If you’re a 3rd- or 4th-year resident, chances are you’re no stranger to unsolicited job offers showing up in your email inbox. Maybe it’s a few a week, or maybe it’s a few a day, but they are always there. The emails find you. I’ve been out of residency for years and I’m still getting them.

The macro reason for this flood of unsolicited job offers is obvious: You’re in high demand. There are many specialties where the number of job openings far outpace the number of new residents looking for a job, including my own, emergency medicine. Employers need to go looking for you much more than you need to go looking for them.

I received one of these emails just the other day that began thus:

Dr. Irwin: I pasted all of my opportunities in Ohio and Pennsylvania. Please let me know what opportunities you would like to talk with.

I don’t live in Ohio or Pennsylvania, nor do I want to, and in all my medical training I never did learn how to “talk with opportunities.” Bad grammar aside, I was struck by just how impersonal and poorly conceived the solicitation was. It proceeded with a bulleted list of job descriptions and their attendant salary ranges, rough locations, and benefits summaries. It concluded:

Don’t forget to visit our website for other permanent opportunities if these are not your dream jobs.

It got me thinking, just who are these people constantly emailing me job offers, and more interestingly, where did they get my email address?

The who is pretty simple. It’s recruiting, staffing, and medical marketing agencies, which appear to have proliferated beyond all reason. At least once a week, a representative of one of these agencies emails asking if I would like to purchase a list of physician email addresses, usually broken down by subspecialty, region, or job title. I get so many offers to buy your email address, it made me want to learn a bit more about how your precious contact information fell into their hands.

First, let’s state the obvious: You did not opt-in to get job offers from these companies. So why do they have your email address?

The answer is publishing partnerships. In short, you subscribe to a medical journal or a news site that covers your specialty. That journal or news site then takes your email address and any other demographic information it has collected and sells it to marketing companies. These marketing companies in turn either sell or rent your email address to companies which are trying to recruit doctors. If the company is reputable, it will normally send you a welcome email that gives you an opportunity to opt-out.

Sometimes the companies that are trying to hire you go directly to the publishers to get your email address, thus cutting out the middle-man. But that is often much more expensive than going through a marketing company, which has an established relationship with the publisher and is buying or licensing the contact details at huge volume. That, in turn, leads to the sort of disconnected, depersonalized solicitations that I mentioned above.

Sadly, the job search is too often boiled down to a faceless exercise in comparing one per-hour salary to the next without any regard to the kinds of things that bring real job satisfaction: Having autonomy over your life and career, being supported in becoming a better physician, and being a part of something you believe in.

A survey from earlier this year of more than 24,000 physicians found that fully 3 in 4 would choose a different practice setting if they could do it all over again. Perhaps that’s the sort of statistic to be expected when recruiting is reduced to a generic comparison of one dollar amount to the next.

This is not to say money isn’t important to you. Of course it is. We’ve all got bills (and student loans) to pay. But it is to say that the continual clutter of job offers in your email inbox means they all tend to blend together, and when that happens, you are even more inclined to fall back on quantifiable, straightforward measures on which to compare the myriad offers, usually to the detriment of “softer” measures like a good corporate culture or opportunities for growing in your profession.

It’s understandable, but amid the clutter of email job offers, at least one thing is clear: If I were a new doctor reviewing offers, I’m nearly certain that my dream job would not come unsolicited to my inbox.

Jesse Irwin is an emergency physician who blogs at The Shift.