1. education
2. graduate school
3. college

Place sub-brand
here
Career Transitions
for the New in
Practice Pathologist:
How to professionally move
from one job to the next
Gene Herbek, MD, FCAP,
President-elect, CAP
Robert Breckenridge, MD,
FCAP, Past chair CMPD
Chad R. Rund, DO, FCAP,
Vice-chair, New in Practice
Committee
cap.org
v. #
Outline
• Part 1: Pathologist’s Perspective
o Finding the next new job
o Resignation process
o New job transition
o Self-Reflection and Assessment
• Part 2: Employer’s Perspective
© 2012 College of American Pathologists. All rights reserved.
Part 1: Pathologist’s Perspective
You have decided to resign.
Question: What do you consider
when looking for the next job?
© 2012 College of American Pathologists. All rights reserved.
Part I: Finding the Next New Job
What do you consider in the job search?
• Is there a demand for NIP pathologists?
• Is there a demand for a particular subspecialty?
© 2012 College of American Pathologists. All rights reserved.
Part I: Finding the Next New Job
Is there a demand for new in practice pathologists?
• Yes! There is a demand.
• Job offer response rate:
o >16 years experience
− 29% ZERO response rate.
o 1-15 years experience
− 8% ZERO response rate.
• Average number of offers:
o > 16 years only about 2
o 1-15 years is about 8
© 2012 College of American Pathologists. All rights reserved.
What kinds of specialties are in demand?
• The market always changes!
• Current data suggests:
o Cyto-, hemato-, dermato-, and GI pathology are
favored
o Community hospitals require surgical
pathologists
o Molecular is the fastest growing sub-specialty
o Clinical Informatics is the newest sub-specialty
© 2012 College of American Pathologists. All rights reserved.
6
What kinds of specialties are in demand?
• Regardless of sub-specialization, most pathologists
spend less than 50% of their time within their subspecialty
• All pathologists should maintain generalist skills;
a solid foundation in AP/CP is necessary
• Very few practices focus on just one sub-specialty
• The demand for sub-specialties and special areas
of expertise (with/without sub-specialty boards) is
dependent upon the needs within the individual
practice
© 2012 College of American Pathologists. All rights reserved.
7
What are the financial implications for various
practice sizes, settings, locations?
• Salary range should be a consideration
• Ask questions about the practice setting
• Salary is dependent on variables including:
o Incentives
o How the group is managed
o How well the group works with the administration
o The “busy-ness” of the laboratory
o Payer mix
© 2012 College of American Pathologists. All rights reserved.
8
Part I: Finding the Next New Job
You have decided to leave:
Question: How do you find another job?
© 2012 College of American Pathologists. All rights reserved.
Part I: Finding the Next New Job
Career transition resources include
• Review the CAP Member Directory
• Leverage relationships with former residents
• Reach out to friends, former colleagues, and
pathologists you know
• Job boards
• State pathology societies
• Locum Tenens
• Physician Recruiters
© 2012 College of American Pathologists. All rights reserved.
Part I: Finding the Next New Job
CAP Resources
• “I found my job by going to the CAP Member
Directory and looking up members in my
geographic area of interest. If they had an email
address listed, I sent an email explaining who I was,
what I was looking for, when I was available and
attached my CV and references. I got three
interview invites from those emails and I think I only
sent about 25 (some were to people from the same
group as well).”
© 2012 College of American Pathologists. All rights reserved.
Part I: Finding the Next New Job
Personal and extended professional network
• “ It is always better (and cheaper) to work through
your friends/colleagues when possible. Additionally,
contacting state pathology societies is a way to
‘cold call’ and get information on a region of
interest. The pathologists involved in the state
societies often times have some insight on who is
hiring, etc., and have a large number of contacts.”
© 2012 College of American Pathologists. All rights reserved.
Part I: Finding the Next New Job
Leveraging past connections:
• “…contact your old training program. Many times they
know of jobs in the pipeline that aren't advertised and
some groups may prefer a pathologist with a little
experience over a fresh trainee. We do this for our grads
all of the time.”
© 2012 College of American Pathologists. All rights reserved.
