Jul 19, 2019
By Mina S. Sedrak, MD, MS
When I began the search for my first job after fellowship, I was geographically tied to one city because of my wife’s career and family. Needless to say, this critical constraint made the search very challenging right from the start. I had to be strategic and thoughtful about my approach. I sought the advice of mentors and peers, and noted the absence of a formal, structured guide to this daunting and potentially chaotic process. Recognizing this gap, I began to assemble my experiences and recollections into a talk that I hoped would provide guidance to fellows engaging in their first job search. After giving the talk locally, I was invited to share it with a larger audience of trainees at the 2019 ASCO Annual Meeting. This mini-workbook is a version of my talk transformed into a practical tool for senior oncology fellows. The emphasis reflects my own priority of finding an academic job. I hope that others, including those seeking a job in a medical practice, will find this a useful guide in their own search.
Before you start applying and interviewing for jobs, reflect critically on what you want to do with your career and your life. Think about who you are, your values, your priorities, and your goals. This period of self-reflection is an investment in your future career fulfillment and satisfaction. This is often the most difficult part of the entire process. The analogy to crafting the Specific Aims page of a grant application is not far-fetched.
As you reflect, seek the perspectives of your mentors, program directors, and department chair. Ask them what they look for in a job, what aspects of their job are most important to them, and if there is anything they would have done differently as they looked for their first position. If you have a spouse or partner, you will want to have an open conversation about your priorities and values as a family. Family members and friends, even those in other fields, will have useful experiences to share about their must-haves and deal-breakers at work.
Identify: What matters to you the most? Rank the priorities in order of importance to you.
- Disease site (e.g., breast, thoracic, GI, etc.), type of patients you might like to focus on (e.g., triple-negative breast)
- Intellectual environment
- Balance of clinical time vs. protected time
- Teaching opportunities that are highly regarded and rewarded
- Presence of potential mentors in your area of interest and a strong culture of mentorship
- Geographic location
- Job availability for your spouse/partner
- Family-friendly culture and policies, including parental leave
- Vacation time, flexibility, and other lifestyle considerations
- Opportunities for collaboration
- Clinical aspects: type of practice, diversity (staff, patients, focus, day-to-day work), clinical trial access, etc.
- NCI designation
- Office culture (team-based vs. independent environment—and no one wants to work in a snake pit)
- Other: ________________________________________________________________
As you think about what matters the most to you, consider what you might have to give up or be less stringent about finding in your first job (i.e., what is the relative weight of each of your identified priorities). For example, my clinical focus in fellowship was in the treatment of thoracic and head and neck malignancies. Although I really enjoyed both the science and patient care aspects specific to these disease sites, I also recognized that it was a little early for me to make a lifetime commitment to a particular disease site, and since I was geographically tied to one city, I decided to be flexible about my disease area of focus. I made it clear in my cover letter and interviews that I was willing to adjust my clinical practice to meet the needs of the institution. Having some mental flexibility is often critical in the job search.
Communicate: Look at the three characteristics you ranked most highly and use the space below to declare what matters most to you. This will serve as a personal mission statement to guide your job search and help you evaluate the suitability of open positions and opportunities.
- Example: I am looking for a job at a practice with a well-established community clinical research program, a friendly and collegial environment, and located in or near a major city.
Define: The right first job for you will be one that aligns with your values and priorities, and that sets you on the path to success as you define it. A position that looks appealing on paper but doesn’t give you the opportunity to achieve your goals will ultimately be unfulfilling. Use the space here to write some of your short- and long-term career goals—and know that it’s okay if your goals evolve over the course of your career (because they will).
What are your short-term career goals (within the next 1 to 3 years)?
What are your long-term career goals (within the next 10 to 15 years)?
Once priorities and goals are identified, you can begin identifying jobs. You should use multiple means to find jobs so as not limit your opportunities.
Browse open positions: Sign up to receive job postings from a variety of internet-based search engines.
- ASCO’s Oncology Career Center
- American Society of Hematology Job Center
- New England Journal of Medicine Hem/Onc Job Center
- Doximity Career Navigator
Occasionally, Facebook groups (such as the Hematology Oncology Women Physician Group [HOWPG]) or Twitter can also be useful sources for identifying available job opportunities.
