Randal S. Weber, M.D.
The University of Texas M. D. Anderson Cancer Center
Speaker:
Good afternoon. I'm really glad that everybody made the long trip over here down the walkway, that's part of our new M.D. Anderson fitness plan. [laughter] Twice. Yeah. Also, I just want to let you know that the presentation today is free, but the food is not. There's an evaluation form on each one of your chairs and I'd appreciate it if you filled that out for me, because we use that to plan our programs for the coming year. It's my pleasure today to introduce Doctor Randall Weber [phonetic] who's gonna be talking to you today about interview skills in your job search.
Dr. Weber:
Thank you. Good morning. We can entertain questions either during my presentation or at the end, whatever you, you feel like doing. We can keep it fairly informal. No matter where you are in your career path at some point and time it's gonna come down to an interview usually. Generally you're not going to secure a position in medical school, graduate school, a residency fellowship, or a job without an interview. So it's important that you have certain skills and that you're prepared for your interview. And I'd like to review what I've learned over the years as I've done many interviews. I've been an interviewee and I've also interviewed a number of people. This is a presentation that I give to my residents and fellows once a year, and they have found it beneficial.
So I'm gonna talk first about private practice. And I know a lot of you are not physicians and you're probably not headed into private practice, but some of you may be. And some of these principles apply to private practice as well. If you're a subspecialist the first thing you would want to ask the group that you may join, is it a general group? For instance, in my specialty, ear, nose, and throat, we cover the whole spectrum of illnesses of the ear, nose, and throat. But there're also subspecialists like ear surgeons, head and neck surgeons like me, pediatric hudler oncologist. So that's important that you establish whether there is a niche for you if you're a subspecialist. I think geography's critically important.
If you're from New York City, Houston might be a stretch for you. I think more of them need to come down and experience the south before they make up their minds about that. But never the less that can be an exclusion factor for some people. They just, there's certain areas of the country they wouldn't want to live in, and therefore you probably wouldn't want to pursue a job in those locations. Practice environment. I recently came from the North East where medicine is under significant challenge from the standpoint of reimbursement. Malpractice insurance rates there are really, some of the highest in the country. And practice expenses are very high.
So when you think about earning a living in a location like that you have to put all of that into the equation. You may be working 20 or 30% harder to make the same income that you might make in another area of the country. That could also apply to you if you're a scientist working in a laboratory. If the cost of living in a certain area is quite high then you need to be compensated appropriately due to the increased cost of living. Your spouse and family needs. I've seen a lot of people make a bad decision moving to a location where their spouse really wasn't happy, didn't want to move there, and that can create some marriage difficulties for you. So it needs to be a joint decision between you and your spouse when you select an area of the country. Family needs. Is this gonna be a great environment to raise my kids? If I like outdoor activities, are those available there? And my niche. What is the best, what has my training best prepared me for? Do I fit in with this particular group? Lifestyle. As I said, cost of living, the commute, schools, etc.
Private practice. Finding the right opportunities. Is the market good for specialists entering practice? There are many areas in the country right now that are over saturated with physicians, and in particular subspecialists. So if you go into a market where it's already over subscribed with specialists it's going to be difficult for you to become established, get a referral practice going, and also make a living. Before you consider a particular area of the country you need to make contacts and look for opportunities. All of the specialties publish a bulletin from their national or international societies, which have job listings. And that's a very good resource to begin your search for opportunities in various areas of the country. Your chairman.
Usually the chairs know everyone across the country in academic practice, but they've also trained a number of people who've gone out into practice. So your chairman is a very good resource for you. And your faculty, they also will have a lot of connections around the country, because most faculty have come from other areas of the country to their current position. And practitioners in the community. Many of our residents go out and spend rotations with private practitioners. It's a great way to make a contact and establish a relationship with someone that with whom you might want to go into practice. Friends and colleagues, fellow residents. Inside your community or in areas where you desire to live.
