Hello, welcome. I'm Dr. Marilyn Bui. I serve as the president of Florida Society of Pathologists. You're at the very first FSP Grand Rounds webinar. Why a Grand Rounds? This comes from the department chair, pathology department chair, and the residency fellowship program director working group. When we meet together in our FSP annual meetings, people feel like we should have a FSP Grand Rounds. This give us the opportunity to bring our community all together. In addition, we can discuss topics are usually are non-pathology topics, but are really needed for the professionalism and the faculty development topic. So this series is gonna be quarterly, targeted to residency fellows and the pathology faculties. So this very first one is about facing the real world, what graduating pathologists need to know, targeted to the graduating residency fellows, as well as faculty who are teaching them. Next slide, please. So this is a CME earning activity. And the instruction to obtaining CME is here. And the CME must be claimed by April 6th. So this is a part of your membership benefit. As far as FSP, as we all know, we have more than 600 members. We have a 75 years history. And our society bring people together by education, networking, and also advocate for the pathologist and the pathology and the laboratory medicine. Next slide. So today we have more than 110 people registered. There are 40 some residency fellows. The rest of them are practicing pathologists. And interestingly, we also have people from other states representing Alabama, California, Arizona, Pennsylvania, and Georgia. So today I welcome four panelists and I will introduce each one of them when we go to their part of the section. The first, next slide, is the representation from academic pathologists by Dr. Jane Macinay, who is my colleague at Moffitt Cancer Center, vice chair of anatomic pathology and also professor of pathology. Dr. Macinay, please take it away. Thank you. Thank you, Marilyn. I asked Marilyn to not introduce me because that's actually part of my talk and it's also embarrassing. So when she asked me to talk about an academic career, I'm like, okay, well, I'll just say what I do because that sort of gives you an idea of what the mix of activities is. And I've been doing this for 28 years. So there's a lot here. To summarize, I'm a Florida product. I graduated from medical school at USF and I did my residency and fellowship. Some people will tell you to be an academic so it's kind of suicide to stay in the same institution. You're academic suicide to stay in the same institution your entire career, but it's been a very fruitful decision for me. So when you're an academic, you kind of have to have accomplishments in four major areas. So as a clinician, I am the section director of DermPath at Moffitt Cancer Center. We see about 2000 new melanoma patients a year. So we have a very rich service in oncology of the skin. I teach to trainees at all levels, including my fellows who have graduated 15, dermatopathology fellows. We also teach at national and international meetings. My research, I have very little like self-directed research. I do mostly work on team science projects with basic scientists doing the pathology support. I've had one federal grant in my career, but I have 267 publications, mostly working with trainees and helping them to get a leg up and with the team science. And I'm the vice chair of anatomic pathology here at Moffitt Cancer Center. And as I said, I direct the fellowship and I'm active in national organizations and leadership positions. So we're going to talk about all of these basic career choices today. First of all, I'll do academic practice and then hand it over to our awesome representatives of private practice in a group setting and in a reference laboratory. And then industry is another choice that we won't talk about too much today, but I think all of us could probably give, answer questions about it. So the definition of academic practice is very vague. It's a branch of medicine pursued by doctors who engage in a variety of scholarly activities. So that goes for both healthcare and other sciences. In healthcare, we usually work for organizations or institutions that in addition to clinical practice have a mission to educate students of some sort. So in considering your choices at finishing your residency or fellowship, I think these following attributes would make you think that academics could be right for you. Do you really like to multitask? Like switch your attention sometimes every 10 or 15 minutes or so. Are you good at multitasking, at handling a variety of things in addition to your cases? Do you like teaching even so much that you like it even if it slows your pace of work? Do you enjoy speaking in public? You really have to, as you're a pathologist, you're probably, education is one of your biggest roles and not just in academics to students, but to your colleagues in clinical care. Do you enjoy collaboration to address clinical or basic science issues? And collaborative research is a huge plus in pathology. Even if you're not like an independently motivated or funded person, many, many projects and basic scientists need pathology input. But if you have a burning desire to answer questions about topic and pathology that are currently unexplored, and as an independent researcher, that is also a very valid avenue. And do you have a desire to become more involved in your specialty and its organizations in the realm of service? So this slide kind of shows the pros and cons of what happens if you happen to have those attributes. You'll have variety in your role. However, you will get pulled in many directions and prioritizing can be challenging. You'll have a big workload, but there's often, I think, less emphasis in academics on your output. You don't get hammered with your RVUs. You don't get hammered with having to read a minimum number of cases a day, but that often equates to a general lower scale of pay in academics. And your schedule, therefore, is potentially more flexible because there's less pay, but you have more of a flexibility to schedule when you're going to read your cases, when you're going to teach. Trainees will often assist with call duty. So if you have a call, it's great to have the backup of trainees. And also, I think I personally feel fulfilled because in addition to bringing home a paycheck, I feel like every day I'm making a difference in teaching the next generation of people. Now, another