Whether you're contemplating your first practice or considering a job change, this conversation offers invaluable guidance from those who've successfully navigated multiple transitions.
AOA Emerging Leader Aaron Brandt, MD, had a discussion with Antonia Chen, MD, FAOA, and Clayton Nuelle, MD, about transitioning jobs early in your career, and how to decide what your non-negotiables are for your workplace environment.
What drives these transitions? As our guests reveal, it's often a combination of "push factors" moving you away from your current situation and "pull factors" drawing you toward new opportunities. Despite the statistic that over 50% of surgeons change their first job within three years, these transitions are rarely discussed openly, leaving many physicians feeling isolated when considering a move.
Both physicians share candid insights about creating personal lists of "negotiables" versus "non-negotiables" when evaluating both current and potential positions. Both surgeons advocate for transparency with leadership when considering opportunities and leveraging mentorship networks to find positions aligned with your evolving career goals. They also discuss practical considerations like understanding contract terms around tail insurance, signing bonuses, and trailing collections before making any move.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 2 (00:22):
Welcome to the AOA podcast.
My name is Dr Aaron Brandt andin this episode we're going to
be discussing changing jobs inearly career.
I am joined by two greatfaculty today, both members of
the AOA.
Dr Antonia Chen she is aprofessor and chair at UT
Southwestern for the orthopedicsurgery department, a hip and
(00:43):
knee surgeon by trade.
Southwestern for the orthopedicsurgery department, a hip and
knee surgeon by trade.
And Clay Nolley, sportsmedicine associate professor,
newly associate professor at theUniversity of Missouri, and
today's podcast is focusedreally on changing jobs, which
is not something that we talkabout very often.
But both of these faculty willbe able to contribute their
(01:03):
views and please feel free tointroduce yourselves and tell me
a little bit about your pathsand kind of the process that got
you to where you are now.
Maybe we can start with Dr Chen.
Speaker 1 (01:15):
How long do we have?
I'm just kidding.
Speaker 2 (01:18):
It's like the little brief, because we will kind of
take it from there.
Speaker 1 (01:22):
So I started my job at Rothman Institute.
I did my fellowship at RothmanInstitute and stayed there as an
attending and my first jobtransition was to Brigham and
Women's Hospital in Boston.
And then my second jobtransition, just this past
September, was from Brigham andWomen's Hospital down to UT,
southwestern.
Very different reasons fortransitioning and all very
(01:42):
different practices.
Speaker 2 (01:43):
Yeah, yeah, very much so.
Speaker 3 (01:45):
Kind of similarly.
I did my fellowship at MizzouUniversity of Missouri in sports
medicine and stayed on asfaculty, but in an interesting
kind of setup where I was notstraight academic faculty, I
actually operated and sawpatients primarily at an
affiliate community hospital.
So it was almost more like ahospital employed position in
terms of like kind of makeup ofthe practice and like kind of
how the situation was for acouple of years.
(02:08):
And then we moved to Texas andI was actually in private
practice.
I'm in a very big, well-runphysician owned private practice
with physician ownership ofsurgery centers and all that
goes into that for four years.
And then we moved back toMissouri and now I am very
academic and strictly atacademic institution and the
mothership, so to speak, if youwant to call it that at an
(02:28):
academic practice and a sportsmedicine practice affiliated
with high level team coverageand all of that sort of thing
and we can get into some ofthose types of things.
But then so I've kind of goneback and forth from almost
really community kind ofhospital employed, so to speak
to big private practice.
Now it's like straight academicpractice.
Speaker 2 (02:52):
Yeah, I mean that's a lot.
Yeah, as someone who's kind ofjust getting going and I did
just go through my own jobtransition it's a lot to process
to see that both of you canhave been moving around.
But I guess start from Dr Chen.
Maybe what led to kind of someof those transitions?
Was it typically just careeradvancement?
Was it anything in particular?
Speaker 1 (03:11):
I think it's a combination of things.
I think, when it comes to jobtransitions, you have to look at
a few things One, you have tolook at yourself.
Two, you have to look at whatyou want in your life.
And three, you have to look atwhat your surroundings are.
I remember starting off at theRothman Institute and it was
great because I was a fellowthere.
But it was also I was a fellowthere, and so one of the things
I learned quickly is thatbecause you're a fellow at a
(03:32):
location and you transition toan attending doesn't mean
everyone treats you like anattending.
And that's one of those hardtransitions to make, because you
know you're familiar with thepeople.
That's really nice.
You know exactly whereeverything is, you know where
the bathrooms are, you know youknow the research team, you know
the clinical team and I learneda lot from being at Rothman
Institute, obviously being aprivademic place.
I learned the business ofmedicine, I learned what I would
(03:52):
like to open up almost like asurgery center that they did and
they started operating out of.
So a lot of the important lifelessons that I learned about
running a practice becoming busy.
Building a practice was reallygood at Rothman Institute and
you know, when I was at RothmanInstitute, it's one of those
things where I think most of usdon't expect to leave your first
job.
I didn't expect to leave myfirst job.
(04:13):
To be perfectly honest, I waslike I'm not going to become a
statistic they say what 50% ofpeople leave within the first
three years and I became astatistic.
So it's just one of thosethings where my interests were
to grow more clinically and Ididn't have that opportunity
there.
I also wanted to grow moreindependently in a research
fashion and I didn't have thatopportunity there.
(04:33):
Right, like I.
You know learn how to run anefficient practice, run.
You know multiple rooms, youknow staggering, doing a good
job with that and able to takethose skills to a different
location.
But I realized that after threeyears that it wasn't a good fit
(04:54):
for me in the long term.
But realizing that is a reallyhard one.
You have to be honest withyourself, honest with your
surroundings and also peoplethat you work with I mean, these
are mentors of mine, right thatI had gone through fellowship
with and to say, hey, I think Ishould go somewhere else was a
tough decision to make.
Easier to talk about it nowthan it was at that time.
But everything happens for areason.
Speaker 2 (05:13):
Yeah, I like that.
It seems like there's achallenge with that.
I think you clearly would haveput in plenty of effort to keep
those relationships and buildthat structure at your location.
So I think that was probablyvery tough.
I totally get that.
Felt the same way about that,dr Nolley, we had talked about
just briefly before.
How are these jobs coming about, or how are these opportunities
(05:36):
coming about?
And I think that's alsosomething that everyone wants to
kind of figure out.
If it's not working, or isthere something that's supposed
to be better for me out there,even if I'm not looking?
What are your thoughts on that?
Or how did how did that happenfor you?
Speaker 3 (05:49):
Yeah, I mean I think you know you start talking about
job changing or people changingjobs and stuff.
There's really probably kind oftwo kind of scenarios in
general.
There's a lot of scenarios,obviously, but two kind of main
scenarios.
One is I'm not happy where I'mat, or this is not a good
situation for me, or I need todo something different.
And then another one is maybeOK, maybe I'm OK here, or maybe
I am happy here, but maybethere's potentially a better
(06:11):
situation, or maybe I'm evengetting recruited to somewhere
else and I could, you know, asDr Chin said, maybe I can rise
clinically or maybe I can riseprofessionally or, you know, in
leadership capacities or thingslike that, and those can be
similar, but they can also betwo very separate things.
I think the first one isprobably encountered a lot more
in very early career surgeons.
