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Since there have been several threads with questions related to this...
1. What is a clinician educator?
For the past 20 years or so, most major academic medical centers have created clinician-educator track positions for primarily clinical faculty, separate from academic faculty. Clinician-Educator faculty are hired and promoted based primarily on their clinical and educational roles, and not on scholarly activity or ability to get (federal) grants as principal investigators. This makes it easier for clinical faculty to get promoted and recognizes the distinct role primarily clinical staff now have vs. those who are mainly researchers.
2. Clinician educator vs clinician Educator - what’s the difference?
Clinician educators (i.e. small e) are primarily clinical faculty who are expected to do some teaching and supervising of trainees as part of their responsibilities. They are primarily hired based on their clinical ability. Depending on the setting, their interaction with residents/medical students/other trainees may be minimal. They are primarily promoted based on a reputation for clinical excellent. Scholarly work (if done) may be clinically based (i.e. case reports, literature reviews, systematic reviews, clinical trials, patient oriented research).
They may be promoted later to senior clinical positions such as division director, chief of service, or vice chair for clinical affairs.
clinician Educators (i.e. small c) have a much more significant educational role though in most cases they remain primarily clinicians. This includes residency directors, associate residency directors, fellowship directors, medical student clerkship directors, and so on. They are more likely to have protected time for education/supervision/curriculum development. In fact they will absolutely have at least 10% of their time for education and in some cases 70-80% of their time may be for this. They are primarily promoted based on a reputation as a leader in education. Scholarly work may be primarily education based (i.e. educational case reports, trainee well being, RCTs of education, model curricula, guidelines or national standards in education).
They may be promoted later to senior educational positions such as dean or associate dean in the medical school, director of medical student wellbeing or diversity, vice chair for education, director or dean of graduate medical education, or designated institutional officer for GME.
3. Why do people take clinician educator positions?
Lots of reasons! These can be seen as positive reasons or negative reasons.
Positive reasons include:
· wish to gain additional education and mentorship at an early stage of career
· wish to work with leaders in the field
· access to grand rounds and educational seminars etc for professional development
· love for teaching and education
· opportunity to see more interesting/challenging cases
· opportunity to develop a specialized clinical service or regional referral center
· can potentially more easily work in multiple clinical areas or lateralize to different role without switching employer
· potential at some institutions to get paid to do psychotherapy
· wish to train the next generation of physicians/psychiatrists and allied professionals
· wish to attend lots of conferences/ participate in organized medicine – easier to do when you aren’t going to lose pay for it
· enjoy mentoring others
· ability to participate in scholarly/research projects
· visa/green card sponsorship
· vacation and leave benefits (many academic institutions, particularly in public sector have may provide generous leave including paid extended sick leave etc)
· academic title
· “prestige” of affiliation with well regarded institution
· eligibility for loan repayment/forgiveness
· retirement benefits (many, but by no means all) academic institutions may provide very generous/competitive retirement benefits or pensions
· some institutions provide other benefits such as free/reduced tuition for faculty (and less often, family)
· may allow you to work from home for part of the time or when recovering from extended illness or injury
Negative reasons include:
· Laziness. Some people believe you can do less work in these positions. In many the opposite is true as these are not 40hr a week positions, and if your residents suck they may slow you don’t. There is no doubt that some positions really are cush and you can literally not be there at all or do anything, but they are hard to find and disappearing.
· Not ready to get a “real job”.
· Feels safer just to stay at home institution than find one’s way in the world
· Want residents to do work for you
· Reliant on narcissistic supply from others
· Want to abuse students/residents for sadistic/narcissistic reasons
· Intimidated/not adept enough to survive in private practice
· After so many years in training, this is all you know
· Meeting expectations of mentors and supervisors who “encourage” you to stay in the academic environment
4. What are the downsides?
This obviously depends on the specific job and institution but some potentials:
· Salary is usually much less competitive compared to private institutions, county institutions, VAs, correctional systems, private practice, HMOs – pretty much anywhere! In some cases including benefits you could be making almost 200k less your first year out of training
· You may not be allowed to do outside moonlighting or have your own private practice (institution dependent; in the NE like NYC and Boston it is typical for attendings to have their own private practice and one major institution lost their child faculty when tried to stop this).