con that I didn't mention here, when your schedule is more flexible, you must like to write papers and create talks at night because often, if your schedule is very flexible and you're just reading your cases during the day, sometimes you can't get to all of the extra stuff, but that's great. You can schedule it at night when the kids are asleep or when nobody's bugging you in your office. Trainees help you, but you also need to supervise them. And you get rid of sort of that, am I living to work or working to live? The sense of purpose that you will get if you're fulfilling your role, I think really helps you to feel motivated about all of the extra activities you're doing. But on a personal level, one of the reasons I love academics is the people. You get fellows. Here's some various fellows that you have lifelong relationships with. You get to work with a diverse group of trainees. There's our Dr. Bui here with our graduating fellows from a few years ago. You get to be a respected part of a multidisciplinary clinical team, and here's our clinicians in cutaneous oncology and the dermatopathologists in the group. You get to participate in educational activities. Most of the time, I feel like with people with much brighter minds than you, so giving talks on a national platform. You often get to present research at exotic locales like Australia. And so that's really some of the pluses that I think you may miss in a private setting. So now that you've decided to enter academics, what's next? Well, the majority of pathologists will choose one of three pathways. The clinical academician or often called clinical educator pathway. In these, most of your time is spent on clinical effort and the secondary of achievement is fixed. The clinical investigator and clinical scientists are more for people who are in MDPHD or who have a specific focus for funded research, and I'm not going to spend too much time on these. These are from our Moffitt Faculty Affairs, and these are the names of the pathways specifically at Moffitt, but they're often mirrored in other institutions. A lot of times, you'll hear about tenure, and just briefly, what is tenure? There's two tracks in most academic institutions, tenure earning and non. Tenure is a guarantee that a faculty member cannot be just arbitrarily dismissed, and thus it's awarded to people who've reached a certain level of accomplishment that's deemed valuable. That generally happens at the first promotion. And in academic institutions, their tenured physicians are guaranteed a base salary. Overall, in pathology, about, depending on whether you work for a basic science department or a clinical pathology department, about 40% of pathologists are on the tenure track and the remainder on a non-tenure track, and some people simply don't have it available, but that's the general definition of tenure. So as you progress in an academic career, your pathway will comprise climbing the ladder to two different levels. Everyone starts as an assistant professor, then the next step is associate professor, and the next is full professor, with or without tenure, and every one of those is linked with a significant salary increase. You are allowed to apply after five years in rank if you have the support of your chair, and more importantly, if you're on, if you're one of those less common people who are actually on a tenure pathway, you have to apply within anywhere between the first five or seven years, and if you are not promoted, you may actually be dismissed. This is mostly basic science researchers that are on the tenure pathway and predominantly clinicians. This does not apply. If you are non-tenured, you generally have unlimited time to apply for promotion, and in fact, some people remain at the assistant or associate level for their entire career. So how do you get promoted? You have to be good or excellent at at least two of the four main domains that I introduced at the beginning. Most pathologists are on that clinical educator track, and so they must excel in clinical care, and then most of them generally choose teaching as their second level of excellence, and the other two, you have to do your work, and you can't slack. You have to do what's required of you as a citizen of the university or institution, but you really have to beat the bar in clinical care and teaching, and my last few slides are more detailed. I'm not going to talk about everything in them, but I understand from Dr. Bowie that this is going to be present as an enduring resource, and they just describe things that beat the bar in clinical care and in teaching and in research and in service. So basically what you're doing is in your first five years as a clinician, you're getting your feet wet. You're trying to get up to snuff in clinical care. You're seeing what am I really good at and honing that. You're seeing for teaching, who do I really like to teach and what do I do well? Do I like to give talks at national meetings or do I want to stay local and maybe make a course for pathology residents or participate in the undergraduate medical course? Or do I really don't, I don't want to teach and go give talks at all. I want to write a lot of papers and do a lot of collaborative work. And service and administration and involvement in your department and your institution are all very important. You also have to be mindful of your reputation and try to get known because upon promotion, you will be asked to have letters of, other doctors write you a letter of support, and those generally attest to whether you're known for your skills, either in the region to get to that first level or nationally or internationally to become a senior member. So, and in the last minute or so, I'm just going to talk about when you actually go up for promotion, which is, I realize far in the distance for most of you, first of all, you'll have a chance for your hospital committee to review your credentials about midway through your five years and tell you, am I on track or do I need a few more years? When you finally go up for promotion, it's a bit of a paperwork quagmire. You have to have a well-crafted CV. You have to do a narrative assessment of your own accomplishment. You have to have teaching evaluations by people who have taught you and as many as possible. Copies or reprints of selected publications, and you have to come up with a list of people to review you and from which three to five, depending on your institution, must actually write