I mean, I think you know, Ithink we've all seen the
(06:31):
statistics from AAOS, you know Ithink it's over 50% of you know
, early career surgeons changetheir for after their first jobs
, right?
You know Dr Chin mentioned Idon't want to be a statistic,
that's the statistics he'sreferring to right?
And so I think those reasonsare probably most commonly
because either the people aren'treal happy in that first job
that they chose, for whateverreason that may be, or they
(06:52):
think that there's definitely,once they get into practice,
they realize their practice ismaybe different than what they
thought it was going to be andthey realize that there may be a
situation that's better forthem or better suited for them
or just gives them differentopportunity.
I think more, once you get tomid-career, oftentimes people
are pretty established andpretty comfortable in their
practice but there may be anopportunity that launches their
career to the next level or aleadership position elsewhere,
(07:14):
or just a general situationwhere they're being recruited to
another institution.
So I think those are twoseparate scenarios, but
certainly for the early careersurgeon or the early career job,
I think people choose theirfirst job out of practice for a
ton of different reasons, right,and sometimes those reasons are
good ones and sometimes thosereasons may not be as good ones.
You know, certainly we hearwhen we talk to our residents
(07:35):
and fellows and we kind of tryand coach them and educate them.
We try to educate them.
That number one, first andforemost.
It's not always just all aboutthe money, you know.
I think that sometimes the youknow the elephant in the room,
but it needs to be saidsometimes because certainly we
all understand people have debtand people have financial issues
and things.
But sometimes people choosejobs based on solely financial
(07:55):
scenarios and they don't thinkabout their actual practice,
life, their home life, all ofthose things that go into that
and the actual clinical practice.
And then sometimes they get ina situation where maybe it's not
super tenable or their clinicalpractice isn't what they want
and that's why they changed.
But sometimes it's just ascenario where people take the
first job that they feel likethey can get and then it doesn't
end up being exactly what theythought it was going to be or
(08:18):
going to be promised to them.
So I think you know there's alot of different reasons that
people change jobs, probablysomewhat based on where they are
in their career or where theyaccept a job or what the
location looks like.
But those are a lot ofdifferent types of scenarios for
sure.
Speaker 2 (08:31):
Yeah, yeah, and this is exactly kind of what the
conversations tend to be, justwith everybody is the why that
first job is always hard, and sothis is kind of the follow up
to the one that we did with theemerging leaders, based on
starting practice and doing that, I guess from your perspectives
, having changed multiple times,what opportunities or how do
(08:52):
you advise kind of the emergingleaders and those early surgeons
to optimize their currentsituation, to try not to be that
our departments, but sometimesit doesn't work, but is anything
(09:16):
you take from your priorexperience that would help
people kind of optimize,advocate for themselves, things
like that.
Speaker 1 (09:24):
I think there's two sects of thought when we're
going through thisdecision-making.
One, you're talking aboutemerging leaders who are looking
for a job, and then emergingleaders who are currently in
their first job, and I mean wecan tackle both of them.
If you're looking for a job,clay really hit it on nail on
the head, right.
You have to understand whyyou're taking a job and then the
expectations of the job.
You know, one of the things Itell people to do when you're
(09:46):
applying for a residency orapplying for fellowship is make
a list of all the things thatyou say are non-negotiable, that
you have to have in a program,and then those things that are
negotiable but are nice to have.
I say the same thing is truefor a job right Now.
The hard part is we don'talways know what we want when we
first start out, right Likewhen I first started out, I
thought I really wanted to do alot of research.
So when they offered me acontract of two days clinical
(10:09):
and three days research, I waslike okay, I can work with, do a
lot of clinical, I want tooperate, I want to be in, I want
to be in that setting.
So you know, I took as muchcall as possible.
I was doing cases on nights andweekends, you know, I was able
to not get out of the park, butI had to work at really odd
hours to get that Cause I didn'thave dedicated OR time and I
picked up more clinic time,those sorts of things.
Right, but I had to claw, Ihave to admit, right, people
(10:33):
like to be, you know, given thattime and you can build it and
things like that.
And so when I went to my nextjob, I made sure that I had a
lot more clinical time.
Right, it was almost allclinical time, but that was my
personal choice and I didn'tknow that about myself, right?
So if, when you're starting ajob, know thyself as much as
possible, make a list of whatare negotiables, non-negotiable.
If location is non-negotiable,put that on the list, because
(10:54):
that will potentially restricthow many places you can go to
Academic versus private, allthose sorts of things like that.
But there's other things thatare non-tangibles, that people
don't necessarily think about,things like mentorship or having
senior partners, you know, orbeing on an island by yourself
versus having other peoplearound.
But on the flip side of things,having 20 arthroplasty partners
(11:15):
versus you know two.
Those are things that you knowI don't really think that I
thought of through when I wasgoing through the process and
then in the process of itself Ithink, when it comes to
switching jobs, once you're inthat place, how to make it
better Again, go back to thatlist of negotiables
non-negotiables.
Are things changeable, right?
Am I able to get mentorshipfrom another attending in the
same hospital, even if they'renot part of my practice?
(11:36):
And if that helps me, thenthat's good, right?
Or you know, I actually wantmore research time, I want more
admin time or something likethat.
Can I negotiate that with mypractice and get that
compensated, right?
Is it a work-life balance thing?
You're like, well, I'm workingon nights and weekends but I
don't have OR time.
You know how can I leveragethat and get OR time so that I
have dedicated time?
So look at your situation andsay what would make me content
(11:59):
Nothing's going to make us happy, but what will make me content
in this job and what can I getfeasibly in that?
And then what are, again, thenon-negotiables that I can
attain that are actually reallyimportant?
And if that's unattainable inyour current practice, then
maybe you start looking atanother practice.
Speaker 2 (12:16):
I love that and, Tony , like content is such a good
word Like we want to beoptimists and we want to walk in
and just have these rosecolored glasses.
But I think that in thisprocess and in this career, it's
that's not how it works andthere's always going to be good,
there's always going to be bad,and just kind of weighing those
options and I love like yourlist.
I wrote them down like tips andI would recommend that to
(12:37):
everybody all the early surgeons, really anybody at any stage.
Have your list, revisit it,decide what's actually
contributing to the challengesthat you're doing.
Is this a me or is thissomething that can't be changed?
So I love that and I thinkcontent is.
We want to be happy, butcontent is a great goal.
(12:57):
But Clay, I guess follow up onthat, yeah, I mean she hit the
nail perfectly on the head.
Speaker 3 (13:03):
It sounds like we're going to be very similar,
antonia and I, in all of thisdiscussion, but that makes sense
with people who have changedmultiple jobs and experienced a
lot of things now, right, and soI mean, I mean, I think the
main tenet is exactly what shesaid and what you reiterated,
aaron there is no perfect job,right?
I mean, we all like to thinkthere is, but obviously we've
all changed jobs a couple oftimes now, so we can all pretend
(13:23):
to that and, truthfully, ifsomebody at a job that's
recruiting you or where you'regoing to, tells you that it is a
perfect job or there's nothingwrong with it, honestly that
could be a little bit of a redflag, right, because everybody
knows that nothing is perfect.
There's great things aboutevery place.
There's not so great thingsabout every place, and every
place has its warts.
Regardless of this or that,it's just a matter of deciding
what works best for each personand deciding whether or not
(13:45):
those warts are really big andreally difficult to deal with,
or they're really small andthey're just things that happen
at every hospital, right, and sothere's no perfect job.
