Can't find a job...

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MediastinalTrach

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I'm a current head & neck fellow FY21 and have been on the hunt for an academic job for the past several months without avail. I know its a relatively small field, but neither my fellowship director, nor several other prominent H&N individuals I've talked to have any leads (several have stated that they are having trouble finding jobs for their own fellows as well). I have been emailing chairs left and right and literally nobody is hiring.

Overall, I believe my CV is solid (~20 publications) and adequately reflects my engagement in research, leadership, and national meetings. I know others are in my boat too, but seems like we're a closeted bunch and don't like to discuss job prospects (part of which I blame on COVID disrupting the usual interview trail experience).

Any advice on where to go from here? My main passion is doing reconstruction/free flaps, but this isn't something that is easily available out in the private sector, where there seems to be a surplus of general jobs. I've talked to a few recruiters for various posting and some have told me that I'm "too qualified" and one flat out told me that partners have "zero interest" in taking call for my H&N patients. The salary for the general jobs seem great, but I'm dreading doing bread & butter until the market opens up.

Any advice? This has been a daily stressor of mine :/

PS: If anyone knows of any established groups doing free flaps or looking to develop a program, please PM me!

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I'm a recently graduated H&N fellow that also struggled with the job search.

Job market since COVID has been AWFUL. I've had a terrible amount of stress finding a job coming from what people tell me is a top fellowship. People in the know (fellowship directors talking to their friends in the same position) have told me that fellows all across the country for the last year have all been in the same position struggling to find good jobs.

I don't have great advice on finding an academic position - they seem incredibly scarce currently. I was fortunate to find a job that fit my interests and goals but I can tell you it was an incredibly competitive process.

H&N seems to be training too many fellows from my perspective. There shouldn't be dozens of people applying for every academic job just for a chance to do what we're trained to do. Feel free to DM me for further discussion, but just wanted to give some perspective to others considering H&N.
 
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Head and neck seems particularly painful because youre essentially focusing you training on academic (or semi-academic jobs). This is unlike other ENT specialties that are equally suited for private practice vs. academic jobs (rhinology, plastics, etc...). COVID has certainly thrown a wrench into the job market. From what Ive seen of past fellows there seem to be pseudo-academic jobs out there that will allow you to do flaps. Certainly has to do with how flexible you are in terms of location. If youre willing to move - I think the jobs are out there.

For med students / junior residents reading - This is an important lesson to learn: Just because you are trained in something doesnt mean that there are tons of jobs waiting for you. There is a massive demand for 'generalist' subspecialty surgeons (ENT, Uro, Ortho) - but just realize that when you decide to become specialized within a specialty, this can potentially affect your job search. Certain subspecialists are highly sought after for all sorts of jobs (including academics), but it can be within fields that arent as desirable within that surgical specialty (huge generalization and not often true).
 
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Yeah I just came off the job search in a different sub-specialty field and the pickings were slim too. The pre-COVID leads I had all went on hiring freezes and still haven't moved forward with their official searches. I was lucky and kind of stumbled on an amazing position beget of a chance encounter a few years ago.

My H&N co-fellow and 2 of my co-chiefs who did H&N all found academic jobs this last time around but pickings were slim then too. There were only 4 posted academic jobs and 2/3 of my friends got one of those. The other one leveraged some personal connections to land a great position that wasn't ever posted.

I know for all of them and for me as well the timeline was vastly different last year than in years past. Most things got signed much later in the year than usual - probably because there was no academy meeting for the first "round" of interviews and whatnot. I think it really is a matter of leveraging every connection you have and circling back with people later in the year. I emailed my now chair in July and didn't get a response; emailed again a few months later and voila -- job! So keep at it and hopefully things will appear.
 
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Man all I have to say is that I've learned so much from you guys here since I was a medical student. I feel sorry that you guys got all this stress from covid and the job market. Hope you do well!
 
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Condolences, I know it has to be tough. Hang in there you're not alone - my coresidents who did fellowships not in H+N have had difficulties finding a job too. Seems to be across the board.

The one thing I'd caution you on is the generalist job with the opportunity to launch your own head and neck program - I had a friend who was offered this but might've underestimated the work required - he has yet to do a single free flap after almost a year. I never pressed him on the reasons but it sounded like a lot of logistics (which I can barely even imagine).
 
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I can’t claim to know exactly what it would take to start up a HN program on your own, but I know a whole lot about logistical and administrative inertia, and here is what I would say:

If you’re joining a practice or hospital system where someone is already doing flaps (maybe a plastics guy) then it would probably be fairly easy. You just have to have cancer patients, and enough cancer patients that you can keep busy. easiest way to know if that is true is to ask around, ask the other ENT guys how often they’re sending out patients because they need a flap. If there aren’t any ENT guys, then how many are in he community? Call them and ask if they could use a local HN guy who does flaps. Or the local oncologist.

If the hospital doesn’t do free flaps, yeah, that’s an uphill battle. You guys I’m sure know more about what it takes to do and manage a flap than I do, but I can tell you for sure that getting nursing on board for anything that requires intense monitoring can be an issue. Getting the required instruments can be an issue. The hospital will promise you with bells on that they’ll buy your micro set and a new microscope and a new doppler and so forth and so forth, but then you’ll join and they’ll immediately drop anchor and do everything that they can to delay getting you any of it. They’ll “approve funding” and then tell you five different reasons why the funding is there but they have to wait for x,y, or z to actually purchase things. (My favorite is always “we have approval but we can’t seem to make contact with the rep….You mean the rep who emails me ten times per week? That rep? The guy who basically lives in the bushes outside the office? That guy? You can’t get in touch with him?)

So if you tried to go that route, I would have it in the contract what equipment you have both agreed needs to be in house and by when so that you can do your job. You can talk to the ICU staff, SLP, oncology, dieticians, etc. ahead of time and ask them if they can support you. But the hospital will gild a turd for sure if it means you’ll sign on.
 
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