To start, you’ll want to cast a wide net. Looking at different jobs helps you understand what is out there, what you want, and what you don’t want. How many job postings should you look at? There’s no right number, but if you’re getting overwhelmed, you’re probably looking at too many. Narrow your filters and focus on jobs that align with your goals and priorities.
Create your own position: In academic medicine, some positions may not be widely advertised, and you may not find obvious, published openings for your ideal job. Reaching out directly to programs (“cold calling”) involves some legwork and purposeful planning (and luck), but can be an extremely rewarding way to create the position you want.
- First, think about where you would love to work, even if those places don’t have any posted positions, and make a list.
- Second, identify and compile contact information for key people (e.g., the cancer center director, division chief and/or department chair, and maybe the program director). Note the contact information for any faculty members there that you know personally or someone who shares your disease or research interests, and perhaps to whom you could be introduced via your mentor(s) or current department chair.
- Third, learn as much as you can about these places so that you’ll be ready when an opportunity does arise and/or when you begin to apply.
- Fourth, network early. Consider reaching out to some of these key people at scientific conferences (e.g., ASCO or ASH) and find a time to chat in person to introduce yourself, explain your interest in their program, and learn about their potential needs. These meetings can lay the groundwork for job opportunities.
Jot down three places where you would love to work as a starting point for the comprehensive wish list you’re going to make:
The summer is an ideal time to update your CV and start drafting your cover letter, which you can (ideally) send out by September or October to division chiefs, department chairs, and cancer center directors (if going into academia), and hiring managers at practices, companies, and agencies (for non-academic positions). I recommend sending copies both by email and snail mail.
A straightforward template for cover letters:
- Introduction (1 paragraph): Who you are and what kind of position you’re looking for.
- Body (2 to 3 paragraphs): What you have done, your experience, skills, and accomplishments.
- Conclusion (1 paragraph): Where you are going, your next steps, plans, and long-term goals.
Ask for an introduction: A brief email of support on your behalf from your institutional leader or mentor will go a long way in helping your application stand out.
Nail the timing: Coordinate with your mentor or leader such that their note of recommendation goes out first, then follow up with your CV and cover letter within 48 hours.
Wait: Be patient. You want to be remembered for the strength of your CV and cover letter, not because you were a nuisance with your follow-up messages. Give people 4 to 6 weeks to review your application before you check in, and when you do, keep your email short and to the point.
- Example: Dear Dr. Jones, I'm following up on a letter I wrote this summer inquiring about a junior faculty position in your Division. I'm planning to be in Los Angeles around Thanksgiving and would be happy to adjust my travel schedule should there be an opportunity for me to meet with you. Sincerely, John Smith
Before the first interview: Do your homework.
- Research the institution (internet search, word of mouth, connections through mentors).
- Learn about your interviewers (publicly available resources such as websites, PubMed, Twitter).
- Ask questions of the faculty at your institution: What do they know about the hiring institution’s reputation, stability, mood, and/or fiscal health? Do they hear any rumors about the place?
- Develop and practice your job talk.
- Tell a story. Pick one or two research focuses. Describe how you got there, what you did, and what deliverables you have accomplished.
- Practice. Practice. Practice. Be aware of time. Make sure you leave time for questions. Don’t rush through it (cut down on slides if you need to). Anticipate questions and have answers prepared in your head. Practice with and get feedback from your mentor, program directors, and peers.
First interview: The employer assesses you.
- Print and bring copies of your CV and cover letter, just in case an interviewer asks for them.
- Be prepared to talk about yourself and your accomplishments during training.
- The focus is typically academic: What are you looking for? What is your long-term goal? What is your research about?
- You will be probably asked to give a job talk (either at your first or second interview).
Second interview: You assess the employer.
- Do not go back for a second interview unless you are seriously interested in the job (i.e., you might take it if it’s offered).
- This is when you assess the faculty's state of wellness, lifestyle, schools, real estate, RN support, research support, what the practice is really like, etc.
- Your partner might be invited to come along and even come to dinner with the interview team.
- You can tell them who you want to meet. In addition to meeting with potential mentors and collaborators, don’t forget about research staff (the person who runs the protocol office), a research nurse, the division administrator, an APP, a chief fellow, someone with common research interests you did not catch the first time around, etc.
- Don’t be afraid to ask candid questions (see examples). This is your chance to see if the job aligns with your values, priorities, and short- and long-term goals.