· Unlikely to be a 40hr week (or less). As it is most likely salaried you may have to work in evenings and weekends
· You will be expected to do more and more (in terms of preparing lectures, joining committees, supervising residents, mentoring, curriculum development) with no protected time or additional compensation
· You will be looked down upon compared to academic faculty. For instance you may lose your office and be moved far away from the department, to accommodate an academic who requests your office as part of their recruitment package.
· Depending on institution, you may not be eligible for tenure
· You will likely have less support staff than at other institutions. You will probably have to do prior auths yourself etc.
· Documentation requirements may be more onerous
· Department is likely to be more disorganized than in an non-academic non-public sector place (of course varies wildly)
· There are a lot of toxic people in academics (including in psychiatry) and you may fall foul of someone important who starts harassing/intimidating/victimizing you
· Many places (more common at “prestigious” institutions) treat junior faculty poorly
· If you have a bad student/resident it may create more work for you
· Depending on benefits package, may be harder to leave until you’ve vested pension etc, even if unhappy
· You may not feel valued by the department and they may see you as easily replaceable (even if untrue).
5. What’s tenure and what’s so good about it? Do clinician-educators get it?
Tenure usually means that you have an indefinite appointment and it is very very difficult to fire you. It may mean you are eligible for paid sabbaticals (for example a paid year off to live it up doing “research” somewhere) or professional leave (shorter excursions with full or partial salary), after several (usually 6 or 7) years of service. It is a marker of significant distinction and prestige. It came about to give faculty free speech without risk of falling foul of the provost or dean of the institution and enshrining “academic freedom”. Even if you flounder in your career, do hardly any work, or are a sexual harassment lawsuit waiting to happen, they will have a hard time getting rid of you. In short, It confers significant security.
Sadly, at most of the larger or prestigious academic centers clinician educators are not tenure track. But then at some places even high power academics are not eligible for tenure. As above, clinician educators are often seen as the ugly step child of the department vs. the academic faculty.
Some departments do allow clinician educators to apply for tenure based on clinical or education excellence. UVA and the University of Colorado are 2 examples. Some departments don’t allow clinician educators tenure, but do allow them to swap into a tenure track position based on clinical or educational excellence, as long as they are also doing some scholarly/research work. OHSU is an example of the latter.
6. I wanted to be academically affiliated and teach but not excited about the salary – what do I do?
You have a couple of options:
- you can get a clinical faculty position (also called volunteer faculty). Basically they won’t pay you anything, but you contribute a certain number of hours of teaching/supervision (typically around 50hrs per year), and in exchange you get to feel good about imparting your wisdom and call yourself “clinical assistant professor of psychiatry” etc. This may help market your private practice, or help establish your credibility as an expert witness for forensic work. Some places will give you title if you provide free therapy to residents.
- You can work at a non-academic center affiliated with an institution. Many VAs are academically affiliated and pay quite a bit better than the center of excellence down the road. Some county hospitals, and even private hospitals may be affiliated, and give you some access to students/residents. In some cases you will be eligible to be a site director for student or the residency program.
N.B. Some places have been trying to pay the academic rate (i.e. crappy salary) at these “affiliated sites.” If that is the case, DO NOT take that job! Run!
