Simone’s OncOpinion

Career development observations and advice for medical professionals from Dr. Joseph V. Simone.

Thursday, January 9, 2014

Negotiating for Jobs

Negotiating the terms for one’s next job can be especially daunting for fellows and early- and mid-career faculty. I remember very clearly my first few attempts at understanding the terms and environment of jobs that I was considering. The experience was a bit bewildering, because at that time in my career I had no experience to guide me. I often didn’t know what questions to ask, and there were other questions I didn’t ask for fear of offending the recruiter.


I also found that it was not easy to find an unbiased, experienced advisor. I did not know senior faculty very well and was not sure whether their advice might be biased because they wanted me to stay at (or leave) my institution or had strong feelings, good or bad, about the place I was considering.


Over the last few years I have lectured on this topic, and not long ago when I was asked by the American Society of Pediatric Hematology Oncology to lead a webinar on this issue, I developed a fairly simple list of the fundamentals of negotiating in the medical environment. What follows is a summary of the webinar.


The common sequence of events, though not uniform every time, starts with an informal chat at a meeting and/or an invitation to visit an institution. Usually you are asked to give a lecture on your work. You should speak of work that you know very well instead of something you only recently started. Answering questions with confidence makes a good impression. A recruitment invitation is often camouflaged as a simple invitation to describe your work.


You should meet and speak with as many people possible in the program that you are considered for. Always get phone and email contacts so you can call or write with questions later. You may be asked if you would consider a move – best to answer vaguely: “It depends on the terms and opportunity” is the true and acceptable answer. The first visit incurs no obligation to make another visit. You may find that you wouldn’t move there no matter what – if so, thank the invitee and simply say you aren’t ready for a move.


The invitation for a second visit usually includes the spouse and should not be accepted unless there is a reasonable chance that you would take the job. Before this visit, you should do a ton of homework. Prepare a list of your professional short- and long-term goals and be able to describe what added value you bring to the program. You should practice describing these goals with a colleague at home before the second visit.


Sources of information could be your current boss and faculty (caution: if they want to keep you, they may denigrate the job) and those you met on your first visit, especially those around your stage of career. Find out about the working environment -- such as whether the boss keeps his/her word, if the clinical schedule is overburdened, if there are enough patients for clinical research, the efficiency of the clinic, and whether there are solid nurse practitioners. You should also check the inviting institution’s websites and the CVs of key players in the program to judge their productivity and the tone of the program.


If you have plans for a serious research effort at the new institution, be sure you are prepared to describe your needs and what startup support would be provided. Speak one-on-one with many people in that division, especially those you would be working with, to get a grasp of what it is like to work there and for the boss. The boss may start negotiating informally, so be prepared to ask detailed questions about clinical assignments, laboratory startup support (if you will have a lab), time allocated for lab work, requirements for promotion, etc.


You should be prepared for a discussion of salary. Get the ranges of salaries for the position you are considering from your current institution and, if possible, from the recruiting institution. Check on the cost of housing and the cost of living there compared with where you are now, and add into the mix any special financial needs your family requires -- e.g., a chronic illness. Consider the cost of schools, the commute, insurance, retirement programs like TIAA-CREF, and so forth. Get as much objective data as possible -- data speak louder than wishes. You must gather this information to arrive at an estimate of what income your family needs to live comfortably in that environment. Have a “deal-breaker” salary level in mind that would be so low that it would kill the deal. Now you should have a good range of possible offers.


When negotiating the terms, understand that you are in the strongest position you will ever be in before signing anything. Also, in some cases the recruiter may have limits of what he/she can offer. Don’t feel sorry for the recruiter! That is their problem and you should be reasonable for a very modest reduction, but reluctant to accept an inferior offer in salary, research time, working conditions, etc. because of some institutional “rule.” A truly inferior offer with an explanation of “this is the best I can do,” should make you consider other options. Once you sign up, you are committed and don’t get a mulligan (in a friendly game of golf, a second try after a bungled shot).


Finally, don’t spend a lot of energy fighting for a relatively insignificant issue. Sometimes it is better to cede that, showing your reasonableness.


There is no substitute for aggressively gathering information and data in advance about the place, people, and position before you commit.


Comments on these “fundamentals” are welcome!