Transcript
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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
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to build their own research program, whether or not they have a mentor.
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As clinicians, we spend a decade or more as trainees learning to take care of patients.
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When we finally start our careers, we want to build research programs, but then we find
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that our years of clinical training did not adequately prepare us to lead our research
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program.
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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
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However, clinicians hold the keys to the greatest research breakthroughs.
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For this reason, the Clinician Researcher podcast exists to give academic clinicians
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the tools to build their own research program, whether or not they have a mentor.
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Now introducing your host, Toyosi Onwuemene.
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Welcome to today's episode of Clinician Researcher.
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It is a pleasure to be talking with you today.
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Thank you for being here.
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I'm excited about today's topic because I'm talking about how to negotiate your salary.
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Yes!
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It's pretty awesome.
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Nobody talks about this.
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And so I think it's important because academic clinicians need to have salary commensurate
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to the work that they do.
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Academic clinicians need to have salary that's commensurate to the work that they do.
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And that's important because if you're going to succeed wildly at your job as a clinician
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researcher, you need to make sure that you have the highest amount of money possible
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for the value that you create.
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And actually, I'll take that back.
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You need to have the highest amount of resources necessary for the value that you create.
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So I'm talking today about how to negotiate your salary.
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And I want to let you know that Academic Negotiation Academy will be enrolling soon.
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And if you are interested, check on our website for more information.
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Clinicianresearcherpodcast.com.
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We have a free masterclass to introduce the academy.
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Create your first, next, or current academic job.
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And if you are interested, please sign up.
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And you'll get information about Academic Negotiation Academy.
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You can check back on our website for more information about the next cohort.
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And that is Clinicianresearcherpodcast.com.
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All right.
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We're talking about salary.
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So I'm sorry.
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I'm laughing because I'm remembering my first salary negotiation, which didn't go as well
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as I would have wanted it to go.
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But I was a graduating fellow negotiating my first academic job.
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And it came to the time to talk about salary.
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And I knew I needed to negotiate because throughout residency and fellowship, I had heard the
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narrative that women don't negotiate.
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And so I was like, well, I'm not going to be the woman who doesn't negotiate.
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I'm going to negotiate.
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But I wasn't prepared.
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I wasn't prepared to negotiate.
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I was definitely not prepared to negotiate well.
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And so I came to the salary negotiation.
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And the first thing that hit me was the starting anchor that was so low.
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My first response was to start crying.
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Yes, I was crying.
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I mean, I didn't negotiate at the point at which I was crying.
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I had to go get over it.
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But I was like, holy cow, this is so low.
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What am I going to do with the salary?
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And I finally pulled myself together.
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I said, hey, you need to talk about the salary.
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We had a discussion.
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And I will tell you that I was shaking.
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I was nauseated.
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And I just felt like a beggar.
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And it just was such an icky feeling asking for more money.
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But I did.
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I asked for more money.
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And I got more.
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And it was a low starting anchor.
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So I got a 4% increase, which is good because I could have not gotten the increase if I
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hadn't asked, but not good in the sense that there was opportunity to negotiate more.
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And if I had been prepared, I would have known what to do.
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And so I want to help you think about how to negotiate salary.
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So clearly, I do a better job today negotiating salary than ever, than I used to.
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And I want to talk to you about how to think about negotiating your salary.
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And I'm talking about this with regards to your first salary negotiation, but it doesn't
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have to be your first salary negotiation.
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This can be negotiating your current salary.
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And for those of you who are thinking about negotiating your current salary, I need you
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to understand that you need to negotiate your current salary.
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The longer you've been in your job, the more you should negotiate your current salary.
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Because what happens is that over time, there's actually a technical term for it that I don't
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recall right now.
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But what happens is when you came in, there was a certain benchmark that you were probably
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targeted to and got a salary that was commensurate to that benchmark.
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But over the years, that increases.
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And the rate at which pay increases happen actually do not accelerate at the rate at
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which people are coming in.
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So when people come in, they get a higher salary relative to where you started.