7. These clinician-educator jobs seem great! How do I get one?
If you are crazy enough to still be interested, having read the above, then congrats! Most every institution is salivating at the thought of eating you up! Many of these jobs have become less attractive to graduates as the perks of these jobs have dissipated, and they pay disparity has increased. Be warned however that the more highly regarded centers will not take any riff-raff. They will usually have a strong preference for their own graduates (unless they were terrible) and people at similarly tiered institutions. For example Harvard or Columbia or UCLA etc are not going to be interested if you trained at some tiny community or minor academic outpost no one has heard of before. The good news is, you can do a fellowship at one of these institutions (not usually competitive especially if its something like geriatrics or psychosomatics) and that will be enough proof of your masochism to earn you a spot.
Otherwise, you should think of the institution(s) you are interested in contact the person in charge. At small places it will be the chair. At large places it will be the Vice Chair for Clinical Affairs, the chief of service, or clinical director. Send them your CV and a cover letter or introductory email re: who you are, what you are looking for, and when you are looking to start. If they are interested, they will call you and invited you to interview!
You can also search for advertised positions. Positions will be advertised on the department or university careers page, on APA’s job central, on indeed.com, linkedin, or HERC. The APA’s psychiatry news also advertises jobs but by the times the print ad comes out it may be gone! You can formally apply.
8. What should I put in a cover letter?
Cover letters or introductory emails should be brief. Provide a brief introduction to yourself, including where you trained, how you heard about the position and how excited you are to learn about opportunities at the institution. Be enthusiastic.
9. They want a teaching philosophy statement. What the hell is that?
A teaching statement is usually about a one-page statement outlining your approach/philosophy to education and teaching. What do you love about teaching? How do you think people best learn? How do you enhance the educational experience based on your ideas of how people learn? What kind of educator are you? What have been some of your pertinent education/teaching responsibilities to date? Where do you see your teaching career going? These are some of the questions you might want to address.
If you see yourself as an educator, you should attach a teaching statement to your application, even if they do not request it.
Further guidance:
http://www.columbia.edu/cu/tat/pdfs/teaching statement.pdf
Teaching Statements
http://ctl.yale.edu/sites/default/f...-materials-files/sampleteachingstatements.pdf
10. They want a “contributions to diversity” statement. WTF?!
If the though of diversity makes you bristle, you may want to pass on this institution. It’s usually these liberal good for nothing institutions that have a commitment to such things and you are best off applying elsewhere. If, on the other hand, you do see increasing the diversity of the profession, and championing cultural aspects of healthcare as an important or worthy endeavor you should be able to describe why that’s important. Again, one page statement. Highlight the ways in which you think it might be important. If you happen to have personal relevant experience, describe it. If you have previous professional involvement in diversity training, mentoring, education etc, then describe. If you see a particular role for yourself, again, describe.
11. So I hear these job offers are pretty much non-negotiable. Is that true?
You almost certainly wont be able to negotiate salary or benefits. But here are things you should/could negotiate:
- Title – what is your job title? Ask for something fancy to make you feel better about the below market pay.
- Time – how much time you do need to accept the offer. Most likely there aren’t people chomping at the bit to accept the position so
- Academic FTEs – how much academic time for education/curriculum development, research etc
- Professional/conference leave
- CME or academic enrichment funds
- The actual type of work you will be doing and % time on what
- Some fringe benefits (for example home loans etc)
- Green card/permanent residency
12. I’m a resident, how can I put myself in a competitive position for a good clinician-educator position with potential for rapid advancement?
- be an excellent clinician who is dependable, intellectually curious, has a good work ethic, has strong interpersonal skills and models professional values and get strong letters of recommendation
- Say yes to things and volunteer. Agree to teach medical students, junior residents, residents in other departments, involvement in interprofessional education, give grand rounds and other departmental talks.
