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

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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