(Pictured L to R) By Aleksandra Yakhkind, MD, Neurocritical Care Fellow, University of Pennsylvania; Pouya Ameli, MD, MS, Assistant Professor of Neurology Neurosurgery, University of Florida College of Medicine; Naomi Niznick, MD, Chair, NCS Trainee Section, Neurology Resident, University of Ottawa, Chair-Elect, NCS Trainee Section
NCS realizes that finding a first "real job" can be challenging, especially during a pandemic. To help applicants find the right job and help hiring parties fill needs, the Trainee Section and the Fellowship Direction Section are mobilizing resources to update the NCS Career Center website in the coming year.
Our first virtual career fair was on Nov. 23, 2020, and featured a panel of neurointensivists from the academic, hospital-based and private practice settings, as well as updates on the job market and typical compensation packages from industry experts. We understand that not everyone was able to attend this session, so we have put together a selection of frequently asked question highlights for Currents as a two-part series.
The new and improved NCS Career Center website will become a resource for applicants and hiring parties, including high-yield advice columns, job postings and a database of NCC providers seeking employment. Browse current job postings here. If you would like to be notified as the new Career Center develops and about future events, including a panel on applying to jobs with a visa, please follow this link to fill out a brief survey.
Please enjoy Part One of Frequently Asked Questions answered by experts in NCS.
Our Experts: (pictured L-R) Andy Fadenholz, MBA, Recruiter for Rosman Search Inc.; Angela Hays Shapshak, MD, Associate Professor of Neurology and Anesthesiology, University of Alabama at Birmingham; Ali Mahta, MD, Assistant Professor of Neurology, Neurosurgery and Neurocritical Care, Brown University; Christa O’Hana S. Nobleza, MD, MSCI, Assistant Professor of Neurology, Neurosurgery, Director, Neurointensive Care Unit, University of Mississippi Medical Center; Dionne Elizabeth Swor, DO, Assistant Professor of Neurology, Wake Forest School of Medicine; Katharina Busl, MD, MS, Associate Professor of Neurology, Neurosurgery, James E. Rooks Jr. Professor and Chief of Neurointensive Care, University of Florida College of Medicine
When should I start to apply for jobs?
AF: We recommend starting to look for a position 12-18 months before you finish training. If you require a visa, start closer to 18 months. Some programs offer a stipend while you finish training for an early commitment (12-24 months before finishing training).
AM: Start communicating with your colleagues and people you know at other institutions at the end of your first year of fellowship. Remember, networking is key for any kind of job hunt.
CN: For fellows with a J1 visa, you should apply in the spring of your first year of fellowship.
KB: The NCS Annual Meeting is a good venue to meet potential employers. Ideally, reach out beforehand and set up meetings during that week.
Where should I look for jobs and whom should I contact?
AF: We recommend utilizing all of your resources when looking for a position. Speak with your mentors, colleagues, look online, utilize recruiters. If you know you want to be at a specific program, don’t be afraid to reach out to them directly even if they are not advertising a position.
AHS: I frequently get cold emails for academic positions. Recruiters and postings on professional society websites may be good resources. A lot of it is word of mouth; ask your mentors and other job seekers.
CN: Until NCS finishes their job search platform, there are generally three ways to find jobs. One is through a recruiter, the second is through job search engines and third, most inconsistent but perhaps the highest yield, is through word of mouth, including your fellowship PD asking around on your behalf.
Is it true that when you leave academia, you can’t go back?
AF: No, there are plenty of neuro-intensivists who work outside of academics and find themselves at an academic program after they have some experience. There are certain positions (director level) that prefer someone to have an extensive amount of academic experience. A lot of the community-based programs with a dedicated neuro ICU also have an academic affiliation and offer research, teaching, etc.
AHS: No. I have seen faculty members successfully transition to academics from community practice. Also, the lines between academic and community practices are blurring. Many health systems have residents, take rotators from medical schools, and many have a clinical trials program. If you're looking at community practice, but academics might be attractive at some point, ask about adjunct teaching appointments or other affiliations with academic centers that would help if you decide to switch.
KB: No. Many different paths are possible; however, you should think of it as a path. Your path may be curvy or straight. Although more jumps and hoops do tend to be more challenging, they are all valid paths.
A lot of jobs these days involve starting a new Neuro ICU. I have been told to avoid this right out of training, but if it is my only choice, how should I approach it?
AHS: I think this would be tremendously difficult just out of training, but it could also be very rewarding.
CN: This is true. If this is your path, you will need three types of mentors. One mentor from your training to guide you in the beginning: the set-up, politics, balance of work and personal life, mainly because they know you. As you befriend senior administrators in the institution, find an administrator mentor. This mentor is ideally someone who can help further your initiatives in the program you are building and eventually act as your institutional sponsor. Lastly, a mentor in NCS may bring you ideas or approaches that can help you in your new program. It is going to be hard, but it is a great learning experience.
KB: Building a new program requires lots of time and full dedication. You will need to supplement your lack of on-the-job experience with great mentors, sponsors and supporters within your institution. Build a network of colleagues who will walk with you. Be realistic about your goals. If you are tasked to start a new service line or build a new unit, this will have to be something you truly love doing.
What is the most important quality that I should look for in a job?
AF: That you feel like you will be successful both from a clinical and personal standpoint. It needs to be a good fit for both you and your family. You also need to be able to trust your employer. A good contract will only be able to protect you so much. It is very important that you and the employer have the same expectations. This should be discussed before you sign any agreements.
AHS: Is the job sustainable? Are they expecting you to build a program, by yourself, while also doing research and publishing? That is not feasible or sustainable, no matter how much compensation they are offering. Working 40 weeks a year (as an intensivist) is not sustainable, but 26 weeks might be depending on the other job expectations. The second most important question to ask is: What is the working environment like? Do collegial relationships exist between key stakeholders? If you're coming into a toxic environment, everything you're trying to accomplish will be that much more difficult.
AM: Each job has many aspects which come as a package. The most important thing is which aspects appeal most to you. Is the environment academic vs. private? How much clinical, research, teaching, administrative time you have? What about location, climate, distance to family, workflow of the unit, environment (specifically relationship with neurosurgery) and compensation?
DS: When you're starting out, I think the most important thing is the potential for good mentorship. Talk to the young faculty members and ask if they feel supported by their chair/section head. Ask about guidance in terms of career development. Make sure you like the place and the people.
What are some “red flags” in a job that I should look for when interviewing?
AF: There are problems at nearly every program in the country (some have more “red flags” than others). It is your job to find out what they are and if you are comfortable with them. Be sure to ask why they are currently hiring (did someone leave, did someone retire, are they expanding?). If someone left recently, ask why and if it would be okay to speak with that person. Talk with referring physicians, mid-level providers and administrative assistants about their experience at the program.
AHS: Be concerned if all the stakeholders don't appear to be on the same page. When interviewing for a directorship, expect to meet with nursing leadership in addition to physicians, APPs and administration. Understand the organizational structure: Is the institution organized in departments or service lines, or "other?" Where does the NICU fit? Is it in the Department of Neurology, Neurosurgery or Critical Care Medicine, or is it part of the neurosciences or acute care service lines? This will determine to whom you'll be reporting, how you'll obtain additional resources and what you may be able to accomplish.
DS: Make sure you are meeting the right people and they aren't hiding certain faculty from you. In general, you should be meeting with the department chair and neurocritical section head, the other neurointensivists and someone from neurosurgery.
KB: High turnover of faculty without a solid explanation. Way-above-average salary without clear explanation. Lack of support structures (ie, night call support).
Stay tuned to Currents for Part 2 of this Career-focused FAQ.