- Serve on committees including in the department (e.g. curriculum committee, education, grievances, admissions), the institution (e.g. QI, GMEC, Diversity, Wellness etc), locally (e.g. state/county medical/psychiatric association), nationally (e.g. on APA/AACAP councils/committees, with AAMC, SNMA, your psychiatric subspecialty organization)
- Present at conferences (posters are least impressive, oral presentations better, chairing symposia etc most impressive). For educators presenting at AADPRT, AAP, ADMSEP and other medical education awards will be better
- Win awards e.g. APA Leadership Fellowship, PRITE/Laughlin Fellowship, AADPRT Ginsberg or IMG Fellowships, GAP Fellowship, NNCI Scholarship, AAP Fellowship, AACAP Educational Outreach Award etc. These will provide mentoring/networking opportunities as well recognition
- Become a Chief Resident. One of the best experiences you will get in developing you educational, administrative and leadership skills will be by becoming a chief resident. It also demonstrates a level of masochism requisite for a junior clinical faculty position
- Publish scholarly work. This does not need to be original research. Peer reviewed publications are preferable. For educators, pieces in educational journals such as Academic Psychiatry, Academic Medicine, Journal of Graduate Medical Education, Medical Education, Clinical Teacher and so on are relevant.
- Consider doing a fellowship (more below)
13. Do I have to do a fellowship?
Not at all. But it is a marker of masochism and one way of helping you to show your expertise in a particular area through training and possibly board certification. Some Non-ACGME fellowships (for example neuropsychiatry, integrated care, public psychiatry, clinical informatics) may actually be junior faculty positions at the instructor level.
While fellowship training is not typically necessary (with the exception of child and adolescent psychiatry positions), many will prefer someone with fellowship training in psychosomatic medicine, addiction psychiatry/medicine, geriatric psychiatry, and forensic psychiatry for respective positions in consultation-liaison, addictions, geropsychiatry, and correctional/forensic evaluation service positions. Already being board certified, the additional year of training, and the opportunity to have another year to develop your educational and scholarly portfolio may further enhance your attractiveness.
For certain positions, for example if you wish to become a fellowship director, you will need board certification/fellowship training in that field. Further, for medical director positions or division director positions in a subspecialty, candidates with added qualifications in that area will be preferred, or may be a prerequisite to applying.
14. Is there a potential for higher earning in the future?
Through promotion one’s salary will increase. Individuals who have leadership positions, or become chair of a department or a position in the Dean’s office can expect a significant bump in pay. At major academic centers, it is almost unheard of for clinician educators to become chair of department, though at small departments it is certainly possible, particularly if the incumbent has established a reputation for excellence nationally as a clinician or educator. Working in clinical services that are particularly revenue generating may also allow one to command higher income in an academic position in the future.
15. Are there ways one can supplement their income as a clinician-educator?
This depends on the department. Some institutions allow individuals to have their own private practice (this is common in areas such as NYC and Boston that are particular expensive). Others allow faculty to have a faculty practice, which is a private practice within the institution, where the department takes a cut (which can vary from about 10% to 50%). Some prohibit any additional such clinical work.
There may be opportunities to moonlight within the hospital or affiliates (for example providing overnight or weekend call or covering shifts in the emergency department), paid at an hourly rate.
There may be the opportunity to do independent mental examinations or serve as an expert in civil or criminal cases. This may include malpractice cases, psychic injury, or disability related cases.
There may be the opportunity to develop clinical services for example suboxone, TMS and ketamine clinics have the potential to be lucrative if allowed by the department.
There may be opportunity to serve as a consultant (both inside and outside healthcare), including as an educational consultant, or work in mediation. Consulting could be to insurance companies, health care firms, technology companies, pharmaceutical companies, laboratories, policy think tanks, governmental and non-governmental organizations.
There may be opportunities to develop research, educational, or psychometric tools for which there is a market.
There may be opportunities to write books (royalties for academic presses however are low; for popular press the income is likely to be greater).
There may be opportunities for public speaking for which honoraria may be received.
The department is likely to have a conflicts of interest policy and want to manage these. In particular, while some individuals continue to make exorbitant amounts of money from pharmaceutical and other companies, academic institutions are likely to limit this income and your professional standing, credibility and reputation could be significantly damaged from such associations.
