Academic Jobs/What one needs to know

[countingdays]

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I started this in the private forum but decided to delete that and open this thread up to the general forum to maybe get more of a response.

As I wait to start fellowship next month, I'm starting to talk to people about interviewing for jobs in academics. I'm sure a lot of the things to look for are the same as in private practice, but maybe there are things unique to academic jobs that I should try to find out during my job hunt?

Most things I know to find out about seem pretty obvious: income & benefits, hours, call, vacation, case types, % of days supervising residents, practice type when not supervising residents (care team vs MD solo), academic production requirements, administrative duties, sub-sub-specialty divisions (peds hearts, peds pain service), any academic days, etc.

I guess there are also major differences depending on how the department is organised, private group contracting with hospital or medical school vs. working as an employee.

Anybody with experience working in academics know of anything else to consider or watch out for?

 

[cchoukal]

PM'd you

 

[gaspasser2004]

With any job, its about finding the right fit for you, your skills and interests. Got a MD/PhD and a dog lab? Hopkins or MGH where promotion is heavily weighted on peer reviewed bench research would be a great fit. Do you like teaching residents and occasionally doing your own cases? Maybe a less academically oriented program that places real value on patient care and teaching would be a better fit.

Another indicator of a department is how much time the chairman spends doing actual anesthesia. A good chairman never expects his faculty to do something that he/she wouldn't do him/herself (Saturday call, teaching CA-1's, bag and drag washouts from ICU, etc.). Don't get me wrong, chairmen need time outside of the OR to perform administrative duties and can't be in the OR all the time. But I personally believe that a chairman who can actually do anesthesia (and does so on a regular basis) is a huge plus.

 

[usnavdoc]

From my experience, I think a big thing to discuss is professional/salary advacement. What does it take to go from assistant professor to associate to full. I know where Im at if you arent into research, you arent going to advance very readily. That means no room for salary growth. When you start out making half what you could in pp, that means alot.

 

[countingdays]

PM'd you

If you PM'd me I didn't get it.

 

[pgg]

Read up on a topic in your office then go into the room and pimp the resident. They (the CA1s) will think you are God's gift to anesthesia. Stick to the topic you read about. If they happen to ask you something you don't know, reply "I know the answer (say this confidently), but I want you to look it up and tell me tomorrow." By doing this everyday, you will appear smart, interested in teaching, and the residents will teach you stuff (without them realizing it, at first). Etc. Good luck.

Classic.

 

[Masseter Spasm]

Make sure you get an expectation of how your career will advance. Some academic departments rely on assistant professors to do the clinical work (with no hope of ever achieving tenure or promotion.) Is it possible to make associate or full professor if you are on the "clinician teacher" track?

 

[Soon2BENT]

Another indicator of a department is how much time the chairman spends doing actual anesthesia. A good chairman never expects his faculty to do something that he/she wouldn't do him/herself (Saturday call, teaching CA-1's, bag and drag washouts from ICU, etc.). Don't get me wrong, chairmen need time outside of the OR to perform administrative duties and can't be in the OR all the time. But I personally believe that a chairman who can actually do anesthesia (and does so on a regular basis) is a huge plus.

may be one of the more intelligent things said on this forum. well said. you boss shouldn't expect his workers to do things he wouldn't do

 

[deleted50478]

may be one of the more intelligent things said on this forum. well said. you boss shouldn't expect his workers to do things he wouldn't do

the chair I know most about doesn't really even need to be a physician, he's almost never in the OR. I'd say he's successful as a chairman, but medical school and residency were more of a launching point to a business career rather than useful training to him.
Why do you all see that as a problem? Out of touch with the workers or something?

 

[proman]

Are there actually places where the chairman does greater than ASA 2 cases?

You mean things like liver transplants, like mine?

 

[pgy13]

Are there actually places where the chairman does greater than ASA 2 cases?

yes

 

[Mista Suprane]

You mean things like liver transplants, like mine?

i will back up proman - our chairman is in the trenches. He takes liver and OB call, as well as regular OR call. Spends time in the hole that is our adult endo/bronch suite (think ASA 3-4 pts. for ERCP or bronch - not fun at all), also does a few days a month in our pre-op clinic. He is the OR anesthesia coordinator 2-3 times a month too. the only things i haven't seen him do are peds and cardiac.

as with any chairman, i'm sure if you ask one of our >100 faculty about him, there will be positive and negatives, however he certainly does lead by example, and in my opinion, is one of our better clinical anesthesiologists and teachers.

 

[fakin' the funk]

Are there actually places where the chairman does greater than ASA 2 cases?

I have heard some "urban legends" about the chair at OHSU taking some gnarly call schedules and doing tough cases with his residents. I bet someone here can back that up.