and send a letter assessing your credentials. When I'm looking for people who are applying for academics, what I want to see is have they been involved in teaching or research above and beyond what's expected in residency? Are they, we ask them to give an oral presentation and we want to know really not are they a super scientist, but are they capable of digesting and presenting a complex subject in a coherent manner? It's a plus if you've been involved in organized medicine like the residence forum or the FSP. We want to see a collegial and team-based mentality during your interview and a realistic understanding of the rigors and requirements of academics. I don't want to hear, oh, I love to teach. I want to see that you actually maybe were involved in it prior or in research. So with that, we also solicited a similar list of expectations and requirements from the community panelists so I will give them the helm now. Thank you, Dr. Masin-Nai. So if you look at Dr. Masin-Nai, you can check her out on Moffitt website or Google her. She is really exemplary academic pathologist. If you choose academic, she is your role model. She is not only doing it fantastically, she's doing it with such a joy and a passion. So she's going to tell us more at the panel discussion on the credential part of it and she talk about what make you drawn to academic medicine, what's the pathway being promoted. But being a scholar is one thing, but being a practicing pathologist provide a high quality of patient care is another thing. So in the hospital, when you start a new job, there's a credential committee looking at your work. So this type of work and Dr. Masin-Nai is going to let us know some more. Now we're just going to change the gear a little bit more to another side because when you're in training, you are interacting with academic medicine like Dr. Masin-Nai and I, but when you go to practice, most of you, 75% of you will actually go out to the community. Many of them may go to the commercial laboratories, some go to group hospital-based practice, some may go to industry or VA hospitals. So today we invited Dr. Peter Bukowski who is the managing partner of Quest Diagnostics in Tampa. Dr. Bukowski is also our FSP board member. Next slide, please. Dr. Bukowski is board certified in APCP, also clinical informatics. Okay, thank you. Thank you, Dr. Bowie for your kind introduction and thank you to my fellow pathologists for participating in this webinar. Before I begin, I would really like to congratulate all who are attending on a great career decision. It is actually a very exciting time to be entering the field of pathology as technology is becoming a vital part of practice. For instance, digital pathology and artificial intelligence are going to change everything. And in many ways, it will place pathologists at the center of cancer care and medicine in general. So we are really entering a golden era of pathology. Quest Diagnostics always welcomes talented and capable pathologists. And most importantly, has the infrastructure to empower them. In case you didn't know, Quest Ameripath is a leading national provider of anatomic pathology, dermatopathology, molecular diagnostic services to physicians, hospitals, also clinical laboratories and surgery centers across United States. Our team of 450 highly trained board certified pathologists and PhD level scientists provide medical diagnostic services in outpatient laboratories, as well as hospitals and ambulatory surgical centers. So what I really find very valuable and important is that we always put the patient first in all aspects of business, but especially with regard to medical quality. So the top priority, as you wish, when we interview and hire pathologists is that they have a true talent and a strong passion and dedication to patient care. It's very important. We also look for team players because it is very important to have a very nice working environment. So we look for pathologists who contribute to such a working environment. For instance, in my Tampa and Central Florida business unit, I have 25 pathologists reporting to me and the team is extremely coherent, almost like family. It makes a difference. Subspecialty fellowship training and experience are a big plus as we work in subspecialty teams. And of course it goes without saying, we look for candidates with APCP certificate and a state license. Next slide, please. Of course, when hiring, we always check references and each candidate has to complete a slide test. Actually, our slide test is quite comprehensive and allows the candidate to elaborate on required special stains, differential diagnosis, ancillary studies, and so on and so forth. So this allows us to get an idea not only about the diagnostic skill of the pathologists, but also about the diagnostic judgment. It's very important. Additionally, we encourage potential candidates to spend some time with us in the form of elective or rotation, as you will. This way, we can spend time together on a double-head microscope with biopsy and cytology cases. And it also gives the candidate the opportunity to interact with our team, our staff. So the candidates can really get a good feel for our working environment. I think it's very helpful. And quite importantly, because Quest AmeriPath covers various types of laboratories, hospitals, and esoteric diagnostic and research centers across the country, potential candidates have the opportunity to select a specific geographic location and desired practice type center. For example, if somebody is interested in digital pathology and artificial intelligence and wants to be a part of a very pleasant environment, I welcome you to spend some time with our team in Tampa. It will be time well spent. That said, I wish you the very best of luck in your drug hunting, and thank you so much for your time. I'd be happy to answer all the questions during the Q&A session. Dr. Bui, I pass this back to you. Thank you so much. Thank you. Thank you very much for this insight. As you can see in commercial laboratories, when you go for interview, please prepare. There will be tests. And then I'm a fellowship program director for cytology, and realized that our training is mainly focused in cancer center. So I send my fellows to VA hospital so they can reach out to different group of patients and also collaborate with Dr. Bukowski so they can see what's the other side of the commercial laboratories. And his laboratory is also the center of excellence