Do your homework ahead of time. What subspecialties do they cover? Do I bring strength? Do I bring a strength that they are lacking? Do they come from good training programs? If you've come from Harvard or Baylor, you know, you may not want to be in a group where perhaps the practitioners in that group have not trained in some of the top programs in the country. So you don't want to get into a group where there's disparity in training. Are they well respected in the community? This is a little harder to find out, but usually if you know some people, particularly physicians in a community, you can check around sort of under the hood and find out how well this group is respected. And I would strongly advise you to stay away from a group, which does not have a stellar reputation. And personality's important whether you're going into a practice group, either academic or private. Will my personality fit with these individuals? And so you get, you need to get to know them well at the time of your interview visits. Know the background of your partners, where they came from, what was their interest in their practice. Be punctual. Be relaxed. Portray enthusiasm. You need to have good posture and dress professionally. Make good eye contact.
I think it's very off putting for an interviewer when the person you're interviewing never makes eye contact with you. And prepare your list of questions ahead of time. When you're in, when you are in, in an interview, give the interviewer the opportunity to ask questions. In some situations the person you're interviewing never stops to let you ask the next question, and so you never really get a good insight into who they are and their personality if they never stop talking. And there's sometimes some very specific information you want to get from the interviewee. So when you're being interviewed your answers should be succinct, to the point, but provide the meaning that you're trying to get across. Remain focused on the subject and sell yourself. And interview is really a time for you to sell yourself. And when you look at two individuals with the same CV, the same background, it's the person that interviews better that's going to get the job. You need to promote your strengths that would bring added value to the group. Follow up your interview with a thank you letter. I think that's critically important whether you like the position or not, or you think you want to pursue it or not. Take a few minutes and handwrite a note and thank your, your interviewer. On the second interview you want to know if the practice has been stable. Yes?
Audience:
I'm sorry. When you say about the letter, is there a difference between letter and email or.
Dr. Weber:
I think either would be okay. Emails less formal. I generally would do a handwritten note. Has the practice been stable? Have partners left? Is there been a big turn over? There was recently one of my residents decided to join a group in Sarasota and I knew the track record of that group that there had been no new partner who had remained more than two years. And that it happened on three different occasions. He decided to go anyway, and he ended up leaving the practice in two years. So it's, you, you don't want to make an error in your first position. It's expensive, it's time consuming, and it sets your career back. So really need to get the background on the group that you propose to join. Is there turnover in their support staff? If they have a revolving door of staff in their office that tells you right away there's something wrong. They're either not paid well, its poor working environment, office manager is not a good manager. What is the buy in?
Some practice opportunities can be absorbantly expensive and would be beyond your reach. You need to know that upfront. And does the practice hold any debt? Sometimes purchase of equipment today is very expensive, you don't necessarily want to get into a practice where they have a high debt. Because, although this never happened previously, there're actually some practices today that go bankrupt. And what plans do they accept? Are they on all the major insurance panels? That's important, because you don't want to get cut out of a major market. So let's move on to the academic practice, which I think is probably more germane to most of you whether you're basic researchers or fellows in training. It's important that you set long-term goals, 1, 3, and a 5-year plan. You need to sit down and really spend the time to think about that. The first five years of your academic practice are critical.
That's the time when you will become focused on your research interest, you'll develop clinical skills, and you'll prepare yourself for promotion. And if you don't develop momentum in focus and direction towards that goal you'll end up at the end of those five years with possibly not being promoted. And in some institutions, the one where I came from it's an up or out situation. So the first thing you do in seeking a position is really define your career path for yourself and where you want to be in five years. Lifestyle. There's some academic departments where the workload is so onerous that you really don't have a personal life. And although work may be challenging and interesting, after a few years of that burnout will quickly follow. Is there a commitment in that department to teaching medical students, residents, and fellows? Is there research on going, either clinical or bench research? Patient care. Such as subspecialization or a broader general practice. Geography.
