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Career Coach

Precept to Perm

Published August 20, 2014 2:05 PM by Renee Dahring

I'm seeing a new trend taking hold - it's called "precept to perm." It is hardly a new idea, but it has been given an official name, causing it to trend and become more common. If you are a student, you might have already encountered this phenomenon. If you are a seasoned clinician looking for a new position, it could impact your job search, as well. 

"Precept to perm" refers to the practice of a healthcare organization agreeing to precept a student with the understanding (or stipulation) that the student will then work for the organization upon graduation. In theory, it's a win-win situation. Students benefit by having a guaranteed preceptor, and in return employers have a supply of future clinicians that don't require the energy and expense of recruitment.

We used to see this arrangement play out quite often in the specialties, but in a much less formal way. The difference was that the student wasn't expected to commit to future employment prior to beginning the rotation. Employers tended to be selective and would precept only those students with strong interests in that specialty. Specialties have always liked to train clinicians themselves, and many prefer the "blank slate" of a student or new graduate so that they can train the clinicians to do things the way the practice prefers. This worked quite well because the student didn't have to make a commitment before they were ready and it also kept the employer motivated to provide make a good impression on the student. This mutual tension insured that everyone played nice.

Some are still playing nice. For many students, the precept to perm arrangement will work out just fine. Many students come to love their clinical rotations and like the security of knowing they will have a job waiting for them after graduating. 

But there is also a downside. There will always be some students who don't fit into this model, and as a consequence, they will have trouble finding a clinical site. For example, students who will be relocating after graduation can be shut out of rotations simply because they will be seeking employment elsewhere. There are many students who still aren't really sure what sort of job they want, even up until the day of graduation. Many tell me they feel pressured to "sign-on" before they have made up their minds or risk being passed over. 

Asking students to make commitments to a job that is still 1-2 years away creates stress and takes away from their educational experience. A student's first priority should be their studies while they are in school.

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    Occupation: Nurse Practitioners and NP Recruiters
    Setting: correctional healthcare/career consulting/teaching
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