Another discussion centered on the importance of identifying mentors, both internally and outside one’s institution, and the utility of personally reaching out to potential employers in practice and at academic institutions to identify career opportunities—whether or not a job opening is listed. The importance of starting the conversation and keeping it going cannot be overstated, said the panelists, and is essential when approaching the workforce after training.
Another fellow asked about the major pitfalls of the workforce and how to adapt to them. Dr. Worthing discussed how changes in the economy can have direct effects on a practice and how a fiscally minded approach is essential to running a practice as a business.
Dr. England said a large part of his day involves writing. To have the ability to explore novel research questions, he needs to be persistent about obtaining grant funding, he added.
Dr. Jayatilleke said that productivity and a sense of how finances are run are essential, even in an academic setting. She also discussed how working in institutions with different financial resources can prove challenging to the care and educational initiatives that one would want to provide.
Each speaker also hosted a round table in the second part of the day to field additional questions.
Contract Negotiations
Melinda Malecki, JD, MS, Malecki Brooks Law Group, Elmhurst, Ill., and Marianthi Kiriakidou, MD, director of the Division of rheumatology and the Jefferson Lupus Program, as well as an associate professor of medicine, Thomas Jefferson University, Philadelphia, discussed contract negotiations with an employer.
Some of the major topics Ms. Malecki discussed included written agreements vs. oral; the language of the contract; the term; what duties are spelled out; evaluating compensation and benefits together; the predictability of a straight base compensation; unpredictable variables in income, such as productivity bonuses; covenants (e.g., an enforceable geographical non-compete); termination without cause; potential ownership; and force majeure. Regarding these last three, Ms. Malecki emphasized the significance of including specific language in a contract to protect oneself as a new employee/contractor.1
Dr. Kirikadou offered an overview of the current landscape of rheumatology training in the U.S. and post-training career decisions. She noted that 126 accredited fellowship training programs were in place as of 2022.2 For the 249 fellows who completed training in 2021, slightly more than a third of trainees were pursuing a career in academic medicine, and over 50% were planning on pursuing private practice.