It's a matter of just trying tofind the job that is the best
fit overall and the best waythat you possibly can and you
used a great word with content,and Antonio made a great point
that we tell our fellows inresidence too we call it a
Franklin T.
That's kind of like the oldschool method of what it is
(14:06):
right, but it's the exact samething Pertinent positives,
pertinent negatives we're allused to that in medical lexicon.
And so what are the things thatyou and I even tell our folks to
even stratify at another leveleven more?
So?
It's things that you absolutelyhave to have, things that you
would like to have, things thatyou absolutely do not want, no
matter what, and then thingsthat you think you probably
(14:28):
don't want but you couldprobably deal with.
So it's actually even kind ofstratified into four categories
and the absolute must-ves andthe absolute don't wants.
Those are absolutes, right, andshe mentioned one.
Maybe one is location for oneor the other in either of those
categories, right, Whether youwant to live in a big city or
you don't want to live in a bigcity, for example, or something
like that, or your family doesor doesn't, and then there's a
whole lot of the like I wouldlike to have and then I don't
(14:49):
think I want or I don't think Iwould like to have, and she
mentioned one for herself interms of research starting out
and then that changing and theones in the middle, the likes
and don't likes, those usuallycan change over time or those
may change as you get intopractice.
Or as you get into a practicethe absolutes usually don't
change or don't change or don'tmove one way or another a whole
lot.
So you can start with those andthat narrows your scope down
(15:12):
quite a bit potentially for somepeople from the start.
And then you start getting intothe likes and wants and don't
wants and don't likes and thenyou can really kind of start to
tease things out and narrowthings down even more based on
those individual factors.
I love that.
Speaker 2 (15:26):
Yeah, and I think that and those factors all
change.
I think that's the other thingthat just be flexible, because
there are things that you thinkthat you want and need that can
change as you work throughthings.
So that's part of kind ofgrowing and developing.
I tell people that with evenresidency applications that like
if you're seeing smoke get outthe fan, you know like you got
(15:48):
to start asking the questionsand pushing those buttons
because it's not perfect.
Speaker 3 (15:53):
So I like that.
I like that term.
I'm going to start using that,Aaron.
So I like that.
I like that term.
Speaker 1 (15:54):
I'm going to start using that, aaron, I like it.
Speaker 2 (16:00):
I'm full of them, awesome.
Well, the other things thatkind of come up with these
conversations is kind of likehow do I find opportunities if I
am starting to look?
Did either of you have thatlike to where you were, saw the
writing on the wall and justwere looking for this next layer
?
Or I think both of yoursituations sounded a lot of kind
(16:20):
of progression and good reasons, but any of the not so good
reasons.
Speaker 1 (16:27):
When I say leaving a job, I would look at the push
and the pull, you know.
Are you being pushed tosomething or are you being
pulled to something else?
Right, in an ideal world,everything's a pull, right?
Oh, this next opportunity isgreat, this is where I want it.
But in reality a lot of time ispush or a combination of the
push and the pull.
I was fortunate in that when Iwas at my first job, someone had
reached out to me at Brighamand said are you interested in a
(16:49):
position here?
And at the beginning I was likeno, I'm actually pretty happy
here.
But it depends what youquantify as happiness.
I think from a push perspectiveit was one of those things
where I was one of manydifferent arthroplasty surgeons
and where I was pretty saturatedwith arthroplasty surgeons, so
that made it not the greatest inthe world.
It also was an opportunitieswhere, again, I had envisioned
(17:11):
myself doing more of theclinical work and more of the
research work in that realm andit didn't feel like I could
achieve what I wanted to achieve.
I said, for lack of a betterterm.
So from a push perspective, itwas one of those things where I
was not necessarily getting thesame support that I thought I
would be getting and versuswhere I was getting a pull from
somewhere else.
They're like, hey, why don'tyou come up here and run our
(17:31):
arthroplasty research, forexample?
And again, from an academicstandpoint, that was a really
cool opportunity.
Now it's because no one wantedto do it, but that said, it was
something that was neat that Icould make it my own.
So the first time I was asked togo interview at this at the
Brigham, where I ended up goingto, I was like I'll check it out
(17:59):
.
And so I checked it out and Ididn't end up going there.
And the second time I checkedit out, the question I got asked
was this is like a guy asking agirl out for a prom date Like,
are you gonna say no to me?
Twice?
I was like, well, the timingwasn't right.
You know and that's the firsttime I checked was a year and a
half into practice and at thatpoint in time, like the boards
collection timeframe, that's,like, you know, one of those
things where it just wasn't agood time to move.
And so the one thing I dorecommend for anyone is it can't
hurt to check out other jobopportunities Right, even if
(18:20):
you're not necessarilyinterested in it at that time,
it can't hurt to look at them.
So there's, you know, some notpositive things and there are
some you know from being in thepush.
And then there's positivethings from the pool.
And I had to start from scratch.
Right, I had to develop a nameagain.
I had to.
No one knew me right.
And so to work and take thatprocess.
I warn people that takes,depending on the practice you
(18:42):
walk into.
If something's not wellestablished for you ahead of
time let's say someone'sretiring and giving it to you
that's three to five years, youknow.
So you can't expect to walk inand say like, hey, I'm going to
have exactly what I had before,my OS flash practice and my new
practice now.
So there are some downsides toit.
But just recognizing whichdraws you more.
Is it the pull that's drivingyou more, or is the push or the
(19:02):
combination?
Either way, then it's a signI'd say.
Speaker 2 (19:06):
Yeah, I like that my thoughts.
Speaker 3 (19:09):
Yeah, I mean, I think you know antonio mentioned
something earlier that I thinkis really vital and can help
when it comes to, like, changingjobs or looking into change
jobs, and that's mentorship andleaning on mentors.
You know, obviously that's onething that I think the aoa does
a great job of is developingthese mentorship programs, and I
would encourage everyone in theaoa to get involved in some
sort of the mentorship programsor the different types of things
(19:29):
.
Or, if you attend the aoameeting, attend some of the you
know some of the mentorshipprograms or the different types
of things.
Or, if you attend the AOAmeeting, attend some of the you
know some of the talks or someof the symposiums that the AOA
does on mentorship, because it'shuge and it can benefit you in
so many different ways, one ofwhich is what we're talking
about with connections, orhaving people that have
connections that can help you,and so just a brief example for
me.
So the reason we moved to Texasis because my wife was military,
and so she had a servicecommitment to the United States
(19:51):
Air Force, where she's going tobe a hand and microvascular
surgeon for four years in theUnited States Air Force in San
Antonio Texas and I was goingwith her.
I wasn't staying behind with,you know, with a family and
everything else but that meant Ihad to find a job in San
Antonio Texas.
And so and I, we knew nothingabout San Antonio Texas, never
even been there before.
So I reached out to a couple ofmy mentors, one of which was
(20:11):
one of my fellowship directors,and I said, hey, you know,
anybody in San Antonio that,like, would be willing to maybe
hire a guy, and sure enough, hewas really good friends with
Steve Burkhart, which is a namethat anybody that's done
shoulder surgery probably knowspretty well or read the books
and stuff.
And he linked me up with himand said this guy's a great guy.
Guy, you got to interview him,you got to talk to him, you know
, you got to take him all thiskind of stuff you know that
(20:32):
mentors do for you.
