Comparing job options: Tenured faculty v. VA Clinical?

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adna51137

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I'm needing to move to another (very high COL, deep blue) state for at least the next year for personal/family reasons (people that can't be relocated here). I've both recently gotten tenure at a public university in my current low COL deep red state (that can be done remotely for at least one year--see below) and been offered a FT clinical job at a VA in the state I need to move to. My priorities are job stability, location, and salary. I'm in a deep red state, although they haven't threatened tenure (yet).

Academia pros:
-I like my job a lot in that I like the content of what I do. I publish well, get good teaching evals, and have some success with grants. I have recently been granted tenure and gotten consistent (though small) merit raises.
-I like my students and colleagues and even my administration.
-Lots of flexibility in actual work hours and physical work location
-I have an outside fellowship that pays me an additional ~$30,000 on top of my salary for this year and possibly next (if it gets renewed) that I couldn't keep if I went VA.
-My department head and Dean have agreed to let me work remotely this coming academic year, because my work is essentially remote as is (I teach online, don't do work that requires physical lab space, and my only in-person meeting is a monthly department meeting).
-Currently good benefits (pension, retirement max, health, short- and long-term disability, etc)

Academia cons:
-No idea if remote would be a possibility after this year if I end up needing or wanting to stay remote, especially as we'll have a new Dean next year.
-There's unlikely to be another VA job in my area in the state I'll be remote in, and I'll likely seriously burn bridges if I turn down the VA job at the FJO stages, especially as the hiring process took forever, so I feel like this is my only chance.
-The state legislature here is, er, not well aligned with my views at all, and I fear what they might do, both socially and, of dir4ect consequence, with the university. (this state hasn't threatened tenure yet but....)

VA pros:
-They are starting me out at the top of the GS step, so I'd actually be making about the same as I do with my current 9-month academic salary.
-Supervisor seems really nice
-Gives me a permanent way to stay in a state I prefer with my SO
-Stricter hours
-VA job stability

VA cons:
-Because it's a single grade position, and I'm starting out at the top step, there's likely no room for salary growth.
-Much less day-to-day schedule flexibility, both in hours and physical work location
-Would have to go through the probationary period (so, essentially, would not have tenure again for a year)
-Good benefits
-I'd miss academic work a bit.

What is your take? What are other things to consider?

Thank you!

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I'm needing to move to another (very high, deep blue COL) state for at least the next year for personal/family reasons (people that can't be relocated here). I've both recently gotten tenure at a public university in my current low COL deep read state (that can be done remotely for at least one year--see below) and been offered a FT clinical job at a VA in the state I need to move to. My priorities are job stability, location, and salary. I'm in a deep red state, although they haven't threatened tenure (yet).

Academia pros:
-I like my job a lot in that I like the content of what I do. I publish well, get good teaching evals, and have some success with grants. I have recently been granted tenure and gotten consistent (though small) merit raises.
-I like my students and colleagues and even my administration.
-Lots of flexibility in actual work hours and physical work location
-I have an outside fellowship that pays me an additional ~$30,000 on top of my salary for this year and possibly next (if it gets renewed) that I couldn't keep if I went VA.
-My department head and Dean have agreed to let me work remotely this coming academic year, because my work is essentially remote as is (I teach online, don't do work that requires physical lab space, and my only in-person meeting is a monthly department meeting).
-Currently good benefits (pension, retirement max, health, short- and long-term disability, etc)

Academia cons:
-No idea if remote would be a possibility after this year if I end up needing or wanting to stay remote, especially as we'll have a new Dean next year.
-There's unlikely to be another VA job in my area in the state I'll be remote in, and I'll likely seriously burn bridges if I turn down the VA job at the FJO stages, especially as the hiring process took forever, so I feel like this is my only chance.
-The state legislature here is, er, not well aligned with my views at all, and I fear what they might do, both socially and, of dir4ect consequence, with the university. (this state hasn't threatened tenure yet but....)

VA pros:
-They are starting me out at the top of the GS step, so I'd actually be making about the same as I do with my current 9-month academic salary.
-Supervisor seems really nice
-Gives me a permanent way to stay in a state I prefer with my SO
-Stricter hours
-VA job stability

VA cons:
-Because it's a single grade position, and I'm starting out at the top step, there's likely no room for salary growth.
-Much less day-to-day schedule flexibility, both in hours and physical work location
-Would have to go through the probationary period (so, essentially, would not have tenure again for a year)
-Good benefits
-I'd miss academic work a bit.

What is your take? What are other things to consider?

Thank you!
Some thoughts:
- does the VA have an academic affiliate?
- does the VA job offer any schedule flexibility?
- you might burn a bridge at that VA if you decline the fjo, but you also might not, especially if they can't meet your scheduling and other requests. Or if you apply to another clinic. Also increasing number of remote VA jobs are coming up.
- do you have any trainees to worry about?
 
