The First Job Residency / Faculty

1. The First JobResidency / Faculty Hilary Sanfey

2. Learning Objectives • What to look for (what to avoid) • Preparing yourself & your CV • The interview • Negotiation

3. What to Look For&What to Avoid

4. Be wary of institutions / programs: • High faculty turnover (ask why) • Financial instability • Programs on probation • Chair about to retire • Barriers to meeting with key staff (other residents) during the interview • Few minorities in key positions

5. The Department Chair? • Chair supportive of junior faculty / residents • Mentorship record • Promotions • Opportunities for leadership • National reputation • Is he / she about to retire or move? • Business plan • Administrative support • Sound billing / reimbursement system

6. What to look for :Residency & Faculty • Know your priorities & goals (1 & 5 year) • Personal • Professional • The department / program • The institution

7. Priorities & Goals Goals should be flexible as interests & opportunities will change • Personal • Professional • Clinical • Research • Promotion • Leadership • Financial • Educational • Long term (5 year) and short term (1 year)

8. SMART Goals Specific Measurable Achievable Realistic Time

9. Preparation

10. Know the program / department / institution • Review institutional / departmental / website / marketing brochures • NIH funding • Educational ranking • National reputation of chair / senior faculty • Talk to faculty / current and past residents / referring physicians • Know yourself • Application / priorities / interests

11. Curriculum Vitae • Is there an institutional template? • Review CVs from successful colleagues • Be concise • Be honest • Make sure significant achievements stand out • Have an explanation for the “gaps” • Watch spelling / grammar • Teaching portfolio

12. Personal Statement /Accompanying Letter • Why this specialty (institution)? • Personal experiences. • Future expectations (vision). • Spelling / grammar. • Use humor cautiously. • Be original. • Ask advisor(s) to read prior to submission.

13. Applying to a Residency Program • Clinical Training - volume and patient mix • Education – board results • Research – optional vs. mandatory • Environment – family friendly or hostile • Hospitals – how many? How far apart? • Where do residents go after training? • Academic vs. private practice • Fellowship placement

14. Job Description (Residents) • Duty hours / night duty / live in time • Rotations • Specialty • Location / hospitals / outreach clinics • Elective • Research opportunities • Funding • Leave • Vacation • Maternity / Paternity • Study

15. Job Description (Faculty) • Ascertain goals and priorities of chair / chief. • Percentage time for : • Clinical work. • Research. • Educational activities. • Administration. • Learn how your salary will be supported. • Is there an inside candidate?

16. Priorities & Goals • Personal • Professional • Clinical • Research • Promotion • Leadership • Financial • Educational

17. Clinical • Outreach clinics • Referral pattern • Who is the competition? • Support for new program development • Financial • Staff • Equipment • Space • Institutional commitment to a new program

18. Research • Percentage / protected time • While awaiting NIH funding, ask about • Salary support • Start up grants • Opportunity for collaboration / sharing staff , space & equipment • Lab space allocation

19. Promotion and / or Tenure Learn the rules! • Tracks • Educator vs. investigator • Clinical vs. non-clinical • Tenure vs. non-tenure • Changing tracks • Definition of scholarship • Promotion record for each track in your department

20. Promotion (continued) • Ascertain relative importance of teaching / research / clinical / service to P & T. • Time limitations / probationary periods. Are these negotiable ? • Consequences of failing to obtain P&T. • “time off the clock.”

21. Leadership (Mentorship) • Chair / faculty with a national reputation in your area of interest • Professional organizations • National / regional committees • Editorial boards • Can they offer you opportunities / consistent with your goals? • Can you identify with the faculty?

22. Financial • How will your salary be supported? • Revenue sources • Clinical / research / other • Salary • Base • Negotiated • Incentives / bonus • Overheads • Collection rate • Office / secretarial support / dean’s tax / shared administrative / clinic staff / collection fees • Malpractice (tail coverage)

23. Educational • Protected time to teach • Relative value placed on resident vs. medical student teaching by P&T • Salary support for teaching • CME requirements to maintain institutional credentials • Time off to attend national meetings

24. Personal • Personal / family time / part time / flexible / maternity / paternity leave • Location / commute • Are benefits transferable ? • College fees differential for children • Schools • Housing / travel expenses • Hobbies / interests

25. The Selection Process : Residency • Getting an interview • Academic qualifications USMLE /AOA /school • CV • Personal statement • Letters • Personal recommendation • Getting a job offer / getting ranked • Compatibility or “fit”

26. Qualities Determining Compatibility • Team player? • Motivation? • Communication skills? • Leadership potential? • Attitude? • Compassion? • Non-academic achievements?

27. The Interview • Appearance • Polite • Be honest / prepared / enthusiastic / well dressed / on time • Write thank you letters • Watch what you say at all times!

28. Interviewing for a Faculty Position • Should talk to: • Chair / Chief • Colleagues from your areas of interest and / or research & clinical collaboration • Business manager • P & T advisor • Residents / Nurses / Secretarial / lab staff • Person vacating the post if relevant

29. Interviews (Faculty) • The first interview • OK to look once even if really not interested • The second interview • Demonstrating intent • Accompanied by spouse / significant other • The third interview • Consolidate expectations

30. Dealing with Inappropriate Questions?

31. The Negotiation

32. Remember Priorities and Goals • Personal • Professional • Clinical • Research • Promotion • leadership • Financial • Educational

33. Starting the Negotiation • Wish list in order of priority • Negotiable vs. not negotiable • Balance your goals against what is being offered

34. Wish List • Salary • AAMC guidelines plus 10% • Department salary range • Penalties for not covering salary • Protected time • Lab space • Part time / flexible opportunities

35. Negotiation • The worst thing you can possibly do is seem desperate to make the deal. That makes the other guy smell blood and then you are dead.. Donald Trump

36. Negotiation • Patience may be a virtue but in negotiating it is a weapon of incalculable power. If you can out wait the other side you usually can out negotiate them. Mark McCormack Author of “On Negotiating”

37. Take Control • Speak assertively • Don’t discount what you say before you say it (don’t apologize for asking!) • Stay focused on your goals • Don’t be seduced by promises • Shake hands and come out fighting • Don’t set yourself up for failure!

38. Beware the "Once you take the job we…………… • Will talk about your • Salary! • Office! • Lab space! • Promotion! • OR time! • Beds!”

39. Get everything in writing • Pick your battles! • Compromise

40. The Decision • Compare notes with personal goals and priorities • Be realistic • Will I fit in? • Will I be happy? • Will this job help me get my next position?

41. Goals • There are two aims in life: one is to achieve your goals and the other is to take time to enjoy them. Only the wisest of mankind achieve the second aim. Logan Pearsall Smith 1965-1946

42. Resources • American College of Surgeons http://www.facs.org/medicalstudents/index.html • American Medical Association http://www.amaassn.org/ama/pub/category/2997.html • Mom MD http://www.mommd.com/ • AAMC http://www.aamc.org/ • JAMA Career Net http://www.jamacareernet.com/ • Association of Women Surgeons http://www.womensurgeons.org/

43. References • The first 90 days : Michael Watkins • On becoming a leader: Warren Bennings • Hardball for women: Pat Heim • Same game, different rules: Gail Evans