Post on 11-Nov-2014
description
What to Look for in a Job and How to Get It
…Or How Not To Make The Mistakes I Did
Kathleen O’Neil, MD
Plan for the Hour
• General comments on jobs in academic/ subspecialty pediatrics and jobs in general
• How to get the info you need about that “perfect” job
• Interspersed tips on negotiating
The BIG Issues• Mentors• Collaborators – the “supportive
research environment”• Salaries/Benefits• Time allocation – clinic, teaching,
research• “Protected” time• Start-up packages • Ways to supplement start-up funds• Funding your time & research costs
Pediatric Job Lists
• American Academy of Pediatrics sponsors PedJobs (www.pedjobs.org/)
• Your subspecialty societies may have website listing positions available
• Bulletin boards at meetings (PAS, SSPR, subspecialty societies, etc.)
• Specialty journal advertisements• Advertisements in Peds, J. Peds,
etc.• List serve listings• Word-of-mouth
Options You Might Face
• Type of position– Pharmaceutical industry– Private practice or a
blend– Academic position
• Join an existing group or individual• Start a new service/practice• Join multi-specialty group
– Internal medicine subspecialists in your discipline
– Pediatric multi-specialty group (not yours)
– General pediatrics
Private Practice• Economically feasible in large cities?
– This is sub-specialty dependent– Neonatology, diabetology, GI
• Most must do some general pediatrics or other
• Might combine private practice with: – Research– Teaching – Administration (peds training
program director, chief of peds at local hospital)
Academic Positions
• Large volume clinical practice (F/T)
• Research (basic or clinical)• Teaching• General Pediatrics
teaching/clinic• Administration (asst. program
director of residency, IRB chair, etc.)
• Other specialty care
Decisions, Decisions
• Join existing person/group• Go where there is nobody in
your subspecialty• Stay on where you did your
fellowship• Join an “adult” subspecialty
group• Become THE pediatric
subspecialist in another division
The biggest issue:Find A GOOD MENTOR
• Take a job with a good mentor, or find one• S/he does not need to be in your division,
your practice/group, or even your department
• The mentorship process is an active one for the recipient, not just the mentor
• Set up regular meetings with your mentor to set goals and monitor progress
• A mentor should look out for your career, your success/promotion/time protection, and should help you find opportunities to advance
• A great mentor will also look out for your health and happiness, and be sure you keep balance in your life
Collaborators Are Essential
• Clinicians – I can’t imagine caring for sick SLE patients without pediatric nephrology, hematology, etc.
• Even if you are a solo pediatric subspecialist, you need colleagues – email, listservers, phone
• Researchers – biostatistics and epidemiology consultants, molecular biologists, basic scientists in related fields…
• The “Supportive Research Environment” is essential to NIH funding success
Issues: Salary & Benefits• How will your position be funded?
– State “line” or other “hard money?”– Departmental guaranteed salary– Clinical revenues– Research dollars– Productivity incentives (work RVUs)
• Benefits– Health, dental & vision insurance– Life insurance– Disability & long-term care insurance– Retirement – ON WHAT PORTION OF
INCOME??• Stipend for travel, professional
memberships, journals, books ~$1-3000/yr
Salary – Where to get #s
• American Association of Medical Colleges Report on Medical School Faculty Salaries (2009-2010)– By specialty, by rank & region (all
peds, all regions)Instruct
or
Assistant
Professor
Associate
Professor
Professor
Chief
193 1144 546 460 159
70 135 165 197 198
114 156 194 232 235
139 187 229 276 287
115.8 170.1 205.7 264.4 264.4
Rank
Number
25th %ile
Median
75th %ile
Mean
Median Salary in Midwest Region by Specialty - AAMC
Sub-Specialty Instructor Asst ProfessorEmergency Peds $135 (17) $175
Endocrinology
$58 (6) $132 (45)
Gastroenterology $59 (7) $159 (51)
General Peds $183 (28) $148 (250)
Heme-Onc $113 (10) $134 (80)
Neonatology $108 (15) $189 (126)
Pulmonary (1) $140 (15)
Rheumatology (1) $140 (15)
Other Pediatrics (4) $152 (84)
Rheumatology-Peds.
InstructorAssistant Associate
Professor Chief ChairProfessor ProfessorCount: 1 9 9 2 8 025th: 136 151 163Median: 140 175 19175th: 149 194 219
SOUTH
Rheumatology-Peds.
InstructorAssistant Associate
Professor Chief ChairProfessor ProfessorCount: 1 15 7 3 4 025th: 132 163Median: 140 16575th: 147 187
MIDWEST
Interventional Radiology(read it and weep) 2010
Region Number
25th % 50th % 75th %
National Ins 71Asst 369Assoc 135Prof 135
271,000298,000347,00341,000
338,000352,000409,000400,000
472,000440,000492,000458,000
Midwest Ins 24Asst 113Assoc 36Prof 34
386,000310,000349,00334,000
522,000440,000511,000377,000
522,000522,000522,000512,000
Highest paid full professor: $579,500 in 20062009-2010 figures not published yet
Benefits• These are generally pretty standard,
but…• Make sure you know if retirement is
calculated on “base salary” or “total compensation”
• If it’s on your base, you might need to contribute to individual retirement acct.
• Don’t forget to budget for disability and long-term care insurance
• Some (rare) universities have tuition for family members. This can be a HUGE bonus – (i.e., Syracuse University plus Boston
College fees exceed my take-home pay)
Time Allocation
• Clinical time• Research time
– Clinical– Bench
• Teaching responsibilities– Fellows?– Inpatient general peds attending?– Students of all sorts?
