No Decision Is Final: Career Planning and Career Transitions

A national virtual job search series for neonatal-perinatal medicine fellows

BACKGROUND

A standardized approach to prepare trainees for the job search has not been described. The objective of this study was to describe and evaluate an educational series on the job search for Neonatal-Perinatal Medicine (NPM) fellows and identify participants' job search knowledge gaps.

METHODS

During the 2020-2021 academic year, we created a virtual, seven-part job search series for NPM fellows that required no funding. The series has been repeated annually. We use REDCap surveys to register participants, collect baseline/demographic information, and evaluate the series' impact at the beginning and end of the job search timeline.

RESULTS

In the 2021-2022 academic year, 290 individuals registered for the series, and 89% completed the baseline/demographic survey. The majority were NPM fellows (89%). Early career neonatologists, NPM hospitalists, and pediatric residents also utilized the series (11%). Less than 25% reported being "knowledgeable" or "very knowledgeable" of core job search components, including the timeline of the job search, contract negotiation, and the general roles and responsibilities of junior faculty. Of those who completed the final job search survey and underwent a job search (60%, 97 of 162), the majority (86%) felt that career planning during training was stressful and believed that job search preparation should be structured into the NPM fellowship curriculum (81%). Many felt that the Job Search Series was helpful in elucidating components of the job search.

CONCLUSIONS

We identified several knowledge gaps in NPM fellows' understanding of how to find, prepare for, and negotiate their first post-training job. We strongly believe these knowledge gaps are not unique to NPM fellows and that all graduate medical education trainees would benefit from a similar, easy-to-implement, no-cost series.

Defining the Educational Needs for a Community-Based Hematology/Oncology Career: A National Needs Assessment

PURPOSE

Little is known about the specific needs during training for hematology/oncology providers practicing in community-based settings. We conducted a national survey of hematologists/oncologists employed in community or academic-community hybrid settings to delineate their educational needs.

METHODS

An electronic questionnaire was developed and distributed nationally through professional organizations. We primarily assessed whether survey participants received any specific training during fellowship for community-based practice. Participants were also surveyed regarding training experiences that might have affected their preparation. Relative risk (RR) and 95% CI were calculated using modified Poisson regression to identify factors associated with receiving training specifically for community-based settings.

RESULTS

Of 125 participants from across 25 states, 63% were male and 58% identified as White. Less than half (41.6%, binomial 95% CI, 32.8 to 50.7) received any training in a community-based setting. Participants identified rotations in community settings (47%), direct mentorship from community-based physicians (40%), and longitudinal clinic in a community setting (36%) as experiences that would have been valuable. Specific curricula of interest included medical operations and administration (63%), health policy (35%), and quality improvement (27%). Respondents in clinical practice for <10 years were more likely to have received any training specifically for a community-based career (RR, 2.13 [95% CI, 1.18 to 3.86]).

CONCLUSION

Our study demonstrates substantial unmet needs as they relate to deliberately training fellows destined for community-based careers. Prospective design of clinical training and curricula emphasizing longitudinal exposures to and key aspects of health care delivery in the community setting are paramount to achieving optimal goal-concordant hematology/oncology training during fellowship.

Preparing Hematology/Oncology Fellows for Success: Implementing an Annual Career Development and Research Retreat

Multiple factors, including job satisfaction, personality traits, and training experiences, influence the career trajectory of hematology/oncology fellows. In an effort to expose hematology/oncology fellows to (1) the various careers in oncology, (2) a diverse group of speakers for future mentorship, and (3) research opportunities, and grant writing experience, we established an annual career development and research retreat. During the retreat, we engaged speakers who covered a range of career trajectories, including academic, private practice, industry, government, and administrative paths. We introduced clinicians and researchers with a track record of providing top-notch mentorship to fellows with aligning interests and detailed research opportunities and grant writing. The sessions were led by senior fellows, and we adopted an in-person and virtual hybrid model to allow speakers from various institutions to participate. Feedback from participants, as gathered through surveys, indicated positive responses: all respondents reported that this retreat was "extremely" or "very helpful," and a majority expressed their intent to pursue academic careers. The curriculum and structure of this retreat may help to inform the development of fellowship career development and research retreats at other institutions.

Training Hematologists/Oncologists for the Academic-Community Hybrid: Creating a Fellowship Framework for the Future

PURPOSE:

Conventional hematology/oncology fellowship training is designed to foster careers in academic practice through intensive exposure to clinical and laboratory research. Even so, a notable proportion of graduating fellows opt to pursue a clinically focused career outside the realm of academic medicine. Given the corresponding shortage of oncologists in nonurban and rural settings, improving the representation of hematologists/oncologists in the community setting is a national priority.

METHODS:

We reviewed current national challenges and changing models of cancer care delivery in the context of the traditional academic training model along with trends in practice patterns for recent hematology/oncology graduates. We defined the Academic-Community hybrid (ACH) and how it supports the evolution in contemporary models of cancer care. We then drew on the authors’ experiences to formulate an innovative goal-concordant training paradigm for fellows seeking careers in the ACH model.

RESULTS:

The ACH hematology/oncology fellowship training pathway emphasizes and optimizes professional development domains including clinical care, patient safety and quality improvement, business and operations, cancer care equity and community access, healthy policy and alignment with professional organizations, and medical education.

CONCLUSION:

This novel hematology/oncology training model provides a paradigm for optimizing preparedness for practice in an increasingly complex cancer care delivery environment while addressing workforce shortages and health disparities.

Physicians in the pharmaceutical industry: their roles, motivations, and perspectives

Although physicians occupy a significant number of key positions in the pharmaceutical industry, practicing clinicians are often unaware of the variety of career paths within this industry, or of the structure of a pharmaceutical company. Here, we address questions that practicing clinicians frequently ask their colleagues in the pharmaceutical industry. In addition to providing an overview of the common roles occupied by physicians in pharma, we also describe the various motivations for transitioning into the industry and discuss different scenarios regarding the timing of the career change. Furthermore, we outline the characteristics and skills that enable physicians to have a successful career in pharma.

Preparing Fellows for Graduation: Perspectives on Career Guidance

At the completion of a hematology/oncology fellowship, trainees are likely to enter into a career differing from the one modeled by the faculty providing mentorship and teaching during training. Fellows benefit from open communication with regard to career goals and opportunities starting early in training. To ensure honesty in the process, program directors must be accepting and supportive of house staff selecting careers different from those of the training environment. Following identification of a long-term career goal, program directors may facilitate a smooth transition to the early career through thoughtful inclusion of alternative experiences and additional mentors. Barriers exist, including funding and limited time in training while completing educational requirements, which may make inclusion of the experiences a challenge.