ABSTRACT

Background A minority of Pulmonary and Critical Care Medicine (PCCM) graduates pursue careers in academic medicine. Although compensation is only a portion of the career decision, job negotiations remain shrouded in ambiguity and inconsistency. Additionally, while role-level salary tables exist through the Association of American Medical Colleges (AAMC), to our knowledge there is no resource that includes important non-salary information such as start-up packages, full-time equivalent (FTE) breakdown, and bonus ranges.

Objective We sought to describe key components of first PCCM academic job offers for both physician scientists and clinician educators, including salary, start-up packages, non-clinical FTE, and bonuses.

Methods An electronic survey was distributed via a snowball method between May - June 2025. PCCM graduates between 2020-2025 who accepted a job in academic medicine were included. Mann-Whitney Wilcoxon tests were used for ordinal comparisons. Qualitative analysis of free text responses was performed with a social cognitive career theory framework.

Results There were 60 respondents who provided information about 103 job offers, with 50% (14/28) of physician-scientists and 66% (21/32) of clinician-educators reporting more than one job offer. Physician-scientists received lower salary offers compared to clinician-educators (respective median ranges: $150,000-$199,999 vs $250,000-$299,999, p<0.001). 35.7% physician-scientists (10/28) received a career development award prior to negotiation, which was associated with a higher start-up package offer (p<0.05). For all clinician-educator jobs (n=59), 42.4% had non-clinical FTE in the initial offer. Many respondents commented on the lack of negotiating power.

Conclusion PCCM physician-scientists and clinician-educators experience wide variability in their initial job offers. Recognizing differences is essential to improve transparency in job negotiations in academic medicine.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

NEI is supported by NIH NHLBI K23HL166783. PGL is supported by NIH/NCI K08CA270383. CAG is supported by NIH/NHLBI K23HL169815, a Parker B. Francis Opportunity Award, and an American Thoracic Society Unrestricted Grant. The funding sources did not have a role in the design, execution, or prior review of the study or in the data presented in this manuscript. Opinions expressed in this work do not necessarily reflect those of the funding sources.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Northwestern University IRB reviewed the study questions, design, and consent language and deemed this study exempt (STU00223858).

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Footnotes

Funding: NEI is supported by NIH NHLBI K23HL166783. PGL is supported by NIH/NCI K08CA270383. CAG is supported by NIH/NHLBI K23HL169815, a Parker B. Francis Opportunity Award, and an American Thoracic Society Unrestricted Grant. The funding sources did not have a role in the design, execution, or prior review of the study or in the data presented in this manuscript. Opinions expressed in this work do not necessarily reflect those of the funding sources.

Disclaimers: None of the authors have relevant financial disclosures to this work.

ATS Subject Category List: 2.7 Professional Education/Training/Certification

The article has a data supplement.

AI disclosure: CAG used GPT4 to help draft and reformat the survey questions and reword some text after initial drafting; she used Claude for assistance in programming; she has reviewed/edited all output and takes responsibility for the text.

AbbreviationsPCCMPulmonary and Critical Care MedicineFTEFull Time EquivalentCDACareer Development AwardAAMCAssociation of American Medical CollegesAMAAmerican Medical Association