Interviewing for academic jobs has changed a lot over the past decade or two. Choosing an academic position used to be primarily about picking an academic institution in a location that worked for you, how much prestige an institution had, and how much they could support your academic endeavors such as research and training future generations of physicians. As academic institutions have had to evolve to stay financially stable in an increasingly complex healthcare environment, the role of an academic doctor has evolved. We now find many doctors in academia in our physician communities asking questions that more closely resemble those that physicians in employed positions elsewhere are asking, such as questions about RVUs, bonus structures, call schedules, contractual terms such as noncompetes, and more.
Career longevity in academia requires choosing a practice environment where you can thrive professionally as well as enjoy your life outside of medicine. During your interview day, you should identify red flags and make notes on things that you need to clarify to ensure your contract is fair, as well as assess whether or not you will enjoy your colleagues and feel supported by the administration. Below, we’ll cover the questions doctors should ask or try to find the answers to when interviewing for positions in academic medicine based on the input of our physician community members.
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Interviewing for a Physician Job at an Academic Institution or Hospital System
Always remember that while you are being interviewed on your interview day, you are also interviewing your prospective employer to see if this is a place where you want to be. You should spend as much time learning about them and the position they are looking to fill as they spend learning about you. Your goal should be to collect relevant information to help you decide if this job is a good fit, both personally and professionally. There are several ways to do this, including by directly asking questions, researching the answers yourself, or by asking your networks (such as our physician communities).
On your interview day at an academic institution, talk to everyone possible, not just your primary interviewer or section chief or department chair. Speak to the other clinicians and support staff who you run into, as well as the trainee residents and fellows. Specifically ask to speak to a few other physicians who work in your prospective department. They’ll be able to give you a less biased response and help you gauge the work environment. If they seem to be keeping you away from speaking to someone in particular or avoiding a specific topic, take that as a red flag and dig deeper behind the scenes.
Note that these questions should be worded in an emotionally intelligent way, and asked in an appropriate context. If you can find out the answers to a particular question by researching it yourself, we recommend not wasting valuable interview time to ask during the interview day, which will fly by before you know it. You can also take notes during your interview day and follow up with those you have connected with to get the answers later if you run out of time or can’t find a good opportunity to ask a specific question. The last thing you want to do is pass up an opportunity for connecting on a personal or professional level because you’re trying to ask 100 questions during an interview dinner with your potential colleagues.
The 10,000 Foot View on an Academic Institution
Before you dive into the details about your specific position, get a general overview of how the academic institution operates and what its priorities are. This can help you gauge potential contributors to dissatisfaction and burnout that might be red flags. Much of this work can be done before the interview day, also helping you to avoid wasting your (and the employer’s) time and resources if you realize that there are things that are deal breakers from the get-go. This can also prevent you from burning bridges, as academia is a small world and you’ll likely cross paths with others in your field at these institutions at conferences and otherwise.
Interview Questions to Ask (or Research Beforehand) to Understand the Academic Hospital and Institutional Environment
What is the institution’s mission as a whole? What is the reputation of the academic hospital system? How about the specific department you are interviewing in?
Who does the leadership consist of? Are there physicians in leadership positions?
How many hospitals or outpatient centers are in the system? Are there any private or VA affiliations?
How much research does the institution produce?
What is the reputation and desirability of the training programs at the institution?
What patient population do they serve, and what is the payor mix?
Have there been any recent mergers or acquisitions, or talks of them?
How active is the academic institution in the surrounding community?
What is the institution’s policy on supervising non-physician practitioners? Of the available jobs, are they hiring more physicians or does their focus seem to be on hiring other healthcare professionals?
Who are some of the more famous members of the department you’ll be working in? Are there opportunities for mentorship that you’d value?
What is the financial health of the institution?
What are the institution and department’s goals over the next decade or so?
Are the salaries publicly available? If so, are they in line with your financial goals?
Learn more about tackling your physician job search.
Interview Questions to Ask to Understand the Physician Position and Job Description
These are probably the most straightforward questions, and ones that you may never need to ask as this is the information that is most likely to be offered to you by the institution ahead of time or by the interviewers and the people that you meet. Keep them in the back of your mind and make sure that you ask for clarification if they aren’t addressed, and dig deeper as needed to understand your exact role and why you are being hired:
What is my exact job description? What academic rank will I come in at?
What are the requirements or criteria for achieving higher academic ranks?
How much of my role is patient care versus academic mission related such as research or teaching responsibilities?
