Career Planning
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Finding the Right Practice
Considering an Academic Program
The question facing every neonatology fellow as they transition from fellowship to practice is whether or not to pursue a career in academic medicine.
There are many considerations when determining if academic medicine is the appropriate career path.
All are worth carefully assessing for good fit in terms of professional goals and areas of interest.
The question facing every neonatology fellow as they transition from fellowship to practice is whether or not to pursue a career in academic medicine.
There are many considerations when determining if academic medicine is the appropriate career path. All are worth carefully assessing for good fit in terms of professional goals and areas of interest.
This can be especially challenging considering that the majority of your mentors likely have had a very successful career within academic medicine and would love to see you follow suit.
KEY ATTRIBUTES
When it comes to academic medicine, there are many considerations as you determine whether or not this is a good choice for your career.
Academic Medical Centers
Medical education, research and clinical care come together to benefit the patient while physicians, who are teachers and researchers themselves, strive to stay at the forefront of major advances in neonatology.
This can be a very attractive practice environment with constant intellectual stimulation and opportunity for clinical advancement with a strong culture and commitment to new discoveries.
Clinical Collaboration
In academics, there is a very public nature of clinical practice where team care, group thought, and interdisciplinary perspectives come together at the patient bedside.
Discussion and collaboration can add value and enhance the clinical discourse and treatment plan delivered to patients. This type of process brings a high level of team-based cooperation to daily rounds and clinical decisions.
Some physicians appreciate dialogue and deliberation and find the intellectual stimulation to be an attractive aspect of academic medicine.
Medical Complexity
Academic medical centers often care for the sickest of the sick. Patients are more medically complex and often in advanced stages of disease progression. These institutions serve as regional referral centers and receive transfers of higher acuity patients from broad geographic areas.
As such, medical teams practicing in academic programs regularly care for some of the toughest conditions to diagnose and manage, which can be immensely rewarding, but also emotionally taxing.
Teaching Others
Training the next generation of students and residents is often cited as one of the most compelling aspects of academic medicine. For some physicians, serving as educators has just as substantial of an influence as one-to-one patient care.
They view the role as making an impact on many patient lives via training the generations to come. Many consider their own professors and mentors and the lasting impact they made on their own careers, and desire to provide this same level of mentorship to others.
Medical Research
Academicians thrive by working where medical breakthroughs actually break through. They want to work with colleagues who not only discover tomorrow’s cures and treatments but also bring these advancements to the bedside safely.
Neonatologists in academic medicine are constantly seeking new scientific discoveries, keeping medical knowledge and clinical care on the cutting edge, and ensuring the best care is delivered to neonates.
Being part of a culture that strives for medical innovation and clinical advancement involves a constant desire for learning, inquiry, and seeking answers.
This aspect of academic medicine can offer a rewarding career for physicians who desire to be at the forefront of new discoveries, and to advance clinical practice via clinical research and investigation.
Variety of Work
Due to the roles physicians in academic programs must fulfill professionally, there is substantial variety in the tasks and duties throughout their days and weeks. On any given day, a physician may teach medical students, proctor residents, examine patients, perform procedures, focus on their clinical investigation, author articles, review literature, apply for grants, give a lecture, or present at a conference.
Many enjoy the variety of their schedule as a way to break up the clinical care, teaching, and research along with the administrative tasks that come with each. For others, this can be a source of stress. These dynamics should be carefully considered in terms of long-term career satisfaction.
Administrative Bureaucracy
Given the breadth of administrative roles and duties within large academic institutions, there can be significant bureaucracy and political agendas to navigate. There may be many positions and opinions voiced when trying to arrive at a decision. Getting a task done can sometimes end up taking significant time, resources, and energy.
In some cases, the three-prongs of the mission – education, research, and patient care – can get in the way of each other. Competing priorities can cause concern for what the real focus or priority is for the organization. This aspect of academic medicine is often cited as being the most professionally draining.
Serving the Underserved
Academic medical centers care for a disproportionate share of medically underserved patient populations. As safety net hospitals, regional referral centers, and teaching facilities, they typically see larger volumes of patients who lack medical insurance, are covered by Medicare or Medicaid, or reside in low-income areas with few resources.
Many physicians decide to pursue academic medicine due to these social and economic disparities and a desire to serve patients who might not have access otherwise. It can be a calling for those who choose the mission-driven, service-oriented approach to caring for the most vulnerable members of society.
It can, however, come with an emotional toll. The constant encounters with the less fortunate can be difficult over time. It is important to be mindful of this aspect of academic medicine to ensure that dedication to those in need will give passion and energy to your career. Work-life balance is paramount.
PRACTICE CHALLENGES
- competing demands of your time and across several job duties
- significant pressure and stress to secure research funding
- dealing with the rigor and high standards for publication
- writing grants
- difficult socioeconomic situations experienced by patients
- may be less opportunity to standardize practice and adopt clinical protocols
- less efficient patient care processes
- dealing with administrative tasks and bureaucracy
PROS
respect in the community, ability to teach, do research, and care for patients, working with accomplished neonatologists, opportunity to publish your work, exposure to complex clinical cases, predictable income, opportunity for tenure track, opportunity to discover new knowledge and clinical advancements, housestaff typically handle EMR data entry
CONS
typically lower salaries than private practice, rigorous job performance criteria, significant pressure to get grants and publish articles, less flexibility in your schedule, tackling several roles, fewer clinical hours, low reimbursement for services, more bureaucracy, patient care can be more time consuming, longer work weeks
- Do you love to teach and mentor others?
- Are you interested in medical research?
- Do you want to hold a variety of job duties?
- Do you enjoy clinical debate?
- Do you like team work and collaboration?
- Do you want to work with neonatology experts?
- Do you strive for constant learning from others?
- Do you have the patience to allow others to learn?
- Do you want to be a well-published physician?
- Do you enjoy public speaking and giving presentations?
- Do you desire the prestige of a renowned academic institution?
- Do you want to serve underserved populations?
- Are you prepared for the time required to reach tenure?
- Are you interested in difficult, complex clinical cases?
- Are you willing to let others take care of your patients?
Additional Resources
An article from the AAP outlining the characteristics of the academic environment for neonatologists. It provides details to help inform you during your career search.
Provides a perspective on the benefits of working in an academic program and why it has been a good choice for one physician.
Shares tips and strategies to help with some work challenges faced in the academic setting.
Offers one physician’s perspective around why he chose to leave academic medicine.
Gives a personal perspective on the challenges and issues with the culture in academic medicine.
A study completed by AAMC surveyed faculty to understand their reasons for choosing a career within an academic program.
Survey responses are summarized and presented to identify the reasons for clinical and non-clinical departures at one academic medical center.
