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You are in the final year of your residency or fellowship. The anticipation of finishing and moving on to a "real" job (like working 80 hour weeks isn't a real job...) is mounting. You've gotten through med school, internship and years of residency; so how tough can it be to find the perfect job?

A surprising number of all doctors don't stay at their first job. Most have no idea what to look for as they cruise the job market. Here are 10 tips:

1) Find out what they want. When you speak to them, ask what type of skills, interests and procedures they want their ideal candidate to have. If they want a pediatrician with genetic counseling background and you don't have it and don't like it, don't try to fake it.

2) Be honest about your needs. There are 3 things to look for in a medical job - location, practice style, money. You'll probably only optimize 2 of the 3. Sit down and figure out what you need and want.

3) Be honest about your skills. When you apply and interview, make sure you are absolutely clear about what you can do, and what you want to do. If you are a general surgeon and absolutely hate trauma, really consider whether it is worth taking that job at a trauma center just to be in the city and in the salary range you want.

4) Look hard at the area. Not only should you take a realtor tour, but try to spend an additional day driving around the region. Look at nearby cities and recreation. Regional factors may turn a drab opportunity into an acceptable one.

5) Find out where you have to live. Never take a job without clarifying this. Certain medical staffs and accreditation agencies may require docs to be available within a certain amount of time. Don't be surprised when you arrive.

6) Be wary of any group that offers to parallel train (train you in a procedure with an existing member of the group. They may mean well, but it just rarely happens. They're busy, you'll be busy; how realistic is it that someone will stop his clinical practice to stand with and proctor you for a dozen cases?

7) Look at subtle clues - growth in the city; maintenance of physical plant of the hospital. Is it clean? Freshly painted? Are shopping and dining opportunities in line with your expectations? For example, if there are closed down fast food franchises, is that a sign of a robust local economy?

8) Do some homework before you arrive. Know something about the geography of the region, local industries, other hospitals. Look at a map to see what is in the region so when you are talking with potential colleagues about recreation and housing you'll have an idea what they are talking about. Check out http://www.city-data.com).

9) Be wary of citations, accreditations, and awards influencing your decision. Bus advertising touting America's Best Hospitals or media ads featuring smiling nurses are created by the same type of media minds that market Swiffer dusters and Oxyclean.

10) Next tip? Wait for my next article; when I'll include the single most important question you can ask when you are sizing up a possible job.