The Next Phase: finding the right job in Radiology for you

1. The Next Phase:finding the right job in Radiology for you and How to get it right the first time…

2. Disclosure of Financial Relationships

3. You Decide Your Future William Shatner said, • “You have to create your life. You have to carve it, like a sculpture. “ What is your vision?

4. Navigating the Job Market It can be a Horror Movie…… • Use a decision tree like the Pocket Horror Movie Computer Source: Gahan Wilson, National Lampoon, November 1971, Vol. 1, No. 20

5. Consider the Options Career paths Enter the trail… • Academics • Institution • Private • Private Practice • Partnership • Non-Partner track • Locums • Government/Research • Teleradiology

6. Current Distribution • 30,000 post-training professionally active radiologists (100/Million)* • Academics: 15-20% • Private Practice: 83-77% • Government: 2-3% *Source : American College of Radiology

7. Current Workload Distribution • “Average” radiologist works 50 hrs/week • ~15-20% work part-time • 25% spend some time teaching • Sadly, only 11% do original research • Number of exams per FTE is growing rapidly as radiologists try to preserve income, last figures are 14,000+ studies per year (2007) Source: Radiology 2009;10.1148.

8. Work Patterns • In 2006–2007, the average annual workload per FTE radiologist: • 14 900 procedures - 7% increase since 2002–2003 and 34.0% since 1991–1992 • Annual  RVUs per FTE radiologist were 10 200, an increase of 10% since 2002–2003 and 70.3% since 1991–1992 • Academic practices performed 33% fewer procedures per FTE radiologist  than others, offset by research and teaching. Bhargavan M, Kaye AH, Forman HP, Sunshine JH. Workload of Radiologists in United States in 2006–2007 and Trends Since 1991–1992.  Radiology 2009;10.1148

9. Identify what and where first. Then identify who… • What (kind of practice) • Where (work and living environment) • Who (which groups or facilities) • What is the legal climate?

10. Key Factors to Consider • Location / Family • Where do you want to live? • Work Environment • How much flexibility do you need with your schedule? • Financial • What are your monetary requirements? • Research • Are you interested in contributing to research? • Teaching • Do you enjoy the academic environment and want to share your knowledge?

11. Don’t ask; don’t get • You better live every day like it's your last day, 'cause one day you're gonna be right.--Ray Charles

12. Set Your goal…prepare a CV • Digital CV • Analogue CV • Prepare an outline • Be complete and factual • No unnecessary Private Information • List publications and original research. If extensive, this may be the time to consider digital or multimedia CV

13. Start looking • The longest journey begins with a single step. Attributed to Lao-tzu (c 604-c 531 B.C.), founder of Taoism.

14. RSNA NEWS 2009 • Diagnostic Radiology 5th highest compensation amongst medical specialties • Median salary of $438,115 • Interventional still hot…salaries are higher • Looming probability of “pay for performance”

15. From the RadRounds Blog • Total survey population:309 fellows, 41 residents (n = 345)Average # of positions applied for:9.3Number of interview offers:7.1Number of actual job offers:1.9Salary range offered:$225,000 - $390,000 (year 1)Number of radiology residents/fellows applying for academic positions only: 25 (7.2%)Number of radiology residents/fellows applying for private practice positions only: 50 (14.4%)Number of radiology residents/fellows applying for both: 270 (78.2%)How many trainees felt that it has been VERY difficult to find a job opening:320 (92.7%)How many trainees felt that it has been MODERATELY difficult to find a job opening:24 (7.0%)How many trainees felt that it has been NOT difficult to find a job opening:1 (0.3%)Where did residents/fellows initially hear of positions / openings?Society Websites (ACR, RSNA, etc): 300 (86.9%)Physician/Radiologist Recruiter: 150 (43.4%)Networking (word of mouth, faculty, friends, family): 330 (95.6%)

16. Search Methods • Word of mouth • Faculty • Cameo appearances • ACR Professional Bureau • radworking.com/auntminnie.com (internet ) • Placement firm (headhunters)

17. Arrange your Interview • 2 schools of thought (experience vs. vacation time taken) • Most practices will pick up the tab for everything • Arrive timely; don’t bring a spouse or friend to the workplace • Most good practices will have the spouse “covered.” • The quality of the interview arrangements is usually indicative of the business structure and “functionality” of the group or facility

18. Prepare for your interview • Learn about the venue from the Internet/Chamber of Commerce, etc. • If you are traveling, pack early and rest • Dress appropriately, shirt, tie, and jacket even if you are told to arrive in casual. This is the first impression. I still believe that “clothes make the man or woman.” • Be professional and grateful

19. On your Interview….Do your homework! • Ask, ask, ask! You are about to marry someone after spending a day or two with them…. • Speak to management/administration • Speak to referring docs especially, if you can; in particular, if you are about to sign with someone • Do your research before signing anything or giving your word to commit

20. You know how to interpret images by now… • What can they do for you? • What can you do for them? • How is the business structured? • What is the payer mix? • If private and partner track, how long to partner? • What is the buy-in to A/R? Equipment? • Who pays for malpractice and other key benefits? Who pays wind down expenses if you leave? • What benefits are covered? How does that change when partnership is offered and accepted?

21. Decisions, Decisions • Go with your gut; you will have to learn to trust it sooner or later • If married or in a committed relationship, your spouse or partner needs to concur • If you have lingering questions, do not hesitate to arrange for a second look interview, even if at your expense

22. Employment Contract Review • Read your contract yourself – twice • Forward a copy to an attorney • Identify any points you feel are in need of negotiation • Negotiate them, on your own behalf • If there are financial questions that you are not clear on, engage your accountant – a great resource, often forgotten

23. Contract Execution • Let your contract sit for a few days after you have made a mental commitment • Then, either accept or decline • If declining, have reasons ready • Radiology is a town of 30,000 people; do not burn bridges

24. Stop and Smell the Roses • After your search is over, enjoy your last few months of training • Maintain relationships at your training institution; they will always be invaluable • Ready yourself (and your family) for the transition to a higher income and life after training

25. Work…for yourself • Wear the cape; never let the cape wear you. Roy Horn, Siegfried and Roy

26. Mark Stephan says, • “The greatest marker of longevity and success in your professional and personal lives, is what lies between your ears. Expect the best…and get it.” • Visit my Blog when you are bored…it’s over at http://angiographer.com