Building an academic career

An academic job is a contract to do three things: see patients, teach and produce scholarship. How those three are weighted, and who pays for each, decides what your life looks like.

Know your track

Most medical schools have more than one faculty track, for example a tenure track for investigators and a clinical or clinician educator track. Each has its own promotion criteria. Ask for the promotion guidelines for your track in writing, and ask who in the department was promoted on it recently.

Protected time is a budget, not a promise

• Ask how it is paid for. Research time is paid by grants, by the department for a start-up period, or by the cancer center. When the start-up period ends, what happens if you do not have a grant yet?
• Get it in writing. The percentage of protected time, for how many years, and what clinical load it means in clinic sessions per week.
• Know the start-up package. Research coordinator or data support, statistics support, funds for a database or a small study.

The usual early-career sequence

1. Finish what you started in fellowship. Publish your fellowship projects in your first year as faculty.
2. Find a niche. One disease, one question. People should know what to send you.
3. Get a career development award. NIH K awards (for example K08 or K23) and foundation awards give you several years of protected time with mentoring.
4. Lead something. An investigator-initiated trial, a cooperative group study, a guideline panel or a national committee.
5. Move to independent funding. An R-level grant, a cooperative group leadership role or sustained trial funding.

Mentors and sponsors

A mentor gives you advice. A sponsor puts your name forward for talks, committees and papers. You need both. Senior people are often happy to sponsor junior faculty who reliably deliver.

Learn to say no. Every committee, review and talk takes time from the work that gets you promoted.