The contractual arrangement—the nuts and bolts of how you affiliate with and bond to a company—must be fair and equitable, but “it shouldn’t be open ended.” In addition to delineating work hours, call duties, and hospital coverage, the employment agreement should also contain language regarding buy-in to the partnership. As an employee, you are guaranteed your salary, Dr. Baraf reminded his audience. As a partner, you will share in profits as well as risk, so you should also familiarize yourself with the partnership’s overall management and compensation structure. Dr. Baraf’s parting advice to his audience: “Do your homework, select the right practice, read your contract, hire an attorney or accountant or practice consultant, and keep your eye on the prize. The initial contract is a means to an end; that is, partnership status.”
Physician, Know Thyself
Young rheumatologists can achieve satisfying careers in the academic arena as well, said Steven B. Abramson, MD, senior vice president and vice dean for education, faculty, and academic affairs and chief of the division of rheumatology at NYU Hospital for Joint Diseases in New York, during his presentation at the session. However, if this is the path they choose, they must ask themselves, “Am I really equipped, in the major domains of research, education, patient care, and administration, to be successful?”
“A lot of us entered practice when you could be a wonderful teacher, educator and researcher,” recalled Dr. Abramson. But achieving success as the “triple-threat” rheumatologist “is increasingly hard to do, particularly if you want to be successful as a researcher,” he cautions. To successfully land National Institutes of Health funding for their research, physicians now have to choose which of the career paths best suits them. Whether they choose to join academic units as clinician-educators or as investigators, young physicians must have their “eyes wide open” when evaluating prospective divisions and institutions, he said. For instance, does the division’s culture foster tenure-track advancement? Does the division offer three-year fellowships and a pathway for obtaining a masters degree, which is increasingly necessary now for clinical research?
This model has worked well in the rheumatology division at NYU, said Dr. Abramson. Also important, he said, is that mentoring committees be composed of outside faculty who can monitor your career pathway and give objective feedback to your division chief about your career trajectory. To succeed in their research careers, academic physicians must secure employment contracts which allow for at least three years of protected time before they are required to secure their own grants (this allow for 75–80% of their salaried hours to be spent in research) and which provide administrative and monetary support for research technicians and supplies. Not every academic unit is the same, so you must investigate the health and infrastructure of the department. Does the unit, for instance, have the bioinformatics support and strong collaborations with other researchers that can foster your own growth?