in digital pathology and AI. That means in his lab, they are going to start using digital pathology and AI. And once it validated, and this can be implemented throughout the entire network. So it's very exciting opportunity there. So now we're going to ask Dr. Brad Cantrell. Dr. Cantrell is also a FSP board member. He has been in FSP for many, many years. And he did his pathology residency as Johns Hopkins and the Memorial Sloan Kettering. And he has been practiced for 42 years at the same location, St. Vincent in Jacksonville. And his group has six pathologists and he has served as the president of this group for 11 years. And he has been FSP member for 42 years. My goodness. Thank you so much for your service. And he has also served in many roles, especially in advocacy. He chairs the legislative committee in FSP. And whenever there is a cut in pathologist fee, Dr. Cantrell will represent FSP to work with our lawyers, our lobbyists and fight back for pathologists. So now we're going to hear his perspective, what he is expected from the graduating trainees. Thank you, Dr. Cantrell. Thank you for that kind introduction. You know, as I prepared my talk today, I started off with the perspective that private practice is a bit different than the other venues, whether you're going to academics or commercial laboratory work. And as I listened to Dr. Messina and Burkowski, I actually hear a lot of the same things I was preparing to say. And I think that's telling me is that maybe it's not that different after all, we still are looking for the same thing in candidates and the candidates are going to be looking for the same things in their job to make sure they're satisfied at the end of the day. You know, in just a few minutes, I'm tasked with teaching you all about trying to get a job in private practice. And of course that's a Herculean task. I don't think we can get from alpha to omega. We do best just to stop at ABC and call it a day. So that's what we're going to do. We're going to make a couple of points. We're going to look at this from your job perspective as you're going around and interviewing with different people for a job. And then from my perspective, as I'm listening to you interviewing for a job. So if you're the applicant, what would I tell you if you were my nephew going out for your first pathology interview? First of all, I'm here to tell you that there are in fact creditors out there and you have to avoid the revolving door situation which many local groups will know such and such group tends to have people come through at two year intervals or three year intervals. And there's no prospect of ever getting an actual partnership position here. They're going to squeeze you as an asset until you finally get smart and leave. So I think you have to recognize that that sort of thing exists. I always tell people when they interview with us that no one's ever left our position, our corporation, except to retire. So somewhere in your interview, you need to work it into the conversation. How many people have had this job in the past 10 years? That's an important perspective. So with that caveat out of the way, there are so many different ways to be in private practice. You can be as I am in a professional association that contracts with the hospital independently. And that's certainly the traditional way that this job has been practiced, but there's so many different new models out there. You can, for example, be working for a specialty group, a GI group, looking at lots and lots of GI biopsies or urology biopsies. You can be working for a corporation. Who is your boss? I got to tell you that there are insecurities. What I do for a living is an independent practice. So we suffer the insecurities of small business. I have to contract. That means do I get along with the administration in my hospital? How does the administration view private practice? It can be confrontational or it can be a delight. I got to tell you that medicine is a hurly-burly business and you've got to be prepared to operate in that environment. You may feel that having a secure employee position is really what you're after. You don't want to deal with all that stuff. That's okay. If so, then it may be that one of those situations where you're working for multi-specialists may be more attractive to you. Next slide, please. So the other thing I've got to tell you is that you're going to be presented with a contract of some description and probably nothing in your training has prepared you to deal with these things. I've seen people get into various difficulties over the years. There's always going to be a paragraph inserted in there about non-compete. So if I decide I don't want to be working with this group, what happens? Can I move to the partnership next door down the street? Or do I have a geographic restriction that I have to move two states away or something like this? You need to know at some point when you're prepared to become a partner, what does that take? Am I going to be prepared to buy my part of a commercial laboratory? Is it just going to be, for example, buying your share of accounts receivable? Or are you going to have to buy a part of a multimillion dollar laboratory with a lot of laboratory equipment involved as well? And you need to make sure at some point that there is in fact a defined process that this is how you get to be a partner. Just as you're looking for tenureship in academia, ultimately you want to be a partner. You want to have your lion's share of the rewards of the partnership. You don't want to be a second tier employee forever and a day. Finally, you've got to look at the practice itself and decide, is this a viable business opportunity? Will they provide enough of my work for me to stay busy and happy? Is the hospital interested in the cancer service line? When I looked for a job, I made sure that there was a linear accelerator in the hospital. So I knew they had a physical commitment to cancer care. I asked to see two weeks worth of OR schedules. So I knew that they were actually cutting out things that were of interest to me. I have also seen groups that failed. They lost their contract. So there was one opportunity I had that had I joined that group. In a year after that, the contract was lost and everyone had to uproot and go find themselves a new hospital. So you need to make sure in fact that the group is a secure location. Next slide. So the other thing is, I got to tell you that at the end of five