Academic medicine can be a very appealing option for early-career endocrinologists, whether a basic scientist or a clinician. Endocrine News spoke to experts about steps you need to take to secure your own spot in the halls of academia.
For early-career endocrinologists or medical students who want to pursue positions in academic medicine, the key elements to do so are knowing what you want and following the best route to get there.
Finding the right academic positions throughout your career — whether they are comprised of leadership, teaching, research, and/or clinical roles — is about looking inward and identifying what is fundamentally important to you, says Ann Danoff, MD, the recipient of the 2021 Endocrine Society Laureate for Outstanding Educator.
“It’s important to define success for yourself,” Danoff says. “I don’t think any external person can tell you what to do with your life. You only come this way once.” Danoff recently retired as the chief of medicine at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia, Penn.
“Develop expertise and demand excellence. While you are doing that, develop more general skills, such as a good elevator speech, and learn how to appreciate and articulate your own skills. All will help you stand out from other candidates applying for the same positions you are seeking.” – Ann Danoff, MD, 2021 Endocrine Society Laureate Award for Outstanding Educator
Determining what you value in an academic medicine job will set the groundwork for a future job search, and ultimately, become the foundation of a satisfying career. “Each individual should think seriously and honestly about their strengths and weaknesses,” says Dolores J. Lamb, PhD, HCLD (ABB), Dow Professor of Urology and vice chair for research, director of the Center for Reproductive Genomics at Weill-Cornell Medicine in New York. “Think about how to define your needs and be able to articulate them. Think about what opportunities you should seek for yourself” as an early-career endocrinologist, if academic medicine is your goal.
Laying the Groundwork
To put yourself in the best position to find and land academic roles, distinguish yourself. “Develop expertise and demand excellence,” Danoff says. “While you are doing that, develop more general skills, such as a good elevator speech, and learn how to appreciate and articulate your own skills” to others. Similarly, learn how to write and polish a strong curriculum vitae (CV), and develop leadership skills and emotional intelligence. “All will help you stand out from other candidates applying for the same positions you are seeking,” she says.
At the same time, it is important to think strategically about where you want to go and what you want to do in your career in an academic position and learn what your hiring institution will expect of you in that role, Lamb says.
“For an academic position, the individual needs to know what it takes to get established, how to negotiate for the job and how to do it well,” she says. “Once you get the position, you need to understand how you support the institution and how it supports you. There will likely be some service requirements. You will have a lot of intellectual freedom, but you may also have responsibilities, such being put on committees or teaching residents. You will need to understand how to protect your time for your patients or research” or whatever you most value, she says.
The transition from fellow to a first faculty position requires a paradigm shift, Lamb says. “While there is the mindset that you are always learning, now you are also in a position of some authority in terms of your trainees, and you change to being a manager, even if it is of your own domain.”
Understand How the Pipeline Works
Once hired, “you need to know your institution, and what its specific rules, regulations and guidelines are for promotion,” Lamb explains. “Know what the titles and terms are. People don’t always know what they need to do to get promoted. Sometimes people think if they see the most patients, they’ll be promoted, but it doesn’t work that way. You have to have excellence in teaching, research, and clinical; there are all different combinations” that are considered in different roles at different institutions.
Danoff agrees. “Talk to a lot of people, especially those who are informed and whose opinions you trust,” she says. “Know what’s important to you. There are different academic tracks at various institutions, and it’s important to understand those things.” For example, being on a tenure track offers different rewards than a non-tenure track. Knowing the position has a pension attached to it means you may retire “with a bucket of money,” she explains.
Understanding the work environment, the vibe of your colleagues, and how things work, especially for a specific academic role, means you’ll move into a position with a good understanding of how things work in the institution and department you’ll be joining. “It’s important not to be naïve about what you are signing up for,” Danoff adds.
Having visible roles both in the institution and in professional organizations also helps, Lamb says. “You can’t be the person who sits in the back of the room — you have to be the one asking a question or speaking up to make professional organizations better. Having youthful enthusiasm on committees is marvelous and younger endocrinologists should appreciate their value.”
At the same time, know that occasionally, untraditional approaches can land academic roles, but the path may be challenging.
