1. 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

2. 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

3. 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

4. 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

8. 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

9. 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)

10. 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

11. 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

12. 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

14. 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

15. 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

16. 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) Rank Number 25th %ile Median 75th %ile Mean

17. Median Salary in Midwest Region by Specialty - AAMC

18. SOUTH MIDWEST

19. Interventional Radiology(read it and weep) 2010 Highest paid full professor: $579,500 in 2006 2009-2010 figures not published yet

20. 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)

21. 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

22. 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

23. 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

24. 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?

25. 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?

26. 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

27. 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

28. 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.

29. 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

30. 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

31. 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

32. 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

33. Other Grant Options: NIH

35. K (training) Awards

36. Resources for New Investigators button

37. K-Kiosk

38. 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

39. Funding Opportunities

40. SEARCH Function

41. New Announcements This Week

42. Further Down Page

43. Subscribing To Subscribe to the NIH Guide LISTSERV, send an e-mail to listserv@list.nih.gov with the following text in the message body (not the "Subject" line): subscribe NIHTOC-L your name(Example: subscribe NIHTOC-L Joe Smith)Your e-mail address will be automatically obtained from the e-mail message and add you to the LISTSERV.

44. 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

45. 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

46. 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