Part I: Finding the Next New Job
Recruiting firms:
“…avoid the recruiting firm if possible. It pushes
people out of their comfort zone to contact
friends/colleges, cold call/mail, and network at
meetings but I think it is worth it. I mailed a cover
letter and CV to 4-5 CLIA certificate holders of the
labs in the geographic area I wanted to live and it
led to two interviews.”
© 2012 College of American Pathologists. All rights reserved.
Part I: Finding the Next New Job
Locum Tenens:
• “There are locum tenens firms that can be used to
stay active while continuing a job search. This will
allow the job seekers to be more selective in their
search and gives them a chance to try practices
out before they join.”
© 2012 College of American Pathologists. All rights reserved.
Part I: Pathologist’s Perspective
You are prepared to resign:
Question: What do you do next?
© 2012 College of American Pathologists. All rights reserved.
Part 1: You are Prepared to Resign
• Don’t resign until you are positive you are leaving!
• Know you are leaving before your employer does.
• You really cannot change your mind.
• Prepare to resign before you resign.
© 2012 College of American Pathologists. All rights reserved.
Part 1: You are Prepared to Resign
What do you do once you decide to resign?
• Resignation does not mean failure.
• There are no guarantees of something better.
• Understand the resignation clause in your contract.
eal risks and issues in leaving and that the risks for
leaving should outweigh the risks and issues for
staying.
© 2012 College of American Pathologists. All rights reserved.
Part 1: You are Prepared to Resign
Interviewing while employed
• Continue to perform your current job duties.
• Sudden multiple days off may be a red flag.
• Pathology is a very small world.
• New employer will have to call current employer to
verify your employment.
© 2012 College of American Pathologists. All rights reserved.
Part I: Pathologist’s Perspective
The resignation process:
Question: When? How? What must be considered?
© 2012 College of American Pathologists. All rights reserved.
Part I: The Resignation Process
Current contractual obligations?
• Seek legal review of your contract
• Resignation notice period
• Employment financial issues
• Malpractice tail coverage
• Non-compete clause
• Non-solicitation clause
© 2012 College of American Pathologists. All rights reserved
Part I: The Resignation Process
When do you resign?
• Preferably after next position is secured
• After a transition plan is established
• After you understand your contract
• It may be advantageous to resign prior to your
employer asking you to leave.
© 2012 College of American Pathologists. All rights reserved.
Part I: The Resignation Process
How do you resign?
• Seek legal advice.
• Ensure “letter of the contract” is met.
• Never verbally resign.
• PUT IT IN WRITING! C
t
© 2012 College of American Pathologists. All rights reserved.
Part I: The Resignation Process
How do you resign? (cont)
• May or may not have to give a reason(s).
• Hand deliver your resignation, don’t email..
• Only email a copy of your resignation after you
resign in person.
© 2012 College of American Pathologists. All rights reserved.
Part I: The Resignation Process
Where do you resign?
• In private.
• This is not a hallway conversation!
• Set up formal meeting.
© 2012 College of American Pathologists. All rights reserved.
Part I: Pathologist’s Perspective
You have officially resigned:
How do you manage the
post-resignation issues?
© 2012 College of American Pathologists. All rights reserved.
Part 1: The Post-Resignation Issues.
Formulate a transition plan. Consider:
• How to continue to work while leaving…
• What you need to finalize with…
− Current employer?
− New employer?
− Yourself?
– Self-Assessment!
© 2012 College of American Pathologists. All rights reserved.
Part 1: The Post-Resignation Issues
How to continue to work while leaving:
• Maintain the status quo.
• You have resigned, not committed a crime.
• Maintain professional relationship with clients.
• Be prepared to explain to clients why you resigned
© 2012 College of American Pathologists. All rights reserved.
Part 1: The Post-Resignation Issues
How to continue to work while leaving (cont):
• Do not isolate yourself.
• Same job performance as prior to resigning.
• DO NOT try to get people to “choose sides”.
o May not share your viewpoints.
o It is extremely unprofessional.
© 2012 College of American Pathologists. All rights reserved.
Part 1: The Post-Resignation Issues.
What do you need to finalize with your current
employer?
• Final paycheck.
• 401K or other retirement benefits.
• Interim insurance coverage (COBRA).
• Relationship with colleagues.
• Take all your stuff (none of theirs).
© 2012 College of American Pathologists. All rights reserved.
