Preparing to negotiate your first job

0:00 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. As clinicians, we spend a decade or more as trainees learning to take care of patients. When we finally start our careers, we want to build research programs, but then we find that our years of clinical training did not adequately prepare us to lead our research program. Through no fault of our own, we struggle to find mentors, and when we can't, we quit. However, clinicians hold the keys to the greatest research breakthroughs.

0:40 For this reason, the Clinician Researcher podcast exists to give academic clinicians the tools to build their own research program, whether or not they have a mentor. Now introducing your host, Toyosi Onwuemene Welcome to the Clinician Researcher podcast. I'm your host, Toyosi Onwuemene, and it is a pleasure to be speaking with you today. Thank you for taking the time to listen as I talk today about preparing to negotiate your first faculty position. And I bring you this episode courtesy of my coaching clients tonight as we went through this in detail.

1:24 And after we were done with the conversation, I really felt like it was important to bring to you so that you can think about what components are necessary to make sure that you've clarified as you are looking for your first faculty position. So as I have talked about in an earlier episode, one thing that people think about a lot is salary. They're like, oh, yes, I want to make sure I have the right salary. And I do think the salary negotiation is a very important negotiation, but it's not the only thing that you negotiate. And it's possible to negotiate well for salary and then to lose out on all the other things that kind of make the salary a little bit irrelevant. And we'll talk a little bit about some of those things today.

2:07 But yeah, so in today's episode, I want to talk to you about preparing to negotiate your first faculty position. And the reason this is for people negotiating a first faculty position is because you don't know what you don't know when you're first starting out. You have no idea. By the time you've been around the block and then some, then you know what to ask for. And it's a different type of negotiation. But when you are starting out, this is your first major negotiation, you until this point have not had a real job in the sense that you've been in training this whole time. And now you have an opportunity within the confines of academic medicine to find a job, to find a career, to get started on and embark on a career that leads you to make the kind of impact you really want to make.

2:56 So it is a big deal, but you don't know what you're missing. And so your primary job as someone who's negotiating your first faculty position is to have an inquisitive mind, ask lots of questions and be prepared to learn. And so it's an interesting concept to think about, but this really is about a learning opportunity. You have a chance to learn what the institution values and to decide how it aligns with your values or at least to think through how it aligns with your values and how you want to contribute through this institution as your platform. It's steep because you might be thinking of it as, I just want a job, give me a job right this moment.

3:42 But what you really want to make sure you have is alignment between your goals and the goals of the institution you're going to, at least at a minimum, the goals of the division or the department in which you will be. So you want to make sure that you understand these components as you prepare to negotiate your first faculty position. Okay, that was a freebie. That wasn't even number one. The first thing that I think is most important is to give yourself enough time. Give yourself enough time because you are doing the hard work of really contemplating making a decision about what you want your career to look like.

4:24 Now I'm talking to clinician scientists and I recognize that many people don't have, like I didn't have, the currency to really have your institution go to bat for you in terms of making the decision to fund you or to resource you to be able to tread water or do well in the years between your initial appointment when you actually get major funding to fund your own independent research program. And so it really does take time to think through all those things, to do the hard work of doing of those things. In fact, it's a great point to stop and say it's what we do in academics negotiate in our academic negotiation academy is to help people really think through what is needed to have a good first academic job negotiation.

5:17 Clearly it's not the only thing that we help with because you know you think you come to just figure out the right salary and you recognize that what you're really negotiating is your impact. It's your career legacy and that's why it's important to give yourself enough time. There is a lot of pressure associated with finding the first faculty position and a lot of the pressure is around money. Hey, I have not earned any money in the last 10 years. That's been of significance. I owe a ton of money that's about becoming due. My family has been looking at me saying I can't believe you still are mooching off of us. When will you ever get a real job? So there's a lot of pressure.

5:57 There's a lot of anxiety. There's a lot of worry. You want to give yourself enough time to make a good decision. Now I will tell you that while you are eager to finish your training and cross over into your first faculty position or perhaps you've been in private practice this whole time and you want to jump in to academic medicine as a faculty member, you want to give yourself enough time. It's a big decision. It's huge. It's the biggest decision you've made really since saying I'm going to start med school and go on this crazy journey because it's an informed decision. But you want to make sure that the gaps in your knowledge are filled and you do that by giving yourself enough time and at the same time surrounding yourself by somebody who can help you.