How much time will I be given for non-clinical work?
Why are you interested in hiring me, and how do you see me fitting within the department?
Who are the other members of the department, and what are their roles?
Is there anybody in the department that’s exempt from call responsibilities or other responsibilities that I may have? How is the workload, including call, tumor board, resident lectures, or any other non-compensated work distributed amongst the faculty?
Is there a particular patient population you want me to see, a particular disease that you need an expert in, a particular research arm you’re looking to develop, or a particular procedure you see me doing more than others?
What types of cases might I expect to see in this position? How are patients assigned?
What are the typical patient demographics?
Is there a resident or fellow clinic that needs to be supervised, or other non-physician team members that need to be supervised?
Interview Questions to Ask to Understand Whether the Job Is in Alignment With Your Personal and Professional Goals
Many physicians leave their first jobs within 5 years, and if you ask them about it, there are things that they probably could have told you wouldn’t have been sustainable from the get go. As job transitions are often complicated, particularly as you establish your life and moving around becomes harder, you want to make sure you set yourself up for success by picking a job that fits your ideal vision of a job/ work-life balance. These are some questions that may help you elucidate that:
What does a typical day look like?
What does the typical schedule look like? (Shift length, number of shifts in a row, night and weekend work, etc.) Is there any flexibility in scheduling?
How many patients will I be expected to see a day? How is the patient load distributed among the attending physicians?
What kind of staffing will I have to help me with my responsibilities (medical students, residents, fellows, MAs, PAs, NPs, technicians, etc)? Are they specifically my staff or are they shared amongst the department, and if so, what determines where they are assigned? Do I have any say in who is hired and fired?
How does PTO and vacation scheduling work? If multiple people ask to be off on the same holiday, what is the process for deciding who gets their requests approved?
Is part-time work a potential, now or in the future?
How does the call schedule work? Do I get paid for call?
Am I expected to come in if I’m not scheduled for clinical responsibilities on a given day?
How do you support work-life balance for the physicians who work for you?
What is the procedure for add-on patients? How are emergencies handled?
When I am away, who covers my patients and inbox?
What resources are available for ongoing career development? (CME stipends, opportunities to attend conferences, research funding, funding for additional degrees or certifications, etc.)
What opportunities for advancement exist if I would like to grow my role with your hospital? What does that advancement track typically look like?
(Ask yourself, not out loud) Are there any giants that are in the department and will this help or hurt your career? For example, this may be helpful in the short term and if you’re willing to move somewhere else for promotions but if you want to stay in the same department will it mean you can never be section head if this is one of your goals?
Interview Questions to Ask About the Responsibilities That Come With the Physician Role
Every job has aspects of it and responsibilities/requirements that may not have been spelled out to you in the beginning but that are expected of you. In today’s employed physician landscape, many physicians are surprised by some of the things that are put on their plate or agreed to in the fine print of their contract without ever having been discussed before. These can lead to a lot of conflict or job dissatisfaction, and even legal issues, so please make sure you ask about at least these common issues in employed positions that we see discussed in our physician communities.
Are there any required research or teaching responsibilities? How much time from the normal work week is given for them, or am I expected to do this outside of normal business hours?
Is there a resident or fellow clinic that needs to be supervised? What kind of oversight and control do I have in how these are run and what is done under my name?
What supervisory or teaching roles of non-physicians, if any, will be expected of me? Do I have the right to decline them? What do these roles look like on a daily basis and if I’m signing off on someone's work, how will I ensure I have the opportunity to supervise them appropriately? Can I choose who I will or will not supervise or teach? Am I paid for these responsibilities?
What call responsibilities will I have? Who determines the call distribution and schedule? How many people are sharing that responsibility, and what is the maximum amount of call I will be required to do if people leave the call pool?
What does call entail? What do the residents and fellows typically handle and what determines what goes escalated to the attending physicians? Am I always on call for my patients? What does a typical call day or night look like? Are there any adjustments to the schedule on the day of or after call?
Are there any committees or other administrative responsibilities that I need to be aware of? Are they voluntary or mandatory?
Interview Questions to Gage How Happy and Supported Their Physicians Are
In our experience, the biggest thing that will keep a physician at their job is interestingly not salary or titles, but actually how pleasant of a work environment a physician is in and how happy they are coming to work every day. While caseload and finances certainly play into that, it’s also about the people you work with, whether you feel heard when you voice complaints, how your work life balance is, and whether you feel like the administration is looking out for you. Here are some questions to ask other physicians that you run into during your interview day, as their experience is likely going to tell you a lot about what your experience will be.