Practice environment, competition, and a desirable location. If you're in a community with three or four medical schools and you're in an academic department, it's gonna be a very competitive environment for you to build a practice. So you need to look at the types of specialization that are in that community, both academic and private practice to make sure that you will bring something to that community, which will have a high likelihood of success and you'll provide a resource to that community. Again, considerations for your spouse and family. If you have young children you may be in a community where private schools are the only option. It could be a quite expensive undertaking. It can quickly get you overextended from the standpoint of your cost of living. What is my skill set? Am I a clinician? How do I define myself? Am I a clinician? Am I a clinician scientist? Am I gonna be a bench scientist? And if I'm, if I'm gonna be a clinician in academic department that's not adequate today in most academic departments. You have to bring something else to the table.
So in this institution, for instance, you can practice as a clinician educator. So you not only have to have impeccable skills as a physician, but you also have to be a good teacher. As far as a clinician scientist, those are physicians who spend probably about a third or so of their time in clinical care, and about two-thirds of their time pursuing either translational or basic research. And if you're a bench scientist you may be in a clinical academic department, but generally all of your time commitment is to the lab and you're not involved in patient care. Am I a good match for the department and for the institution? Is the institution a good fit for me culturally? Groundwork. Finding opportunities. Again, academic practices can sometimes be difficult to seek out, so you need to learn by word of mouth, talking to colleagues in other institutions, the bulletin published by the subspecialties. Or, for instance, science or the other academic journals that are out there that would post good job opportunities. And also candidates for the best positions are actually sought after.
So if you have any experience with being on a search committee you know that all of your due diligence is really done behind the scenes. Everyone on that committee's making phone calls. You identify the most promising candidates by, by contacts around the country, and you find out who the really up and comers are. And so that's your target group for interviews. If you're a fellow you've gotta be proactive. You can't wait till May to start that job search. Takes you about three months to get oriented to the institution in your fellowship, for the faculty to learn you, learn about you, and get to know you. But I would strongly suggest by the November, and no later than December you're already out there looking for academic positions. Call your friends. Call your colleagues. Call your former faculty, either from your medical school or from your former training program. Your chairman should be an excellent resource for you to help you make some connections.
Either your past chairman in residency or your current chairman in fellowship. And get them to assist you. They can make phone calls and they can write letters. What I do for my fellows is I send a letter out to all the academic programs in the United States. There's about 100 of them. Or I may narrow the list down with a fellow, or if they have certain areas of the country they're interested in, or certain positions they wish to target. But your chairman can be a great resource for you to help you find some opportunities. It's hard to do it on your own without some help.
Audience:
Is it acceptable to approach your chairman and offer them like to draft a letter?
Dr. Weber:
I mean that's quite acceptable. If you're talking about a very specific letter regarding your skills and their knowledge of you, yeah, I think you could do a first draft and then pass it on to the chairman just to facilitate it. Because all of us have a number of things on our plate, and sometimes, you know, that doesn't get the highest priority. So that'll facilitate getting the letter out. And you have to be a little, little bit persistent about it too. But I think that's a good idea to do that. And I've had my fellows do that in the past if they really wanted to highlight some of their, their attributes. Keep your CV current. Obviously you don't want any typos on your CV or any inaccuracies, because that tells the person a lot about you, that you're perhaps sloppy in your work or you don't pay attention to detail. And when you're looking for someone to join your department or your laboratory you definitely want someone that's not sloppy or does not pay attention to detail.
Use a standard format for your institution. That's readily attainable. Make it organized in chronological order. Delete articles submitted. Remove the fluff, grand rounds, lectures, things that are really not significant, and are not a significant academic achievement. Get those off your CV. When, when I see a CV that's 25 or 30 pages long for someone who's an assistant or associate professor, it's really hard to pick the meat out of that CV if they're listed every grand rounds they ever gave, or every, you know, lecture they gave to, to the hospital staff. So put the key things on there and keep it organized so that the person reviewing it can really get the information about you quickly. You should include articles in press. Those have passed peer review. The revisions are accepted. And now it's ready for publication. So that's totally acceptable to put those on your CV. Thoroughly know the material on your CV. Don't get blindsided by having your name somewhere in the pack on an article and not having a clue about it, because that's a red flag that perhaps, you know, you weren't really involved in that project, you don't know much about it.
