interviewing for an academic position: what to know before you go

1. Interviewing for an Academic Position:What 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 P&T) 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. P&T, 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 P&T Will you be assigned a P&T 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 P&T(It’s never too early!) Keep your CV up to date and inclusive Develop a teaching portfolio Track all lectures, case conferences, teaching materials you’ve 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 P&T 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 doesn’t 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 department’s 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

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 don’t have enough clinical responsibilities! Teaching is essential from a P&T standpoint What types of teaching interest you the most? Hint: teaching of medical students usually counts more than teaching of residents from a P&T 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 Don’t 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 It’s 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