And then, sure enough, you know, after meeting with him a
couple of times, it worked outreally well, and so I was
fortunate to link up that way,but it really went.
It really went.
That simply is that you know,one of my mentors talked to one
of his good friends, who thenkind of linked us all up
together and made it all workand it ended up being a great
opportunity in a privatepractice in Texas.
(20:52):
And so I would just say, youknow, leaning on mentors or
trying to develop thoserelationships or utilize your
mentors or your connections thatyou have through organizations
like AOA and things like thatcould really help you.
You know, guide the job searchor guide, you know, to certain
positions that people, trustedpeople, can give you better
information about.
Speaker 2 (21:10):
Yeah, yeah, and that's something that I've
noticed through the process isand I'm going to throw out what
may seem like random commentsthrough this conversation but
authentic authenticity and beingauthentic as a person
throughout this process, nomatter what you're doing, is
huge, because that's when theopportunities really do come.
So those mentors, thosesponsors, those people are going
(21:31):
to be able to advocate for youbetter or help you find those
spots If you know at least alittle bit of what you want and
who you are.
And so that's why I've enjoyedkind of hearing your guys' paths
, because it seems like,regardless of whether it was a
push or a pull, theseopportunities came or these
changes came because of thosethings as well, and that's that
(21:52):
for me.
I just made that change myself.
It wasn't that I wasnecessarily looking, it wasn't
quite the right situation, but Ihave been very lucky to have
great, wonderful sponsors andpeople who have advocated and
pulled, which has been helpfulfor me, because I'm going to be
the first to admit I don't knowwhat I want.
I know a little bit of what Idon't want, and so that's kind
of how I've made decisions.
(22:13):
So that's part of the process.
I want to kind of work into theprocess of leaving.
And these are the hardconversations.
And, antonio, you're now chair.
I'm sure you've had to havethese conversations and we've
had them a few times now.
But how do we have theseconversations and do it without
hurting our situation wherewe're at, and doing it the right
(22:35):
way?
I guess, if there is a rightway.
Speaker 1 (22:38):
So everyone has a different path.
I would actually add somethingto the whole mentorship and
people idea.
This is a topic that peopledon't talk about.
I remember when I was lookingfor a new job and leaving I felt
like a pariah.
I feel like there was no oneopened up about it Again.
Where I was coming from,everyone was like, well, no one
leaves the Rothman Institute andyou're like, wait a second, but
if I leave then, am I weird?
What's wrong with me?
Things like that.
Speaker 2 (22:59):
So I hope you find what you're looking for is what
I kept hearing.
Speaker 1 (23:05):
I'm like find yourself.
It's a millennial topic, that'sone of the things.
But the discussions are hard,so there's a few ways to look at
this.
So I think it depends on thereason why you're leaving, right
?
So before leaving my first job,it was a discussion of the
people that are saying, hey,these are the things that I'd
want.
Is it possible to achieve these?
More clinical time or whatever.
And if they can't deliver that,then when you look for another
(23:28):
opportunity to present anotheropportunity to them, it's not a
surprise, right?
You've been asking this for aperiod of time.
They can't fulfill it, and youknow, for whatever variety of
reasons, and if they can'tfulfill it, then you have to
seek somewhere else toaccomplish that.
On the flip side, when I wasleaving Brigham, I had some job
interviews and all the jobopportunities.
I was very upfront with mychair very early on.
(23:49):
I was like, hey, I'minterviewing at these other
places, this is what I'm lookingfor.
Are these things that I canachieve here?
So, for example, I wanted to bechief of arthroplasty just to
really get the leadershipopportunities there, to
understand what it's like and toreally help change the needle
of what we did in arthroplastyat Brigham and after some time
(24:16):
my chair, to his credit, gave itto me, which is really nice,
and you go.
You know, what can we do tokeep you here?
Or what can we do to?
You know, advance your careerhere.
And every time I brought upsomething.
Sometimes they could do it,sometimes they couldn't right,
and I had to ask myself is thisenough of a needle to move me to
move somewhere else or not movesomewhere else?
But I think the worst thing todo is to be clandestine and not
be upfront with your leadershipand interview at jobs.
Then all of a sudden spring ajob at them or say, oh, I'm
going to this job opportunitybecause I couldn't have that
here, and they're like well, Ididn't know you had all these
(24:36):
concerns or questions and thingslike that.
So communicating early, I think,is one thing and then
communicating with theirpatients is another thing.
That's always a tough one.
After establishing a practicefor a period of time.
It's always tough to leave them, tough to leave the people that
you've worked with.
But again, as long as you'reupfront as to why you're doing
it and what you're going to.
So here was a big pool.
Right, I was.
I got to be a chair of adepartment which is a pretty
(24:59):
cool pool.
So less of a push, really, notmuch of a push there, but much
more of a pool here.
But again some.
And then there's some thingsthat I did say to my chair.
I'm like, well, you know,here's the few things that I
would want to be able to change,and some things are not
changeable, as we know, from asystems perspective.
So, no matter, as much as mychair would love to be able to
do so, that's not necessarily afeasible thing.
So being honest with people youwork with, so that nothing's a
(25:22):
surprise, is a nice thing, Ithink.
Speaker 3 (25:24):
I love that you gave your first you know your first
spot at Rothman the opportunityto meet you at your goals and
expectations, or at least youset those expectations and you
gave them things that you werelooking for to further your
career and at least you gavethem the opportunity to do that.
At least it sounds like it andthat sometimes that may be
feasible and sometimes may not,and that's okay, right If
certain places that you justsaid can't meet you at those
(25:45):
things, but you at least gavethem that opportunity Cause then
when those opportunities didarise for you elsewhere, like
you said, they couldn't besurprised when you went to then
go take those opportunities.
I love that.
Speaker 1 (25:55):
Yeah, it makes sense, but one of those things for you
to be honest with yourself andthen honest with them, you know,
and that's not a funconversation either.
Speaker 3 (26:07):
How about for you, clay?
So if I could, I think thefirst thing I always say is if
you're thinking about leaving oreven looking into leaving
number one and we say it all thetime and it seems basic, but
it's so true and obviously we'veall heard the horror stories
Don't burn any bridges anywhere,anytime.
Like it's easy to say, it's alot harder to do, especially if
you're going to take a new jobor if you know you're going to
go somewhere else, or if youeven really don't like where
(26:28):
you're at.
Like don't burn bridges.
Like this is a small world,it's a small community, no
matter what special subspecialtyyou're in, whatever.
Like just don't burn bridgesanywhere you are, even if
somebody wronged you.
Like just take the high road ahundred percent of the time.
It's a lot easier said thandone for all of us, of course,
but like just try and keeprepeating that mantra to
yourself before, during andafter a job search or a job
(26:49):
leave.
If I could get slightly moregranular, I won't dive too far
into the weeds, but I think oneof the things that is important
is before you even sign acontract, whether it even be
your first contract or whenyou're looking for a next
contract is to.
You do have to ask some of thehard questions ahead of time,
and some of the things as simpleas like if I were to leave,
what is my tail insurance looklike?
(27:10):
Who pays for it?
Do I have to pay for it?
Does the department or theinstitution or the group pay for
it?
What about a signing bonus thatI may or may not have received?
What about some of thecompensation?
What about some of the trailingcollections?
Who gets that or does it stillcome?
