Job Negotiations in Academic Medicine: Building a Competency-Based Roadmap for Residents and Fellows

J Gen Intern Med. 2019 Jan;34(1):146-149. doi: 10.1007/s11606-018-4632-2. Epub 2018 Oct 1.


Negotiation skills are critical to career success, yet many physicians feel ill-equipped to negotiate for professional opportunities. Enhancing competencies in this arena may be especially critical for women and underrepresented minorities to reduce disparities in compensation and resources that begin upon entry into the workforce as junior faculty. This perspective offers a comprehensive overview of negotiation strategies and the job search process for individuals finishing medical training and seeking first-time employment. First, we extrapolate lessons from clinical medicine to provide a negotiation roadmap for residents and fellows. We use both a clinical and an employment scenario to illustrate the concept of principled negotiation in which negotiating partners elicit each other's values and interests and identify options for mutual gain. We then describe approaches to seeking and negotiating job opportunities and discuss typical timelines for these activities. We supply a list of professional needs to consider before a negotiation begins and introduce the concept of a best alternative to negotiated agreement to help ensure essential requirements are met in a final employment offer. Finally, we explore the utility of third-party assistance and published benchmarks and offer best practices for negotiating.

Keywords: career advice; career development; negotiation; pay disparity; women in medicine.

Publication types

  • Review

MeSH terms

  • Attitude of Health Personnel*
  • Career Choice
  • Clinical Competence*
  • Education, Medical, Graduate / organization & administration*
  • Faculty, Medical / organization & administration*
  • Humans
  • Internship and Residency / organization & administration*
  • Job Satisfaction*
  • Negotiating / methods
  • Total Quality Management / methods*
  • United States