Part 1: The Post-Resignation Issues.
What do you need to finalize with your current
employer? (cont)
• Reaction to your resignation
o Hostility
o Support
o Indifference
• Prepare in advance for the reaction
© 2012 College of American Pathologists. All rights reserved.
What do you do if your employer becomes
hostile?
• Hostile reaction.
o Be professional.
o Seek legal counsel.
o Employer is held to contract also.
• You are employed, not a prisoner.
o Express your concern about the hostility in
writing.
o Document the hostility.
© 2012 College of American Pathologists. All rights reserved.
Part 1: The Post-Resignation Issues
What do you need to finalize with your new employer?
• What is your resignation story if asked?
• Turn the conversation into a positive dialogue as
opposed to a negative monologue.
• Do not let your resignation dominate the
conversations.
© 2012 College of American Pathologists. All rights reserved.
33
Part 1: The Post-Resignation Issues
What do you need to finalize for yourself?
• Do not end one job on Friday and begin the next on
the following Monday.
• You need to reset and recharge.
• Self Assessment
© 2012 College of American Pathologists. All rights reserved.
What do you need to finalize within yourself?
Self-Assessment:
• Did I make my employer's job much easier or
difficult?
• When I gave notice was there a sense of relief or
dread?
• After I gave notice, what will I do differently in my
next job?
© 2012 College of American Pathologists. All rights reserved.
35
What do you need to conclude with yourself?
Self-Assessment:
• Did I perform my job better than my employer could?
• When I ask how I could have improved previous job:
o Cite external factors?
o People and resources?
o Take responsibility?
• Did self-perception match employer’s or colleagues
perception/assessment of me?
© 2012 College of American Pathologists. All rights reserved.
36
Part II: New Employer’s Perspective
You have secured a new job:
What is your new employer’s perspective?
© 2012 College of American Pathologists. All rights reserved.
Outline
Part II: Your New Employer’s Perspective
How to facilitate a smooth transition:
• What you should do
• What you should avoid
• Of what you should be aware
© 2012 College of American Pathologists. All rights reserved.
Part II: What should you do?
Identify the practice’s expectations
• Ask straightforward questions like:
o “Will I be handed cases to sign out?”
o “Should I grab work on my own?”
o “Should I keep my door open or work quietly with
it closed?”
© 2012 College of American Pathologists. All rights reserved.
Part II: What should you do?
Observe
• Watch how others behave.
Volunteer
• Ask “what else can I do?”
• Identify what isn’t being done and volunteer to do it.
• Continue to learn and add new skill sets to the
practice.
© 2012 College of American Pathologists. All rights reserved.
Part II: What should you do?
Volunteer
• Express interest in the practice’s area of need; be
willing to take on a new role. Fill a need even if it
isn’t your main area of interest.
Speak up
• Speak your mind, as long as it is done with respect.
• Ethical concerns? Ask questions.
• Handle conflict in a direct manner.
• Ask questions, then ask more questions.
© 2012 College of American Pathologists. All rights reserved.
Part II: What should you do?
Be a good colleague
• Communicate: interact with the group and clinical
physicians.
• Treat everyone with respect.
• Honor time.
• Finish all of your work before you leave.
• Try to do more than your fair share.
• Dress and act professionally.
© 2012 College of American Pathologists. All rights reserved.
Part II: What should you avoid?
• Leaving the worst cases for others
• Passing work off on others or complaining about
your workload
• Spreading gossip within the laboratory
• Gossiping about the pathology department
throughout the facility
• Discussing internal or external politics
• Sexual or any other type of harassment
• Saying, “I wouldn’t have made that diagnosis” to a
peer
© 2012 College of American Pathologists. All rights reserved
.
Part II: Of what should you be aware?
• You are being observed all the time
• You need to earn and keep respect, it is not a given
• Your signed out cases will be reviewed
• You are unaware of historical, political dynamics of
the practice
• You may be asked to review another pathologist’s
case; there is a protocol for this process
• You are held to a different standard
© 2012 College of American Pathologists. All rights reserved.
Part II: Your New Employer’s Perspective
Relationships matter
• Build and nurture
Remember the three A’s:
• Availability
• Affability
• Ability
© 2012 College of American Pathologists. All rights reserved.