How much turnover has there been amongst physicians in recent years? How long have each of the physicians in the group been there? Why did the people who left over the last few years leave?
What do you like the most about working here?
What do you like the least about working here?
What do the residents and fellows complain about or rave about at this institution?
When you have a complaint, who do you take it to? Are they responsive? Can you give me an example of something that has been changed after a complaint that you brought up?
Do the physicians or other staff hang out outside of work? Are there opportunities to get to know each other?
How many hours a night do you spend charting?
What EMR do you use? Do you like it?
How are you evaluated and by whom? Is it fair? Is it tied to compensation in any way?
How does the team in your department collaborate? How do your physicians and support staff (NPs, PAs, etc.) typically work together?
What specialists are available for consultation?
Interview Questions to Ask to Understand the Potential Job Restrictions
While every job has policies, as more and more physicians look to develop alternative income streams for doctors, you may be surprised to find out that many contracts heavily restrict what you can do outside of work hours, and for whom. These are especially common in academic work contracts. Make sure you ask about these if you already have a side business in place or are interested in developing one:
What is your policy on moonlighting or other after hours work?
Are there any restrictions for other side gigs (speaking, consulting, etc.)? Do we have to get permission?
Is a noncompete clause typical? What are the typical restrictions put in place for a noncompete?
Does your company have any rights to my work product that’s done outside of this job?
Do you get a piece of (or even all) of my earnings in my work that isn’t related to the institution?
If I develop a patent do you have a right to it?
Make sure that your physician employment contracts clearly spells out in writing anything you’ve been told in this regard verbally.
Questions to Ask for a Growth-Based Opportunity (Newly Created Position)
When you are replacing an outgoing physician, the job description and compensation expectations are typically a lot more clear. However, if your position is being created because the employer is starting a new office, growing a particular service line, or planning for the future, you’re going to want to make sure that there’s a plan in place to make sure that you are set up for success. Particularly if you are taking on an RVU based contract, they may be taking little risk if you’re not busy from the get-go, while you may find yourself woefully undercompensated for the efforts you’re putting in. Make sure that you’re both mutually incentivized to ensure that you’re best set up to hit the ground running.
What new business is coming to the department or advancement/innovation in the field has happened to spur the creation of this new position?
How will the academic institution/hospital system market me to ensure my success? Will they fund my networking and educational conferences to make sure I can get visibility?
Are there any accommodations within the contract financially to acknowledge that it may take some time to get busy without penalizing me on the compensation side?
What kind of mentorship, if any, is available as I integrate into your system?
Assessing an Offer and Contracts from a Hospital System
While most of your contract negotiations will happen once you’ve completed the interview process and both parties have expressed interest in going forward, note that both parties are likely assessing each other in this regard on the interview day itself. We’ll cover some questions you’re going to want to figure out the responses to below. Also note that they may ask you a few questions in regards to expected salary. Do NOT agree to anything or give them an expected salary range. This almost always can only hurt you. Let them make the first offer. If pressed, just reply that it’s hard to give a salary range until you understand all the responsibilities and benefits, so you want to wait and see the compensation package prior to weighing in on whether you think a certain salary is appropriate.
Once your job search shifts to the job offer and the contract negotiation process, also reference our physician career resources, especially our physician contract negotiations page, along with our physician salary compensation data. Note that while academic contracts typically have less wiggle room on things like benefits or other things that are standardized amongst their physician contract agreements or university as a whole, there are always still opportunities to negotiate for other things that can make a huge difference in your job satisfaction.
Salary and Compensation Pay Structure
Different hospital systems implement different pay structures. It’s important to discuss how you will be paid: if you will be paid a base salary, compensated on a production model, or some hybrid version of the two. You’ll want to make sure you understand:
What is the base salary?
What is the bonus structure? If it's based on RVUs, what will you realistically hit?
What have others in your position made on average when including the bonuses?
How are the production models calculated/determined?
If your salary is based on collections rather than RVUs, what percentage of collections do you get?
How will I be informed of my RVU productivity? Is there a transparent tracking system?
Is there a performance bonus? How is it calculated?
How does non-RVU generating work get compensated (administrative responsibilities, tumor board, etc.)?
Learn more about RVU based physician contracts.