6:42 So you want to give yourself enough time. You want to find a friend. You want to find a friend who will ask you the hard questions. You want to find a friend who's going to give you space for that level of introspection. And so it's important space that as a coach I have the privilege to walk through with people and I invite you to sign up to talk about whether a coaching relationship is meant to be, will work out, really will serve the needs that you have. And so that's an important thing that we should think, you should think about even as you prepare to negotiate your first faculty position is that you need enough time and you need a friend. And the reason, one of the other reasons you need a friend is that institutions do not negotiate alone.

7:24 There's a whole team of people and by a whole team, maybe it's not a big team, but it's definitely more than a solo activity. Your department chair is integrally involved in your hire even if you are coming into a division setting or maybe you're going into a center. Like there is somebody who cares beyond just your immediate supervisor. And so they at a minimum are negotiating as two people, not as just one person. And so not only do you want to give yourself enough time, but you actually want to get a friend who can help you as you move forward. Okay, so give yourself enough time and get a friend that's number one.

8:05 The second thing is you want to be very clear about how you want to split your time. And as I say that, I recognize that that can give people a ton of anxiety. It's like, oh no, I just can't figure it out. This is too much. But you really do need to clarify which of the tripartite arms of being in academic medicine are you going to take as the lead? And so everybody says, I want to be a great clinician. I want to be a great researcher. I want to be a great educator. And yes, after many years of honing your skills over and over again and creating time for rest and reflection and deliberate practice, you're going to be able to do that.

8:49 But right now, you really do want to think about which one is going to be the leader? Which of these tripartite missions am I going to lead with? Am I going to lead as a clinician? Am I going to lead with being a researcher? Am I going to lead with being an educator? And that's really important to decide up front. Now, here's the thing. There's a secret. It does cause a lot of anxiety when people are trying to decide because they're like, I don't want to lock myself down. And I want to assure you that you are not locked down. What it does allow you to do is to make a decision and start to move towards the decision. Because as you make a decision, then you're able to commit to the decision until such a time as you get more information that might lead you to think that, OK, maybe it's time to uncommit from this decision.

9:39 And so you want to know how to split your time. And I have to say it's very difficult and frustrating when applicants come through and they say, well, you know, I'm not sure what I want to do. And it's difficult because you can't tell somebody what to do. And no, people try all the time. But in a faculty career, the faculty member is really building their own career. And so for that reason, they should be clear about how they want to split their time. And even if they're not clear yet, starting somewhere and then using that to work backwards ultimately. OK. So number two is to think about how you want to split your time because you want to make sure that you have a clear understanding of how you're going to be judged at your institution.

10:26 OK. So you want to understand what the institution values. So I will tell you that every institution values things differently. Your institution may be different from mine. Well, what the institution is interested, as far as your clinical leadership, in general may fall into broad categories of patient care, safe and effective and efficient patient care, but also safe and, well, actually effective closing of the charts, right, so that people can get paid. And so but, you know, one of the ways that you can really understand what the institution values is to go and find their promotion and tenure documents. And sometimes people will say, well, I'm a clinician.

11:07 As long as I continue doing great work as a clinician, oh, I should be fine. But in reality, at any academic medical center, one component of your promotion is your scholarship. It is such an important part of your package, no matter where you are, no matter where you sit in the medical school environment. So you want to understand what your institution values. When you go look at that document and they say, we want you to be a national leader so that all referrals for this disease tend to come to you, right, if that is what your institution values, then you want to know, do I have the right list of resources?

11:49 And so that's what leads me to number four. For every component that is important to you and you find that the institution values, you want to make sure you have a list of resources. Okay, let's stop here and unpack that for just a little bit. For example, you want to excel as a clinician while you need access to seeing a large volume of patients as efficiently as possible. You want opportunity to see a large volume of patients as efficiently and as safely as possible. Okay, what does it take to do that? Well, is there an MA who needs to be in clinic? Do you need a PA? Do you need an MP?

12:29 Did you inherit somebody's clinic and now you need help managing that clinic? Because the kind of challenge it is to run a clinic as someone who's brand new is different from the challenge of someone who's been running the same clinic for a couple of years. And so if somebody's left open a space and you are the clinician stepping into that space, recognize that it's going to feel overwhelming to have all those patients come upon you at the same time. But what resources do you need to succeed in the clinical space? Do you need a scribe? Do you need a very efficient note dictation software? What are the things you need for every component? I want to be a great clinician. Okay, what resource do I need to do that?