45
Questions Raised and Answered During Webinar:
1. What are the components of a strong cover letter?
a. Quality stationary, good grammar, proper
punctuation. If you're not sure, show your draft to
someone who knows how to write.
b. Have a short introductory paragraph that states
who you are and what you are seeking.
c. After the who and the what comes the where,
when, and how. Make it brief, to the point, and
respectful.
© 2011 College of American Pathologists. All rights reserved.
46
Questions Raised and Answered During Webinar:
1. Components of a strong cover letter (continued)
• d. Mention your strongest characteristic, one that
puts you above others. Everything else should be in
your CV which should also mention several items
that differentiate you from the competition.
•
e. Although your address will be at the top of the
letter, make sure your phone number and email
address are included somewhere.
© 2011 College of American Pathologists. All rights reserved.
47
Questions Raised and Answered During Webinar:
2. Why is it that everyone wants a fellowship trained
pathologist but you eventually end up doing
general pathology anyway?
• We want everyone to be boarded in AP/CP so they
can take call and field most problems. We divide
up the work evenly based on location. However,
when a difficult case comes up, we like to show the
case to our in-house expert to get their opinion. If
this in-house expert feels uncertain/uncomfortable,
we will send the case to an outside consultant.
© 2011 College of American Pathologists. All rights reserved.
48
Questions Raised and Answered During Webinar:
2. Why is it that everyone wants a fellowship trained
pathologist but you eventually end up doing
general pathology anyway? (continued)
• By relying on our in-house expertise as much as
possible, we avoid delaying the diagnosis and have
someone available to discuss the case with our
clinical colleagues. Sending the case outside is
expensive, prolongs the time until diagnosis, and
may create doubt among the other physicians
about our competence.
© 2011 College of American Pathologists. All rights reserved.
49
Questions Raised and Answered During Webinar:
3. What is the best way to approach your future
employer about not contacting your current
employer? (The current employer doesn’t know that
I’m looking for a new job).
• First, have an open and direct communication with
your future employer about the issue. This is not a
unique situation and should not be an out of the
ordinary conversation with the future employer. If
you feel that premature verification of your
employment may potentially compromise your
current position, I would let the future employer
know that in no uncertain words.
© 2011 College of American Pathologists. All rights reserved.
50
Questions Raised and Answered During Webinar:
3. Best way to approach your future employer about
not contacting your current employer? (continued)
•
One approach would be to request that the
potential employer not contact your current
employer to verify employment until you have
signed a letter of intent to work for your future
employer or you have a fully executed contract.
• Alternatively, see what avenues can be utilized by
the future employer to verify your employment
without having to contact the current employer
directly. In other words, put the issue back on to the
future employer and see what options are
available.
© 2011 College of American Pathologists. All rights reserved.
51
Questions Raised and Answered During Webinar:
4. Do you have advice for new pathologists who are
taken advantage of (such as given much higher
case loads, more calls, etc.) because they are
new?
• Tough issue here. As far as case load, it depends on
if this is a perception or objective issue. Example:
I could see 80% of my monthly case load in two
weeks and others in the group have a different
percentage split. So, on my "bad week(s)" I could
get the wrong impression of doing more than my
fair share of cases when in reality, I am just seeing a
higher percentage of cases in a given time frame.
© 2011 College of American Pathologists. All rights reserved.
52
Questions Raised and Answered During Webinar:
4. Advice for new pathologists who are taken
advantage of because they are new (continued)
• Provided that the working environment is not hostile
and/or that the group members are reasonable and
respectful professionals, these issues can be
discussed openly.
• Some groups tally the case load monthly to get at
the issue. Granted, this is a long term look at the
issue.
© 2011 College of American Pathologists. All rights reserved.
53
Questions Raised and Answered During Webinar:
4. Advice for new pathologists who are taken
advantage of because they are new (continued)
• If the expectations were not made known during
the interview process, get hold of those
expectations now. Do it from a positive position
when you approach your employer and be honest
if you see it as a potential issue.
• Call: Ask how the call schedule is set up. If there is
no rotational holiday schedule, offer to cover a
holiday. You have to be an active participant in
your practice.
© 2011 College of American Pathologists. All rights reserved.