Is the VA job GS-12, 13, or 14? 13 is average for clinical jobs. 12 is below average. 14 for a non-supervisory job is rare.

On a personal note, do you need the added stress of a new job on top of a move? Is it worth taking a year at the old job and getting licensed in the new state for non-VA job opportunities? What type of work do you prefer doing? Where do you prefer to live long term?
 
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Have you done prac, internship/fellowship, or worked in the VA before? Going in brand new versus being seasoned with what the VA is and what the VA is not is very relevant IMO, especially if academia has been your only professional gig.

Also, have you already accepted the VA position yet or have a deadline to do so? It sounds like a direct hire situation (as opposed to competitive process via a public listing) which works in your favor.

Given hiring/retention trends in the VA currently where many facilities are 20-30% below their expected FTE levels for clinical mental health staff (levels which are often too low already) even if you turn down this offer, there will likely be future opportunities, although those are more likely to be public postings/competitive process and you might not get your currently negotiated step offer if selected.

And if you haven't formally accepted versus accepting and going through parts of the onboarding process and then backing out (which is becoming more and more common in VA land), you're less likely to rub administrators the wrong way.

For me, whether a VA job is a good job depends a ton of your specific facility and specific clinic.

Honestly, I'd be wary of VA jobs in high CoL areas due to the balance between # of patients the facility is needing to offer mental health appointments to and the # of available staff, which is going in the wrong direction everywhere but especially at non-rural VAs. If your current facility has lots of active postings on USAJobs (including indefinite open continuous ones), that's a bad sign.

If your facility (and clinic) is going to be one where every single bookable slot will quickly be booked for 2-4 months out, even if your supervisor is good, the benefits are solid, you like the clinical work, etc, it's gonna be a grind and you're likely to be looking for a way out (out of the VA, transfer to a different clinic/facility) sooner than later. Stability is only relevant if it's something that is sustainable.

And depending on how your facility is handling access, you may need to compromise on care (e.g., therapists being allowed to offer a max of 6 follow-up appointments to any single patient for an episode of care due to lack of ability to see everybody regardless of what clinical practice guidelines say) while running into uncompromising bureaucracy (e.g., advance leave requests are denied if not submitted 45 days out, leaving you to rely only on the 8 hrs of sick leave you'll accrue per month).

Based on what you wrote, I might ride out the remote teaching gig for the year and see what happens. If that turns into a dead end, the VA will likely still be there for you. And you'll hopefully also have a chance to navigate the local market and see if there might be a better fit. Good luck and happy to chat further about all things VA related.
 
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The one benefit I'd add for VA jobs: the non-compete is non-existent. So although your VA pay may be capped unless you find a way to get a Grade upgrade, you can do non-VA clinical/forensic work very easily.

Relatedly, although many/most AMCs have non-competes, your contract may allow for you to do outside/PP-type work through the department. They'd take a cut. of course, but you'd get to use their resources (e.g., office space) while supplementing your income.

Edit: Ack, I completely misread Academia as AMC. My fault. I'll leave the above for folks looking at AMC vs. VA, but it's not relevant here. I really doubt your university has a non-compete for clinical/forensic services.

Even though the politics don't align, do you actually like where you live now overall?
 
I live in a very red state and am glad that there are people with opposing views in academia. Just got back from a conference where that was apparent from some of the discussions regarding recent legislative actions. It sounds like you currently have a pretty cushy and flexible setup and I don’t think that would be as feasible in the VA system as you stated. If you want to stay in the state you move to, then you have a year to find a good job and if I was going to do as much hard clinical work and hours as a VA system would require, then why not go private practice? Academic plus clinical on the side is a good gig, I would think.
 
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The one benefit I'd add for VA jobs: the non-compete is non-existent. So although your VA pay may be capped unless you find a way to get a Grade upgrade, you can do non-VA clinical/forensic work very easily.

Relatedly, although many/most AMCs have non-competes, your contract may allow for you to do outside/PP-type work through the department. They'd take a cut. of course, but you'd get to use their resources (e.g., office space) while supplementing your income.

Edit: Ack, I completely misread Academia as AMC. My fault. I'll leave the above for folks looking at AMC vs. VA, but it's not relevant here. I really doubt your university has a non-compete for clinical/forensic services.

Even though the politics don't align, do you actually like where you live now overall?

While this is true, the downside is that it's on top of your required 40-45 hour week in the VA. Unless you can find a way to finagle less than a 1.0 FTE role.
 
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Seems like a no-brainer to me.

