All right, we're going to go ahead and start this next session. The first talk is about interviewing, and interviewing is at this stage about sharing who you are and getting the info you need to make a decision about your job. So I've got kids, and I read this story a lot. It's about Philippe Petit. Does anyone know the story about Philippe Petit? Okay, so Philippe Petit was a tightrope walker who strung a line between the Twin Towers in 1979, and he walked across them. They were the tallest towers in the world at that time. And right at dawn, he's got the line strung, and he puts on his outfit and takes the pole and steps onto the line. And there's a line in the book that says, all his life, he had trained to be there, to do this. And I feel like most of your life, in some way, has brought you to this moment where you are so skilled, as Dr. Wood said, you're so ready to work and to contribute, and now it's really important that you check out your opportunities and take the best one for you. So I'm going to actually talk very little about selling yourself, because I think the tables have turned. You've sold yourself all your lives, getting into medical school, getting into residency and fellowship. And at this point, it's less about selling yourself and more about evaluating your opportunities. But same rules apply. You want to share all the training that you've done and what you want to do in the practice. So I remember, and you want to really practice your story and your pitch to your stuffed animal or to your kids or to your partner or whoever. I remember doing a fellowship interview, and this woman was so, she said, I've done this training in addiction medicine, and I'm interested in addiction medicine. And she had this story so beautiful and nice. And I went to the lunch afterwards with all the interviewing faculty, and the head of our center, our NIH-funded center goes, oh, yeah, I just want to offer this woman the fellowship right now. So it does make a difference. And you can change your story depending on the practice you're interviewing in and the kind of the role that you see yourself playing in the practice. Be honest. You know, don't say something that you really don't want to do. Be respectful to everyone, the custodian that you are with in the elevator, the receptionist, all the people interviewing. Share any particular interests, whether that's in, you know, the business side or esophageal motility or things like that. All right. So the more important thing really is to get the info that you need to make this decision. So schedule. You want to know how many days a week will you work, among which sites, and all this is in your handout and will be emailed to you. What will be the breakup of endoscopy and clinic? How long are the endoscopy slots? Are they, like, an hour? Are they half an hour? Are they 15 minutes? Will you be overseeing physician extenders? And what's the breakdown of inpatient and outpatient work? Nursing support. This is critical to your sanity and to your quality of life. So who's going to be triaging your inbox if you have a patient portal, which a lot of practices do now? Who's triaging that? Who's triaging calls? Where are they in relationship to you? So if they're in some office that isn't where you work at all, it's sometimes even more challenging to kind of communicate with them if they were in your same office. Who's communicating results, particularly just kind of normal results? So if you're having to do all your pathology letters, that's different from someone else doing that, because there can be a lot of pathology letters. If there are nurses or MAs, you want to know what the ratio is to provider to support. So having a nurse who's supporting eight providers is very different from having a nurse who's, like, one-to-one or maybe one-to-two, and what you can expect out of them. All right. Call. Okay. How much call are you going to do? How many hospitals are you going to cover? And who is the first line for after-hours calls? So is there a triage line? Is there a PA? Is there a fellow, or is it just the physicians taking these first-line calls? Salaries and bonus. So how are the salaries and bonus set? Is this RVU-based, or is this other criteria? The retirement plan, the benefits, often there's, like, an HR person who will go over this stuff with you, and then you want to know the salary comparables. So you can get this in various ways. For the AMC, I actually have it in your handout from 2023. As far as just broad GI salaries, there's a map in Doximity that will actually, you'll click on the point in the map, and they'll show you salary range that's been self-reported by physicians. Medscape has also a compensation report every year. So this was just something I found online, this Medscape GI compensation report. Average annual compensation was $500,000. Paying salaries included kind of on the lower side $315,000, mid $500,000, $750,000 high. And then you can do this more regionally, which probably makes more sense as well. This is the AAMC data for academic GI salaries by percentile, and the handout also has this. So helpful to know if you're interested in academics. Great. All right, vacations and leave. So what are the vacations a year? How many weeks a year? What's the coverage plan for those? I would say just, I think it's helpful to interview at all sorts of practices, even if you're not that interested in a certain type of practice. I mean, I remember one practice that I interviewed that was hospital-based, and it was like, wow, you're on call for your patients all the time. There's absolutely no coverage plan at all. It was very interesting. So family leave. So this is like when a lot of people are starting families or continuing to have babies. So if there's a plan for that, some practice may not have a plan, so that's also helpful and interesting. What's the patient coverage plan for that? So they might have an idea, but who's actually going to cover my patients during that time? Ownership. So who owns the practice? If the group owns the practice, have there been talks to sell to private equity or a hospital system? So as an example, my brother-in-law is an anesthesiologist, and his first, well, his job that he has continued for the last decade, I guess, was at the practice in his hometown. And it was a private practice, physician-owned. He got there, and one year later, the owners had sold to private equity, which has been very different. And he's not very happy about the management. So I think there's a range of satisfaction, but he doesn't like having the control that kind of they ceded when they sold. So does the group or the private equity own the ASC, pathology, anesthesia? If equity owns the ASC, often they will control staff schedules, the equipment, those things like that. Do they own real estate? If so, can you buy into that? That can be a big revenue stream for a physician to have ownership in the company real estate. What's the criteria to make partner? And how many years is it considered to make partner? Is the buy-in a lump sum, which can be a lot of money that often people will have to take a loan out to get into? Or is it just taken out of earnings gradually? Okay, so for those, all of you who are interested in academics, it's important to know which track that you're hired for. And there are different tracks, like clinical educator track versus tenure track. There can be differences between them. So as an