years of hard work, you've learned the basics of pathology, but there's probably no more delayed adolescence in the world than being a pathologist. You're never allowed to actually make a decision until the very end of the day. So you've been watching other people making these decisions for years, and suddenly you're going to switch to the other side of the microscope and you're expected to be the one that says, yes, this is cancer. Next slide, please. Not, no, that was back to the previous slide, please. Thank you. It's important that you're not dumped in a 200 bed hospital by yourself as a newbie. I think that you need to be in a situation where you can have support on a daily basis from experienced partners. So that's just something you need to be aware of. It will depend from position to position how much support there is. You may be joining or looking to join a 30 man group, or you may be looking to join a two man group. Your demands placed on you are going to be very different in each of those situations. And finally, you have to realize that all of a sudden you're going to go down to the frozen room. There's not going to be a histotech cutting frozens for you or a pathology assistant necessarily. You may have to do a few of the physical tasks of pathology yourself, including on up to autopsy evisceration. So you need to make sure that you've got the mechanical skills necessary to perform your job. In addition to that, you know, you can't simply pay lip service to clinical pathology responsibilities. You're probably going to be asked to take over one section of the laboratory. You're going to need to know, you know, how to perform flow interpretations or examine bone marrows, et cetera. Next slide, please. So aside from what you're going to be asking me, you need to know what am I going to be asking you and what am I looking for? Well, it's very important that you're not simply a guru of frozen sections in microscopy. You've got to have social skills. You know, I'm a small businessman and part of small business is generating goodwill, goodwill in the medical staff. You've got to have successful interactions. You've got to deal with pathologists well, but not just that, you've got to deal with lab techs well, not just that, you've got to deal with medical staff well. Some of them may not be the easiest individuals to deal with. You've got to smile when you don't have the instinct to smile and you've got to find solutions that find a worthwhile solution to the questions that they're asking you. So generating goodwill is absolutely a vital role to me. It's not just a matter of disappearing into your office and signing out surgicals. You've got to be outside that office in the hospital itself, making your presence known. So what am I personally looking for in a candidate? I want to make sure that they've got the horsepower necessary to do the job. So I'm looking for their class ranking or the AOA or some such. I'm really not looking at what medical school you went to so much as I'm looking at where did you do your residency? Where did you do your fellowship? Where was the last stop that you trained? I'm looking for someplace that's nationally known that has a high volume. So I know that you presented with lots of funny looking things and you've learned how to recognize funny looking things. I don't expect you to be a finished product. I expect you to have good knowledge base. Next slide. So slide tests. People vary on their reliance on slide tests. If I give you 30 slides, I'm not sure that tells me that you're going to exercise good judgment. I'm more interested in sitting down across from a double-headed scope and listening to you about how you're going to work up this funny looking slide with maybe 10 cancer cells on it or at least you think they're cancer cells. Is this definitive or is this suggestive? How much technology should I throw at that slide? Am I going to do 15 immunostains or am I going to call this, I can't tell. I'm looking for maturity. I'm anxious to avoid people that are showboating and trying to be arrogant about their knowledge base. I mean, it's very important that we exercise responsibility and I'm looking for that judgment. I've found that people that train others are always very candid and honest in their recommendations when I ask them about a candidate. Next slide. Finally, I'm looking for attitude. I mean, you have to realize that what I'm doing is I'm going to share my salary with you. So it's very important that you convince me that you're going to be a hard worker. I want to make sure that the person next to me is pulling on the award just as hard as I am. And with that, it's very important that you don't turn me off. What are the things that really turn me off? I don't want to hear someone asking how much time off is provided. What's the starting salary? What's the starting salary? What are the required hours? Required hours are until the job gets done. That may mean when the sunlight goes down. Finally, well, one of my newest partners suggested, by the way, there seems to be this urban legend that you've got to have two fellowships if you really want to be a candidate. And from his perspective, that wasn't true. And I can tell you from our perspective, it's not true. I'm looking for some kind of subspecialty because we're only a six-man group. If you're a 30-man group, you may be looking for a full-time neuropathologist. I can't afford that luxury. You're going to have to be doing neuropath. You're going to have to be doing dermpath. You're going to have to be doing cytology. But yes, it's important that I have someone who's particularly expert in one particular area. We, for example, have people with cytopathology fellowships and heme path fellowships. They're very helpful. One fellowship probably does the job. That's what I've got in a nutshell. I'd love to talk to you more about it, but there's simply not enough time. Thank you so much for this insight too. As you can see, three totally different practices setting. They all have a lot in common, but they also have something very particular about that group. So now that if you get a job offer now, so the next person you're going to interact is going to be a HR person. So we are inviting my colleague Ms. Carol Ann Herman from Moffitt to talk about the onboarding for new attendings. Next slide, please. Carol Ann is currently the department administrator at Moffitt Cancer Center in pathology. She's very experienced in healthcare