Physician Benefit Details
As above, these are more things that you likely just want to know about, as large academic institutions often have these things standardized amongst their contracts. Here are some of the compensation components to consider when reviewing the contract and negotiating your final overall package:
Is there a signing bonus? When is it paid and are there any conditions associated with it? Learn more with our overview of signing bonuses for physicians.
Is there a relocation bonus? What happens to unused funds?
What is the PTO policy?
Are you fully vested in your annual PTO at the beginning of employment or do you need to accumulate PTO per pay period?
Does unused PTO carry over? Is this different for vacation and sick days?
Are there paternity/maternity leave policies? How much, if any, is paid versus taken from PTO or unpaid?
Are there CME days?
What benefits are offered? Is there an employee match for retirement plans? How high is the deductible on the health plan?
How is the call schedule defined?
Visit our compensation data for physicians to use in contract negotiations to look for comparable data points to your prospective opportunity. You can view overall stats on how much paid time off (PTO) and vacation doctors get and on call schedules and compensation for doctors. You can then dive deeper with our salary and compensation stats by specialty and our full, free salary and compensation database for doctors.
Unique Things to Negotiate in Your Academic Physician Contract While You Have Leverage During the Hiring Process
Since so much of a university contract is standard, we find many physicians stating things like, “There’s no point in negotiating an academic contract - it just is what it is.” Honestly, for most academic institutions, that’s not true. We’ve all seen certain people getting certain perks and wonder why their situation is different than others, and chances are, they used leverage to negotiate that special treatment. In academic institutions, this can include things like:
Academic titles
Funding for academic pursuits
Academic or administrative time
Research lab supplies or space
Support staff such as post docs and PhD students, statisticians, and more
Call responsibilities (or lack there of)
Tumor board responsibilities (or lack there of)
Preferred OR time or block schedules
Funding for special equipment or other preferred materials
Development of ancillary services or lines that the institution doesn’t currently have
Marketing or startup budgets for projects you want to undertake
Remember, not everything in the physician negotiation process is related to money. Look around when you’re interviewing and think about things you’d like to ask for at a time that you have more leverage to ask for special considerations.
Physician Contract Details - Legal
Some of the most frustrating situations we see physicians encountering are unfair non-compete clauses, termination clauses, or rights to alter compensation structure that are heavily weighted towards protecting the employer and disincentivizing you from leaving a job or making
Is there a non-compete clause? Although it’s ideal as an employee not to have one, many jobs will require one. You’ll have to decide whether or not you’re willing to pass up a job if they won’t let it go. If you do have one, the linked article on non-compete clauses for physicians goes over how to negotiate it to make it as reasonable as possible
What is in the termination clause?
Under what circumstances can you be terminated with or without cause? How much notice do you need to give?
Is there a maximum amount of call you can be required to take?
Who will cover the tail insurance if needed?
Under what conditions can they change your compensation structure?
Does it list everything that you agreed to verbally? If it’s not on paper, assume it can’t be enforced.
Learn more about red flags in physician employment contracts.
Additional Tips for Your Interview Day
Interviews can be intimidating, especially when you’re interviewing for your first attending position. Some tips from our physician Facebook groups:
Be yourself. It’s hard to honestly tell how well you’ll fit into the role and location if you aren’t authentic during your interview.
Show them what you can offer them with your unique training and experience.
Be prepared to field questions about why you are interested in working with their hospital system. You should not only have an answer prepared, but should flip the question on them and ask why you should work for them as well.
Don't be afraid to tell personal stories or strike up conversations about things in their office or that you notice about them. In academics in particular, people spend a lot of time working together. They want to know that they'll look forward to seeing you.
Go out of your way to talk to the residents and fellows. Their positive input could be a nice supporting factor to your application. If you are asked to prepare a conference for them, make sure it's engaging and on a topic you know well, but also useful to them.
Learn more tips to nail your physician interview.
Conclusion
The interview day, along with the weeks leading up to and after an interview, is an opportunity to learn as much as you can about the job. While you don’t want to bombard the potential employers with lots of questions that you could find out the answer to by other means to the point where it’ll get in the way of both parties getting to know each other and assessing whether other things are a good fit, you want to make sure you leave the interview day really understanding what it means to be a physician working for this hospital system. That includes not just the job description, but whether physicians there are happy, what red flags you may see that you need to do more due diligence on, or things about the job that you may need to make sure are specified in your physician contract to protect yourself. With the healthcare landscape changing rapidly, making sure you have the tools you need to succeed as well as protect yourself – and be happy in the process – is key.
Related Job Search Resources for Doctors
Explore all our physician career resources and education, including: