, weekends)
• Non‑compete tolerance (geography and time)
• Deal breakers from your current job (“no more 1:3 Q3 home call with 30 calls per night”)

If you do not know your current market value, you are negotiating blind. Get real numbers:

• MGMA or AMGA data if you can access it
• Ask trusted colleagues what they are actually making (not what’s “typical”)
• Look at posted ranges for similar roles in your region

Typical Physician Offer Timeline (Months Before Start)

Category	Value
-9	0
-8	5
-7	20
-6	40
-5	65
-4	80
-3	90
-2	97
-1	100

Step 2: Pull your current contract and read the traps

At this point you should know exactly what you are leaving.

Highlight:

• Notice period (60, 90, 120 days?)
• Non‑compete: radius, duration, scope (hospital vs group vs entire system)
• Repayment clauses:
  • Sign‑on bonus
  • Relocation
  • Loan repayment or stipends
  • CME or board fees
• Malpractice:
  • Who pays for tail if you leave?
  • Claims‑made vs occurrence

You are building a checklist of “exit costs” so your new deal either offsets them or explicitly accounts for them.

Step 3: Quietly update your professional profile

No “Excited to explore new opportunities!” posts. You are still employed.

Instead:

• Update CV: clear dates, procedures, volumes, leadership roles.
• Clean up LinkedIn and Doximity with current, accurate info.
• Make a confidential email for job search (not your hospital email).

At this stage you do not:

• Tell partners you are “thinking of leaving”
• Give soft verbal notice
• Commit to a specific start date anywhere

You are gathering leverage, not starting fires.

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4–6 Months Before Planned Start Date: Interviews and Offers, Still No Resignation

This is when the clock really starts.

Safe Physician Job Change Flow

Step	Description
Step 1	Identify Market Value
Step 2	Review Current Contract
Step 3	Apply and Interview
Step 4	Receive Written Offer
Step 5	Negotiate Terms
Step 6	Signed Contract
Step 7	Credentialing Starts
Step 8	Give Formal Notice
Step 9	Transition and Start New Job

Month −6: Initial interviews and rough timeline

At this point you should be interviewing and planting the “start date” flag in every conversation.

When a recruiter asks, “When are you looking to start?” your answer should sound like:

“Realistically, 4–6 months from a signed contract. I have a [90]-day notice obligation and typical credentialing time. So if we sign in [Month X], a [Month Y/Z] start is realistic.”

You just:

• Set expectations early
• Signaled that you respect your current contract
• Gave yourself a buffer

Month −5: Push for written offers only

Verbal “we’ll pay around $320K” means very little. At this point you should:

• Continue interviews but push serious prospects to a written Letter of Intent (LOI) or offer.
• Make sure written offers specify:
  • Base salary
  • Bonus / RVU structure and threshold
  • Call pay
  • FTE status and clinical hours
  • Expected start date (labeled “anticipated” or “target”)

Never resign based on a verbal offer. I have seen physicians do this and end up unemployed for six months when admin “restructured the position.”

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3–4 Months Before Planned Start: Negotiate Hard, Lock Terms, Still Do Not Resign

This is the negotiation window. This is where most people get the order wrong.

Month −4: Systematic offer comparison

If you have more than one offer, you need structure, not vibes.

Item	Offer A	Offer B	Offer C
Base Salary	$280K	$310K	$295K
Bonus/RVU Threshold	5000 RVU	6000 RVU	5500 RVU
Non-compete Radius/Time	10 mi / 2 yr	20 mi / 1 yr	None
Tail Coverage	Employer	Split 50/50	Physician
Sign-on / Relocation	25K / 10K	15K / 5K	30K / 15K

At this point you should:

• Build a simple table like this for your real offers.
• Assign weight to each line item:
  • Non‑compete and tail coverage are often worth more than an extra $10K base.
• Decide your negotiation priorities:
  • Example: “I will trade $10K of base for employer‑paid tail and no non‑compete.”

Week‑by‑Week in Month −4

Week 1–2: Contract review

You send the draft contract or LOI to:

• A physician contract attorney with real healthcare experience
• Optional: a trusted senior physician who has seen multiple contracts

Tell them your goals:

• “I need employer‑paid tail.”
• “I cannot accept more than 10‑mile non‑compete.”
• “I must have a target start date of August 1 with flexibility up to September 1.”