executives with a history of working with the health industry for many years. And she has onboarded, Carol will tell us how many people since she arrived in Moffitt, and you will really enjoy her insight. So Carol, please take away. Thank you very much, Dr. Bui. I bring a unique perspective to the group. I started as a medical technologist, then elevated to laboratory administration. Then I did hospital administration, then I did laboratory compliance, and now I'm back to my roots in the laboratory as a department administrator. So I'm one of the individuals that you would interface when you're trying to secure a job at our facility. So with your job search, the good thing about this information is it's timeless. So I know we're targeting fellows going for their first job, but as you heard all throughout this talk and what you'll hear information from what I'm providing, it will also be valuable to you as you work through your career. So just some highlights. When you're looking for a job, you wanna start early. The process is pretty long. There's a lot of documentation, a lot of steps to it. If you're a fellow coming out in the spring, we recommend that you start in the fall for your search. If you have not started, no better time than the present to get rocking and rolling. When you're searching for a job, of course you wanna take a step back and decide what are you interested in? You've heard really good information today about academics, private practice, reference laboratories. What's of interest to you? What do you wanna go for? How you can look for those jobs, various journals. Professional organizations are extremely valuable as just as FSP. As far as networking, job boards, word of mouth, LinkedIn, social media often has or always has jobs posted. A good source of information. Utilize your resources. So as you are in your fellowship, you have program directors, you're building colleagues, you have friends, you have family. Listen, listen to what is out there and what might be of interest to you. There's nothing more important than mentors. So I spend a lot of time mentoring master's in health administration students to prep them walking out to what we call the real world. So similar for our fellows, look for a mentor, look for someone that can sit with you, talk with you, coach you. No better time now and in your future as you progress in your career to network. As you look for jobs, you likely will submit a lot of applications. So my advice to you is to remain positive, patient, persistence in a good way. You wanna make sure that you remain courteous and professional. So your main points of contact when you are applying at different facilities are your human resources person, often called a talent recruiter, talent advisor, and then someone as myself, that's a practice administrator for the pathology group. Next slide. So as far as application materials, you will have to gather quite a few things. The bread and butter is your CV. So as far as format, there's not any one prescriptive format or content. There's suggestions and you can look at different professional organizations, or if you're applying for a specific industry, they may have a format that they want your CV in. My recommendation is that you make sure that it's crisp and clear. It has a nice visual ability and not only content. You have to remember that you're one of many applicants for a particular job. So you want your CV to stand out. A cover letter. Some organizations will ask you for a cover letter. If they do, I recommend that you do that. You want to tell them who you are, why you're interested in the job. I'd also recommend personalizing this cover letter to each position that you're going for. You want to let them know why you're the best for that position. In that cover letter, if you're mentioning any contacts that you have at that organization, make sure that you've let that contact know so they're not blindsided by a call from the organization. You'll have an opportunity to do a position application, always online. Must be accurate and complete, so please take your time to do that. Again, if you're listing any references, make sure that you're asking that person before you list. Very important. Assessment tests. Some organizations do a written test or look in at your personality, want to see if you fit in by doing a test and on paper. And then letters of reference and recommendation. You may not be asked for this right up front, but as the process progresses, you certainly will be asked for letters of reference and recommendation. Next slide. So when you go through the interview process, again, it's going to be what you are going to consider long and labor-intensive. You're going to interface with many individuals. I've already mentioned human resources will be your friend. As you have questions, as you go through the process, they're your point of contact. One of the things that I recommend to the healthcare administration students that I'm working with are mock interviews. No better time than to practice. So whether it's with a fellow that you're working with or your program director, again, a friend, a family member, just sit down and practice. You want to be succinct when you're asked a question. So have pretend questions tossed your way and just take a run of it. Do your research about the practice or institution before you interview. I know that sounds back to basics, but it's very, very important that you're familiar with the organization because you're going to be asked what you know about the organization. Most interviews start out virtual and then they flex the onsite so you can see the lay of the land, the area, the town that you're going to be in or potentially be in. Assessment tests, this was mentioned earlier by one of our panelists. A slide review potentially could be part of your interview. You might be asked to do a presentation. In our organization, it's a presentation of your choice. So we know that you are good clinically. We want to make sure that you can connect personally and by doing a presentation, that's the best of both worlds because you're telling us how much you know clinically and then also how you can present the information. As you go through the interview process, it's definitely a two-way street. The organization is looking to see if they want you and you're also looking to see if you want them. So you definitely want to learn about their benefits and ask questions. As our panelists already