AOFAS Orthopod-Cast: "Changing Jobs"
Date: October 23, 2024
Host: AOFAS Podcast Committee
Guests: Dr. Casey Humbert (Penn), Dr. Cesar de Cesar Neto (Duke), Dr. Kelly Hines (WashU)
Episode Overview
This episode of the AOFAS Orthopod-Cast, produced by the AOFAS Young Physicians Committee, explores the experiences and challenges involved in changing academic jobs as a foot and ankle orthopedic surgeon. The panel—Drs. Humbert, de Cesar Neto, and Hines—share personal narratives, practical tips, negotiation strategies, and reflections on transitions to new institutions. The conversation provides candid insights for physicians considering a career move or currently navigating a job transition.
Key Discussion Points & Insights
1. Backgrounds and Catalysts for Changing Jobs
[00:27 - 03:54]
- Dr. Casey Humbert spent seven years at Johns Hopkins (12 including residency), moving to Penn in 2021 as Division Chief after pandemic-related delays and family considerations.
- Dr. Cesar de Cesar Neto completed four years at University of Iowa, was not actively looking to leave, but ongoing dialogue and family priorities led to an unplanned move to Duke in May 2023.
- Dr. Kelly Hines transitioned from University of Chicago (almost 8 years) to WashU in August 2024, spurred by serendipitous outreach and opportunities aligned with both her and her partner’s career interests in research and administration.
2. Timing and Approach to Notifying Colleagues
[03:54 - 06:28]
- All panelists emphasized a respectful, above-board approach.
- Most waited until an offer was in hand and a real possibility before notifying chairs and colleagues.
- Dr. Humbert: “I told my chair when I had an offer in hand...I think it was really important for me that it played out in an above board way.” (04:06)
- Dr. de Cesar Neto: Communicated early when interest became public, kept leadership informed during the drawn-out decision process.
- Dr. Hines: Notified about a month before accepting the offer after significant deliberation.
3. Shaping and Negotiating the New Position
[06:28 - 11:53]
- With experience and established credentials, the second negotiation is more confident and comprehensive.
- Learned to advocate for non-monetary factors: leadership roles, academic resources, administrative support, and contract specificity.
- Dr. Humbert: “...when you’re taking your first job...you're still an unknown quantity...As someone who was coming in, you know, having been board certified, like there isn't that stress for the new job...I negotiated for a lot of non-financial things...” (06:46)
- Importance of contract details: “If it’s not written down, it never happened. And it’s not going to happen.” (10:48 - 10:53, Drs. Humbert & de Cesar Neto)
- Emphasized getting everything in writing due to institutional memory loss and turnover.
- BATNA (Best Alternative to Negotiated Agreement): When you’re not desperate for a new position (and happy in your current role), you have more negotiating power.
- Discussed gender inequities and need for transparency in salary discussions (especially for women).
4. Logistics of Transition: EMR Templates, Research, and Assets
[13:28 - 16:30]
- Practical tips for carrying over EMR templates (smartphrases), OR preference cards, and Dragon dictation commands.
- Dr. Hines: “You can download all your smart phrases...You cannot take other things like preferred orders and lists...I would definitely recommend [exporting your smartphrases].” (13:52)
- Dr. de Cesar Neto: “I brought my Dragon commands as well...that helps Dragon and accent from international people. They help a lot.” (14:48)
- Research and data constraints:
- Patient-identifiable data typically cannot be taken, so finish projects ahead of leaving.
- NIH/other grants can complicate transition—must coordinate proactively with grants managers. (16:30, Dr. Humbert)
5. Surprising Challenges and Perks
[17:09 - 20:00]
- Fresh starts can be revitalizing, making it easier to implement one’s own systems and processes.
- Emotional difficulty of leaving and separation anxiety (for both faculty and themselves).
- Dr. de Cesar Neto: “The separation is always more traumatic than you would imagine...Not a good idea to keep moving. That would be my takeaway.” (17:38)
- Changing institutional culture: new colleagues may treat you differently (e.g., as “the expert” vs. “the resident/baby attending”).
- Dr. Humbert: “...faculty partners...it’s really hard for them to not view you as a resident. And the nurses and the staff all knew you as a resident...When I came in to Penn, everyone's like, 'Oh, this is the chief.'...It was just a very different feeling...” (18:30)
Notable Quotes & Memorable Moments
- “If it’s not written down, it never happened. And it’s not going to happen.”
— Dr. Humbert & Dr. de Cesar Neto [10:48 - 10:53] - “[Negotiating] the second job...it’s much more comfortable because...if they’re trying to recruit you, they know you want more. It’s not about money. It’s about academic opportunities, leadership, and some other stuff.”
— Dr. de Cesar Neto [09:48] - “When you’re looking for your first job, you don’t have a job...My BATNA...was staying in a job that I loved. So I’m going to ask for all the things...”
— Dr. Humbert [11:54] - “Not a good idea to keep moving. That would be my takeaway of changing jobs.”
— Dr. de Cesar Neto [17:38] - “You come in and everyone’s really impressed with you, and then you just try and maintain that and try and keep that first impression going...it’s way easier to do when you’re not having the anxiety of, 'Oh, this is my first solo calc fracture.'”
— Dr. Humbert [18:30]
Timestamps for Important Segments
- 00:27 – Introductions and each guest's job change story
- 03:54 – When to tell your current institution about considering a move
- 06:28 – Negotiating your new job (differences from first job, what to ask for)
- 13:28 – EMR, order sets, preference cards: what you can take with you
- 15:04 – Research assets and regulatory issues
- 17:09 – Surprising challenges and cultural shifts in a new workplace
Conclusion
The episode delivered rich, real-world advice for surgeons navigating job changes, from how and when to break the news to colleagues, negotiating strategy, handling the nitty-gritty of EMR and research transitions, and the unexpectedly emotional aspects of leaving and joining new institutions. It’s a must-listen for any orthopedic surgeon considering a career move—and a helpful resource for all academic physicians facing similar transitions.