“I think it’s extremely hard to move up the academic ladder if you haven’t had a straight and narrow trajectory,” Danoff says. “Some people can do it, but it’s very hard to move from a straight non-academic clinical practice back into academia. It might be easier for those in industry because they have what is considered something of value. I’m not saying I agree with that. I stepped off the track and I’m very lucky I got back on.”
After working as a junior faculty member for Albert Einstein College of Medicine in New York, Danoff adopted newborn twins and made the difficult decision to move to a different, less academic, institution.
“I felt like I couldn’t do it all — compete with PhDs and do translational research, provide high-quality clinical care, and raise my kids,” she says, recalling her experience. “I went to an affiliate of Einstein, Bronx Lebanon Hospital, from 1994 to 2002. Although there was much that I learned in that environment, when my kids were older, I had the good fortune to move to New York University and the Manhattan Veterans Affairs, where I became director and program director of the Endocrine Division and section chief at the Manhattan VA. I was willing to take a significant pay cut to make that move, because money is less important to me than quality of life.”
The move helped Danoff return to what she called “the thick of academia,” and offered her many opportunities to collaborate with others as well as “the intellectual stimulation I had been missing,” she says.
Cultivating Relationships with Mentors
Finding and building relationships with mentors — both formal and informal, in medicine and outside it — throughout your career will help you as you determine what your career goals are and how you can achieve them, say both Lamb and Danoff.
“I always try to make sure all my trainees, as well as myself, do what we love to do. You have to have a passion for what you do. When people excel at what they do, they will be happiest when they do what they are good at.” – Dolores J. Lamb, PhD, HCLD (ABB), Dow Professor of Urology, vice chair for research; director, Center for Reproductive Genomics, Weill-Cornell Medicine, New York, N.Y.
“Everybody needs mentors,” Lamb says. “There are all different ways to do that. Even with peer-to-peer mentoring, which is underestimated, a peer may have faced a challenge you can learn from. Other mentors will be masters or supervisors, and some could be role models, either from an institution or from professional organizations like the Endocrine Society. At Weill-Cornell, I’m part of a whole mentoring career development academy where we try to pair a senior person in a department with people when they first come on board. There are also virtual mentors; for example, I train people remotely through virtual Zoom meetings, and some I knew before and others I didn’t know. We have lots of mentoring options today,” she says.
Ultimately, “I always try to make sure all my trainees, as well as myself, do what we love to do,” Lamb says. “You have to have a passion for what you do. When people excel at what they do, they will be happiest when they do what they are good at.”
Alkon is a Massachusetts-based freelance writer who is the author of the book, Balancing Pregnancy with Pre-Existing Diabetes: Healthy Mom, Healthy Baby. She wrote about overcoming imposter syndrome in the August issue.
Before You Accept the Job
Congratulations! You’ve been offered an academic position! But before you say yes, take a close look at the following considerations, according to Dolores J. Lamb, PhD, HCLD (ABB), Dow Professor of Urology, vice chair for research, director, Center for Reproductive Genomics, Weill-Cornell Medicine, New York, N.Y.:
- Your contract. Read it through closely and make sure you understand every section of it, particularly as it relates to the cost of living in the area where the job will be based. Lamb says to look over details about your research space and time, equipment, housing, moving expenses, whether you will need daycare or other childcare expenses, teaching requirements and anything else important to you and your staff. “Not only do you need to know your salary and benefits, but your staff salary and needs,” she says. “You are not just asking for yourself, but for your team.”
- The negotiation process. “Once you do your initial negotiations for what you want in your contract, and you have a reasonable level of agreement, you should probably get an attorney involved,” Lamb advises. An attorney, particularly one well-versed in employment contracts for physicians, should be able to advise you on any specific nuances you may need to be aware of, such as non-compete clauses.
- The difference between hard and soft money. Hard money is specified in your contract and could be a guarantee of 25% of your income which will come from the institution. Soft money are opportunities, such as research grants or clinical work, you need to get on your own. In some positions, “if you don’t see enough patients, that will directly affect your salary, either by bonuses or a certain percentage of what you bring in,” Lamb says. When deciding about what salary you should request, “you need to know what it is that the position will pay or cover, and you need to do your homework, by looking at reports from the Association of American Medical Colleges and the Department of Labor to see average salaries and the statistics for city cost of living numbers.”