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What to Know Before You Go Stacy ... Final Thoughts

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Title: What to Know Before You Go Stacy ... Final Thoughts


1
Interviewing for an Academic PositionWhat to
Know Before You Go
  • Stacy Rudnicki, MD
  • Associate Professor of Neurology

2
Overview
  • Academic vs. Private Practice
  • Academic Pathways
  • Promotion and Tenure
  • Departmental Support
  • Salary and Benefits
  • Department Expectations and Protected Time
  • The Interview
  • Final Thoughts

3
Questions to Ask Yourself
  • Do I enjoy research?
  • Do I enjoy writing/can I write?
  • Do I have a single area of interest in which I
    want direct my efforts?
  • Fellowship training
  • Do I enjoy teaching?
  • Do I enjoy the stimulation of continued education
    that an academic center provides?
  • Am I willing to get paid less compared to a
    private practice physician?

4
Finding What is Out There
  • Journals
  • Web sites
  • Meetings
  • Word of mouth

5
What is a Triple Threat?
  • Clinician
  • Educator
  • Researcher
  • Can one person be all three?
  • What about a departmental triple threat?

6
Academic Pathways
  • Tenure
  • Non-tenure
  • This is a system that is in a state of flux and
    varies substantially between institutions
  • What does tenure mean?

7
Tenure Tracks at UAMS
  • Research Clinical Teaching
  • Basic 50-85 5-30 10-30
  • Scientist
  • Clinician- 15-85 5-70 10-50
  • Scientist
  • Clinician 5-15 30-85 10-60
  • Educator

8
Non Tenure Tracks at UAMS
  • Clinical Track

9
Level of Appointment
  • Both tenure and nontenure tracks will have
  • Instructor
  • Assistant Professor
  • Associate Professor
  • (Full) Professor
  • Tenure is typically achieved with promotion to
    Associate professor

10
Initial Level of Appointment
  • Will you be an instructor or an assistant
    professor?
  • At some institutions, if you are not board
    certified you must be appointed as an instructor
  • Appointment as an instructor will allow you
    additional time to get your academic career
    underway
  • or
  • Appointment as an instructor increases your time
    to be eligible for promotion to associate

11
The Move Away From Tenure Tracks
  • Tenure tracks
  • More and more reserved for those with significant
    basic science research
  • Frequently but not exclusively for MD/PhDs
  • Expectation that you will receive competitive
    funding to support yourself
  • Non-tenure tracks
  • Everyone else - including those with teaching,
    clinical, and research responsibilities
  • May be broken down in a similar manner as the
    tenured positions

12
Philosophical Question
  • If you are a clinician, clinical researcher and
    or teacher applying for a position at an
    institution that only has tenure tracks for those
    who do basic science research, does that imply
    something about what the institution thinks about
    the value of what you do?

13
What Track Will You Be On?What Track Should You
Be On?
  • What is the system at the institution?
  • Ask younger faculty what track they are on and do
    they feel it is appropriate for what they are
    doing
  • Older faculty may have initially been on tracks
    that either no longer exist or whose requirements
    have changed along the way
  • You want to be on a track that you can be
    promoted on AND that you believe is fair
  • What track is most appropriate for you is
    dependent upon your background and interests but
    also is institution dependent

14
Promotion and Tenure(aka PT)
  • Obtain the regulations for the institution
  • Frequently can be found on the web
  • Alternatively, ask for a faculty handbook
  • Requirements for promotion are going to be a bit
    vague - but usually generalities can be gleaned
  • ex rules about the soonest and the latest you
    can go up for promotion from Assistant to
    Associate Professor

15
PT, continued
  • Requirements differ b/w Tenure and Non-Tenure and
    b/w different tenure tracks
  • Teaching
  • Residents
  • Medical Students
  • Clinical workload
  • Research
  • Competitive
  • Industry
  • Other
  • Publications

16
Additional Questions to Ask About PT
  • Will you be assigned a PT committee, a mentor or
    alternatively meet with your chair yearly to
    discuss your progress?
  • Who has recently been promoted to associate
    professor? Talk to them about the process
  • Has anyone come up for promotion in the last few
    years and not been promoted? If so, why not?

