Laying a Strong Foundation:
How to Flourish as a Young Attending
By Jennifer A. Kim, Thomas Bleck, Jose Suarez and Jonathan Rosand
Securing one’s first job as
an attending is an exciting
time! The first few years of
being an attending form
a crucial foundation for
success throughout the
remainder of your career.
For those who choose
to enter academics, we
interviewed Dr. Thomas
Bleck, founding chair of the
Neurocritical Care Society
and director of clinical
neurophysiology at Rush
University Medical Center;
Dr. Jonathan Rosand,
chief of neurocritical
care and emergency
neurology at Massachusetts
General Hospital; and
Dr. Jose Suarez, director
of neurosciences critical care at Johns Hopkins Hospital and
current vice president of the Neurocritical Care Society. (Note: This
interview has been paraphrased for brevity.)
What should new faculty do in the first few months to ensure a
successful start?
Bleck: 1) Make sure you’ve completed all mundane credentialing
requirements because you don’t want to impact your start time
and make the chair mad at the start. 2) Latch on to another junior
faculty member (ideally at least 2 years ahead) in your division
for advice. 3) Understand the conditions of your employment
(like grants) and have a back-up plan from the start. Even if you
have a start-up package or initial grant fund, start thinking early
about what resources are available and needed for your next grant.
4) “Shadow” round another faculty member when you arrive to
see the flow in their unit. 5) Make connections early, including
with financial administrators to get to know them and build trust.
6) Billing training is part of credentialing, but understand local
rules to avoid audits. 7) Navigating the academic landscape of a
new institution takes time and can be a challenge. Set goals for
yourself, but realize they are soft as things are likely to derail them.
Rosand: If you’ve found yourself a good institutional fit and
negotiated effectively through building trusting relationships,
then your sponsors are likely those most involved in your
recruitment. Who spent the most time with you or advocating
for your vision? Keep those people in mind because they are the
most invested in your success. It is important to identify mentors
early who could serve as role models or sounding boards
invested in your future. NCC is also highly interdisciplinary
(neurosurgery,
neurology,
critical
care), and
it is important
to know how your
new ICU is overseen within
the hospital hierarchy. For example, neuro-ICUs are often
fundamental to maintaining neurosurgical volume, so the
neurosurgery department should also be invested in your success.
Suarez: It is very important that new faculty understand what
is expected of them from the beginning to make sure that they
meet those expectations. It is equally important to set realistic
and achievable goals with their division or department director/
chair. New faculty should review and understand the pathways
for promotion and advancement (in academics) or other
administrative and clinical advancement (in non-academic). Set
specific yearly goals so when the time for promotion comes faculty
members have everything covered and they can proceed without
hiccups.
What are common challenges that junior faculty members face,
and how should they approach them?
Bleck: Depending on department culture, you may be asked to
provide coverage or other duties you weren’t expecting when you
arrived. If you do commit to a task, take those commitments
seriously and do a good job, as it reflects upon you at this early
stage. If you are overwhelmed, ask your division chair for advice
on balancing these “good citizenship” tasks with your other goals/
duties. Secondly, don’t be shy about asking for help, especially
clinically. Put patient safety before any pride/embarrassment and
you will be viewed as a better doctor. If after the first year or two,
you are having difficulty with meeting expectations, like securing
grants, discuss options with your division and department chairs
early. Actively check in with senior members on how to improve.
Take advantage of faculty development programs/office as a
resource outside of the department.
Rosand: It is challenging to join a new community and find
your voice. Learn to advocate for yourself. First, determine the
metrics for promotion and success at your institution. Also, saying
“no” can be difficult, but under promising and over-delivering
is preferable to the opposite, especially for your first impression.
Rely on mentors to advise you on when and how to say no. Don’t
get burdened with committees or review articles that are time
consuming at the start. Keep the perspective that your career is
long-term. It is common for a new hire’s role to get redefined as
they settle into their new environment. That transition, when
successful, is usually because mentors and sponsors helped
generate exciting new opportunities.
CAREER ADVICE SERIES:
Jennifer A. Kim
Jose Suarez
Thomas Bleck
Jonathan Rosand
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