Week 2–3: First pass negotiation

At this point you should push for:

• Compensation:
  • Base and realistic RVU or productivity targets
  • Call pay explicitly defined
• Legal / risk:
  • Non‑compete narrowed or deleted
  • Employer‑paid malpractice tail, or a tail stipend negotiated
• Logistics:
  • Clear statement: “Anticipated start date: [Month Day, Year], subject to credentialing and mutually agreed upon adjustments.”

This is also when you look back to your current contract:

• If you need 90 days’ notice, count backward from your target start date.
• Build at least 30 extra days of buffer for credentialing delays.

Example:

• Desired new start: September 1
• Notice period: 90 days
• Latest safe resignation date: June 1
• Add 30‑day buffer for delays → target to have contract signed and credentialing started by May 1

You do not leave a 2‑week gap. You leave a 4‑ to 8‑week cushion.

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2–3 Months Before New Start: Signed Contract, Credentialing, Then Notice

Here is the critical rule: Contract signed and credentialing initiated before you resign.

Risk Level by Resignation Timing

Category	Value
Before Offer	100
Verbal Offer Only	80
Signed Contract	40
Contract + Credentialing	10

Month −3: Signed contract and onboarding paperwork

At this point you should have:

• Final contract language agreed
• Target start date in writing
• Clear details on:
  • Who pays for tail
  • How non‑compete interacts with your current job’s radius
  • Sign‑on bonus timing and repayment terms

Only now do you sign.

Immediately after signing, you:

• Complete the new employer’s credentialing packet within days, not weeks.
• Send all required:
  • Licenses
  • DEA
  • Board certification
  • References
  • Case logs or procedure numbers

You ask one pointed question:

“Based on your typical timelines, when do you expect hospital credentialing and payer enrollment to be complete for my start?”

If they say “maybe August, maybe October,” you do not give June notice with a September start. You delay your notice until there is real progress.

Month −2.5 to −2: Safe window to give notice

Now you do the math.

Example timeline:

• Target new start date: September 1
• Notice requirement: 90 days
• Today’s date: May 20
• Credentialing packet: submitted May 1, in progress

At this point you should:

• Confirm with new employer:
  • “Are we still on track for a September 1 start?”
  • Get an email from credentialing or HR with their best estimate.
• If it aligns, schedule resignation for early June (about 85–100 days before new start).

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Scripted Exit: How to Actually Resign (And What Day to Do It)

Week‑by‑Week in the Notice Month

Week 1: Verbal + written notice

You do this in order:

1. Meet with your direct leader (department chair, medical director, or practice owner).

   • Do it early in the week, early in the day.
   • Script:

     “I have accepted another position that better fits my family and long‑term goals. Per my contract, I am giving [90] days’ notice. My last working day will be [Date]. I am committed to a smooth transition.”

2. Follow up with a brief written notice the same day.

   • One paragraph, not a therapy letter.
   • Include:
     • Today’s date
     • Contract reference (“Pursuant to Section X of my employment agreement…”)
     • Final working date
   • Send to:
     • Your leader
     • HR or practice manager
     • Keep a copy.

3. Do not trash‑talk the place on your way out. Medicine is small and vengeful.

Week 2: Clarify logistics and money

At this point you should:

• Request a written summary of your exit financials:
  • Unpaid bonus structure and timing
  • PTO payout or loss (check contract and state law)
  • Outstanding repayments (sign‑on, relocation, stipends)
  • Final paycheck date
• Confirm malpractice tail:
  • Get it in writing from risk management or HR that:
    • Tail will be purchased by [who]
    • Coverage dates and retroactive date
• Align your last day:
  • Protect at least one week free between jobs if possible.
  • Avoid a last day that is also a heavy call day.

Week 3–4: Transition plan

You build a basic plan with your group:

• Last new patient date
• Handoff of complex patients
• Outstanding projects or leadership duties
• How in‑basket messages and test results will be handled after you leave

You document this in a short email so nobody can later claim “abandonment.”

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The Gap Between Jobs: Financial and Legal Safety Checks

You should plan for a possible unpaid gap, even if you hope to avoid it.

