Dr. Phillips
is a Professor in the Departments of Radiology, Neurosurgery, and
Otolaryngology-Head and Neck Surgery, and the Director of the
Division of Neuroradiology in the Department of Radiology,
University of Virginia Health Systems, Charlottesville, VA.He is
also a member of the editorial board of this journal.
This time of year we realize how transient many relationships
truly are in academics. Folks come in, get trained, grow up, get
smart, and then go into the real world. I hear a lot from our
residents and fellows about their job hunts and their plans for big
houses. This leads me to the following observations.
Early on I realized I could be pretty comfortable
financially in private practice. I could pay for my kids'
expenses through any school, have nice clothes and food, a nice
house, a sweet car or two, and some scratch for all that vacation
time. When I decided to stop working, I could run away to walk on
the beach with a bad hat and a metal detector. That was all a
given. But (and that is a big but), job satisfaction, comfort, and
happiness were important to me, and I was comfortable, happy, and a
bit satisfied here. There is an incalculable bonus in
still smiling at the end of a day. There is an incalculable value
in the friendships, laughs, traded quips, practical jokes, and
off-hour relaxing after a job you enjoy. An academic career, my
colleagues, my academic peers, and friends have all contributed to
this. A few residents and fellows limit their job searches not so
much on the colleagues they will gain, but on the
financial value it promises. For my nickel, I think that
is a mistake.
I have been mostly happy in my academic position most of the
time. There are certainly times when I'm not happy and other times
when I'm ready to run out of here like my hair is on
fire. I am vexed by the sheer number of bureaucratic
oddities and unbelievable tasks I am asked to perform. Such is the
wonder of modern healthcare. However, most of my days still end
with me a bit bedraggled, but smiling, nonetheless. There has been
a certain amount of job satisfaction here. I enjoy watching
residents and fellows come in knowing little and leave knowing a
lot, and thinking that I may have helped a little. I know they will
take good care of patients. It is a special bonus when some of
these folks go into academic practices. I emphasize to people about
the priorities they may consider on their job hunt and how to
evaluate practices. Some pay attention, and others don't.
I hear from prior residents and fellows in good practices that
they can't recruit new staff because they don't pay as much as
another practice, or they offer a little less vacation or a smaller
meeting allowance. Some can't even get people to interview because
of the salary. I understand the pressures of medical school debt
and loans, starting a new family, and moving to a new area, but a
longer term view of one's career and mental health is in order. It
is very difficult to put a price on the intangibles of a
practice. Getting along with everyone in the group, loving the
town, etc. They all add up.
Dr. Ted Keats (former editor of this journal and previous chair
of my department) used to quip that living here was worth $75K a
year. Well, that's a big opinion, and only that. Sorry, Ted.
Wonderful places to live are everywhere. I could have used that
$75K to put my kids through college. But, I agree that
Charlottesville is a wonderful place to live and that I work with
nice folks. All just another factor in staying here, working at
this odd profession. Please consider some of these intangibles in
your academic or private practice selection.