Back to Insights
Recruitment Strategy

The First 90 Days After You Hire

How Smart Onboarding Prevents Turnover and Builds Loyalty

October 15, 2024
11 min read
First 90 Days Onboarding

Introduction

Hiring a great clinician is only half the battle. Without a strong start, even the best new hire can become an early turnover statistic.

Industry research shows 23% of healthcare hires leave within their first year, and most departures trace back to poor onboarding—not poor performance.

At MedStaff Nationwide, our data proves a structured 90-day onboarding plan can cut first-year turnover by more than 50%. The first three months are your opportunity to deliver clarity, connection, and confidence. Here's exactly how to do it.

Why the First 90 Days Matter

Within the first month, 40% of new hires question whether they made the right decision. That moment of doubt—often triggered by confusion, isolation, or lack of feedback—determines long-term retention.

The ROI of Strong Onboarding

  • • Saves $150K–$300K in replacement costs per clinician
  • • Boosts engagement and productivity within 30 days
  • • Strengthens employer reputation and referral hiring
  • • Increases patient continuity and satisfaction

When onboarding is intentional, retention becomes predictable.

Days 0–30: Lay the Foundation

Pre-Day 1

  • ✓ Send a personalized welcome packet including parking info, first-day agenda, and local resources
  • ✓ Assign a peer mentor and introduce them via email before start date
  • ✓ Ensure IT setup is complete—email, EMR access, and workstation ready
  • ✓ Share a first-week schedule so there are no surprises

Day 1

  • ✓ Begin with a personal welcome from leadership—not just HR
  • ✓ Provide a facility tour and introductions to every department the clinician will interact with
  • ✓ Host a team lunch or coffee break to encourage early relationship building
  • ✓ Review mission, values, and organizational structure in human terms

Week 1

  • ✓ Conduct EMR and systems training (don't expect "figure it out")
  • ✓ Schedule shadowing time with senior clinicians and support staff
  • ✓ Verify that all credentialing items and security access are complete

Weeks 2–4

  • ✓ Gradually increase patient load: 50% → 75% → 100%
  • ✓ Hold weekly one-on-one check-ins between the new hire and their supervisor
  • ✓ Discuss CME or professional development interests early
  • ✓ Encourage informal social touchpoints—lunch, coffee, case discussions

Days 31–60: Build Integration

Clinical Integration

  • • Full patient panel with growing independence
  • • Attendance at department or case review meetings
  • • First exposure to quality metrics (purely educational)

Relationship Building

  • • One-on-one meetings with key leadership team members
  • • Peer mentor check-ins transition from weekly to biweekly
  • • Offer community integration support for relocating clinicians

Feedback Loop

  • • Host a 30-day feedback session: "What's working? What's confusing?"
  • • Document action items and follow up the next week

Days 61–90: Strengthen Commitment

Career Path & Development

  • • Discuss long-term goals and how they connect to organizational pathways
  • • Identify CME funding or certifications aligned with those goals
  • • Map potential leadership or committee roles for year one

Performance Calibration

  • • Review quality metrics together and celebrate early wins
  • • Address small issues before they grow—coaching, not criticism
  • • Reaffirm mission alignment and team impact

90-Day Formal Review

Schedule a structured conversation covering:

  • • Job satisfaction and workload
  • • Peer relationships and support
  • • Career growth expectations
  • • Next 90-day goals

This conversation should end with written commitments from both sides.

Manager's 10-Point Checklist

Use this every time you onboard a clinician:

✓ Welcome plan sent one week pre-start

✓ Mentor assigned and introduced

✓ IT and workspace ready on Day 1

✓ Leadership welcome + facility tour completed

✓ EMR and systems training scheduled

✓ Weekly one-on-one check-ins booked for first month

✓ 30-day feedback meeting held and documented

✓ Career development conversation by Day 60

✓ 90-day formal review on calendar

✓ CME budget and first-year goals confirmed

How MedStaff Nationwide Helps Employers Execute

Our recruiters don't stop at offer acceptance. Every client receives MedStaff's Onboarding Blueprint, built from thousands of successful placements.

Key features include:

Credentialing acceleration

Pre-collected candidate packets cut start times to 26 days (42% faster than industry average)

Automated AI reminders

Proprietary tech, developed by President Pat Raymond, keeps both HR and clinician on schedule

Retention analytics

Post-hire follow-ups at 30, 60, and 90 days to identify early risk factors

Result: smoother starts, stronger retention, and fewer re-hires.

Conclusion

The first 90 days define every hire's trajectory. When onboarding is personal, structured, and data-driven, clinicians feel valued—and they stay.

Hospitals and clinics that follow this model consistently see lower turnover, higher morale, and measurable ROI.

MedStaff Nationwide provides the frameworks, automation, and recruiter follow-through to make it happen.