• Administration– Committees for Univ. - Dept. - Hosp. -
National groups – Service organizations
Clinical Time Issues
• Each ½ day of clinic is 10%, but – Dictations, Editing letters,
Triaging urgent referrals, Prescription refills, Prior authorizations for insurance coverage, Home care orders, Lab result review, Phone questions,
– ALL add to total clinical time
• Inpatient service and consultations
• Procedures
Preserve Your Time
• In academic settings, the university’s promotion policies are usually online
• You must do some “citizenship” duties and provide some service
• Choose your service commitments wisely. – IACUC, IRB can take LOTS of time– Be sure it pays a % of your time– Don’t take on responsibilities you are
not prepared to handle, e.g., division chief in year 2 or 3
Your Support Personnel and Your Time
• Will you have a dedicated nurse (or even a ½-time nurse)
• PA, PNP, fellows, etc.• Will you have a secretary who will do
your work?• Is there a GCRC, research office,
departmental research nurse or group of them for clinical studies?
• Will you have a lab assistant if you are doing bench research?
The Myth & Reality of PROTECTED TIME
• Most offers speak of “protected time.”
• How will your time be protected?
• Who will cover service if your boss is out?
• How often does s/he travel?
• Blocks of time are essential for most lab-based research
• Who answers the phone calls and triages them?
Start-Up Packages
• Your job offer should include the seeds you need to be successful – (not the whole tree)
• Office space, computer, secretarial support, +/- nursing support
• Laboratory space – Might be shared• Basic equipment to get started –
available and accessible research cores, shared facilities
• Basic supplies, typically for 2-3 years• Some technical help (salary, benefits)
for the lab for 2-3 years – unless you have > 75% protected research time
Letters of Offer• Hand-outs – examples of academic
offer• Letters are pretty standard• Academic rank, or administrative
title• Expectations / conditions of
employment• Pay / benefits• Terms of renewal or promotion
– Often referenced in the faculty handbook or online policies if academic
– Conditions for partnership or advancement in practices
• Not a contract – a basis for negotiation
MedCenterToday Check List: The Must-Haves in Academic Med
Center Contracts • Negotiating an employment contract for your self?
Quickly consider these basic things as a framework for conversation and contract...
• Strive for a clear description of job duties and the institution's short term and long term expectations of you as a faculty member.
• Request a detailed description of and timetable for career-advancement opportunities.
• Be sure that the contract contains fair and equitable contract term lengths and termination provisions.
• If you seek an academic life of teaching and research, get comfortable with the specifics arrangements of how "protected time" will be afforded and guaranteed.
• Have detailed conversations and include in your contract, well-defined terms regarding future ownership of intellectual property.
• Things may not work out, avoid unrealistic non-competition provisions.
- MedCenterToday.com staff.
Supplementing Your Start-up Package
• Are there institutional research grants?
• How competitive and how much $$?• Are there foundation grants in the
community?• Does your chairman have cash for
shortfalls if your first grant is close, but doesn’t quite get funded?
• Some universities have a transition program that funds young faculty while they begin independent research programs, often called fellowships
When to Apply for Grants
• Each grant mechanism has a lag time
• Some can be awarded only once to any one investigator
• Others must be relinquished if you get outside funds
• Know this in advance, and use your start-up funds first, and wisely
What Else Do You Need for Success?
• Do you need an MPH, or other training to achieve your goals?
• Can the university provide this as part of your start-up, or give you discounted tuition?
• Do you need 3 more months in your current lab to be ready to move the project to your new position?
• If you don’t ask, you won’t get it
Grants for New Faculty
• Seed grants from the university or department
• Foundation grants (e.g., Arthritis Foundation, Lupus Foundation, etc.) are increasingly competitive at national level, but local chapters might offer money
• COS (www.cos.com) Community of Science – you enroll, get periodic emails with grant opportunities from your keywords
• https://proposalcentral.altum.com/ - online proposal management service, a number of current funding opportunities
Other Grant Options: NIH
K (training) Awards
Resources for New Investigators button
K-Kiosk
Other NIH Mechanisms
• R03 – the small grant– $50,000/year for up to 3 years– Cannot have been PI on R01 or other major
NIH grant– Good way to get preliminary data
• R21 – the exploratory/developmental award– Up to $275,000 divided over 2 years– Requires less preliminary data than R01– Allows some element of risk to the project
• R15 – AREA grant, the academic research enhancement award– For institutions with <$3M in research
funding– See website for excluded institutions
Funding Opportunities
SEARCH Function
New Announcements This Week
Further Down Page
Subscribing
• To Subscribe to the NIH Guide LISTSERV, send an e-mail to listserv@list.nih.gov with the following text in the message body (not the "Subject" line):
subscribe NIHTOC-L your name (Example: subscribe NIHTOC-L Joe Smith)
Your e-mail address will be automatically obtained from the e-mail message and add you to the LISTSERV.
As You Prepare for the New Job…
• Apply for your license 6 or more months before your start date
• Apply for hospital privileges• Apply for insurance plan provider
status (often many, many forms)• Keep everything in a safe file• Keep your CV up-to-date• Seriously consider credentialing
company – they maintain permanent files
A Few Parting Thoughts• Remember your value during
negotiations• Value = quality/cost. You bring quality -
at some reasonable cost. The numerator drives the equation
• The first offer is just that – negotiation is OK
• Look at all your options• If you and a spouse are job-seeking,
both of you must be happy with the outcome
• The employer gets a bargain with 2-for-1 family deals – don’t assume you are lucky just to get an offer for both of you
• It is common to move after a few yrs
Wherever you go andwhatever you do
• Do it with passion• Get involved• Remember what a privilege
it is to be trusted to care for someone’s child