andHow to get it right the first time…

Disclosure of Financial Relationships

William Shatner said, “You have to create your life. You have

to carve it, like a sculpture. “

What is your vision?

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It can be a Horror Movie…… Use a decision tree

like the Pocket Horror Movie Computer

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Source: Gahan Wilson, National Lampoon, November 1971, Vol. 1, No. 20

CAREER PATHS Enter the trail…

Academics Institution Private

Private Practice Partnership Non-Partner track

Locums Government/Research Teleradiology

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30,000 post-training professionally active radiologists (100/Million)*

Academics: 15-20% Private Practice: 83-77% Government: 2-3%

*Source : American College of Radiology

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“Average” radiologist works 50 hrs/week ~15-20% work part-time 25% spend some time teaching Sadly, only 11% do original research Number of exams per FTE is growing

rapidly as radiologists try to preserve income, last figures are 14,000+ studies per year (2007)

Source: Radiology 2009;10.1148 .7

In 2006–2007, the average annual workload per FTE radiologist: 14 900 procedures - 7% increase since 2002–2003 and

34.0% since 1991–1992

Annual  RVUs per FTE radiologist were 10 200, an increase of 10% since 2002–2003 and 70.3% since 1991–1992

Academic practices performed 33% fewer procedures per FTE radiologist  than others, offset by research and teaching.

Bhargavan M, Kaye AH, Forman HP, Sunshine JH. Workload of Radiologists in United States in 2006–2007 and Trends Since 1991–1992.  Radiology 2009;10.1148

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What (kind of practice) Where (work and living environment) Who (which groups or facilities) What is the legal climate?

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Location / Family Where do you want to live?

Work Environment How much flexibility do you need with your

schedule? Financial

What are your monetary requirements? Research

Are you interested in contributing to research? Teaching

Do you enjoy the academic environment and want to share your knowledge?

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You better live every day like it's your last day, 'cause one day you're gonna be right.--Ray Charles

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Digital CV Analogue CV Prepare an outline Be complete and factual No unnecessary Private Information List publications and original research. If

extensive, this may be the time to consider digital or multimedia CV

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The longest journey begins with a single step. Attributed to Lao-tzu (c 604-c 531 B.C.), founder of Taoism.

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RSNA NEWS 2009

Diagnostic Radiology 5th highest compensation amongst medical specialties

Median salary of $438,115

Interventional still hot…salaries are higher

Looming probability of “pay for performance”

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From the RadRounds Blog Total survey population: 309 fellows, 41 residents (n = 345)

Average # of positions applied for: 9.3Number of interview offers: 7.1Number of actual job offers: 1.9Salary range offered: $225,000 - $390,000 (year 1)Number of radiology residents/fellows applying for academic positions only: 25 (7.2%)Number of radiology residents/fellows applying for private practice positions only: 50 (14.4%)Number of radiology residents/fellows applying for both: 270 (78.2%)

How many trainees felt that it has been VERY difficult to find a job opening: 320 (92.7%)How many trainees felt that it has been MODERATELY difficult to find a job opening: 24 (7.0%)How many trainees felt that it has been NOT difficult to find a job opening: 1 (0.3%)

Where did residents/fellows initially hear of positions / openings?Society Websites (ACR, RSNA, etc): 300 (86.9%)Physician/Radiologist Recruiter: 150 (43.4%)Networking (word of mouth, faculty, friends, family): 330 (95.6%)

Word of mouth Faculty Cameo appearances ACR Professional Bureau radworking.com/auntminnie.com

(internet ) Placement firm (headhunters)

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2 schools of thought (experience vs. vacation time taken)

Most practices will pick up the tab for everything

Arrive timely; don’t bring a spouse or friend to the workplace Most good practices will have the spouse

“covered.” The quality of the interview arrangements is

usually indicative of the business structure and “functionality” of the group or facility

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Learn about the venue from the Internet/Chamber of Commerce, etc.

If you are traveling, pack early and rest Dress appropriately, shirt, tie, and jacket

even if you are told to arrive in casual. This is the first impression. I still believe that “clothes make the man or woman.”

Be professional and grateful

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Ask, ask, ask! You are about to marry someone after spending a day or two with them….

Speak to management/administration Speak to referring docs especially, if you

can; in particular, if you are about to sign with someone

Do your research before signing anything or giving your word to commit

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What can they do for you? What can you do for them? How is the business structured? What is the payer mix? If private and partner track, how long to

partner? What is the buy-in to A/R? Equipment? Who pays for malpractice and other key

benefits? Who pays wind down expenses if you leave?

What benefits are covered? How does that change when partnership is offered and accepted?

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Go with your gut; you will have to learn to trust it sooner or later

If married or in a committed relationship, your spouse or partner needs to concur

If you have lingering questions, do not hesitate to arrange for a second look interview, even if at your expense

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Read your contract yourself – twice Forward a copy to an attorney Identify any points you feel are in need of

negotiation Negotiate them, on your own behalf If there are financial questions that you

are not clear on, engage your accountant – a great resource, often forgotten

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Let your contract sit for a few days after you have made a mental commitment

Then, either accept or decline If declining, have reasons ready Radiology is a town of 30,000 people; do

not burn bridges

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After your search is over, enjoy your last few months of training

Maintain relationships at your training institution; they will always be invaluable

Ready yourself (and your family) for the transition to a higher income and life after training

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Wear the cape; never let the cape wear you. Roy Horn, Siegfried and Roy

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“The greatest marker of longevity and success in your professional and personal lives, is what lies between your ears. Expect the best…and get it.”

Visit my Blog when you are bored…it’s over at http://angiographer.com

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