example, when I was at Stanford, and this probably may have changed, but when I was a fellow at Stanford, the non-tenure track did not have access to housing subsidies that the tenure track folks in the medical school had access to. And they were also not able to vote in the medical legislature, I guess. At UNC, there is not hardly any difference like that. But for example, tenure track can take a sabbatical. Some people do, rarely, whereas non-tenure track don't. So what is the protected time that you will have? Ideally, research, if you're wanting to have a research program, you'll have 50% or more. For clinical educator, usually it's more like 20%, but it can be more. I started at 30%, and now I have some funding to protect more time, but the standard is 20%. How long is the time protected before you need funding? What are the teaching expectations? So are you going to do fellow teaching, resident teaching, medical student, things like that? What support services for research exist? So is there a statistician in the group? Are there database analytics? Is there a clinical trials group? You want all of that stuff. You want all that stuff already in place, so you don't have to be trying to start those things up. And then usually for academics, the package includes a startup funding, and that can range from like $20,000 to $50,000, kind of, or more. And the startup funding is helpful for buying your professional fees, things, if you don't have a stipend for that, a yearly stipend for that, going to DDW and different things. And this is important, so patients, where do your referrals come from? Is there a large primary care group? Like for Kaiser, you kind of got your primary care referrals all set, but other places, even some academic centers don't really have a primary care base. So you'll want to know, kind of, if that's already in place, and what's the payer mix. All right, so depending on how many practices you interview, I would encourage you to maybe even make an Excel spreadsheet with all this information to kind of keep track of, because it's, depending on how many you interview at, you could have a lot of information, and you need a way to keep track of it. All right, so you're ready. If you're second or third year, you're ready to get out there and assess jobs. We are going to do an exercise, where, oh, what's that? Oh, we were going to, okay, well, we'll just move on to the, yeah. Oh, yeah, yeah, so, okay, so here's just a handout for you to have, and when you get home, before you go out interviewing, I would recommend that you pair up with someone, your partner or a friend, a fellowship friend, and just practice asking these questions, because really, some of these questions are kind of awkward, right? Like we're not used to asking about how much we're going to get paid, and you know, that's not a conversation that we do on a daily basis, so the more facile you are, the better you'll feel about going into these interviews. All right, thank you. Good luck. Thank you. Yeah, I think that'll give us time for more questions and these other talks, I think, rather than shorting them on time, so, and then, so we can make it to lunch and all these other activities. Any questions for Dr. Miguel? I have a quick question. For this table that you showed us, the AMC table, these different percentiles, what are those percentiles? Yeah, they're, they're 20th, let me look at the table, oh, no, sorry, sorry, so above shows the column, so the percentiles are already shown, right, but the first column is for instructor, the second column is for assistant professor, the third for associate, the next column for full professor, the next column is for division chiefs, and then the very last column is for department chair, like gastroenterologists who are chairs of departments. Like how do we know, like, is it a regional-based percentile system? No, this is just all comers, so, and as you see, they probably didn't have salary data on every single professor because, you know, they're, I guess they have a sample of 918, but this is not regional, so this will vary by region. But you can get an AMC data by region, you know, but, again, all of that, I think, has to do with the Grand Salva for the reasons you said, so if we get a survey every year from AMC and you either fill it out or you don't, there's workforce surveys, both within ASGE, some other societies, but, yeah, the data does exist regionally as well, so you have to take, again, think of it as the whole, you know, what's the salary in Boston or L.A. versus what it might be in Wichita, Kansas. Check this one. I have a question. About interviewing with the small practices, is it rude to ask them to see their financials? I have heard that that can be a major issue, that if the small independent groups are unwilling to show you their financials, then that is a red flag. I don't know if any of you have heard anything about that before. I would say that that's information that you need and that you should be able to ask for that, and if they don't want to show you that, then I think that is a concern. I don't know what other folks in practice think. I think the problem is that they can show you the books, and it might as well be written in hieroglyphics. Like, you would have to hire an accountant to look at that. I mean, I couldn't read that. I do think, though, that it's not something you would want to ask at the first interview. I don't view these as a single entity, right? You're going to go for a first interview. You'll probably come back for a second as you start coming up with your plan. I think this has been my experience, at least in academics, is you have your first set of Then if you want to come back or they want you to come back, you maybe develop kind of what your job is going to look like, and then you can start kind of, and Doug will talk about negotiation, but again, thinking about before you start really asking the nitty-gritty, which is as hard as coming out of fellowship. You're like, I need a job, I need to know about how much money I'm going to make, and it's hard to do that at the first interview, I think, sometimes. I don't know if other people have thoughts on that. I think it's helpful to know a salary range at the first interview. I just came in. I'm Ron Koppolo from Jackson Practice in Jackson, Mississippi. Can you hit your microphone if it's not already on? Is this it? Yeah, until it turns green. Yeah, thank you. I apologize. I had a missed connection. It's fine. I think it's, I interview a lot of folks for our practice, and I think it would be perfectly reasonable to ask what the average income is for the physicians in the practice, what the low and the high is, and also what percent of collections you would expect to take home, because that gives you a pretty good idea of their expenses and things like that. What about asking about first-year, what's the first-year salary? Is that a reasonable question? First-year? What would you expect of someone right now? Oh, yeah, sure. Anticipate a first-year salary, sure. See, I think it's a bias of the academic people where practice, they're like, sure, ask, and in academia, it's sort of be like, you're supposed to be here for noble purposes. Right? I mean, maybe. First-year salary, you're not supposed to care about that. Great. Thank you.

job opportunities

evaluating job opportunities

well-prepared story

questions to ask during interviews

gathering information during interviews