And particularly if you don't understand the science or the methodology don't have that on your CV. Or if you do have it on your CV be really prepared to talk about it. And I think you need to be introspective. What are my strengths, clinical or bench research, outcomes, reconstruction? What do I bring to the table? What are my weaknesses? Grant writing, practice organization, teaching, covering other clinical areas. Can I leverage this position into one that will build upon my strengths and provide opportunities to correct my weaknesses? And do I have the deliverables? If I want to come into this program as a reconstructive surgeon, can I really do that? Am I good at what I do? Because you don't want to set yourself up for failure! You don't want to sell yourself as a bench researcher if you really don't have the burning desire to do it, and you don't have the background to do it. Preinterview ground work. Find out about the department from individuals within the department, the institution, or the community. Really important that you try to learn as much about that place before you go there. What is the chairman like?
Does he have, he or she have a reputation for being fair? Is the person a national leader? If you really have a strong desire to ascend the academic ladder and you go to a program, for instance, in our specialty, The University of New Mexico, it's really not a program that's on anyone's radar screen. It doesn't mean that they're not there doing good work, they're probably taking fine care of patients, but they're not on the academic radar screen at all. There's no significant papers that come out of there. So while it might be a great place to live, if you're really interested in ascending in academics that's not the type of program you should pick. Is the chairman honest? Is he or she a role model? Do they have a track record for mentoring faculty? It's a red flag if you go look at a department and no one's been promoted in five years. If everyone's still an assistant professor, an associate professor, and there's not the environment for advancement opportunities for publishing, and they're sort of stuck in their current positions that's a red flag.
Are the faculty respected within the institution? Some of these I, I gather or I understand are going to be difficult for you to sort out. But if you have contacts in the institution where you're interviewing I think you can get access to this information, particularly if you have friends. Who will be my competition from within the department, institution, and externally? For our specialty, for instance, if I'm a thyroid surgeon and they've got ten surgical oncologists that all do thyroids, probably not a good fit for me. And you don't want to set yourself up for frustration or not being able to develop in the area, which you wish to do. Preinterview prep. Yeah?
Audience:
How do you indicate that you're looking at faculty and you see that members of the faculties are actually fellows graduate from the same program?
Dr. Weber:
It's an inbred program? Is that what you're asking me?
Audience:
Yes. It's part of that. Because it can be a double edge blade. If there are some people from the program that stayed, it means maybe it's a good environment.
Dr. Weber:
Right.
Audience:
Spend some time down there.
Dr. Weber:
Right.
Audience:
If they don't like it nobody would quit them. But at the same time, how much could set a good environment and maybe they don't want to come back.
Dr. Weber:
Well programs tend to hire fellows, their own fellows, because it's a known commodity. They can screen them from among other fellows that they've trained, or the current fellowship class and decide that these are the best individuals to retain. Can also mean that they're having difficulty recruiting into the department. And I think you have to sort that out. It's, if they've had a number of people come through and interview and no one's accepted a job from the outside that would be somewhat concerning to me. That perhaps there's something wrong with the environment or the opportunities aren't there. So try to define the strengths and weakness of the program. Is there a niche for me in that department? Learn about the chairman and the division head. What are their clinical and research interests?
Know some of their publications. You can request resource documents about the department if they're available. Those can be the newsletter, can be their annual report, can give you great insight into the activities, both clinical and academic that are ongoing in that department. It's important to be rested. Don't fly in, you know, have to get up at 4 o’clock in the morning, catch a 6 o’clock flight, your interviews at 8:30 or 9, and you know, you're cutting it too short, you're harried, you're tired. Try to get there the night before and rest up and try to be relaxed as possible. And plan for travel glitches today, particularly in the winter or even any time of the year right now. There's, there's so much air traffic and schedules are totally unpredictable. Preinterview preparation. Formulate a vision for your career, the division, the department, and the institution. Have your academic game plan thought out, 1, 3, and 5-years. And then begin to think about the resources that you need to accomplish your goals.