 

[Jay K]

i will back up proman - our chairman is in the trenches. He takes liver and OB call, as well as regular OR call. Spends time in the hole that is our adult endo/bronch suite (think ASA 3-4 pts. for ERCP or bronch - not fun at all), also does a few days a month in our pre-op clinic. He is the OR anesthesia coordinator 2-3 times a month too. the only things i haven't seen him do are peds and cardiac.

👍

 

[DrDre']

Dr. Kirsch takes in-house 24 hour call twice a week every week. He has taken friday night call for five years if he is not on vacation.

He does all cases, teaches even when busy and on call. He also turns over rooms, mops floors etc.

He never asks someone to do something he would not. He works harder than any resident or staff.

I have heard some "urban legends" about the chair at OHSU taking some gnarly call schedules and doing tough cases with his residents. I bet someone here can back that up.

 

[Jeff05]

my old chair still does cardiac cases.

 

[lushmd]

my old chair still does cardiac cases.

As does my chair.

 

[Narcotized]

Dr. Kirsch takes in-house 24 hour call twice a week every week. He has taken friday night call for five years if he is not on vacation.

He does all cases, teaches even when busy and on call. He also turns over rooms, mops floors etc.

He never asks someone to do something he would not. He works harder than any resident or staff.

Almost the same situation where I trained except for a few small differences. My chairman didn't take Friday night call, 24 hour call, in-house call, and I don't believe any call, didn't do many cases, didn't teach a whole heck of a lot, certainly didn't mop floors or clean rooms, and didn't work harder than any resident or staff. But other than that, the similarities were overwhelming; such as he did have Dr in front of his name and he did take vacation.

 

[Lonestar]

lol...narcotized is right on. It is a rarity nowdays for your chairman to do real anesthesia.

 

[Tuohy]

I think the stability of the department obviously lies with who your chairperson is... The stats don't lie-there is much attrition among chairs-I believe the stat is that 25% of all anesthesia chairs change every 5 years. Regarding an academic job, certain things are set in stone when it comes to negotiation (I have worked in two different academic centers)-time off is pretty much (usually) set by the affiliated university (ie very hard to change). What you can negotiate is non-clinical time (be sure it appears as an actual percentage in your final contract). Other things that you can negotiate for: a computer (NOT from your educational/discretionary money), not having to use meeting days if you present at a conference, moving/sign on bonus. These are just some ideas....

 

[Johnisit1234]

Dr. Zaidan at Emory does hardcore cardiac cases too...

 

[Laryngophed]

In all of the jobs I've had and teams I've been on, I've determined that it's a helluva lot easier to follow those who lead from the front and not from the back. Granted, I also think it's a helluva lot better to be the leader than a follower, but the same adage applies.

 

[pd4emergence]

I am not sure I totally agree with the requirement for a chairman to be in the trenches. My program had a great chairman, good administrator, advanced the department nationally, was relatively popular with attendings (he wasn't in the or much but he was a fair person). He did do some cases but they weren't complicated. But he kept the department running smoothly and was able to attract top academic attendings.

 

[Masseter Spasm]

It is rare to find a chair who can balance excellence in clinical care, research, and administration/leadership. Many struggle to do even one adequately.

 

[foxtrot]

I think the stability of the department obviously lies with who your chairperson is... The stats don't lie-there is much attrition among chairs-I believe the stat is that 25% of all anesthesia chairs change every 5 years. Regarding an academic job, certain things are set in stone when it comes to negotiation (I have worked in two different academic centers)-time off is pretty much (usually) set by the affiliated university (ie very hard to change). What you can negotiate is non-clinical time (be sure it appears as an actual percentage in your final contract). Other things that you can negotiate for: a computer (NOT from your educational/discretionary money), not having to use meeting days if you present at a conference, moving/sign on bonus. These are just some ideas....

What do most people try to negotiate for with regard to percentage of non-clinical time if you are on a regular full time clinical track?

 

[fakin' the funk]

Our chair is clinical 1-2 days a week, in the regular cardiac rotation, including night and weekend call, as well as main OR work pool, as well as the occasional weekend call at the main university hospital doing gangbanger ORIF's and OB.

Definitely not a crusty old attending you don't trust getting you out for a break.

 

[cchoukal]

What do most people try to negotiate for with regard to percentage of non-clinical time if you are on a regular full time clinical track?

I had a few mentors in residency who were able to carve out about 40% non-clinical, even without research grants, based on taking on certain administrative and educational roles (mentoring all the grand rounds presentations, or being asst PD, or whatever).

For clinical people 20% is more typical, although it kind of seems like even THAT is shrinking. Where I am, it seems like many young attendings are overscheduled, relative to their "clinical committment." I can also think of at least 2 residency colleagues who are fellowship trained and now at academic institutions you've heard of who have ZERO non-clinical time.

The lesson, I guess, is that if you plan to try to negotiate any non-clinical time, you should come in with a real plan for what you intend to do with it and how the department will benefit from it.