mentioned, you don't want to come hot out of the gate asking how much am I going to get? You want to reserve that for a later conversation when you know that the organization is serious about you and you're serious about them. Next slide. So when you are selected for the position, which is great because it's a lot of steps that you're going to go through to get to that, you're going to get an offer letter agreement. As mentioned, there's going to be a lot of legal mumbo-jumbo in there, but some of the nuts and bolts of it, it will mention your position details, such as your title. In our organization, it'll talk about how much time you'll be doing clinical, how much time you'll be doing research. It will have salary in there. Word to caution is it's not apples to apples from organization to organization. So each organization has a base salary, but many organizations have what they refer to as total cash compensation. So you want to look at your base salary, any incentives that you have an opportunity to obtain, what is the merit increase process at that organization? So again, it's not apples to apples. So if someone tells you, oh, you're going to get X thousands of dollars per year, make sure you understand what that is. Is it just my base salary or is that base salary and any kind of incentives? In the offer letter, if you're offered a relocation reimbursement, it'll spell that out as to how much. And then also in your offer letter, it typically tells you how much you would get per year. So you could go to seminars, buy reference materials, books, that's typically spelled out. Next step in the process would be, the organization would look at your reference checks. They're going to do a background screen. They're going to do a drug screen, credentialing as was mentioned earlier. That typically is the longest part of the process. So sometimes it takes two to three months. That usually aligns well if someone is relocating because that usually takes two or three months for you to come to the new town, figure out where you're going to stay, if you're going to rent, if you're going to buy. And then of course, you're going to obtain the state license for that specific state that you're going to. So, important to ask questions, definitely a two-way street, be patient, utilize your resources. Again, HR is going to be your partner. The practice director will be your partner and they'll help you navigate. You'll meet lots of individuals during your interview process. You'll meet your peers, your leadership, your colleagues. This is your time to shine. You want to make sure you have an elevator speech that you can encourage the organization that you're the one for the position. And congratulations on getting hired. I'm looking at the positive thing, but it's exciting to navigate your first job and then all throughout your career, you're going to experience the same cycle. Hopefully not many cycles. Hopefully you'll stick around in one position and grow into that and learn more. That's it, thank you very much. I appreciate the opportunity. Thank you, Kerri-Ann. So now we have heard all our panelists from their personal experience and their perspectives. So we're open to questions and answers. Please, I'd like to remind everyone, this is a webinar format. So your opportunity to ask question is by typing it in in Q&A session. And this is going to be reported. So later on, the live attendance will get a CME. The rest of the people will be able to review this and listen to this and watch this in the future as enduring material. So the first question and this towards academic medicine, ask Dr. Masin-Ngai, can you please explain where does clinical instructor fits? The second question is to private practice. So we're going to ask Dr. Masin-Ngai to answer the clinical instructor question first. Yeah, just briefly, it means different things to different institutions, but basically it is a time limited position that is an entry level position after training that's meant to launch the candidate towards an academic career without actually being in a formal academic rank. These aren't available at all institutions. Conversely, some institutions say Harvard use them quite often. And it's almost considered like to be the lowest level of academic rank. They generally are a lower salary than an assistant level position and they come with a teaching responsibility. Some of them even come with a time where the person in the clinical instructor position can get additional education in a non-accredited fellowship format, but participate in education activities for themselves. So I hope that clarifies it. But if anybody has any questions, I think our emails are going to be somewhere located and you please feel free to email me individually. Thank you. So the second question is to do small group practices, hire CP fellowship trained folks or only AP fellowship trained are desirable. So- So I guess that's directed toward me. Yes. Well, interestingly, even though I'm the director of my laboratory, I'm an AP only. So College of American Pathologists has seen that this crazy thing might happen. And so it's certainly possible. In fact, it happens in my laboratory that I delegate responsibilities to other members of my pathology staff to supervise chemistry and blood banking and all of those necessary things that we do. In the history of our practice, once upon a time, we had a CP only pathologist as a matter of fact. So we had one guy who was an AP only, sorry, and one guy who is a CP only, and it actually worked quite well. And this is only in a six man group. Now, if you're a 30 man group, it's much easier to do that. Obviously, and have someone who's totally devoted to blood banking or microbiology, whatever it is. I will tell you that, yeah, we see that as an asset. I think that it's important as a pathology group not to pay simple lip service to clinical pathology. If you want to justify producing clinical pathology bills, you better be providing clinical pathology expertise. So I think clinical path is a great fellowship to have. I don't necessarily have to have all of my pathologists as experts at diagnosing sarcomas. If you can recognize this as a sarcoma, I'd better get help. That's good enough for me, just as long as you recognize it's a sarcoma and you seek help. Very good. Thank you. The next question is also for academics. Dr. Messonnier, what are the ups and downs of choosing tenure over non-tenure? What would prompt someone interested in academic