Salary, don't, there's nothing wrong about requesting as high a salary as possible if you're worth it. Secretarial support. If you're writing all your own papers, if you're preparing all your own grants, if you're having to, in some institutions you might have to even prepare letters to referring physicians or to colleagues. That doesn't leave you any time for your academic pursuits. So make sure you have proper support, secretarial, nursing support, laboratory space. Is a technician going to be included in my start up? If you're interested in clinical research, is there a clinical research infrastructure, which includes research nurses, data managers. Is there start up funds? It's gonna take you a while to find resources to support your program, either through industry or through grants. And be realistic about what your goals are and don't over reach. Protect. Gary?
Audience:
What about asking for protectant three times?
Dr. Weber:
I was just getting to that. Yep. I'll do, I'll talk about that in just a second.
Audience:
Is it appropriate up front to ask them how much you have, what percentage of your salary you have to have versus?
Dr. Weber:
I think you need to have a clear indication of that for sure. Yeah. And it should be pretty well spelled out for you depending on what track you're in. I don't talk about salary on the first interview though.
Audience:
Do you have any suggestions for coming up with a 1, 3, and 5-year plan that is what people are looking for? I can come up with a 5-year plan, but I don't, I don't know if that's realistic or overreaching. How formal of a process would, do you think you should use to develop that? How many people do you think you should bounce it off of? Who? Do you have any suggestions?
Dr. Weber:
Well I think by the time you're applying for your first academic position you should have at least some idea of what your, what your clinical one interest is, but also what your research endeavor would be. Is it, is it going to bring a new research direction to that institution? Am I starting from scratch? Or is there already infrastructure there? Are there mentors there for me that can help me along the way to get started? That's, again, I think some of the things that you have to really try to pick apart as you look at a potential institution where you may, you know, may wish to a, to seek employment.
Audience:
Do you think it's important to talk with your current superiors to try to develop that?
Dr. Weber:
Absolutely! And especially if, what I think you should do is go through the thought process first, put the things down really in writing where you can organize them, and then take them to your chairman or your mentor. Go over with them, because they've been down that road already. They're going to be able to tell you if this is realistic or not. Protected time is critical. No matter, and usually this affects clinicians. If you really are going to have to be in the clinic three days a week and, or in the OR, or if you're on service two weeks a month, you may not really have the time to devote to your academic interests. And once you're there it's very hard to get things sort of retroactively. So make sure you plan it all out ahead of time. In most institutions you'll get at least one day a week of academic or administrative time. If you're going to be on the research track as a clinician scientist you probably need 60% or more protected time; possibly 80%.
So all of those have to be decided up front. Salary support. There's only a couple of ways of doing it, either it's through grants or through clinical practice, or it's through start up funds, which will protect you for a certain number of years. That all needs to be worked out and decided up front. If you want to come to an institution and start a new program, as you discussed, for instance maybe you're interested in chemoprevention and you have some ideas for establishing a clinical research programming, chemoprevention. Is the institution able to help you market that program so that you can attract patients to the program? And a title. It may be that you'll be in charge of the residency program, or the residency coordinator. Those are things that you should think about and ask up front. And don't take anything for granted. Again, once you've decided to take the position, you've signed the contract, it's very hard to go back and sort of get an additional amount of resources for things that you really didn't think about prior to taking the job.
Actively participate in structuring the interview process. You want to seek appointments with key individuals. If you are interested in, in a certain area of research and you need a transgenic mouse model, make sure that they have that person in your institution. And make sure on your interview that you, or during your visit to that institution that you have an interview with that person. Make sure that they're willing to collaborate with you and help you. From the standpoint of a surgeon, it might be that I would need to meet with the endocrinologist if I have a strong interest in thyroid surgery, or the endocrine surgeons, or the plastic surgeons. Some of these people may be competing with you, but you may also win them over towards developing a joint program. And that's a win win for everybody. If you're a head and neck cancer surgeon, you want to know if they have good radiation and good medical oncology. You can't go to an institution and be a great surgeon and take care of patients in a multi-disciplinary way if they have poor radiation oncology, if they have poor medical oncology. It just won't work.