1–2 Months Before Leaving: Cash and coverage

At this point you should:

• Have 3–6 months of living expenses available (savings or credit line).
• Understand:
  • When your current health insurance ends (last day of employment or end of that month).
  • When your new coverage begins (often first of the following month after start).

Schedule:

• If there is a gap:
  • Evaluate COBRA vs marketplace short‑term coverage.
  • Explicitly plan for continuity of expensive meds, maternity care, etc.

Retirement and tail risk

Before your last paycheck:

• Maximize any:
  • 403(b) / 401(k) contributions you intend to make.
  • HSA contributions if you are switching plans.
• Get confirmation on:
  • When you become ineligible for the old plan.
  • How vesting works for any employer match or pension.

On malpractice:

• If you are responsible for tail:
  • Get actual quotes from carriers.
  • Ask your new employer explicitly: “Will you reimburse part or all of my tail as part of my signing package?”
• Do not have a day where you see patients without active coverage.

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0–1 Month Before New Start: Coordinating Start Date, Schedules, and First Check

Month −1: Locking in the start date in reality

At this point you should:

• Confirm with new employer:
  • Start date
  • Orientation date(s)
  • First clinic/OR day
• Confirm:
  • Payer enrollment complete for major insurers (Medicare, Medicaid, big commercial plans).
  • Hospital privileges approved and start date active.

If a payer is delayed:

• Verify:
  • Will you still be paid a guaranteed salary even if collections lag?
  • Are they planning to delay your start or limit your schedule?

Push for written clarity. Vague promises here turn into months of “accounting adjustments” later.

2–3 Weeks Before Start: Practical setup

You handle the boring but painful things:

• Licensure:
  • Confirm all state licenses, DEA, and controlled substance registrations align with the new practice location.
• Addresses:
  • Update NPI address.
  • Update state boards, medical staff offices, and professional organizations.
• Banking:
  • Set up direct deposit info for new employer.
  • Plan for gap between last old paycheck and first new one (often 2–4 weeks).

Common Timing Between Last and First Paycheck

Category	Value
0-2 weeks	20
3-4 weeks	50
5-6 weeks	20
7+ weeks	10

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First Week in New Job: Verify Compensation Matches the Contract

At this point you should shift from survival to verification.

Day 1–5 Checklist

You sit down with HR or your practice administrator and confirm:

• Base salary
  • Annual amount and per‑paycheck gross.
• Bonus structure
  • When RVU or productivity calculations occur.
  • When quality or performance bonuses are paid.
• Call pay
  • Exact nightly/weekend rates.
  • How and when it is logged.

You keep a copy of:

• Signed contract
• Any addenda or amendments
• Email chains confirming unusual arrangements (tail reimbursement, sign‑on timing, repayment rules)

If anything does not match the contract:

• Flag it early, in writing.
• Attach the relevant contract section when you ask for correction.

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Putting It All Together: A Compact Timeline

Here is the “if you remember nothing else” version.

Month-by-Month Job Switch Timeline

Task	Details
Preparation: Define goals and review contract	a1, 2025-01-01, 60d
Preparation: Quiet job search and interviews	a2, 2025-02-15, 60d
Offers and Negotiation: Receive and review offers	b1, 2025-04-15, 30d
Offers and Negotiation: Legal review and negotiation	b2, 2025-05-15, 30d
Commitment: Sign contract	c1, 2025-06-15, 5d
Commitment: Credentialing and enrollment	c2, 2025-06-20, 75d
Transition: Give notice at current job	d1, 2025-07-01, 90d
Transition: Exit planning and financial prep	d2, 2025-07-01, 90d
Start New Job: Orientation and first clinic	e1, 2025-10-01, 14d

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Three Things You Should Not Forget

1. Sequence matters more than speed. Signed contract and credentialing underway come before notice. Every time.
2. Total package > headline salary. Tail coverage, non‑compete scope, and start‑date reliability can easily outweigh an extra $10K–$20K in base pay.
3. Buffer saves careers. Leave weeks of cushion between last day and assumed start day, and months of cash buffer in case credentialing or payers drag their feet.

If you follow the timeline—define, compare, sign, credential, then resign—you will switch jobs with your income, license, and sanity intact.