13:12 And then you're like, oh, well, I want to be a scientist. And it's like, hmm, how can I minimize some of this clinical time and instead expand my time in this area of research? And that's why for each component you want to develop a list of resources. In the clinic, again, we said you'll have an MA, perhaps you'll have a PA, perhaps the schedule will be tailored exactly to your needs for a clinician scientist, for a researcher. You want to make sure you have protected time so that you can actually do this research and get in the money to be able to fund the team to do the research. You want to make sure that you actually have access to educational materials since this is not something you've done before as part of your regular career.

13:54 So you want to know what's their list of resources for me as a clinician, as a researcher, but what about as an educator? Perhaps somebody's called you to be an associate program director role. And the question is, well, who is paying for this role? Who is going to allow me to do this work and to also do the other work that is necessary? So you want to make sure that you have the time to do this work. And if you don't, that's important to bring up because what you're saying is, hey, you want me to do this, but this is what it takes to do this. And I need to be resourced so I can do this. And if for whatever reason people can't resource you to do it, you can decide to leave, or you can say, well, if there are not going to be enough resources, how do we narrow down the scope for that work?

14:42 Right? So you want to make sure that you develop a list of resources, whether it's your clinician side, your educator side, or your research side that's going to lead in your promotion and tenure process. You actually want to go and find out what things are needed. So at the institution, you're going to go around and you're going to poll other investigators to find out, hey, you're in this role. What do you need? You're a researcher in this role. What did you ask for? What did you wish you had asked for? You want to ask all those questions as much as possible so that you can develop a well-informed list of resources that you're going to need so that you know that you have everything you need in your moving forward and asking questions that help you clarify how these resources can help you move forward.

15:31 OK. The one thing people talk about first, which I like to put pretty much at the end, is really to think about the salary. OK. You want to make sure that you're thinking about salary. And salary, again, is important, but it's not the most important thing. But with the grant to salary negotiation, I actually did do a podcast episode about this about three weeks ago about how to negotiate salary. And if you go to our website, clinicianresearcherpodcast.com, you can access the episode. Yes, but I talk about how to negotiate your salary. So you definitely want to do this objectively. You want to make sure that this is not about how you feel about yourself or how much you think or do not think you're worth. It really is about what are the salary benchmarks for someone like me starting this position.

16:16 And that's what you're going to ask for, because there's objective data. Again, the AAMC compensation report that comes out every year. There are other resources as well. So you want to make sure you have access to hard data. And if you don't have access to hard data, that's where you poll other investigators to see what's needed. You're like, hey, I have this great opportunity. What do you think about it? What did you do with this opportunity? What would you have done differently? And so those are the things you want to do. And to be honest, all of this is a lot of work, but so important, so important so that you are going to the table prepared to negotiate for yourself. And it's a really, really, really awesome thing to be able to do when you have the right resources and the tools to be able to do that.

17:00 So it's important, really, I think, wrapping up to be prepared to take time to think. The people who do the best negotiations and succeed wonderfully as faculty are those who take time to think, to think about what they really want to do, to think about what resources are available to them, and to think about the offer when it is presented so that you're not knee-jerking a response just to make somebody happy. You want to make sure that you prepare to take time to think so that you can make the right decision and the informed decision. Okay? That's all I have for today.

17:41 I would say if somebody you know is looking for a coach to guide them through their first negotiation as an academic, please reach out to me. Have them reach out to me. And they can reach out to me on Facebook, Instagram, also on LinkedIn as well. And please definitely take time to think about your career because if you do not prioritize it, nobody else will. All right. It's been a pleasure talking with you today. Someone's got to have this episode. Please share it with them. If this episode resonated with you in any way, we'd love to hear about it. Leave a voicemail on our podcast website, clinicianresearcherpodcast.com. And I look forward to seeing you again the next time.

18:29 Thanks for listening to this episode of the Clinician Researcher Podcast where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. If you found the information in this episode to be helpful, don't keep it all to yourself. Someone else needs to hear it. So take a minute right now and share it. As you share this episode, you become part of our mission to help launch a new generation of clinician researchers who make transformative discoveries that change the way we do healthcare.