January 2003

The first step in job-hunting is knowing what you want and need. It is critical to define your professional and personal goals in order to determine what you need to achieve success. Determine the essentials (e.g., protected time, mentoring). Decide what would be nice but is not necessary. Being prepared will enable you to forcefully and cogently defend those items that you see as "non-negotiable" (e.g., months of protected time) and give you maneuvering room on other items (e.g., vacation,salary). In the first of this two-part series, we will focus on identifying those issues that you need to think about before and during your jobsearch. The second column will discuss negotiating strategies. While this series is written from the point of view of an aspiring physician-scientist, most of the discussion will be directly applicable to candidates seeking a career in private practice or clinician-educator.

Ask yourself: "How do you define success? What is a "good" job? Talk to your mentor(s) and colleagues, but realize that ultimately you need to decide what is important for you. For instance, a budding MD-researcher will require mentoring, protected time and a "nurturing" environment in which to develop an independent, productive research program. But the specific requirements of what a particular candidate needs in those areas will depend on the individual.

Begin gathering information in order to identify potential institutions of interest. It is important to focus on the institution, the department as well as the division to which you are actually applying. What are the mission(s) of the institution/department/division. Are they insynch? What are their values and general climate? What are the faculty like? In addition to the working environment, what is the living environment (i.e., city, neighborhoods, schools, etc.) like?

Information gathering continues at every step of the jobhunt. Consult colleagues, friends, alumni. Do you know anyone who has trained or worked at the institution? Were they supported? "Successful"? Happy? Examine written policies. Ask and re-ask the same questions. Do you hear and see consistent answers?

The first interview is like a first date. You are just getting to know each other. Some people say that the first visit is for them to decide if they want YOU, the second visit is for you to decide if you want THEM. Take this opportunity to get to "know" the faculty--what research they are doing, what are the historical areas of expertise for the group, the department, etc. Look at the division/department/institution websites. Check out some of the key faculty members on Medline. Another helpful website is the NIH CRISP database (http://crisp.cit.nih.gov/) in which you can usually enter the city or institution in order to "scope-out" NIH-funded research. On the first or second visit, be sure to spend some time with the fellows and any nurse practitioners in the program. Both of these groups can often be a valuble source of "inside" information about the interactions of the faculty group and about how the clinical service runs.

During the interview process, target the following areas for discussion, so that any potential stumbling blocks can be identified. Once these general issues are resolved, then you can negotiate the specifics.

1. Job description. This can be difficult for MD-researchers. "Protected time" is a key issue. In concept, this sounds great. But practically, someone has to pay your salary and what will they expect in return? It will be important to know how the powers-that-be define "protected time." From your point of view, you will be developing a new area of research and acquiring the necessary skills and data with which to successfully pursue this research. To a division or section chief, however, you might look like someone who can always be called upon to "fill in" on the clinical service. It is hard to say no when someone asks. What are the needs/expectations of the division? Are they in line with your needs? A division that needs clinical help may say that they will give you protected time but then, in a pinch, will come to you for help. What has happened to junior faculty folks in the past when the group has been short-handed? We all want to be team players and it is hard to say no. But being a team player does not always get mentioned at promotion time and buys you little in terms of career development, so it is your career that suffers! Again, a strong mentor can help shield you somewhat from politics.
2. Environment: Does the division provide a conducive environment within which a budding research career can be nurtured? What have been the experiences of previous junior faculty? Financial and political stability are critical. You need to be assured that any agreement reached between you and the current chief would be honored if, for some reason, the chief changes. Numerous examples exist where previous obligations and agreements were not honored by a new chief. The best way to avoid this is to have the department chair and dean of the medical school sign off on the offer letter. What are the opportunities for advancement? Are there possible niches that you could fill?
3. Mentoring: This is the top priority. Making the transition from a K award to R01 can be tricky and require some amount of academic savvy. What are the opportunities for you to be mentored? Can they help you identify a mentor? What are the potential opportunities for collaboration among your colleagues or persons in other divisions?

You will need some hard answers to these questions. If things look good, then you and the organization will be ready to move on to more specifics. Again, it is important that you be prepared and think carefully about your needs. Be honorable and fair. You want to ensure that you have what you need to succeed, but you don't want to alienate future colleagues by seeming unreasonable or making unrealistic demands.

What things are negotiable? Be prepared to talk about:

1. Job description: As discussed,this can be difficult for MD-researchers. Focus on defining "protected time." Although you may assume that you are there to do research.
   
   Practically speaking, your job description is also key to defining your salary source(s). After all, someone will be paying your salary and what will they expect in return? It may be tempting and flattering to be offered some administrative responsibilities, e.g. director of a clinic or respiratory therapy. In general, though these jobs don't count for very much when it comes time for promotion or salary negotiation. Time devoted to these responsibilities diminish your ability to conduct research. They are often the "scut" work of the division. If part of your salary comes from a veterans administration, how much clinical service will the section chief and/or chief of staff expect in return?
   
   In addition to research and clinical duties, we must also teach and provide university service. Although the latter two are not often objectively discussed, they are not only important but can also take up a large amount of time that is not accounted for.
   
   Are there additional courses (e.g., an MPH) that you might want to pursue? Can this be built into your schedule (or even paid for)? You could argue that these courses would significantly enhance your ability to perform clinical research and obtain future funding.
2. Financial Compensation: Money is often treated as a "dirty" subject in academics. However, it is important to know the overall salary structure of the department/division in order to know what is fair. How are salaries determined? For instance, what is the starting salary of an assistant professor? While academic payscales do lag behind private practice and industry, there still should be some rational and fair pay structure within the division. As mentioned, the source of the salary is also important. The source determines the expectations and hence can drive the job description (i.e., what strings are attached?) Every medical school has a book with the American Association of Medical Colleges salaries by clinical dept by division; for Pediatrics, this information is updated yearly by the Pediatric Chairs group. You should not go to an interview without either having obtained this information or without some idea about what a fair starting salary would be. You may be asked what salary you are looking for, and you want to have an answer.
   
   The start-up package should include at least THREE years of GUARANTEED support. You need protected time to develop a research project; therefore the department will need to support you until you can achieve your own funding. Three years will give you time to get a project started (first year), collect preliminary data or better yet, publish (second year) and then write for your K08/K23 or RO1 (middle to end of second year). Other (negotiable) items to consider are:
   • Relocation expenses
   • Healthcare
   • Family benefits
3. The "Start-up" package should also include:
   
   Support: technical and/or administrative.
   Office--including a networked computer! Consider asking for a laptop to help you work at home (i.e. increase productivity).
   Laboratory Space: Who assigns space?
   Other:
   Vacation (more important with a family).
   Travel
   Grantwriting support.

Next month: Negotiating Tips and Strategies.