You are already tenured and making the same salary in 9 months that the VA is paying for 12 months. The flexibility your university is already providing you shows a great deal of the possible flexibility in the future.

Not sure how far apart the two cities are but, in the future, can you possibly split your time? You’ll have summer and winter break to be in the city and maybe can even spend just 3 days at your university? Can you buy courses out with future grants? Without the details, your university position offers the kind of flexibility to make this work. Once you go VA, it’s much harder to get back to academia. Also, you can keep your current tenured job and hope to find a new one in the new area over the next few years.
 
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Thanks for all the feedback, everyone! Some answers (@summerbabe , @PsychPhDone , @DynamicDidactic , @AcronymAllergy ):

I have gotten a verbal FJO but not yet a written one, so I haven't officially accepted it yet. It's taken about 6 months to go from TJO to FJO.

The VA doesn't have any academic affiliation. AFAIK, there aren't a ton of openings on USAJobs, though I do know they've been hiring multiple people in Mental Health.

As for where I want to live location-wise, definitely the state with the VA job despite the high COL. The politics of this state are getting rather scary if you're anything but a White straight evangelical Christian man, and I can't really fault my family members who are none of those things for not wanting to live here and for being concerned about me living here.

I have some experience with VA and so I have a decent idea of what I'm getting into--if the content of the work was the same in both states, I'd probably choose academic work, but I've also known a lot of people in the VA and truly think it's the best route to go if you're going clinical (no interest in private practice--the small business ownership piece has never appealed to me).

The travel between the two locations is tricky--12 hour flight time, plus 90 minute drive on top of that, due to the university not having an airport in town--if it was even just a six hour flight or so, I'd just fly in for the monthly department meetings and be done with it.
 
I have some experience with VA and so I have a decent idea of what I'm getting into
YMMV but I interned in 2017 and did fellowship in 2018 and while I know trainees are somewhat to largely shielded from general systems concerns, the VA has changed a ton since I took a staff job in 2019 and especially post-COVID (and largely not for the better, at least for clinicians)
but I've also known a lot of people in the VA and truly think it's the best route to go if you're going clinical
If you’ve been out of the system for a bit, it might not hurt reaching out to some of them and seeing their current thoughts on job satisfaction.

I’m not trying to be a debbie downer since I’m personally in a mostly sustainable VA clinical job but I have waaaaaay too many colleagues who are in varying stages of burnout (with non-clinical factors often accounting for a high degree of that) and looking/thinking about leaving or at least moving around in the VA to find something better.
 
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YMMV but I interned in 2017 and did fellowship in 2018 and while I know trainees are somewhat to largely shielded from general systems concerns, the VA has changed a ton since I took a staff job in 2019 and especially post-COVID (and largely not for the better, at least for clinicians)

If you’ve been out of the system for a bit, it might not hurt reaching out to some of them and seeing their current thoughts on job satisfaction.

I’m not trying to be a debbie downer since I’m personally in a mostly sustainable VA clinical job but I have waaaaaay too many colleagues who are in varying stages of burnout (with non-clinical factors often accounting for a high degree of that) and looking/thinking about leaving or at least moving around in the VA to find something better.

Agreed with this sentiment. There are good jobs and bad jobs at the VA. It is often based on the clinic you are located in and the level of staffing. Some clinics remain chronically short-staffed and some are fine. General mental health always seems tougher to keep than specialty clinics.
 
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I'm only half time general mental health and I am veeeery burnt out right now, lol.
 
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Thanks for all the feedback, everyone! Some answers (@summerbabe , @PsychPhDone , @DynamicDidactic , @AcronymAllergy ):

I have gotten a verbal FJO but not yet a written one, so I haven't officially accepted it yet. It's taken about 6 months to go from TJO to FJO.

The VA doesn't have any academic affiliation. AFAIK, there aren't a ton of openings on USAJobs, though I do know they've been hiring multiple people in Mental Health.

As for where I want to live location-wise, definitely the state with the VA job despite the high COL. The politics of this state are getting rather scary if you're anything but a White straight evangelical Christian man, and I can't really fault my family members who are none of those things for not wanting to live here and for being concerned about me living here.

I have some experience with VA and so I have a decent idea of what I'm getting into--if the content of the work was the same in both states, I'd probably choose academic work, but I've also known a lot of people in the VA and truly think it's the best route to go if you're going clinical (no interest in private practice--the small business ownership piece has never appealed to me).

The travel between the two locations is tricky--12 hour flight time, plus 90 minute drive on top of that, due to the university not having an airport in town--if it was even just a six hour flight or so, I'd just fly in for the monthly department meetings and be done with it.
If you like the academic work and they're letting you be flexible this year, I'd be hesitant to ditch that for a VA job with no academic affiliation.
 
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