Getting academic jobs after Derm residency?

[PremedSurvivor]

Had a few questions about seeking a job after Derm residency, as I'm unfamiliar with the process. Particularly curious as to how this works if you are considering pursuing an academic position at a state different than that of your residency program.

- How early should you start looking academic jobs, during residency? I've heard PGY2s discuss places they have their eyes on.

- do you do audition electives if you're especially interested in a place?

- Are fellowships an unspoken requirement for an academic position?

- Is getting an academic jobs insular and largely via connections?

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[Skindoc83]

I never looked seriously into academics, but it seems to me that most departments are open to hiring general dermatologists. However that does not mean that you will necessarily be working with residents. A lot of departments are opening up satellite clinics that residents don’t rotate through. I personally would not be interested working in a private practice setting, for low academic pay, and all of the dysfunction and red tape that comes with a large bureaucracy and academic department. These positions often have high turn over. I do not think you need to do an audition rotation. Connections always help, but I think the only instance it may be needed is if you’re looking to be in a very desirable and saturated area, like stanford or NYC. There aren’t a lot of fellowship options in derm: Peds, mohs, derm path. Peds derm is always in high demand but there are very few mohs or path positions in academics given overtraining, and the sheer volume of referrals needed to keep one doc doing full time mohs or path. Path is especially difficult because one pathologist can sign out over 200 cases a day

 

[asmallchild]

Had a few questions about seeking a job after Derm residency, as I'm unfamiliar with the process. Particularly curious as to how this works if you are considering pursuing an academic position at a state different than that of your residency program.

- How early should you start looking academic jobs, during residency? I've heard PGY2s discuss places they have their eyes on.

- do you do audition electives if you're especially interested in a place?

- Are fellowships an unspoken requirement for an academic position?

- Is getting an academic jobs insular and largely via connections?

I agree with skindoc83's points. I returned to my residency program as an attending for 1 year after my fellowship. The setup was similar to what skindoc83 had mentioned. Rather than having me at the main campus, the program wanted to utilize me in an academic satellite clinic in an effort to expand the reach of the program. I didn't get to see residents regularly. My pay was significantly lower than that of my private practice colleagues (e.g. 50% less). This is obviously not true of every program but there can be an odd dynamic if you return to your residency program to teach. Often times, there is the feeling that your colleagues will always look at you as the trainee you started off as and not a true peer (or at least it takes a few years to shake that label).

Back to your specific questions:

- If you have to be in a specific city or specific institution, it never hurts to start looking. It would probably be odd to start interviewing as a PGY2. I don't think most PGY2's understand enough of Derm to know what to look for in a job. There are some very motivated PGY3s who nail down their job by the end of the PGY3 year. That seems to be a more realistic timeframe in my eyes. I think nailing down a job at the beginning of your PGY4 year is still being ahead of the game. Most of my co-residents who didn't pursue fellowship finalized their job plans in the 2nd half of their PGY4 year.

- I don't think you need to do audition electives to secure an academic position

- If you want to practice in a particular subspecialty then yes, fellowships are definitely required. If you are talking about general Derm, then no, fellowships are not required. As skindoc83 mentions, Peds Derm is always in high demand. It is not any easier to find a 100% Mohs or 100% dermpath job in academics as compared to private practice. Most will have to do a split and claw their way up to the desired percentage.

- Getting an academic job is a lot like getting a job in private practice. The best way is to have connections and/or utilize your residency program's contacts to get a head start on the other applicants. You still have the opportunity to cold call and get a position as the job market for general Derm is still quite favorable

 

[reno911]

Admittedly, I haven't been actively involved in this stuff in a while, but I'm sure you could cold call the majority of academic depts in the country, tell them "I'm finishing residency this summer and I'm interested in working at your department*", and expect an interview, followed by a job offer.

*I'm talking about a general medical dermatologist. It would work for peds derm also. As stated by others, derm path and Mohs are different.

 

[dermie1985]

Current PGY4 here, applying for academic positions. Some general advice.
- Most people start applying at the end of PGY-3 year or beginning of PGY-4 year for academic positions. I would generally recommend starting to apply at least 12 months in advance of your intended start date...most people don't want to start work until September after they graduate (July for taking boards and August for traveling/relaxing). There is some more administrative tape to go through to get started (i.e. approval of your position by the Dean of Medical School, other licensing issues, etc.) which can take 3-6 months even after you "get the job". So never bad to start early.
- I would say PGY-2 year or the 1st half of PGY-3 year is definitely too early.
- That being said, it's never too early to network as this is the key part to landing any *good* academic position.
- You can "cold call" (or email) academic programs. Most jobs aren't listed and programs are often flexible in hiring new faculty if they think you're a "good fit" and it makes financial sense.
- No need to do an "away" or audition rotation. Just make sure your home program director likes you and will go to bat for you.
- Getting an academic job at the assistant professor or clinical instructor on a clinician-educator track in general dermatology is the "standard" path. Harder coming out of Mohs or path fellowship (there's limited volume to support those positions, so they really only open up if someone leaves or retires, or the department expands considerably and can support that person)... whereas there is a near endless volume for general dermatologists (and pediatric dermatologists, because there aren't many of them), especially as those providers end up supporting the pathologists and Mohs surgeons with path and surgical volume.
- The process is entirely different if you want to be primarily research (but there are so few people who fit that description....so I'll glance over).
- It's advantageous to have a "specialty" area of concentration, even as a general dermatologist. I.e. "I want to start X and Y specialty clinics that would be regional or national centers for referrals". This is what academic departments are looking for, even if it's only a 1/2 day per week or every few weeks. So find your "niche" and the research/advocacy/experiences to back up your "claim" for expertise.
- Many departments will want you to work in satellite clinics - you need to be creative in order to get around this - but you can try and negotiate out of it if you know how to sell yourself. It's institution-dependent, though.
- I've personally found that "big-name" programs on the coasts tend to (1) offer much lower salaries (2) want you to work in satellite clinics and/or less with residents. Programs outside the coasts, even "big-name" programs, tend to offer better salaries and more flexibility with clinical schedule/job description. Something to consider when you're "starting out" - I think I started this process really wanting to work at a research powerhouse program on the East or West Coast, but quickly realized that some of the "smaller" or "less prestigious" programs offer way more flexibility, work-life balance, and $$$$...and may actually be the "better" places to start out if you're otherwise well-supported.
- That being said, everyone starts somewhere, and just because you're working in a satellite clinic now or don't have your "dream job" out of residency, doesn't mean things won't change.

PM me if you need anymore advice.