1. What is a clinician educator?
For the past 20 years or so, most major academic medical centers have created clinician-educator track positions for primarily clinical faculty, separate from academic faculty. Clinician-Educator faculty are hired and promoted based primarily on their clinical and educational roles, and not on scholarly activity or ability to get (federal) grants as principal investigators. This makes it easier for clinical faculty to get promoted and recognizes the distinct role primarily clinical staff now have vs. those who are mainly researchers.
2. Clinician educator vs clinician Educator - what’s the difference?
Clinician educators (i.e. small e) are primarily clinical faculty who are expected to do some teaching and supervising of trainees as part of their responsibilities. They are primarily hired based on their clinical ability. Depending on the setting, their interaction with residents/medical students/other trainees may be minimal. They are primarily promoted based on a reputation for clinical excellent. Scholarly work (if done) may be clinically based (i.e. case reports, literature reviews, systematic reviews, clinical trials, patient oriented research).
They may be promoted later to senior clinical positions such as division director, chief of service, or vice chair for clinical affairs.
clinician Educators (i.e. small c) have a much more significant educational role though in most cases they remain primarily clinicians. This includes residency directors, associate residency directors, fellowship directors, medical student clerkship directors, and so on. They are more likely to have protected time for education/supervision/curriculum development. In fact they will absolutely have at least 10% of their time for education and in some cases 70-80% of their time may be for this. They are primarily promoted based on a reputation as a leader in education. Scholarly work may be primarily education based (i.e. educational case reports, trainee well being, RCTs of education, model curricula, guidelines or national standards in education).
They may be promoted later to senior educational positions such as dean or associate dean in the medical school, director of medical student wellbeing or diversity, vice chair for education, director or dean of graduate medical education, or designated institutional officer for GME.
3. Why do people take clinician educator positions?
Lots of reasons! These can be seen as positive reasons or negative reasons.
Positive reasons include:
· wish to gain additional education and mentorship at an early stage of career
· wish to work with leaders in the field
· access to grand rounds and educational seminars etc for professional development
· love for teaching and education
· opportunity to see more interesting/challenging cases
· opportunity to develop a specialized clinical service or regional referral center
· can potentially more easily work in multiple clinical areas or lateralize to different role without switching employer
· potential at some institutions to get paid to do psychotherapy
· wish to train the next generation of physicians/psychiatrists and allied professionals
· wish to attend lots of conferences/ participate in organized medicine – easier to do when you aren’t going to lose pay for it
· enjoy mentoring others
· ability to participate in scholarly/research projects
· visa/green card sponsorship
· vacation and leave benefits (many academic institutions, particularly in public sector have may provide generous leave including paid extended sick leave etc)
· academic title
· “prestige” of affiliation with well regarded institution
· eligibility for loan repayment/forgiveness
· retirement benefits (many, but by no means all) academic institutions may provide very generous/competitive retirement benefits or pensions
· some institutions provide other benefits such as free/reduced tuition for faculty (and less often, family)
· may allow you to work from home for part of the time or when recovering from extended illness or injury
Negative reasons include:
· Laziness. Some people believe you can do less work in these positions. In many the opposite is true as these are not 40hr a week positions, and if your residents suck they may slow you don’t. There is no doubt that some positions really are cush and you can literally not be there at all or do anything, but they are hard to find and disappearing.
· Not ready to get a “real job”.
· Feels safer just to stay at home institution than find one’s way in the world
· Want residents to do work for you
· Reliant on narcissistic supply from others
· Want to abuse students/residents for sadistic/narcissistic reasons
· Intimidated/not adept enough to survive in private practice
· After so many years in training, this is all you know
· Meeting expectations of mentors and supervisors who “encourage” you to stay in the academic environment
4. What are the downsides?
This obviously depends on the specific job and institution but some potentials:
· Salary is usually much less competitive compared to private institutions, county institutions, VAs, correctional systems, private practice, HMOs – pretty much anywhere! In some cases including benefits you could be making almost 200k less your first year out of training
· You may not be allowed to do outside moonlighting or have your own private practice (institution dependent; in the NE like NYC and Boston it is typical for attendings to have their own private practice and one major institution lost their child faculty when tried to stop this).
