self-made, I know, I got lucky with that. It was very important for me to find a job before leaving, and I started to lose hope...but things happen when you least expect them. So I'm happy with the way things are coming together.
As for vacations...that's the way I planned it - to go to Russia before starting a job, because once you start it's almost impossible to get a 2-4 weeks off right away. I should have gone in August, but when buying the tickets I wanted to give myself some cusion time, in case I had to retake my Boards. Fortunately though, the person I am replacing is leaving sometime by the end of September, so it's working out well for everyone. And yes, I'd like to think that if they really want you, they'll understand, but...there are no irreplaceble people.
Good luck with your job search. I'm sure you' find something great with your excellent skills and experience.