You won't be able to, to develop a program. Meet with a director of research for the department or for the institution. Be sure you meet with the departmental administrator. Try to determine is the, is the department on sound business footing. Now you may not be able to find this out in the first interview, but you defiantly need to know before you take a position. Is that department in the red? How longs it been in the red? Because what happens when departments are in the red, the chairman may get replaced, they may cut salaries. So it's important that you really do your due diligence from the standpoint of the economics of the department. Talk to the residents and fellows. If they're happy, you're probably gonna be in a good environment. If they're unhappy, if they've had attrition that's a, that's a definite red flag. The initial interview is like a first date. Is there chemistry, and can we dance? Be punctual. Be relaxed, but professional. Properly attired. You body language is important. You don't want to slouch in the chair. You want to sit up straight and make good eye contact. Don't fidget. No throat clearing, tapping your feet, or rustling papers. It just sends a message sometimes either you're not interested, or you are too nervous.
Display enthusiasm, but don't be disingenuous or overly eager. Focus responses to questions. Avoid tangential answers or too lengthy responses. And give the interviewer time to ask you questions. Be prepared for questions that may seem provocative, and maintain an even keel emotionally. Some interviewers, and people are very skilled at this; they want to put you off balance. They want to see if you can think on your feet. Discuss your strengths. You don't have to feel uneasy about that. You don't need to be shy. Let them know what really is your skill set. Let them know what you're bringing to the table. Describe your vision of where you would like to take this opportunity, and how it's a good fit for the position, the department, and the institution. For instance, if you're a, one of the, came out of one of the best spine programs in the country, you need to promote that when you go for your interview. That's what I'm gonna bring to you. I'm gonna make this place the best spine program in the country, because that's my background. That was what my training was in. Discuss your interests outside of medicine. I think today we're looking for people that are more well rounded. We don't want just robots that go to work and do all the things related to their work life, but have no outside interests.
It also helps you engage the interviewer much better if you can share some of your outside interests with them. There are ways of self destructing; poor manners at dinner, or at your luncheon meeting. I, I think in most high level business jobs, they will not hire you without taking you out into a social situation. Because it's a disaster if they hire someone that really can't interact in a social function. Arrogance. I'm from M.D. Anderson Center. I'm from the M.D. Anderson Cancer Center and you're lucky to have me here. I've seen that happen to a number of people. Not just from Anderson, but they come from Hopkins, or Harvard, or elsewhere. And it's the level of arrogance that's very off putting. So, display self-confidence, but don't be arrogant. Don't be poorly dressed or groomed; too talkative, or overly anxious. First interview do's and don'ts. Get a sense if you're the person they're looking for. Sell yourself. Be prepared. Know about the position and the department. Have a vision. You have to have some thoughts and a game plan for where you want to go, an idea of the resources necessary. Don't ask about salary on the first interview, unless the subject is brought up.
Don't seek privileged information on the first visit. You can do that on the second visit if it's appropriate. Don't come unprepared, lacking a vision or a game plan. Post interview assessment. I think whenever I've finished an interview I would always look back over it. What did I do right? What did I do wrong? What could I have done better? And really think about if, if I'm interested in the position. You don't want to go back and waste your time and their time if you really don't think you have a strong interest, particularly for the second interview. The first interview is, you know, is there interest there on both, on each of our parts? And do we want to pursue it? Does the individual recruiting me share my vision? If your visions are divergent it's probably not gonna be a good situation for you. What are the resources necessary to facilitate my success in that environment, and what are the impediments to success? So always look at the roadblocks too, and know if they're surmountable or not. Do the resources exist? Are they attainable? Or is it smoke and mirrors? Post interview. Send a thank you note to your recruiter and the key individuals. That might be the department chair, the director of research, whoever, they are those individuals that are gonna be critical to your success in that position. This, it could be other individuals in the faculty, the cancer center director, or the director of research. If there's a real interest on your part agree to a second interview. Did I like the chair and the faculty? Did I like the institution?
