A paraphrased reader question:
I am still in the middle of residency but entertaining the idea of doing 100% remote work fresh out of training. I want to live in a rural area out west, so I am thinking of swing shift jobs in CST/EST. Do you have any advice for what to look for in my job search?
In general, compensation and PTO for many smaller or lower-density markets can be shockingly good, so it’s always worth looking at any local options—you may find the balance appealing even if the practice is small or more generalist than your training focus.
For remote work, central/east-coast tele is very reasonable. Generally, most daytime-remote jobs skew toward general and ER work, but as more groups struggle to recruit locally, more are entering the tele market for subspecialty needs as well (if you like general or body imaging, for example, we’re hiring).
If you’re open to swing shifts, one important question is how the exact hours fit into your life. Some shifts would be seamless with the time change; some remain mildly annoying. One upside is that many swing roles have 7/7 or 7/14 scheduling, which opens doors for internal moonlighting, secondary gigs, or a serious hobby. When available, a mix of call styler and non-call work also helps with sustainability and variety. For example, having part of a shift devoted to outpatient and part to inpatient/ER can keep things from becoming a grind (which is what our group did for our swing positions, which have been filled mostly by our own partners).
There’s no real shortcut to finding what you want—you’ll likely need to browse swing listings and see what matches your preferences. Most of these positions are not partnership-track, but occasionally you’ll find one that is. Depending on your plans, a conventional employed position or a contractor arrangement may fit better anyway. Insofar as job security goes, employed swing tele jobs are probably substantially safer than daytime tele.
You can find fully remote daytime work if you’re patient and willing to sift through postings, but those jobs are less common, and you have to accept they often come with less long-term security. The number of groups hiring for daytime tele has been increasing as the on-site recruitment pool dries up nationwide, but it doesn’t mean that those jobs aren’t the first to get cut if the workforce becomes more productive or that those groups are healthy enough to survive until then.
If you want to leverage time zones and earn more for your hours, swing tele is absolutely an efficient solution. The practical constraint for someone in residency is timing: groups usually don’t want to hold a very specific swing opening for someone years away from graduation. Many are also quite reasonably hesitant to place a brand-new graduate on a high-volume, high-stress, high-acuity list. Most good swing slots tend to be filled within a few months. Realistically, you might as well wait until late in R4 or early in fellowship.
Bottom line: explore local options, look closely at swing roles for flexibility and compensation, and expect the real job search to happen closer to the end of training when groups are ready to hire for these specific needs.