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