· Unlikely to be a 40hr week (or less). As it is most likely salaried you may have to work in evenings and weekends
· You will be expected to do more and more (in terms of preparing lectures, joining committees, supervising residents, mentoring, curriculum development) with no protected time or additional compensation
· You will be looked down upon compared to academic faculty. For instance you may lose your office and be moved far away from the department, to accommodate an academic who requests your office as part of their recruitment package.
· Depending on institution, you may not be eligible for tenure
· You will likely have less support staff than at other institutions. You will probably have to do prior auths yourself etc.
· Documentation requirements may be more onerous
· Department is likely to be more disorganized than in an non-academic non-public sector place (of course varies wildly)
· There are a lot of toxic people in academics (including in psychiatry) and you may fall foul of someone important who starts harassing/intimidating/victimizing you
· Many places (more common at “prestigious” institutions) treat junior faculty poorly
· If you have a bad student/resident it may create more work for you
· Depending on benefits package, may be harder to leave until you’ve vested pension etc, even if unhappy
· You may not feel valued by the department and they may see you as easily replaceable (even if untrue).
5. What’s tenure and what’s so good about it? Do clinician-educators get it?
Tenure usually means that you have an indefinite appointment and it is very very difficult to fire you. It may mean you are eligible for paid sabbaticals (for example a paid year off to live it up doing “research” somewhere) or professional leave (shorter excursions with full or partial salary), after several (usually 6 or 7) years of service. It is a marker of significant distinction and prestige. It came about to give faculty free speech without risk of falling foul of the provost or dean of the institution and enshrining “academic freedom”. Even if you flounder in your career, do hardly any work, or are a sexual harassment lawsuit waiting to happen, they will have a hard time getting rid of you. In short, It confers significant security.
Sadly, at most of the larger or prestigious academic centers clinician educators are not tenure track. But then at some places even high power academics are not eligible for tenure. As above, clinician educators are often seen as the ugly step child of the department vs. the academic faculty.
Some departments do allow clinician educators to apply for tenure based on clinical or education excellence. UVA and the University of Colorado are 2 examples. Some departments don’t allow clinician educators tenure, but do allow them to swap into a tenure track position based on clinical or educational excellence, as long as they are also doing some scholarly/research work. OHSU is an example of the latter.
6. I wanted to be academically affiliated and teach but not excited about the salary – what do I do?
You have a couple of options:
- you can get a clinical faculty position (also called volunteer faculty). Basically they won’t pay you anything, but you contribute a certain number of hours of teaching/supervision (typically around 50hrs per year), and in exchange you get to feel good about imparting your wisdom and call yourself “clinical assistant professor of psychiatry” etc. This may help market your private practice, or help establish your credibility as an expert witness for forensic work. Some places will give you title if you provide free therapy to residents.
- You can work at a non-academic center affiliated with an institution. Many VAs are academically affiliated and pay quite a bit better than the center of excellence down the road. Some county hospitals, and even private hospitals may be affiliated, and give you some access to students/residents. In some cases you will be eligible to be a site director for student or the residency program.
N.B. Some places have been trying to pay the academic rate (i.e. crappy salary) at these “affiliated sites.” If that is the case, DO NOT take that job! Run!