Example: Questions to ask during your second interview
- “What kind of person are you looking for to fill this position?”
- “What track will the ideal candidate be on? How does that work at your place?” (Before the second interview, you should have found and read through the department or division literature on tracks, promotion, etc. This information is almost always available online; if it isn’t, ask for it either before or during the second interview.)
- “Tell me about your division/department. What are the broad research themes? What are people working on? Who are they collaborating with?”
- “Do you anticipate any major changes in the health system itself, med school department, or division leadership?”
- “What portion of the faculty is on an academic track?”
- “Is there a formal mentoring program at the department or division level?”.
After the interviews: Say thank you. I emailed every single person I met a simple thank-you note. Keep it simple and sweet.
- Example: I really enjoyed meeting with you. I learned a great deal. I am quite interested in the activities of the division, and I very much welcome the opportunity to learn more.
Deliberate, negotiate, and celebrate.
Once interviews are completed, it is important to consider all of your options. There may not be a “perfect” job that aligns with all of your goals and priorities. It is important to weigh all the pluses and minuses of each position as you decide between opportunities. Rather than focusing on finding the perfect job, focus on the job that is a good fit.
Deliberate: When deciding what job to take, ask yourself the following questions:
- Who will be your mentor(s)? Is there someone clearly committed to your success? The value of a forceful advocate in your starter job cannot be over-emphasized. Absent such a person, the job is probably not good for you.
- Who will assess you? What are the metrics?
- What are the requirements/expectations for promotion?
- Is the division growing or shrinking? Is the turnover high? What’s the stability of the faculty?
- Is the health system in the red or black?
Negotiate: When you receive an offer, consider it carefully. If there is a part of the contract you want to negotiate, you’ll be most successful if you approach it from the “same side of the fence”—start from the idea that you and the employer are in this together and share good intentions. This is definitely an art, not a science. Once you get the offer letter everything is negotiable, in theory.
- Compensation often varies based on type of practice setting and location. Salary reports online in public forums, such as Medscape or Doximity, or available for purchase through the American Association of Medical Colleges (AAMC), can provide references for understanding what is fair. Additionally, increasing evidence has demonstrated disparities in compensation between men and women in medicine. If there are concerns about compensation equality, it is acceptable to ask, “Is this salary fair?” and/or “What steps does the institution or organization take to ensure equality in pay?”
- Salary is not the only thing you can negotiate and often it is the one thing you can’t negotiate, as they tend to be very standard. You can ask for more protected time, start-up funding, clinical NP support, AA support, a formal approach to ramp up clinic over a couple of years, moving expenses, a loan for a home, service time, number of clinic days (based on proposed track), etc.
- Distinguish what you need from what you want (key advice I got from a wise mentor). What would it really take for you to be fulfilled and successful in the role?
- Do your research and know what is typical for the position, field/industry, and geographic area. If you try to negotiate for something far beyond the norm, you risk looking unreasonable. Know your value and have your research to back it up. This is especially critical for items such as salary; if they have a lowball offer and you have data on comparable salaries, cost of living differences, etc., you may succeed.
- Talk to your mentor, program director, and/or department chair about what you should (and should not) negotiate. Let them read the offer letters. They will have valuable experience to share.
Celebrate: It’s time to accept the offer, sign the contract, and celebrate achieving a big milestone in your life journey. Congratulations!
In most cases, your first job will not be your last job. Starter jobs do not have to be perfect. In fact, they probably won’t be. Your first job does, however, have to launch your career.
Once you have a job—even a great job that you love—keep an eye on new job postings. You may not realize you want a new opportunity until you see it. You’ll also see what employers are asking for and can keep your skills updated accordingly, so that you’ll be a desirable candidate when you are ready for a job change.
Acknowledgement: I dedicate this article to my mentor, Dr. Roger Cohen, program director of the hematology/oncology fellowship program at the University of Pennsylvania. His commitment to trainees and dedication to mentorship is exemplary, was instrumental to my success (and the success of a generation of junior faculty), and continues to impact and inspire me.
Dr. Sedrak is an assistant professor in the Department of Medical Oncology & Therapeutics Research and breast cancer oncologist at City of Hope. He is a member of the ASCO Annual Meeting Scientific Program Committee, Technology Research Group, and Trainee & Early-Career Member Lounge faculty. Follow him on Twitter @MinaSedrakMD.