I am not quite sure what you intend. An example output would have been helpful.

One approach is to construct a hash of FILE1 based upon the NAME.
Read FILE2 and see if any records update JOB for a NAME in FILE1.
I am not sure if this is the intent?

Changing all occurrences of MD -> Doctor without reading FILE2 would be easier, but then what is the point of FILE2?.

#!/usr/bin/perl
use strict;
use warnings;
use Data::Dumper;
use Data::Dump qw /pp/;
$|=1;   #turn off buffering to stdout

use Inline::Files;
use constant {JOB =>0, CITY=>1, STATE=>2};

my %db;

<FILE1>;              #skip first line of file
while (<FILE1>)
{
   next if /^\s*$/;   #skip blank lines in file
   chomp;
   my ($Name, $Job, $City, $State) = split /\s*,\s*/,$_;
   $db{$Name}=[$Job, $City, $State];
}

<FILE2>;              #skip first line of file
while (<FILE2>)
{
   next if /^\s*$/;   #skip blank lines in file
   chomp;
   my ($Name, $Job, $City, $State) = split /\s*,\s*/,$_;
   if (exists $db{$Name})
   {       
       my $current_job = @{$db{$Name}}[JOB];
       if ($current_job ne $Job)
       {
           print "$Name\'s job changed $current_job->$Job\n";
           @{$db{$Name}}[JOB] = $Job;
       }
   }
}

pp \%db;

=Prints
Jim's job changed MD->Doctor
Julie's job changed MD->Doctor
George's job changed MD->Doctor
Uma's job changed MD->Doctor
Pete's job changed MD->Doctor
{
  Bob    => ["Nurse", "Pinole", "CA"],
  George => ["Doctor", "Pinole", "CA"],
  Jim    => ["Doctor", "Pinole", "CA"],
  Julie  => ["Doctor", "San Pablo", "CA"],
  Kate   => ["Nurse", "Oakland", "CA"],
  Pete   => ["Doctor", "San Pablo", "CA"],
  Sherry => ["Nurse", "Pinole", "CA"],
  Tara   => ["Nurse", "San Pablo", "CA"],
  Tim    => ["Nurse", "Pinole", "CA"],
  Uma    => ["Doctor", "San Pablo", "CA"],
}
=cut



__FILE1__
Name, Job, City, State
Jim, MD, Pinole, CA
Tara, Nurse, San Pablo, CA
Julie, MD, San Pablo, CA
Sherry, Nurse, Pinole, CA
George, MD, Pinole, CA
Tim, Nurse, Pinole, CA
Bob, Nurse, Pinole, CA
Uma, MD, San Pablo, CA
Kate, Nurse, Oakland, CA
Pete, MD, San Pablo, CA

__FILE2__
Name, Job, City, State
Jim, Doctor, Pinole, CA
Tara, Nurse, San Pablo, CA
Julie, Doctor, San Pablo, CA
Sherry, Nurse, Pinole, CA
Jan, Doctor, San Pablo, CA
George, Doctor, Pinole, CA
Tim, Nurse, Richmond, CA
Bob, Nurse, Pinole, CA
Uma, Doctor, San Pablo, CA
Kate, Nurse, Oakland, CA
Paul, Doctor, Oakland, CA
Ruth, Nurse, Richmond, CA
Joe, Nurse, Oakland, CA
Nick, Nurse, Pinole, CA
Pete, Doctor, San Pablo, CA
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