7. These clinician-educator jobs seem great! How do I get one?
If you are crazy enough to still be interested, having read the above, then congrats! Most every institution is salivating at the thought of eating you up! Many of these jobs have become less attractive to graduates as the perks of these jobs have dissipated, and they pay disparity has increased. Be warned however that the more highly regarded centers will not take any riff-raff. They will usually have a strong preference for their own graduates (unless they were terrible) and people at similarly tiered institutions. For example Harvard or Columbia or UCLA etc are not going to be interested if you trained at some tiny community or minor academic outpost no one has heard of before. The good news is, you can do a fellowship at one of these institutions (not usually competitive especially if its something like geriatrics or psychosomatics) and that will be enough proof of your masochism to earn you a spot.
Otherwise, you should think of the institution(s) you are interested in contact the person in charge. At small places it will be the chair. At large places it will be the Vice Chair for Clinical Affairs, the chief of service, or clinical director. Send them your CV and a cover letter or introductory email re: who you are, what you are looking for, and when you are looking to start. If they are interested, they will call you and invited you to interview!
You can also search for advertised positions. Positions will be advertised on the department or university careers page, on APA’s job central, on indeed.com, linkedin, or HERC. The APA’s psychiatry news also advertises jobs but by the times the print ad comes out it may be gone! You can formally apply.
8. What should I put in a cover letter?
Cover letters or introductory emails should be brief. Provide a brief introduction to yourself, including where you trained, how you heard about the position and how excited you are to learn about opportunities at the institution. Be enthusiastic.
9. They want a teaching philosophy statement. What the hell is that?
A teaching statement is usually about a one-page statement outlining your approach/philosophy to education and teaching. What do you love about teaching? How do you think people best learn? How do you enhance the educational experience based on your ideas of how people learn? What kind of educator are you? What have been some of your pertinent education/teaching responsibilities to date? Where do you see your teaching career going? These are some of the questions you might want to address.
If you see yourself as an educator, you should attach a teaching statement to your application, even if they do not request it.
Further guidance:
http://www.columbia.edu/cu/tat/pdfs/teaching statement.pdf
Teaching Statements
http://ctl.yale.edu/sites/default/f...-materials-files/sampleteachingstatements.pdf
10. They want a “contributions to diversity” statement. WTF?!
If the though of diversity makes you bristle, you may want to pass on this institution. It’s usually these liberal good for nothing institutions that have a commitment to such things and you are best off applying elsewhere. If, on the other hand, you do see increasing the diversity of the profession, and championing cultural aspects of healthcare as an important or worthy endeavor you should be able to describe why that’s important. Again, one page statement. Highlight the ways in which you think it might be important. If you happen to have personal relevant experience, describe it. If you have previous professional involvement in diversity training, mentoring, education etc, then describe. If you see a particular role for yourself, again, describe.
11. So I hear these job offers are pretty much non-negotiable. Is that true?
You almost certainly wont be able to negotiate salary or benefits. But here are things you should/could negotiate:
- Title – what is your job title? Ask for something fancy to make you feel better about the below market pay.
- Time – how much time you do need to accept the offer. Most likely there aren’t people chomping at the bit to accept the position so
- Academic FTEs – how much academic time for education/curriculum development, research etc
- Professional/conference leave
- CME or academic enrichment funds
- The actual type of work you will be doing and % time on what
- Some fringe benefits (for example home loans etc)
- Green card/permanent residency
12. I’m a resident, how can I put myself in a competitive position for a good clinician-educator position with potential for rapid advancement?
- be an excellent clinician who is dependable, intellectually curious, has a good work ethic, has strong interpersonal skills and models professional values and get strong letters of recommendation
- Say yes to things and volunteer. Agree to teach medical students, junior residents, residents in other departments, involvement in interprofessional education, give grand rounds and other departmental talks.