Could my family and me be content in this geographic location? If you think the job is great, but you really don't like that area of the country, don't go there. You or your wife won't be happy. The second interview's the time that you get engaged. I'm really interested, and if the resource is available I'm willing to make a commitment. On the second interview everything's on the table. Write down your wish list. Know your wish list or have it with you before you go to that second interview. Get specific. Tour the laboratory space. Tour your office space, the clinic space, the support personnel. Talk to all those individuals. Where is my lab space? How much bench space do I get? Do I have access to core facilities? Do I have a technician that's dedicated to me? And if it's necessary for your success, you have to ask for all of it. I think it's great on the second interview to talk about salary. Most of the time the person recruiting you will bring it up, but if they don't you should certainly bring it up on the second interview. Know what the benefits are.
They should have you meet with the benefits person when you go for that interview. And what is my title? When I left here I wanted to direct the head and neck cancer program. I made sure that that was a title that I received when I took that position. The spouse should accompany you on the second visit. They may not have anything set up for your spouse. Sometimes they'll have other faculty wives or husbands meet with your spouse. But it's very important that your spouse get a feel for the environment, for the geographic location, the schools, looking at real estate. It's all critical, because this has to be a joint decision between both partners. And what's the environment like around there? If you're an outdoors person and you like to be out 365 days a year, you may not be able to do that in Minnesota, particularly if you don't like cold weather. So be realistic about all of those things in, that go along with your lifestyle. Negotiating.
I think if you go back for the second visit it means that you're really interested and you want to negotiate in good faith. You should have a genuine interest in the position. If terms of agreement are reached you should be willing to accept the position. On what issues are you flexible and what are deal breakers? You're never gonna get 100% of what you want. But you should also know what the deal breakers are. If you want to be director of cancer research and they're not willing to give you that title, and the authority that goes with it, and the finances to build the, a research program, don't go near that job. That should be a deal breaker for you. Counter offers from other institution are acceptable, but be up front with the individual recruiting you. It's fine to do some leverage. You know you may not be fully committed that you're ready to leave an institution. But you've got a great job offer out there, and sometimes that can create leverage for you to get an even better environment where you are. And then you don't have to go through the, the turmoil of moving or, or going into a position, which you think is good, but there's still some unknowns. Rank and title. Assistant professor tenure track, or nontenure track. Director or co-director.
Those are all really physician specific and we can't go into details about them. Salary support for X number of years. That's really important. It may take you three years to get your first RO1. Make sure that you're fully supported for that time, so that you're not having to do some other service in order to make your salary. For clinicians what you can do is you can negotiate for salary support, you can get reduction in your overhead for the first several years. Bonus plan. How long will it take before I'm in the bonus plan? Is my salary at the appropriate level as set by the AAMC Standards? That's publishable. Most institutions, most good academic institutions want their faculty at least as the fiftieth percentile. That data's out there, and you can get access to it. And cost of living. You may need a bigger salary, obviously if you live in New York City or Boston than if you live in Houston. It's really important you have the proper support personnel.
Those things aren't going to be forthcoming if you don't negotiate for them and get them in writing. Secretarial support, administrative support. Do I have a clinic nurse? Will they provide a research nurse during my start up phase? Physician extenders and a laboratory technician. Office space. Do I have dedicated office space? Is it in a good location? If you're a clinician and you're gonna run a busy practice, if you only have one or two exam rooms to try to do a fully day of clinic you're gonna be very miserable and in a bad situation. So you want to have the adequate space to support your activity. Dedicated OR time. That's the big mistake that surgeons make. They go to a, into an institution and they don't realize that the block time's all taken up. So you're, you get a start time, but it's at 4 o’clock on Friday afternoon. So be sure you look into that carefully before you take the position. And dedicated laboratory space.
It's okay that maybe you're only gonna get 600 square feet now, but the new research building's gonna open up in a year or two and you're promised in writing that you're gonna get double that space when that new building opens. You just gotta cover all the details. So I think that's it. I think that covers everything I wanted to say. I'd be happy to answer any questions. But if I could summarize, it's really take the time to be introspective. What am I looking for? Develop a game plan. What are the resources that I'm gonna need to implement my vision and to allow me to achieve my goals over the next 3 to 5 years? Good. Thank you.
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