And so those are maybe a littlebit more granular things that
may be beyond the scope of thisparticular general conversation,
but those are hard questions toask when you're negotiating
(27:34):
with a new job or a new place,right, because you don't want to
give the idea of I'm alreadylooking for my out before I even
sign or before I even join theplace.
But they're important thingsbecause, again, as we've stated,
the statistics half of peopleare going to leave, and so, like
you need to plan ahead for the,just in case.
It's just like getting lifeinsurance or disability
insurance, right, we all hopethat none of us ever have to use
or need any of that.
But somebody's going to, someof us are going to, someone's
(27:55):
going to need to, so you got tohave it right and so you really
got to like, get down, fine tuneall those granular details of
some of those specific thingsahead of time to prepare
yourself, if and when you doleave or you do need to leave,
that all those things are linedout and written and in contract
form well ahead of time.
Yeah, yeah.
Speaker 2 (28:14):
Yeah, that's not completely part of the part of
this, but it is.
I mean, these are part ofhaving the conversations, is
being prepared to have theseconversations and you don't want
to go into it with looking forthe out, but this is, it's part
of the job, it's something thatI, like I felt awful trying to
go and have these conversationswith my chair.
It was someone that I still, tothis day, consider a game
(28:36):
changer for me, not just mentor,but kind of that next level, if
you will.
So, like you said, I was veryupfront with him from the start.
I got mixed information on kindof how to approach that.
Some people were like you don'thave to talk to anybody, you can
just kind of explore and see,but to me it just didn't feel
(28:58):
truthful and so, again, justgoing back to just not burning
bridges in the way that I wantedto be perceived Like, is it me
to kind of go behind back andlook for jobs or do I want to
kind of be upfront and gothrough the process with them?
It also gave me the opportunityto talk about the things that I
was having trouble with, andthat conversation needs to be
ongoing.
It's part of optimizing thatfirst job and optimizing your
situation and I'm not the bestat that and we're still working
(29:19):
on it, but learned a lot fromthe first process, so I love
that.
Yeah, I think that's important.
That first contract or thatsecond contract, whatever
contract you're in beingcomfortable and safe in your job
is great.
It takes a lot of pressure offof you too as far as just kind
of focusing on the work.
Speaker 1 (29:37):
How do you like what?
Something that Clay said, and Ireally do like to emphasize,
like don't burn bridges anddon't burn bridges from
residency, don't burn bridgesfrom med school, don't burn
bridges from fellowship.
I ended up my job at Brighambecause my chair was my
residency attending.
You know, and that's crazy howsmall of a world we had.
Right, clay's.
Back to you know, it's allright, like it's.
There's reasons that thingshappen and if you had burn
(29:59):
bridges then it'd be a verydifferent discussion.
Orthopedics is a very smallworld.
Private, academic, doesn'tmatter what it is.
It's a small world.
So don't piss people off, youknow, and there's obviously
reasons and when to you know,obviously not to burn bridges
but to bring things to lightthat are wrong, but to have you
know things that I didn't likein my last practice but I wasn't
(30:33):
just like this is dumb, this isstupid, you guys stink for
having it this way or making medo this for the last four years.
Speaker 3 (30:39):
I said, hey, like this is a situation, this is
something that's kind ofdifficult.
This is not why I'm leaving I'mleaving for different reasons
but this is something you guysmay want to look at as a group
moving forward, or this issomething that could, you know,
potentially be an opportunity toimprove.
And they took that to heart,like they took what I said.
You know, I had an exitinterview with a bunch of the
folks in the group and I saidthis is all the things that I
love about this place.
You guys are doing awesome inso many ways.
(31:00):
Here's a few things that youknow were difficult for me while
I was here and that could bebetter, and they since changed
almost every single one of thosethings for the new partners
that they've added, and it'smade it a better opportunity for
the surgeons that have comebehind me, and so and I still
have great relationships withall those people.
I think, at least in partbecause of that, because they
feel like they've gotten betterin some respects just from
learning and from some of thoseconstructive parameters that you
(31:23):
know that I gave them beforeeven leaving Awesome.
Speaker 2 (31:27):
Yeah, yeah.
I think that's incrediblyimportant and to that end, I
went to medical school here inNew York and did not want to
stay for residency, which manypeople would be like, oh, like
there's no way they would everbring you back, you know.
But that's kind of how thisopportunity came back was
(31:47):
mentors and sponsors whorecalled that, even with me
being like I really don't wantto be here, coming back and
asking that question.
I thought was pretty, prettycool.
So just to follow up on that,those points of the not burning
those bridges, keep things openand have kind of truthful
conversations.
But we're running a little bitlow on time.
I think this has been exactlywhat I think people need to hear
(32:11):
and people should talk about.
Hopefully it will kind of leadto more conversations and more
openness about these discussionsbecause it is a real thing, a
real common thing, definitelynot advocating for job change,
but it's part of the career,part of the process.
I guess any kind of closingwords of wisdom from you guys
before we sign off.
Speaker 1 (32:31):
Reach out anytime is what I would say.
You know, we've gone through it.
You'll be surprised at how manypeople have gone through the
process of changing jobs, and ifone person can't relate to the
reason why you're changing a job, find someone else.
You know everyone has differentreasons for it, and maybe your
mentor for something is not yourmentor for changing your job,
and that's okay.
It's okay to have mentors inmultiple different spots.
(32:53):
I like what Clay said abouthaving your mentorship leaning
on people.
The AOA is a great foundationfor that.
There's multiple different waysthat you can do that, and so
finding your people, to talk toit, that you can be candid with
and honest with, and to get areally good assessment of
whether or not you should leave,what you should leave for, if
the opportunity is really thereason to leave, those are
important things to have.
Speaker 3 (33:12):
I always tell our folks don't be afraid to ask for
anything or within scope ofreason, of course, but don't be
afraid the worst that any placeor any new place or any
different place, the worst thingthat can happen is they say no
or no, we just can't do thathere.
But don't be.
I think when people are lookingfor jobs especially their first
job, but even their second joblike people are afraid to ask
for something or afraid tonegotiate something because
(33:33):
they're like, oh, I don't wantto come across as a greedy
person or I don't know if theywould even be able to do it.
Like the worst thing that canhappen is they say we can't do
that, like, right, like so,don't be afraid to ask, and if
you don't ask, you may nevereven have the chance to get it
Right.
This is what I always tell ourfellows and residents.
Like if you really wantsomething, or even if you think
you want something but you don'task, they're probably not just
going to come out and give it toyou, or just come out and say,
(33:55):
oh, how about we give you thisextra day of our time?
Or how about we give you thisor that Right?
Or how about we give you justtwo academic days of paid time.
You know, whatever it may be,you can name the situation.
So not they may be able toaccommodate you, or maybe
something else may not workquite as well, but they
accommodate you for what the askis or what the ask was.
(34:18):
And especially if you arechanging jobs, it's important to
know to think about the factthat, like, you're in a little
bit different situation thanwhen you're just coming out of
training, right, like whenyou're first coming out of
training, a lot of people arejust hoping to get a good job.
Right, once you've been inpractice, especially if you've
been in practice for a few years, or especially if you're board
certified, or especially if youknow you've established yourself
in research space or academicspace or clinical volume,
(34:40):
whatever it may be.
Now you hold a few more cards alittle bit right, like you've
established yourself as aquality surgeon, hopefully, or
whatever, in different places,and so you hold a little bit
more cars and a little bit moresway, and so your negotiating
power is a little bit better.
