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I recently interviewed and was offered a position in Family Medicine. I spoke with the recruiter today who said that a 'letter of intent' would be sent to me as well as a sample contract, but the organization does not allow for an actual contract to be signed until after I graduate and am certified. 

Is this normal? It seems like a huge red flag since the 'letter of intent' is generally not a legally binding agreement. 

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I've personally never heard of that in medical jobs. By doing this, they're not putting any skin in the game, which is a small red flag to me. After all, you want an employer who wants you and shows it. A letter of intention to me is just words. But to play devil's advocate, from their point of view, they don't know you and don't want to commit to someone who still may not be able to practice if they don't pass but they still want to get someone at least lined up. From yours, you're relying on them to hold up their end when you do graduate. However, there's no contract so there's no guarantee that you'll have a job available.

My employer had a clause in my contract stating that I must be licensed, so that solved that problem for me. So even though I signed the contract prior to graduation, my start date was set after I was assumed to have passed my boards and they paid for my licensing, credentialing, and a signing bonus. They went out on a limb for me by committing to me as an unproven student. 

You can ask if they would commit to you by offering a contract and include a clause about being licensed to practice. If not, tell them that you need some kind of skin in the game to show they are serious about hiring you as a post-grad, like a signing bonus or paying for licensing. If not and you still want to take the job, keep networking and interviewing in the unfortunate event they don't hold up their end. 

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