54
Questions Raised and Answered During Webinar:
4. Advice for new pathologists who are taken
advantage of because they are new (continued)
• If you are comfortable enough to approach the
employer about the case load, do it from a nonconfrontational position: e.g. " I want to make sure
that I am doing my fair share in an objective way. Is
there a way that I can know my case volume versus
the others in the group?”
• Moreover, know that all groups are different in their
approach with newly joined pathologist.
© 2011 College of American Pathologists. All rights reserved.
55
Questions Raised and Answered During Webinar:
5. Is it advisable to give more notice than what is
required by the contract?
• I preface this by stating that I am in no way giving
legal advice and such advice needs to come from
a competent contract attorney that understands
your contractual obligations.
• With that said, however, I would not recommend
giving any more notice than required by contract
unless you have a superb relationship with your
current employer and your leaving is seen as a
mutually understood situation.
© 2011 College of American Pathologists. All rights reserved.
56
Questions Raised and Answered During Webinar:
5. Is it advisable to give more notice than what is
required by the contract? (continued)
• Moreover, I do not believe you can legally go
outside of the resignation terms in the contract.
Meaning, if there is a 90 day notice, then you can
only "legally" give a 90 day notice. Also, know that
some contracts have an employer clause that
allows them to expedite the "notice period" (a.k.a.
90 day notice period).
© 2011 College of American Pathologists. All rights reserved.
57
Questions Raised and Answered During Webinar:
5. Is it advisable to give more notice than what is
required by the contract? (continued)
• What this means is that your employer has the legal
right to terminate your notice period anytime after
you give your resignation notice.
• For example: You resign on Wed and your
employer exercises the resignation clause and tells
you to leave on the next day (Thurs). Thus, you
really never had a 90-day notice period. That
period remains in effect as long as the employer
does not exercise their contractual right to
prematurely terminate your notice period.
© 2011 College of American Pathologists. All rights reserved.
58
Questions Raised and Answered During Webinar:
5. Is it advisable to give more notice than what is
required by the contract? (continued)
• As an aside, the notice period is the actual "length"
of your contract. You may have a 5 year contract,
but the notice period (90 days) is the actual
...legal...length of the contract. You are technically
only contracted for 90 days. Most people do know
that so be aware.
• In my opinion, I would resign with notice per the
letter of the contract. Please seek a legal opinion on
this to fully understand your situation.
© 2011 College of American Pathologists. All rights reserved.
59
Questions Raised and Answered During Webinar:
6. How do you address negative attitudes from others
which surface once you resign?
• Be professional and stay above the fray. If there are
significant issues that arise...document them. If the
hostility really escalates, then get legal counsel
about options.
• Do not under any circumstance, do anything that
will cause a legal crisis for yourself. Quite frankly, it
is better to just walk away and not go back to your
current employment than to compromise your
future professional life.
© 2011 College of American Pathologists. All rights reserved.
60
Questions Raised and Answered During Webinar:
6. How do you address negative attitudes from others
which surface once you resign?
• Petty or rude comments? Treat them as such:
“Sticks and stones…”.
• Offer positivity and kindness in return.
© 2011 College of American Pathologists. All rights reserved.
61
Questions Raised and Answered During Webinar:
7. How do you react if your current job finds out that
you are interviewing when you did not tell them
yourself?
• This speaks to the key part of the webinar. This
should be part of the "transition plan" that you
should have in place before you resign or begin
interviewing for a new position. You should have an
answer for this in place.
© 2011 College of American Pathologists. All rights reserved.
62
Questions Raised and Answered During Webinar:
7. How do you react if your current job finds out that
you are interviewing when you did not tell them
yourself? (continued)
• If you have a confidant, have that person play the
role of the employer and see how you respond. It
sounds a bit theatrical, but is better to say all the
wrong things in your practice sessions in order to
be really prepared for the real thing.
© 2011 College of American Pathologists. All rights reserved.
63
Questions Raised and Answered During Webinar:
7. How do you react if your current job finds out that
you are interviewing when you did not tell them
yourself? (continued)
• One potential option: Say that you did not want
your move to cause a major disruption to the daily
operation of the practice. You were not being
secretive, but instead, trying to be respectful to the
fact that your leaving may cause a disruption to the
practice and you were trying to mitigate that.
© 2011 College of American Pathologists. All rights reserved.
64