I disagree with the above advice strenuously. While OB/GYN might need such services, EM jobs are plentiful, no services are needed. Here is how I proceeded (as did almost all of my residency classmates).
1. Decide what what you want to do and where (i.e., community versus academic, what area of the country).
2. Make sure your CV is angled toward those things (if you are trying to go academic, it should list every talk you have ever given ever given, for community it should focus on your skill set - specifically things such as ultrasound, moonlighting, unusual features of your residency, etc).
3. Pick 10 places that you thinks you would like to work, regardless of whether or not they are advertising a position.
4. Send CV and a well crafted letter of introduction - both electronically and via snail mail to the chairmen at each of those institutions.
The feedback received from that should dictate further actions.
If you are going for a community job at a specific site that you know is hurting for staffing, they might extend an offer to you as a second year (I have mixed feeling about accepting these offers), OR if you are planning to stay where you are training and they generally extend offers to PGY2s, then you should start talking to those places now.
Otherwise, for a general search starting in August or September of PGY3 at the earliest should work.
A couple words of advice - most residents don't keep their CVs updated. Get it done NOW. Many larger academic institutions publish templates or guidelines. If your program does - use it. Otherwise, find a few faculty and borrow theirs (or PM me and I'll send you one).
The "cover letter" for EM should be a letter of introduction (as opposed to the traditional cover letters the groups like doctorjobs.com will help you author). The formula is simple. First paragraph gives your name, training level and a quick factoid - then proceeds to "kiss ass". Tell the reader why you want to work at their hospital. Second paragraph is a quick blurb about both you and your residency program. End with a statement of how you would reach some goal at their institution and close the letter. That's it.
Have at least 4-5 of your faculty proof the CV and letter, minimum.
Using this "formula", I have a couple of friends that didn't get good responses off of their initially contacts (which is why I wouldn't make more than 10 contacts initially). One of them called where he applied and asked if there was a problem in his application. That was a good move on his part. I don't remember what it was, but the chair instantly told him the problem, he fixed it, and sent the revised CV and letter out to a different group of hospitals. He got interviews from all of those.
I anticipated a much weaker response than I got - the other reason for only applying to 10 off the bat at most. Everywhere I contacted offered me an interview, regardless of having a position available. When it came to scheduling all of these, I had to turn some down (there just wasn't enough time during residency).
At the end of the day, ANY resource (other than free forums like SDN) costs money somewhere. They will charge either you or the hiring institution. The fact is that jobs are too plentiful in EM to take up that cost. It is a waste.
As for a service that "prints out numerous letters to all physicians of your specialty in the area where you want to work", in a field as small as EM, do you really want your CV "out there" as unsolicited junkmail to people other than chairpersons in specific areas of your job hunt?
- H