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And so what's possible and what can happen, especially in academic institutions, is that
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people who come in later can earn a higher salary than people who have been there longer.
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So this is for people, really, who are negotiating a first salary.
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But it's also for you if you are renegotiating your salary.
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And I would say, please renegotiate, renegotiate, never stop negotiating.
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That is my philosophy.
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OK.
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So when it comes to negotiating your salary, your goal is to get the maximum amount of
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resources.
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Now, I didn't say money, but I'm saying resources possible to resource you in your role.
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Why I don't talk about just money is that if all you're negotiating is money, then you're
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not going to get the maximum benefit out of your negotiation.
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And so you want to make sure that you are clear on the resources that are needed for
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you to succeed in the role for which you're being hired.
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Now, it's not about the highest amount of money you can get, but it is about getting
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the maximum amount of resources possible for you to succeed in your role.
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OK.
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I'm going to talk a little bit more about what that means as I go through seven steps
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to negotiate a higher salary.
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So the first thing I will say that's important is to have a clear picture of the value that
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you create.
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Now, sometimes I hear people that they say the term know what you're worth.
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And I have a little bit of a problem with that term, know what you're worth, because
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in reality, your worth is infinite.
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Your worth is your your your your invaluable, your priceless.
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Nobody can put a premium on what you're worth.
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It's important to separate what you're worth from the value you create in any given role.
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So salary is about creation of value and really how that value is priced in the market.
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So it's about the value you create and how that value is priced in the market.
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And so it's not what you're worth.
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It's about what the value of what you create is worth in the market at any given time.
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So once upon a time, if you were a cardiologist, maybe you didn't create as much value as,
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say, a cardiothoracic surgeon to a hospital.
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You're always creating value as a physician.
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Never forget that.
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But let's say the example of of cardiologists before they discovered cardiac catheterizations
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and cardiothoracic surgeons, and so a hospital system might say, well, the value that cardiothoracic
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surgeons create is greater than the value of a cardiologist until the market changed
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and all of a sudden cardiologists could do cardiac caths, decrease the amount of cardiothoracic
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surgery that was needed for a certain population of patients, and then all of a sudden the
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value equation changed.
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So all of a sudden, the value that a cardiologist could create in cardiac catheterizations that
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prevent patients from needing cardiothoracic surgery changed in the market.
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So it's a value you create and what it's priced in the market.
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And that's important because you're not negotiating your value like, oh my gosh, this is how much
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I'm worth, which is why sometimes people tie the salary negotiation to how they feel about
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themselves.
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And at the end of the day, this is not about you.
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It's not about you as a person.
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Holy cow, you're incredibly awesome.
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And from the moment you were born, you had immense value that cannot be priced.
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And so don't think about your salary negotiation as an attempt to match your salary to your
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value and think about it as something that determines your worth.
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It has nothing to do with that.
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But what it does have to do is with the value you're creating and how much that value is
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worth in the marketplace.
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So you've got to understand that.
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And the reason you understand that is because your salary is a reward for the value you
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create.
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So if you are clear about what value you are bringing to a role, then you could negotiate
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well because you understand what that value is priced at in the marketplace.
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And you use the salary negotiation to help you create that value excellently.
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And so when you're negotiating based on just, you know, there's how much I think I'm worth.
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If you don't think you're worth very much, which a lot of physicians need to work on
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their self-esteem, definitely, then it's kind of like really you're negotiating your self-esteem.
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And I think I would say going back to my first negotiation, I was negotiating my self-esteem.
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And if I was crying over a salary negotiation, I didn't feel very highly of myself in that
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moment.
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I just wasn't sure what value I was bringing.
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But anyway, so the first thing you want to do is have a clear picture of the value that
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you are creating.
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That's so important and what that value is priced at in the marketplace.
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And when you have a clear understanding of that picture, then it allows you to do number
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two.
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And number two is about getting the numbers.
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So a salary negotiation is not about you.
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It's not about your personal value.
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It's not about, oh, this is my self-esteem issue.
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It's just really a numbers game.