Not that, again, that it's allabout negotiating power.
It should be about finding thebest opportunity and the best
fit for you.
But don't be afraid to ask forthings, and if a place is
(35:02):
looking at you once you've beenin practice for a few years
already it's probably becausethey have a need and because
they want you, hopefully andpotentially in many cases.
So don't be afraid to like kindof push the envelope a little
bit again, within reason.
Like we've said before, youdon't want to be a jerk to
anybody or anything, but likedon't be afraid to ask for
things and push the envelopeAwesome.
Speaker 2 (35:22):
Yeah, I mean that's perfect.
You even kind of referencedback to that starting practice.
You definitely have to optimizeand do your best in that first
job, like if it turns into yourcareer job, wonderful, but it
still is going to affect theprocess moving forward.
So just taking advantage ofthat optimizing and then I love
it.
I think that asking thosequestions, utilizing programs
(35:43):
like the AOA, is huge.
It's leaders, it's people allover the country that want to
help and want to be a part ofthat process and want to have
conversations like this Likewhat other organization is going
to breach subjects like thisopenly?
So utilize those resources,join the AOA, become an emerging
leader, kind of all thesedifferent things, because you're
(36:03):
going to have these networks towork from.
I wrote down so much stuff formyself from you guys today.
This was an awesome discussion.
I think it's really going to behelpful to people.
So thank you both for your time.
Please look out for the nextrecordings, the next episodes of
the Emerging Leader Podcast and, if this is the first one
you're kind of listening to, wehave one on starting practice
(36:25):
earlier, as well as a coupleothers in queue.
So thank you again for yourtime.
This was wonderful and I'll seeyou at the next meeting.
Speaker 1 (36:33):
Thanks so much for organizing this, Aaron.
Speaker 3 (36:35):
Oh yeah, Thank you very much, Aaron.
Thanks for inviting usAppreciate it.
Speaker 1 (36:45):
Yeah, thank you.
Welcome to the AOA podcast.
My name is Dr Aaron Brandt andin this episode we're going to
be discussing changing jobs inearly career.
I am joined by two greatfaculty today, both members of
the AOA.
Dr Antonia Chen she is aprofessor and chair at UT
Southwestern for the orthopedicsurgery department, a hip and
(00:43):
knee surgeon by trade.
Southwestern for the orthopedicsurgery department, a hip and
knee surgeon by trade.
And Clay Nolley, sportsmedicine associate professor,
newly associate professor at theUniversity of Missouri, and
today's podcast is focusedreally on changing jobs, which
is not something that we talkabout very often.
But both of these faculty willbe able to contribute their
(01:03):
views and please feel free tointroduce yourselves and tell me
a little bit about your pathsand kind of the process that got
you to where you are now.
Maybe we can start with Dr Chen.
Speaker 1 (01:15):
How long do we have?
I'm just kidding.
Speaker 2 (01:18):
It's like the little brief, because we will kind of
take it from there.
Speaker 1 (01:22):
So I started my job at Rothman Institute.
I did my fellowship at RothmanInstitute and stayed there as an
attending and my first jobtransition was to Brigham and
Women's Hospital in Boston.
And then my second jobtransition, just this past
September, was from Brigham andWomen's Hospital down to UT,
southwestern.
Very different reasons fortransitioning and all very
(01:42):
different practices.
Speaker 2 (01:43):
Yeah, yeah, very much so.
Speaker 3 (01:45):
Kind of similarly.
I did my fellowship at MizzouUniversity of Missouri in sports
medicine and stayed on asfaculty, but in an interesting
kind of setup where I was notstraight academic faculty, I
actually operated and sawpatients primarily at an
affiliate community hospital.
So it was almost more like ahospital employed position in
terms of like kind of makeup ofthe practice and like kind of
how the situation was for acouple of years.
(02:08):
And then we moved to Texas andI was actually in private
practice.
I'm in a very big, well-runphysician owned private practice
with physician ownership ofsurgery centers and all that
goes into that for four years.
And then we moved back toMissouri and now I am very
academic and strictly atacademic institution and the
mothership, so to speak, if youwant to call it that at an
(02:28):
academic practice and a sportsmedicine practice affiliated
with high level team coverageand all of that sort of thing
and we can get into some ofthose types of things.
But then so I've kind of goneback and forth from almost
really community kind ofhospital employed, so to speak
to big private practice.
Now it's like straight academicpractice.
Speaker 2 (02:52):
Yeah, I mean that's a lot.
Yeah, as someone who's kind ofjust getting going and I did
just go through my own jobtransition it's a lot to process
to see that both of you canhave been moving around.
But I guess start from Dr Chen.
Maybe what led to kind of someof those transitions?
Was it typically just careeradvancement?
Was it anything in particular?
Speaker 1 (03:11):
I think it's a combination of things.
I think, when it comes to jobtransitions, you have to look at
a few things One, you have tolook at yourself.
Two, you have to look at whatyou want in your life.
And three, you have to look atwhat your surroundings are.
I remember starting off at theRothman Institute and it was
great because I was a fellowthere.
But it was also I was a fellowthere, and so one of the things
I learned quickly is thatbecause you're a fellow at a
(03:32):
location and you transition toan attending doesn't mean
everyone treats you like anattending.
And that's one of those hardtransitions to make, because you
know you're familiar with thepeople.
That's really nice.
You know exactly whereeverything is, you know where
the bathrooms are, you know youknow the research team, you know
the clinical team and I learneda lot from being at Rothman
Institute, obviously being aprivademic place.
I learned the business ofmedicine, I learned what I would
(03:52):
like to open up almost like asurgery center that they did and
they started operating out of.
So a lot of the important lifelessons that I learned about
running a practice becoming busy.
Building a practice was reallygood at Rothman Institute and
you know, when I was at RothmanInstitute, it's one of those
things where I think most of usdon't expect to leave your first
job.
I didn't expect to leave myfirst job.
(04:13):
To be perfectly honest, I waslike I'm not going to become a
statistic they say what 50% ofpeople leave within the first
three years and I became astatistic.
So it's just one of thosethings where my interests were
to grow more clinically and Ididn't have that opportunity
there.
I also wanted to grow moreindependently in a research
fashion and I didn't have thatopportunity there.
(04:33):
Right, like I.
You know learn how to run anefficient practice, run.
You know multiple rooms, youknow staggering, doing a good
job with that and able to takethose skills to a different
location.
But I realized that after threeyears that it wasn't a good fit
(04:54):
for me in the long term.
But realizing that is a reallyhard one.
You have to be honest withyourself, honest with your
surroundings and also peoplethat you work with I mean, these
are mentors of mine, right thatI had gone through fellowship
with and to say, hey, I think Ishould go somewhere else was a
tough decision to make.
Easier to talk about it nowthan it was at that time.
But everything happens for areason.
Speaker 2 (05:13):
Yeah, I like that.
It seems like there's achallenge with that.
I think you clearly would haveput in plenty of effort to keep
those relationships and buildthat structure at your location.
So I think that was probablyvery tough.
I totally get that.
Felt the same way about that,dr Nolley, we had talked about
just briefly before.
How are these jobs coming about, or how are these opportunities
(05:36):
coming about?
And I think that's alsosomething that everyone wants to
kind of figure out.
If it's not working, or isthere something that's supposed
to be better for me out there,even if I'm not looking?
