In contrast to the familiar college, medical school, residency and fellowship application mechanisms, securing the first academic faculty position has no ground rules and no timelines. The open-ended and idiosyncratic nature of securing a job can be frustrating. Negotiating a competitive start-up package when continuing on the faculty of one’s training institution can be particularly challenging. Deciding which offer to accept should be determined less by the “best deal” that can be negotiated and more by the short-term and long-term opportunities for career success.

You have successfully navigated the first phase of your faculty recruitment process. Through a combination of personal contacts and responses to advertisements, you were invited to visit and interview at several institutions. At each of these initial visits you will have (should have) put your best foot forward irrespective of any pre-visit biases you may have had. You will have come to each of the first interviews very well prepared, having done advance research about the institution, program and individual faculty members you were likely to meet. At the interviews, you will have asked probing questions but invariably projected an overall sense of enthusiasm and excitement.

After the First Visits

It is important to decide as soon as possible after the first visits which, if any, of the institutions are clearly not good fits for you for whatever reason (family, location, immediately apparent lack of critical mass or resources, etc). If at this point you are virtually certain that you would not accept any kind of a job offer from such an institution, it is best to promptly notify the division chief and any others who were involved in organizing your recruitment and visit that you wish to withdraw your candidacy. Giving a simple and direct reason for why the job is not a good fit for you is always the best tactic. As uncomfortable as it may seem at first, personal phone calls (rather than emails, leaving messages, etc) are the most dignified and sincere ways to deliver your decision. Never burn bridges in academic medicine! You will be astonished later in your career to find how often you will encounter many of these people again, whether socially, in the context of collaborations, or even as reviewers of your grants and papers. You may even see them again during job explorations elsewhere many years later.

For those institutions that remain in the running for you, prompt personal follow-up after your visit is essential to demonstrate your continued, serious interest. Again, nothing replaces the personal touch. Make calls to the key individuals to thank them for their hospitality and to express your wish to pursue the opportunity. You should particularly focus on contacts with those on the faculty with whom you think you established a nice rapport: they can become your champions at a later phase of the recruitment.

Getting to the Job Offer

There are no ground rules in academic medicine regarding the timeline between becoming a candidate to being extended an actual offer for any given position. The relatively open-ended and idiosyncratic nature of the process can be bewildering and frustrating to those accustomed to working with clearly defined college and medical school application deadlines or residency and fellowship match dates in making previous career transitions. A decision may occur shortly after the first visit or it may be maddeningly protracted through several visits, punctuated by long, mystifying periods of silence. In most cases you must just go with the flow. (This is one reason why it is a generally good idea to launch a full-scale job hunting campaign as early as possible once you and your mentor have agreed on your readiness for independence.) One situation that can give you an opportunity to expedite the process is to have another highly competitive offer in hand with strings attached for you to respond within a certain period of time.

The most difficult circumstance may involve the institution where you are training. In some cases there is a relatively early, explicit understanding with your division chief and mentor that you will (or will not) be offered a faculty position there within a clear timeframe. More often, however, your future prospects for a job there remain awkwardly uncertain. This situation is particularly prevalent at institutions where opportunities and funding for prolonged periods of research training are reliably available and intermediate positions (eg, Instructor) can be occupied for several years while you remain in limbo. In these cases it may fall on you to initiate a serious “career planning” dialog with your mentor.

Components of the Job Offer

Once a verbal offer has been extended, you will enter into a hopefully brief and intense period of negotiating your “start up” package, typically with the division chief. If the offer comes with a fixed package, you should not hesitate to diplomatically request additional considerations if you feel the offer is inadequate. By this stage you should already have a good idea of what resources will be needed to maximize your chances of succeeding in an academic position. You should keep a working list of resources needed, which can be continuously revised and refined. In this way you should be essentially ready to begin negotiations as soon as an offer is extended. However, it is always a good idea to ask for at least one more visit at this point, during which it is up to you to thoroughly investigate the availability and accessibility of key resources.

The basic components of the job offer, which you should expect in the form of an offer letter, are listed in Table 1 . Even at this stage, some specific items are still usually open for negotiation. In fact, many institutions will first send you a “draft offer” letter that is open to some revision. The ball is now in your court and it is expected that you will move expeditiously at this point to finalize the agreement (or turn down the offer).

A written offer should be expected. It is not a legally binding document. However, it is an important communication vehicle to have in order to clarify mutual understanding of the terms and to serve as a reference in case of future changes in the administration.

Competing Job Offers

If you land in the fortunate position of having competing job offers, you should not try to leverage them into a bidding war. In general, you should know quite clearly at this point what resources and support you will need to optimize your opportunity for career success. If more than one offer contains these core requirements, you should weigh your decision based not so much on which is the “best deal” but rather on the relative qualities of the environments: availability of continued mentoring, strong intellectual critical mass, sound and stable institutional situation, track record of success with other junior faculty, and your level of confidence that you will get long-term career support (which cannot be specified in any offer letter).

An important but challenging consideration is negotiating a faculty position at the institution of your training. Theoretically, you should expect a start-up package that is no less generous than that offered to a comparable junior faculty candidate being recruited by your institution from the outside. In practice, this rarely happens. The glaring disparity that is typically seen in offers extended to external and internal candidates can be a function of several factors: the assumed “home court advantage” your training institution enjoys in competing with others, coupled with your possible fear of leaving, an apparent lack of appreciation of your real value (being “taken for granted” because you are already there), and other intangibles. In reality, you may indeed require fewer resources if you continue onto the faculty at the same institution since many of them are already in place as a function of the very nature of the research you have been conducting. After taking this into consideration, however, you should not allow yourself to be shortchanged in the process. Remember that it is also to the advantage of your home institution to equip you well with the support needed to succeed as an independent investigator.

 Conflict-of-interest disclosure: The author declares no competing financial interests.
 Off-label drug use: None disclosed.

Author notes


Weill Cornell Medical College, New York, NY