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It's a numbers game.
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So that's why you get the numbers.
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For one, you get your numbers.
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And what do I mean by that?
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OK, you're an internal medicine physician and you are pursuing a position as a hospitalist.
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OK, there's a benchmark out there of how much hospitals are paid that does vary across the
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country.
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It varies across geographic regions.
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It varies when you're coming to public versus private academic institutions.
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There's variation.
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And those numbers are actually available.
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If it's a public institution, many of those numbers may be available online.
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At least the baseline compensation levels are available online.
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Usually for public institutions, they're publicly available.
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So find it.
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And even for private institutions, you can ask, like, what is the range of salary for
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a starting assistant professor in this specialty?
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So those numbers are available.
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And you should, at a minimum, know what those numbers are.
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For those of us in academic medicine, the AAMC, American Association of Medical Colleges,
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has a salary book that they publish, compensation book.
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I forget what the name of it is, but it's available.
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And if your institution contributes data, then that book is available to you for a reduced
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fee online.
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And if your institution does not contribute data to the publication, you can buy it at
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a higher amount.
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And I would say it is worth the investment, because I will tell you that having information
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about what the numbers are can increase your salary negotiation by a couple of thousands,
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probably tens of thousands, I will tell you.
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But so if they tell you that the book is worth $1,000, I would say pay the $1,000.
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You may be like, oh, maybe you're a fellow.
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And you're like, oh my gosh, I can't afford $1,000.
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I would tell you you cannot not afford to get the information that's necessary to negotiate
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well.
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So those are two ways to get the book.
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It's the AAMC compensation book.
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And there's a technical name for it that I don't recall right now.
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But I'll put it in the show notes.
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And if your institution has access to it, your library probably has a copy of it too.
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So one thing I did was just reach out to my librarian and I said, can I have a copy of
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it?
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So you have information that you need to have ever before the salary negotiation.
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And you should get that.
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And you have the opportunity to ask the institution, what is the range of salary for professors
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that are starting out for assistant professor at the academic institution?
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So at a minimum, your starting point is to get all the numbers.
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What is the going market rate for the value that this specialty creates at this given
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time?
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You should know those numbers.
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Number three is to prepare for the negotiation.
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And it is so important to know what you want, what they want, and how you can align your
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value that you create with what they value.
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And so one of the ways to know that, so start with what you want.
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Let's go back.
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Start with what you want.
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So important.
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What do you want in the salary negotiation you're going into?
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So you see the numbers, you know what the benchmarks are, you know what the median is,
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you know what the 75th percentile is.
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And you should know that because by now you've gotten all that information.
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What do you want?
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And in clarifying what you want, this is not like you put a pin on the page.
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And you're like, OK, I want the 78th percentile, the highest, that's the amount I want.
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It's not so much a number as much as what resources do you need to succeed in this role?
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For example, you're being hired.
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I mean, I'm talking to clinician researchers, but I'm also talking to faculty who are usually
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hired in a highly clinical role and they are transitioning to becoming clinician researchers.
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So for many of us clinical faculty, at least that was my starting point, I came in clinical
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and I was trying to make this transition to clinician researcher.
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Now for those who already start in that place, good for you.
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You already kind of have the protected time, but much of what you do is still clinical,
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at least there's still a good amount of what you do that's clinical.
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So you start with looking at your clinical job.
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What do you need to succeed as a clinician in this role?
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So there are some things that kind of you may not think about when you're starting,
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but are really important, really basic.
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You need administrative support.
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You need MA support.
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So who's going to return patient calls?
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Who's going to answer in-basket messages?
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Who's going to resource you in that way?
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You need support for the administrative work.
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Who's going to respond to pharmacy requests for medication refills and get all that work
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together so you're not doing clerical work instead of your job as a physician?
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If you are responsible for the care of an individual in your family, say you're taking
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care of a parent or you're taking care of a child, who's going to be there to support
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your child or support your family member when you are working?
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So what are the resources you need to function maximally in this role?
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What's the minimum level and what's the dream level?