What are your thoughts on that?
Or how did how did that happenfor you?
Speaker 3 (05:49):
Yeah, I mean I think you know you start talking about
job changing or people changingjobs and stuff.
There's really probably kind oftwo kind of scenarios in
general.
There's a lot of scenarios,obviously, but two kind of main
scenarios.
One is I'm not happy where I'mat, or this is not a good
situation for me, or I need todo something different.
And then another one is maybeOK, maybe I'm OK here, or maybe
I am happy here, but maybethere's potentially a better
(06:11):
situation, or maybe I'm evengetting recruited to somewhere
else and I could, you know, asDr Chin said, maybe I can rise
clinically or maybe I can riseprofessionally or, you know, in
leadership capacities or thingslike that, and those can be
similar, but they can also betwo very separate things.
I think the first one isprobably encountered a lot more
in very early career surgeons.
I mean, I think you know, Ithink we've all seen the
(06:31):
statistics from AAOS, you know Ithink it's over 50% of you know
, early career surgeons changetheir for after their first jobs
, right?
You know Dr Chin mentioned Idon't want to be a statistic,
that's the statistics he'sreferring to right?
And so I think those reasonsare probably most commonly
because either the people aren'treal happy in that first job
that they chose, for whateverreason that may be, or they
(06:52):
think that there's definitely,once they get into practice,
they realize their practice ismaybe different than what they
thought it was going to be andthey realize that there may be a
situation that's better forthem or better suited for them
or just gives them differentopportunity.
I think more, once you get tomid-career, oftentimes people
are pretty established andpretty comfortable in their
practice but there may be anopportunity that launches their
career to the next level or aleadership position elsewhere,
(07:14):
or just a general situationwhere they're being recruited to
another institution.
So I think those are twoseparate scenarios, but
certainly for the early careersurgeon or the early career job,
I think people choose theirfirst job out of practice for a
ton of different reasons, right,and sometimes those reasons are
good ones and sometimes thosereasons may not be as good ones.
You know, certainly we hearwhen we talk to our residents
(07:35):
and fellows and we kind of tryand coach them and educate them.
We try to educate them.
That number one, first andforemost.
It's not always just all aboutthe money, you know.
I think that sometimes the youknow the elephant in the room,
but it needs to be saidsometimes because certainly we
all understand people have debtand people have financial issues
and things.
But sometimes people choosejobs based on solely financial
(07:55):
scenarios and they don't thinkabout their actual practice,
life, their home life, all ofthose things that go into that
and the actual clinical practice.
And then sometimes they get ina situation where maybe it's not
super tenable or their clinicalpractice isn't what they want
and that's why they changed.
But sometimes it's just ascenario where people take the
first job that they feel likethey can get and then it doesn't
end up being exactly what theythought it was going to be or
(08:18):
going to be promised to them.
So I think you know there's alot of different reasons that
people change jobs, probablysomewhat based on where they are
in their career or where theyaccept a job or what the
location looks like.
But those are a lot ofdifferent types of scenarios for
sure.
Speaker 2 (08:31):
Yeah, yeah, and this is exactly kind of what the
conversations tend to be, justwith everybody is the why that
first job is always hard, and sothis is kind of the follow up
to the one that we did with theemerging leaders, based on
starting practice and doing that, I guess from your perspectives
, having changed multiple times,what opportunities or how do
(08:52):
you advise kind of the emergingleaders and those early surgeons
to optimize their currentsituation, to try not to be that
our departments, but sometimesit doesn't work, but is anything
(09:16):
you take from your priorexperience that would help
people kind of optimize,advocate for themselves, things
like that.
Speaker 1 (09:24):
I think there's two sects of thought when we're
going through thisdecision-making.
One, you're talking aboutemerging leaders who are looking
for a job, and then emergingleaders who are currently in
their first job, and I mean wecan tackle both of them.
If you're looking for a job,clay really hit it on nail on
the head, right.
You have to understand whyyou're taking a job and then the
expectations of the job.
You know, one of the things Itell people to do when you're
(09:46):
applying for a residency orapplying for fellowship is make
a list of all the things thatyou say are non-negotiable, that
you have to have in a program,and then those things that are
negotiable but are nice to have.
I say the same thing is truefor a job right Now.
The hard part is we don'talways know what we want when we
first start out, right Likewhen I first started out, I
thought I really wanted to do alot of research.
So when they offered me acontract of two days clinical
(10:09):
and three days research, I waslike okay, I can work with, do a
lot of clinical, I want tooperate, I want to be in, I want
to be in that setting.
So you know, I took as muchcall as possible.
I was doing cases on nights andweekends, you know, I was able
to not get out of the park, butI had to work at really odd
hours to get that Cause I didn'thave dedicated OR time and I
picked up more clinic time,those sorts of things.
Right, but I had to claw, Ihave to admit, right, people
(10:33):
like to be, you know, given thattime and you can build it and
things like that.
And so when I went to my nextjob, I made sure that I had a
lot more clinical time.
Right, it was almost allclinical time, but that was my
personal choice and I didn'tknow that about myself, right?
So if, when you're starting ajob, know thyself as much as
possible, make a list of whatare negotiables, non-negotiable.
If location is non-negotiable,put that on the list, because
(10:54):
that will potentially restricthow many places you can go to
Academic versus private, allthose sorts of things like that.
But there's other things thatare non-tangibles, that people
don't necessarily think about,things like mentorship or having
senior partners, you know, orbeing on an island by yourself
versus having other peoplearound.
But on the flip side of things,having 20 arthroplasty partners
(11:15):
versus you know two.
Those are things that you knowI don't really think that I
thought of through when I wasgoing through the process and
then in the process of itself Ithink, when it comes to
switching jobs, once you're inthat place, how to make it
better Again, go back to thatlist of negotiables
non-negotiables.
Are things changeable, right?
Am I able to get mentorshipfrom another attending in the
same hospital, even if they'renot part of my practice?
(11:36):
And if that helps me, thenthat's good, right?
Or you know, I actually wantmore research time, I want more
admin time or something likethat.
Can I negotiate that with mypractice and get that
compensated, right?
Is it a work-life balance thing?
You're like, well, I'm workingon nights and weekends but I
don't have OR time.
You know how can I leveragethat and get OR time so that I
have dedicated time?
So look at your situation andsay what would make me content
(11:59):
Nothing's going to make us happy, but what will make me content
in this job and what can I getfeasibly in that?
And then what are, again, thenon-negotiables that I can
attain that are actually reallyimportant?
And if that's unattainable inyour current practice, then
maybe you start looking atanother practice.
Speaker 2 (12:16):
I love that and, Tony , like content is such a good
word Like we want to beoptimists and we want to walk in
and just have these rosecolored glasses.
But I think that in thisprocess and in this career, it's
that's not how it works andthere's always going to be good,
there's always going to be bad,and just kind of weighing those
options and I love like yourlist.
I wrote them down like tips andI would recommend that to
(12:37):
everybody all the early surgeons, really anybody at any stage.
Have your list, revisit it,decide what's actually
contributing to the challengesthat you're doing.
Is this a me or is thissomething that can't be changed?
So I love that and I thinkcontent is.
We want to be happy, butcontent is a great goal.
(12:57):
But Clay, I guess follow up onthat, yeah, I mean she hit the
nail perfectly on the head.
