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Some thoughts for young surgeons

Changing Jobs

In the course of my academic career, I made three moves. The first move was from New York University, where I did my residency, to Marshall University in Huntington WV, where I was appointed Assistant Professor. That one almost doesn’t count, because many people leave their residency site for their first job. The second and third moves were real moves. Desire to work at a larger University Hospital where I could specialize in GI surgery (my ambition, at that time) took me from West Virginia to the University of Mississippi. The third move took me to the University of Iowa, where I remain to this day. Each job was a great job, and each time I moved for a specific reason.

Most academic surgeons move once or twice during their career. One of my mentors once said, “You academic surgeons are a migratory bunch.” In a way, it’s unfortunate that it can be difficult to attain promotion into leadership roles without moving. In another way, it creates a tremendous cross-fertilization.

Young surgeons sometimes ask me: how do you know when it is time to move on? Here are some things I tell them to consider when they evaluate the desirability and timing of a move.
• A move is a big deal. It’s disruptive for your family. You will lose some momentum in your career as well, even with a promotion and the assurance of a better job.
• A move can be expensive, even with a salary increase. Be prepared to carry two mortgages for a while, for difficulty finding work for your spouse, or for unanticipated expenses.
• Have you accomplished what you set out to do at your current job? I went into my first job with the goals of consolidating my surgical skills, getting some publications, starting a research lab, passing the ABS exams, and being inducted into FACS. Unless you find yourself in a really bad situation, four to five years is the minimum time you should spend in your first job.
• Have you reached the limits of what you can accomplish? If you want more leadership opportunities, for example, discuss this with your current Chair.

Another thing that young surgeons often ask is: should I tell my boss? I always say yes. Here are the reasons:
• Academic surgery is a small world. Your boss will find out, either from a phone call or a conversation at a national meeting. It is futile to conceal what you are doing.
• You want to leave on good terms. Make it clear to your boss, when you discuss a possibility move (or when you start to look around), that you value continuing the relationship with them and the institution you would be leaving.
• If you are making a move up the ladder, your boss may actually help you. Launching you into a leadership role reflects well on your boss and the institution you will be leaving.
• Finding a good next job is often a protracted process. You may be looking around for a year or two before you find the right next job.
• Keep your boss informed so that a replacement can be found. Nobody like surprises.

Even if you are in a really bad situation in your current job, it is rare that these simple courtesies will fail you. And remember this advice I was given once. If pressed for the reason for your move, blame your spouse or partner! Sounds awful, but works. “I love it here, but my spouse is miserable (or allergic to the vegetation, or needs to be closer to home, etc)” is a graceful way out of a difficult situation.
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