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What's the minimum level and what's the dream level?
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So it's so important to know that so that you can be very clear about what's the minimum
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amount that you will accept for this role.
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And it's not the minimum amount to feel good about yourself.
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It's the minimum to really do great in this role because they're hiring you for this role
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for a reason and they want you to succeed.
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They need you to succeed.
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You want to succeed.
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And so it's a mutually beneficial negotiation because if you are a resource to do your job
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well, then when you start the job, you can do it really, really well.
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And if you're starting as a clinician researcher and not fully clinical, okay, you're going
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to need time to really establish a research program.
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And if you're like most clinicians, you haven't had much research training, what research
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training resources are going to be available to you to make that transition well.
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Many times faculty get caught in the, oh, you have three years and you're going to,
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once you can, you know, in these next three years make the transition to independence,
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you'll be fine.
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If you don't make it in three years, sucks for you.
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And three years is really not a lot of time to get the research training that you didn't
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get over the course of your clinical career.
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But that's a topic for a different podcast episode.
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But what you do want to say is if all I have is three years, what is the maximum amount
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of resources that I need so that I can succeed in these three years?
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What's the maximum amount of protected time I need?
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What is the mentoring that I need?
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What are the coaching needs that I have?
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And so you want to have all of those together so that you're clear on what you want.
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The second thing you want to be clear on as you prepare for the negotiation is what do
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they want?
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And how do you find out what they want?
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You will figure it out in their promotion and tenure documents, which should be available
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online.
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So what is promotable at your institution helps you understand what is valued.
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What is promotable helps you understand what is valued.
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So go to their AP&T academic promotion and tenure documents and see who do they promote.
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They'll say, the institution might say, we promote clinicians who are well known in their
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field.
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It's like, well, if I'm going to be well known in my field, I'm going to need to go around
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giving talks.
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We're going to need to have something to talk about.
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So you want to make sure that whatever they want you to achieve, you have a resource,
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whether it's financial resource or the specific resource, say writing support, that allows
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you to create the value that they recognize.
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So what do they value?
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What is promotable helps you understand what they value.
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OK, number four is to ask questions to gather information.
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Ask questions.
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The most important piece of any negotiation is your ability to get information.
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And you only get information by asking the right questions.
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And let's say, for example, you are negotiating your first salary.
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You're asking, what are the benchmarks at the institution?
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How are these determined?
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What national benchmarks does the institution benchmark to?
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Because there's AAMC, but there's other options as well.
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So every institution is different according to what they benchmark.
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You want to know this because it helps you go back and do some more homework.
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So when you're thinking about the kinds of questions you ask in your negotiation, discussions,
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and I say discussions because you're not going to have just one discussion.
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You're going to have multiple discussions as you get closer to where you want to be.
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And I hear some of you saying, I don't have all the time in the world.
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I need a job in November.
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I would tell you that if you are negotiating a salary, you need time because it takes time
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to negotiate well.
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And if you are desperate, you're not going to negotiate very well.
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And so if for whatever reason you're feeling pressure of, I need to have this job by X
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amount of time, take a step back and think about what else you can do so that you give
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yourself a long enough time.
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Now one thing people are very surprised to find when they're negotiating in academic
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institutions is how much time it takes for the institution to figure it out.
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And sometimes the bigger and badder the institution is, however we define bigger and badder, the
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longer they take to get back to you.
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And that's not necessarily because the institution wants to be obnoxious, though maybe you could
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argue that it is, but it's that there's so many layers of bureaucracy and it takes so
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many people to approve this one hire, this one salary increase, that it really does take
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time.
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And so the institution has a lot of time to negotiate.
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And if you're desperate, you're going to come up against the, just give me a salary now,
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I'll take whatever you give me.
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You don't want that.
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You really do want to have time.
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So if you're a fellow just starting out this negotiation thing, you want to start as early
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as possible.
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Give yourself at least a year because it does take time.
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But no matter where you are in the negotiation phase, you're going to take time to do this
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negotiation because you're going to do it well.
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And so in your discussions, you're going to ask questions that are open-ended.
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Remember as clinicians, we learned how to ask open-ended questions.
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So you could be like, hmm, how come my salary is below the 25th percentile of the national
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average?
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Or you could ask, to what extent do faculty increase their salaries over the course of
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their time here at this institution?
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Or you could ask, what is being done at this institution to close the gender pay gap?
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And then you might find out, oh, there's no gender pay gap here.
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Or oh, yeah, we've been working at it for the last 20 years.
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But you want to ask questions that give you information because information helps you
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go back and readjust your negotiations.
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Okay.
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Number five is to make the ask.
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So when you make the ask, don't start.
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And many times it's like, who's starting first?
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Usually I think the institution may start first, but you don't have to.
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You can wait.
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Wait and see what they say.
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But you're going to make the ask.
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No matter what they say, you're going to make the ask.
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It's possible that you're like, you have this number in mind, and then they come with a
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higher number.
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And then you're like, whoa, that's higher than I expected.
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And I've had people say, oh my gosh, that's so much higher than I expected.
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I'm good with that.
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But again, this is not what you expect as much as what are the benchmarks nationally?
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What does the value you create?
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How is it valued in the marketplace currently?
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You want to make sure that no matter what number they throw at you, that it's commensurate.
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And whatever value, whatever number they give you, you can come back with a different number.
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Yes, the more resourced you are, the better you do.
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You can come back with a different number.
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So you're going to make the ask.
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And when you make the ask, you could start by saying, hey, well, thank you.
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I see that you are working very hard to come up to national benchmarks with the number
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you gave me.
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And then you're going to, before you give your number, you're going to talk about the
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value you create.
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I am a hematologist.
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In general, there are not many hematologists across the country.
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But although hematology is an E&M specialty, I will be bringing consultation to the hospital,
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which will help to decrease hospital costs, which will help to improve surgical outcomes.
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I will also be working towards the creation of a research program, which increases value
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of scholarly output.
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And the national benchmarks say a median salary of X, and therefore my ask is Y.
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And so you're going to be very clear, before you even give a number, what that number represents.
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What value that number represents.
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So you're going to make the ask.
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And when you make the ask, you're going to say, here is how the value I create aligns
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with what this institution values.
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For that reason, here's the salary request.
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Or if you're asking for a salary increase, this is not about, I can't believe the people
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who came before me are paid more than me.
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Ah.
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That doesn't necessarily help get the other person on the same side of the table as you.
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But you'll see, you know, in the last 10 years since I've been here, I've created X value,
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this value, this value.
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I see the most number of patients across the institution.
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And this is the value that that creates by my calculations.
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Or you actually can request the numbers.
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You can say, what have my RVUs, you know, what RVUs have been generated?
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If you're, you know, you're actively working in growing a research program, you know what
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grants you submitted, which ones have been funded, what manuscripts.
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You bring all that information and say, hey, here's a value I've created over the last
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few years.
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And here's what that value represents.
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And here are the current values.
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Here are the current benchmarks.
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It wasn't the benchmark 10 years ago when I started, but here are the benchmarks now.
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And based on this, this is a salary increase that I request.
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You make the ask.
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You make the ask based on objective criteria, not based on how you're feeling.
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Okay.
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Number six, don't take no for an answer.
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Yes, don't take no.
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So you may not get the money you want, but what else can that money get you?
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And can you ask for that instead?
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For example, you have student loan debt and you're really asking for a higher salary because
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you want to offset that student loan debt.
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So if they're not going to give you a high salary, like, okay, here's student loan debt
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that I have.
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How can you help me pay this?
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Because one thing that I find that academic institutions don't want to do, they don't
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want to commit to high salaries because then they have to fund high salaries.
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But many times, sometimes there's money for like the bonus, the payoff of a student loan
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or the helping to fund one thing or the other.
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And so you just want to ask, what do you need?
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For someone else, it might be that, okay, childcare costs are going to be really high
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so that I can come in in the middle of the night to take call.
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I need to have an au pair at home overnight.
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And so what's the salary increase that you need to be able to get that?
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And so if you don't get that, then the question is, what are the childcare resources available
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to you through your institution potentially that can get you what you want?
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So when I say don't take no for an answer, I'm not saying be disagreeable and saying
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if you don't get the money to satisfy that need, what else can you request that also
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gets your interests met?
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And so that's why you want to go back to the very beginning is to just be clear about what
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you want so that you can come back with, okay, if you can't meet the median salary, if you
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can't meet the national benchmarks, what can you do?
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And when you come with a list of things that you need and you've done your homework and
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you know what the institution can provide, you know that there is a daycare associated
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with the institution.
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It's like, how can you get me in so that I don't have to pay the astronomical cost of
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childcare covered by my salary?
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And it just allows the salary negotiation to go further.
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The seventh thing that you should do is go with a friend.
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So academic institutions are big places and many of them have been around for decades,
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possibly centuries.
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They've been negotiating for a long time.
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You know what?
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The more you negotiate, the better you get at it.
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And you, let me see, how much negotiation training or coaching did you get at your institution?
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Okay, I'm going to guess minimal.
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And if you did, it is not anywhere near the amount of negotiation experience that your
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academic medical institution has.
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So I would argue that you're negotiating with a very savvy negotiator.
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Don't go it alone.
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Don't go it alone at a minimum, at a minimum.
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You should have a person you report back to every time there's a conversation around that
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negotiation.
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You should have someone you sit with and say, this was the conversation.
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This is what they offered.
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This is what I think makes sense.
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And it just helps you to negotiate better.
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I would argue that you should work with an academic negotiation coach.
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Yes, you should reach out to me and we should work together on your next negotiation.
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But at a minimum, you need someone to walk through this process with.
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Don't go it alone.
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This is, it's a big deal.
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Negotiating your salary, negotiating the resources you need to succeed as an academic clinician,
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as a clinician researcher is a big deal.
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Don't try to do it by yourself, especially if you're just graduating.
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Make sure you have someone that you can just continue to talk with through the process
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and someone who mirrors you, who can tell you, you're acting desperate.
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What else can you do?
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Or like, oh, is that what they're offering?
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Do they have administrative support?
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Okay.
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How come?
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Someone who can really ask the hard questions, someone who's not kind of just really so enamored
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by the institution or so invested in the outcome that they can't think objectively.
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So definitely go with a friend.
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All right.
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Those are the seven things I want you to think about as you negotiate your salary.
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If you are in the middle of a salary negotiation and this helps you negotiate a higher salary,
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please let me know.
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00:30:52,600 --> 00:30:58,840
Leave us a voicemail on our podcast website, clinicianresearcherpodcast.com, and I will
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00:30:58,840 --> 00:31:03,720
play your voicemail in a future episode and build an episode around that.
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I'm going to wish you success in your salary negotiations.
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And if there's someone else you know who's negotiating salary or renegotiating salary,
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00:31:11,840 --> 00:31:14,320
definitely make sure that you share this podcast with them.
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00:31:14,320 --> 00:31:15,320
All right.
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It's been a pleasure talking with you.
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00:31:17,440 --> 00:31:24,480
Please leave us a five-star rating, an honest five-star rating, and also share this podcast
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00:31:24,480 --> 00:31:26,960
with somebody else who needs to get value from it.
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00:31:26,960 --> 00:31:27,960
All right.
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Talk to you next time.
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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic
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clinicians learn the skills to build their own research program, whether or not they
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have a mentor.
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If you found the information in this episode to be helpful, don't keep it all to yourself.
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00:31:56,120 --> 00:31:57,880
Someone else needs to hear it.
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00:31:57,880 --> 00:32:01,920
So take a minute right now and share it.
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00:32:01,920 --> 00:32:07,400
As you share this episode, you become part of our mission to help launch a new generation
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00:32:07,400 --> 00:32:13,360
of clinician researchers who make transformative discoveries that change the way we do healthcare.