17
Planning Ahead for PT(Its never too early!)
  • Keep your CV up to date and inclusive
  • Develop a teaching portfolio
  • Track all lectures, case conferences, teaching
    materials youve developed, etc
  • Collect and save teaching evaluations
    (particularly the good ones!)
  • Determine if your institution has a model for
    CV/teaching portfolios that you need to follow
  • Ask others in the department for their CV
  • Consider meeting with the head of the PT
    committee within a few months of when you arrive
    to get pointers

18
Departmental Support
  • Office space
  • Lab space
  • Computer (s)
  • ? Access from home
  • On line journal access through library
  • Secretarial support
  • Nursing support
  • The busier you get the more you will appreciate
    how much time they can save you

19
Salary
  • Know your worth
  • If the institution is a state university,
    salaries are usually public record
  • However, this may exclude bonuses and so be
    misleading
  • Data available from professional societies
  • Advertisements
  • Colleagues, fellowship directors
  • Data from AAMC Salary Support
  • To purchase a copy call the AAMC Section for
    Publications Orders 202 828 0416 or on line
    www.AAMC.org

20
AAMC Report on Medical School Faculty Salaries
2000-2001
  • Mean Salary, Private and Public institutions, all
    regions
  • Assistant Professor
  • Pediatrics (2450) 121, 000
  • Family Practice (1079) 132,000
  • General Surgery (533) 194,000
  • Ob/Gyn (833) 173,000

21
Salary
  • What is the source of your salary?
  • State, clinical income, medical school
  • If you are on a track that expects you to support
    yourself through funding, how long are you given
    to obtain funding?
  • Your current salary will play a role in
    determining your future salary
  • Money doesnt make you happy but it sure helps!
  • Consider other benefits that are offered
  • Think of it as a package

22
Bonus Plan
  • Does it exist?
  • How long has it been in existence?
  • Is it guaranteed at an institutional level or is
    it dependent on your departments finances?
  • What is the range of recent bonuses paid out in
    the department?
  • How frequently is it distributed?

23
Bonus Plan, cont.
  • How is it determined
  • Clinical productivity
  • Number of patients
  • Billing vs. collections
  • Relative value work (RVW)
  • Industry sponsored studies
  • Competitive research
  • Publications
  • Teaching
  • Awards

24
Future Salary
  • What is the average percent merit salary increase
    per year, and what is the range?
  • Have there been years with no increase or a pay
    cut?
  • Are there cost of living allowance (COLA)
    increases yearly?
  • Is the salary increase when you are promoted
    significantly more than the typical salary
    increase?

25
Other Potential Sources of IncomeAre these yours
or theirs?
  • Legal fees
  • Honorarium for talks
  • University / Professional meeting
  • Pharmaceutical sponsored engagements
  • Consultant fees for industry

26
Slush Fund
  • Fund to help pay for
  • Attending meetings
  • Buying books
  • Professional dues
  • Journal dues
  • License fees
  • Is this taxable or non-taxable income?

27
Retirement Contributions
  • What are your options?
  • TIAA CREF
  • Other mutual funds
  • If your salary is split between 2 institutions
    (such as VA and a University Hospital) or between
    2 funding sources within the same institution
    (ex medical school and clinical group) how does
    this affect your retirement contributions?
  • What amount does the institution contribute?
  • What will you contribute? (This is pretax
    dollars)
  • What about matching funds?
  • How long before you are vested?
  • If you are working for a for profit
    organization, is there a profit sharing plan?

28
Additional Benefits
  • Signing bonus
  • Loan repayment
  • Moving allowance
  • Vacation time
  • Sick leave
  • Maternity/paternity leave
  • How does this influence the promotion clock?
  • Holidays

29
Additional Benefits, continued
  • Malpractice Insurance
  • CME time
  • Health insurance
  • Who pays?
  • Options
  • Dental plan
  • Parking

30
Some More About the Business End of Things
  • Privileges at hospitals (how many?)
  • Becoming a provider for various insurance plans
  • Obtaining license / DEA number
  • These may take much longer than you imagined!
  • What happens if your start date ends up before
    you have this taken care of?