- Serve on committees including in the department (e.g. curriculum committee, education, grievances, admissions), the institution (e.g. QI, GMEC, Diversity, Wellness etc), locally (e.g. state/county medical/psychiatric association), nationally (e.g. on APA/AACAP councils/committees, with AAMC, SNMA, your psychiatric subspecialty organization)
- Present at conferences (posters are least impressive, oral presentations better, chairing symposia etc most impressive). For educators presenting at AADPRT, AAP, ADMSEP and other medical education awards will be better
- Win awards e.g. APA Leadership Fellowship, PRITE/Laughlin Fellowship, AADPRT Ginsberg or IMG Fellowships, GAP Fellowship, NNCI Scholarship, AAP Fellowship, AACAP Educational Outreach Award etc. These will provide mentoring/networking opportunities as well recognition
- Become a Chief Resident. One of the best experiences you will get in developing you educational, administrative and leadership skills will be by becoming a chief resident. It also demonstrates a level of masochism requisite for a junior clinical faculty position
- Publish scholarly work. This does not need to be original research. Peer reviewed publications are preferable. For educators, pieces in educational journals such as Academic Psychiatry, Academic Medicine, Journal of Graduate Medical Education, Medical Education, Clinical Teacher and so on are relevant.
- Consider doing a fellowship (more below)
13. Do I have to do a fellowship?
Not at all. But it is a marker of masochism and one way of helping you to show your expertise in a particular area through training and possibly board certification. Some Non-ACGME fellowships (for example neuropsychiatry, integrated care, public psychiatry, clinical informatics) may actually be junior faculty positions at the instructor level.
While fellowship training is not typically necessary (with the exception of child and adolescent psychiatry positions), many will prefer someone with fellowship training in psychosomatic medicine, addiction psychiatry/medicine, geriatric psychiatry, and forensic psychiatry for respective positions in consultation-liaison, addictions, geropsychiatry, and correctional/forensic evaluation service positions. Already being board certified, the additional year of training, and the opportunity to have another year to develop your educational and scholarly portfolio may further enhance your attractiveness.
For certain positions, for example if you wish to become a fellowship director, you will need board certification/fellowship training in that field. Further, for medical director positions or division director positions in a subspecialty, candidates with added qualifications in that area will be preferred, or may be a prerequisite to applying.
14. Is there a potential for higher earning in the future?
Through promotion one’s salary will increase. Individuals who have leadership positions, or become chair of a department or a position in the Dean’s office can expect a significant bump in pay. At major academic centers, it is almost unheard of for clinician educators to become chair of department, though at small departments it is certainly possible, particularly if the incumbent has established a reputation for excellence nationally as a clinician or educator. Working in clinical services that are particularly revenue generating may also allow one to command higher income in an academic position in the future.
15. Are there ways one can supplement their income as a clinician-educator?
This depends on the department. Some institutions allow individuals to have their own private practice (this is common in areas such as NYC and Boston that are particular expensive). Others allow faculty to have a faculty practice, which is a private practice within the institution, where the department takes a cut (which can vary from about 10% to 50%). Some prohibit any additional such clinical work.
There may be opportunities to moonlight within the hospital or affiliates (for example providing overnight or weekend call or covering shifts in the emergency department), paid at an hourly rate.
There may be the opportunity to do independent mental examinations or serve as an expert in civil or criminal cases. This may include malpractice cases, psychic injury, or disability related cases.
There may be the opportunity to develop clinical services for example suboxone, TMS and ketamine clinics have the potential to be lucrative if allowed by the department.
There may be opportunity to serve as a consultant (both inside and outside healthcare), including as an educational consultant, or work in mediation. Consulting could be to insurance companies, health care firms, technology companies, pharmaceutical companies, laboratories, policy think tanks, governmental and non-governmental organizations.
There may be opportunities to develop research, educational, or psychometric tools for which there is a market.
There may be opportunities to write books (royalties for academic presses however are low; for popular press the income is likely to be greater).
There may be opportunities for public speaking for which honoraria may be received.
The department is likely to have a conflicts of interest policy and want to manage these. In particular, while some individuals continue to make exorbitant amounts of money from pharmaceutical and other companies, academic institutions are likely to limit this income and your professional standing, credibility and reputation could be significantly damaged from such associations.
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