to choose non-tenured over tenured? One thing is that not all institutions even have a choice, but if you are presented with a choice, generally you would choose tenured if you are going to consider... Most people that choose tenure do it if they are a heavily, like a funded researcher or more heavily involved in research because the bar to be given tenure, when it actually is associated with a salary guarantee, the bar is pretty high to actually achieve the tenure. So you want to make sure that you're not So you want to make sure you can actually meet that bar. So you have to basically be very involved in doing research that would be successful at achieving that. And just like Carol Ann's excellent presentation pointed out, there's a lot of information that's thrown to you at the beginning of when you're embarking on an interview at an institution. The guidelines for achieving promotion and achieving tenure are readily available and can be shared with you at any time. And they're pretty clear about and prescriptive about what is looked for, for being successful at this. Yeah, I appreciate and agree with Dr. Messina's answer. I just want to add, there are some faculty that love clinical practice, they love teaching, but they are not very motivated in research. They don't want to hold to a higher level, have to constantly publish or go out and teach national meetings. So they will sign on to academic, but non-tenure. So they can continue to do the clinical practice, teaching locally, multi-hyperscope teaching without having to publish, but not every institution has that opportunity. So before you look for a job, you have to ask, is that possible? So another question is asking about after you are hired, what's the credential, like an AP director, Dr. Messina, what are you checking on your new faculty to make sure they will transition? Because if there is a problem in the first three, six months what will happen as far as the diagnostic ability? This probably counts for most, this probably applies to Dr. Cantrell, Dr. Borkowski. We do assessment of the pathologist performance by a peer review process. We will get a significant number of their cases and QA their performance on them. And that is, you know, if there are significant problems, then we determine whether it's remedy B, remedy B all whether we can fix it or whether we can't. This has not happened in my career, but it can. I don't want to go back to tenure too quickly to say what I gave for tenure was the classic definition of tenure. Some institutions, including Moffitt use it slightly differently and it doesn't come with this quote, unquote salary guarantee. So just like getting informed about academic progress and promotion, make sure you get the definition of tenure at the place that you're going to, you know, considering employment for. So for credential, every two years you will reapply for your credential for your hospitals and all that. And then that also involves people write your letter of recommendations, things like that. Usually it's electronic process. So Dr. Cantrell, Dr. Bukowski, do you add anything? How do you, when you onboard your new faculty how do you check the quality of their work? Mary, you want to start? Sure. We, we have, okay. So we do have a very strong QC program. To all the pathologists. So this is number one, the quality is number one. Also the overall performance, you know, the relationship with the commercial team, with the clients, the consultation performance, things like that, add up. So that's pretty much it. Well, I can say from our perspective, you know as a six man group, we're up and down one hallway together. So it's impossible for anything to take place in this hallway that all of us don't immediately know about it. And as chief of the group that also involves being chief complaint officer. So every time a gastroenterologist calls and says can you look at that liver biopsy from Dr. Jones? I don't trust that liver biopsy results. And I apologize, Dr. Jones, who actually is one of my partners, I'm not impugning his hepatology abilities. But the point is that you get immediate feedback without even having to have a formal review process. And of course you're required to have a formal review process as part of the CAP accreditation. But it's generally immediately apparent if someone has a weakness. Typically what we'll have is a one-year trial period in our group where we make sure that your knowledge base is satisfactory and your judgment skills are satisfactory. And at the end of that, we pretty much commit to you moving forward into a partnership track. If there's a problem, we will sit down and tell you generally before that year is up and say that maybe you need to go to a meeting and bone up on your cytology skills or maybe you need to improve your interpersonal skills. So we're not bashful about telling a partner that we see a limitation here, you need to address this. It seldom comes to saying you're just not one of us. That's not taken place to date. We have had to take some remedial actions along the way until we're satisfied. So, I mean, it's an oversight but it's certainly a general oversight and it's meant to be a constructive oversight. Yeah, very good. So we're at the end of the hour. Dr. Jim Tsai, our immediate past president just want to say a final word. Dr. Jim Tsai, well, you don't, because you're, can you type in your comments? Because this is not a live. All right. It looks like he subsequently typed in congratulations. Oh, okay, very good, very good. All right, so thank you everyone. This is really wonderful. We still have more questions, but the previous slide, let's go back quickly. That's for you to claim CME. Yes, the evaluation will send it to whoever registered. Next slide. It's a promotional material. Please sign up to the FSP summer meeting. This QR code is specially made for this group of attendees. You can just take a cell phone picture or just hover over and get the registration down. The reason we're talking about now because you can get an early bird rate comparing to the onsite registration, you save about $100. So please join us. And one last time, a round of applause to our panelists. I learned a lot from this, and I thank FSP give us this opportunity to build our community and provide this very timely and a very informative peer-to-peer help. With that said, thank you everyone. Please take care and be well. Bye-bye. Thank you.

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