GI fellowship job search timeline

A month-by-month plan for the job search in your last 18 months of fellowship. Not legal or immigration advice: confirm timing with the official sources linked here and with your program.

15 to 18 months before you finish

Decide what you want

  • Practice type: academic, hospital-employed, VA, independent private practice, or a private equity or corporate platform. See who owns GI practices.
  • Procedure mix: general GI, or a real ERCP/EUS practice. When we have the data, the job page shows the Medicare procedure mix within 30 miles.
  • Geography and family constraints. Compare states on the GI market table.
  • Talk to recent graduates of your program about their first contracts.
  • Set up job alerts and save jobs you like with the Save button.

12 to 15 months before

Apply and interview

  • Apply on the employer site. Every DigestiveJobs listing links to the employer careers page.
  • Use the "what to ask" list on each job page in your interviews: pay model, call, partnership terms, schedule, ERCP/EUS volume, APP support, malpractice tail, noncompete, visa.
  • J-1 physicians: check your Conrad 30 eligibility first. USCIS says that unless Congress extends the program, physicians admitted in or acquiring J-1 status on or after October 1, 2025 are not eligible; those with J-1 status by September 30, 2025 still are. If you are eligible, Conrad slots run on the federal fiscal year (October 1 to September 30), many states open around October 1, and some fill fast, so line up an employer and your state early. Most slots require a shortage area; up to 10 of a state's 30 can be "flex" slots outside one, and state rules differ. If Conrad is not open to you, ask about interested government agency waivers (for example VA, HHS, the Appalachian Regional Commission, or the Delta Regional Authority). State J-1 contacts.
  • H-1B physicians: four kinds of employer are exempt from the H-1B lottery: universities, nonprofits related to or affiliated with them, nonprofit research organizations, and governmental research organizations (USCIS). Affiliation is a legal test, so confirm who files the petition. Separately, an H-1B that follows a Conrad 30 or government-agency J-1 waiver is also exempt from the cap. See which employers have filed for GI physicians on the H-1B page.

9 to 12 months before

Compare offers and negotiate

  • Put offers side by side in the offer calculator: state tax, cost of living, 5-year cash, PSLF eligibility, local market.
  • Check how long the role has been open (job page, Posting history). Roles open 6+ months are often negotiable.
  • Have a lawyer who reviews physician contracts read the agreement before you sign.
  • Then share your offer anonymously so the next fellow sees real numbers.

6 to 9 months before

Sign, then start paperwork early

  • State medical license: timelines vary by state; some take months, so apply as soon as you sign. The Interstate Medical Licensure Compact speeds up extra licenses, but it needs a full unrestricted license in a member state and current board certification, so it usually cannot get a fellow a first license.
  • DEA registration and state controlled-substance registration after the license, where required.
  • Hospital credentialing and privileges plus insurance enrollment often take 3 to 6 months. Send documents as soon as the employer asks.
  • Plan for the ABIM gastroenterology certification exam on ABIM's current schedule.

Final 3 months

Before day one

  • Confirm your start date against license and credentialing status in writing.
  • Confirm malpractice coverage type (occurrence or claims-made) and who pays for tail if you leave.
  • If you have federal student loans and a nonprofit or government employer, look into Public Service Loan Forgiveness at studentaid.gov.

Questions

When should a GI fellow start looking for a job?

About 15 to 18 months before fellowship ends, so that interviews, offers, licensing, and hospital credentialing (often 3 to 6 months) all fit before the start date. J-1 physicians should start earlier and first check Conrad 30 eligibility: USCIS says physicians admitted in or acquiring J-1 status on or after October 1, 2025 are not eligible unless Congress extends the program.

Which GI employers are exempt from the H-1B lottery?

Per USCIS: universities, nonprofits related to or affiliated with them, nonprofit research organizations, and governmental research organizations. Many academic medical centers qualify, but affiliation is a legal test, so confirm the petitioner. An H-1B that follows a Conrad 30 or government-agency J-1 waiver is also cap-exempt. DigestiveJobs lists employers that have filed H-1B paperwork for GI physicians.