31
The Structure of Your Schedule
  • Clinic time
  • Other patient related care
  • Attending responsibilities
  • Teaching responsibilities
  • Other administrative responsibilities
  • Protected time
  • Quality of life issues are increasingly being
    considered

32
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33
Clinic Time
  • How many half days of clinic will you have?
  • Do you have control over how the clinic is
    scheduled?
  • Amount of time for new and f/u patient
    appointments
  • How are overbook appointments handled?
  • What type of patients will you be seeing?
  • ie if you have subspecialty interest, will you
    see only those patients or all comers
  • Self referred or doctor referred
  • How many half days of clinic do other faculty
    have?

34
Other Patient Care Responsibilities
  • Procedures
  • OR time
  • Interpreting studies
  • How are things assigned?
  • In blocks
  • By patients

35
Attending Responsibilities
  • Ward time
  • Consult service
  • Resident clinic
  • Call schedule
  • What happens to your clinic schedule when you are
    on service?

36
Teaching Responsibilities
  • Medical Students
  • Basic science lectures
  • Lectures for students in their clinical years
  • Mentoring
  • Summer work programs
  • Shadowing
  • Clinic

37
Residents
  • Teaching Residents and Fellows
  • Didactic lecture series
  • Grand Rounds
  • Bedside
  • What is the quality of the training program?
  • How many per year?
  • Does the program fill?
  • Do the residents participate in research at a
    clinical level?

38
Other Responsibilities
  • Residency director
  • Many if not all ACGME programs now require that
    the director be 3 years out of training
  • Clerkship director
  • May involve no more than a one time meeting with
    the students and filling out paperwork to giving
    all didactic lectures to students on rotation
  • Ask details!

39
Protected Time
  • Time in which you have no patient
    responsibilities
  • Ideally, it should be sacred
  • Time to
  • Do research (including clinical research)
  • Write papers
  • Work on presentations
  • Teach

40
What You Should NOT Have to do in Your Protected
Time
  • Answer patient phone calls
  • Dictate notes
  • Fill out patient forms
  • See overbook patients
  • Protected time should be used for you to advance
    your academic career

41
What Makes Sense for You?
  • Will depend upon what your track is
  • Scientist vs clinician vs educator
  • What is your focus?
  • It is likely that no one has ever said they dont
    have enough clinical responsibilities!
  • Teaching is essential from a PT standpoint
  • What types of teaching interest you the most?
  • Hint teaching of medical students usually
    counts more than teaching of residents from a PT
    standpoint
  • Hint getting residents or students involved in
    research projects may increase your research
    productivity with the added bonus of making the
    chairman happy

42
The Position and Department
  • Are you replacing someone or are they increasing
    the number of faculty?
  • Talk to those who have left recently
  • Is the number of faculty appropriate for the work
    load?
  • Will you be starting a new area of subspecialty
    for the department or joining an existing one?
  • A good mentor who can help promote your career is
    worth their weight in gold!
  • Does the department have a good reputation within
    the institution and on a national level?

43
A Few Comments on Negotiating
  • Set priorities and determine what you
  • Want
  • Need
  • Can get
  • Be realistic
  • Negotiating requires investigation
  • Dont be afraid to ask
  • Negotiating begins with you
  • You are your own best advocate
  • Negotiating is a 2 way street

44
Negotiating
  • Your in a stronger position if
  • You have more than one job offer
  • They have a clear cut need that you can meet
  • There are limited potential applicants with the
    required skills
  • Set limits but keep them private
  • A bad job offer may be worse than no job offer

45
The Money
  • Its not easy to talk about money
  • But it is important to be up front about it
  • Salaries may be fairly structured within an
    institution - and salary of current faculty play
    a role in what you will be offer
  • Where is there give?
  • Signing bonus
  • Paying off school loans
  • Paying for meetings, etc

46
Who to Meet?
  • Department Chair
  • Division chair if indicated
  • Clinic director
  • Young faculty member
  • Some of the residents or fellows
  • Business manager
  • Realtor
  • Think ahead of questions to ask each of these -
    and chose carefully what you ask of whom!
  • Listen carefully to what is said and what is not
    said

47
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