Speaker 3 (13:03):
It sounds like we're going to be very similar,
antonia and I, in all of thisdiscussion, but that makes sense
with people who have changedmultiple jobs and experienced a
lot of things now, right, and soI mean, I mean, I think the
main tenet is exactly what shesaid and what you reiterated,
aaron there is no perfect job,right?
I mean, we all like to thinkthere is, but obviously we've
all changed jobs a couple oftimes now, so we can all pretend
(13:23):
to that and, truthfully, ifsomebody at a job that's
recruiting you or where you'regoing to, tells you that it is a
perfect job or there's nothingwrong with it, honestly that
could be a little bit of a redflag, right, because everybody
knows that nothing is perfect.
There's great things aboutevery place.
There's not so great thingsabout every place, and every
place has its warts.
Regardless of this or that,it's just a matter of deciding
what works best for each personand deciding whether or not
(13:45):
those warts are really big andreally difficult to deal with,
or they're really small andthey're just things that happen
at every hospital, right, and sothere's no perfect job.
It's a matter of just trying tofind the job that is the best
fit overall and the best waythat you possibly can and you
used a great word with content,and Antonio made a great point
that we tell our fellows inresidence too we call it a
Franklin T.
That's kind of like the oldschool method of what it is
(14:06):
right, but it's the exact samething Pertinent positives,
pertinent negatives we're allused to that in medical lexicon.
And so what are the things thatyou and I even tell our folks to
even stratify at another leveleven more?
So?
It's things that you absolutelyhave to have, things that you
would like to have, things thatyou absolutely do not want, no
matter what, and then thingsthat you think you probably
(14:28):
don't want but you couldprobably deal with.
So it's actually even kind ofstratified into four categories
and the absolute must-ves andthe absolute don't wants.
Those are absolutes, right, andshe mentioned one.
Maybe one is location for oneor the other in either of those
categories, right, Whether youwant to live in a big city or
you don't want to live in a bigcity, for example, or something
like that, or your family doesor doesn't, and then there's a
whole lot of the like I wouldlike to have and then I don't
(14:49):
think I want or I don't think Iwould like to have, and she
mentioned one for herself interms of research starting out
and then that changing and theones in the middle, the likes
and don't likes, those usuallycan change over time or those
may change as you get intopractice.
Or as you get into a practicethe absolutes usually don't
change or don't change or don'tmove one way or another a whole
lot.
So you can start with those andthat narrows your scope down
(15:12):
quite a bit potentially for somepeople from the start.
And then you start getting intothe likes and wants and don't
wants and don't likes and thenyou can really kind of start to
tease things out and narrowthings down even more based on
those individual factors.
I love that.
Speaker 2 (15:26):
Yeah, and I think that and those factors all
change.
I think that's the other thingthat just be flexible, because
there are things that you thinkthat you want and need that can
change as you work throughthings.
So that's part of kind ofgrowing and developing.
I tell people that with evenresidency applications that like
if you're seeing smoke get outthe fan, you know like you got
(15:48):
to start asking the questionsand pushing those buttons
because it's not perfect.
Speaker 3 (15:53):
So I like that.
I like that term.
I'm going to start using that,Aaron.
So I like that.
I like that term.
Speaker 1 (15:54):
I'm going to start using that, aaron, I like it.
Speaker 2 (16:00):
I'm full of them, awesome.
Well, the other things thatkind of come up with these
conversations is kind of likehow do I find opportunities if I
am starting to look?
Did either of you have thatlike to where you were, saw the
writing on the wall and justwere looking for this next layer
?
Or I think both of yoursituations sounded a lot of kind
(16:20):
of progression and good reasons, but any of the not so good
reasons.
Speaker 1 (16:27):
When I say leaving a job, I would look at the push
and the pull, you know.
Are you being pushed tosomething or are you being
pulled to something else?
Right, in an ideal world,everything's a pull, right?
Oh, this next opportunity isgreat, this is where I want it.
But in reality a lot of time ispush or a combination of the
push and the pull.
I was fortunate in that when Iwas at my first job, someone had
reached out to me at Brighamand said are you interested in a
(16:49):
position here?
And at the beginning I was likeno, I'm actually pretty happy
here.
But it depends what youquantify as happiness.
I think from a push perspectiveit was one of those things
where I was one of manydifferent arthroplasty surgeons
and where I was pretty saturatedwith arthroplasty surgeons, so
that made it not the greatest inthe world.
It also was an opportunitieswhere, again, I had envisioned
(17:11):
myself doing more of theclinical work and more of the
research work in that realm andit didn't feel like I could
achieve what I wanted to achieve.
I said, for lack of a betterterm.
So from a push perspective, itwas one of those things where I
was not necessarily getting thesame support that I thought I
would be getting and versuswhere I was getting a pull from
somewhere else.
They're like, hey, why don'tyou come up here and run our
(17:31):
arthroplasty research, forexample?
And again, from an academicstandpoint, that was a really
cool opportunity.
Now it's because no one wantedto do it, but that said, it was
something that was neat that Icould make it my own.
So the first time I was asked togo interview at this at the
Brigham, where I ended up goingto, I was like I'll check it out
(17:59):
.
And so I checked it out and Ididn't end up going there.
And the second time I checkedit out, the question I got asked
was this is like a guy asking agirl out for a prom date Like,
are you gonna say no to me?
Twice?
I was like, well, the timingwasn't right.
You know and that's the firsttime I checked was a year and a
half into practice and at thatpoint in time, like the boards
collection timeframe, that's,like, you know, one of those
things where it just wasn't agood time to move.
And so the one thing I dorecommend for anyone is it can't
hurt to check out other jobopportunities Right, even if
(18:20):
you're not necessarilyinterested in it at that time,
it can't hurt to look at them.
So there's, you know, some notpositive things and there are
some you know from being in thepush.
And then there's positivethings from the pool.
And I had to start from scratch.
Right, I had to develop a nameagain.
I had to.
No one knew me right.
And so to work and take thatprocess.
I warn people that takes,depending on the practice you
(18:42):
walk into.
If something's not wellestablished for you ahead of
time let's say someone'sretiring and giving it to you
that's three to five years, youknow.
So you can't expect to walk inand say like, hey, I'm going to
have exactly what I had before,my OS flash practice and my new
practice now.
So there are some downsides toit.
But just recognizing whichdraws you more.
Is it the pull that's drivingyou more, or is the push or the
(19:02):
combination?
Either way, then it's a signI'd say.
Speaker 2 (19:06):
Yeah, I like that my thoughts.
Speaker 3 (19:09):
Yeah, I mean, I think you know antonio mentioned
something earlier that I thinkis really vital and can help
when it comes to, like, changingjobs or looking into change
jobs, and that's mentorship andleaning on mentors.
You know, obviously that's onething that I think the aoa does
a great job of is developingthese mentorship programs, and I
would encourage everyone in theaoa to get involved in some
sort of the mentorship programsor the different types of things
(19:29):
.
Or, if you attend the aoameeting, attend some of the you
know some of the mentorshipprograms or the different types
of things.
Or, if you attend the AOAmeeting, attend some of the you
know some of the talks or someof the symposiums that the AOA
does on mentorship, because it'shuge and it can benefit you in
so many different ways, one ofwhich is what we're talking
about with connections, orhaving people that have
connections that can help you,and so just a brief example for
me.
So the reason we moved to Texasis because my wife was military,
and so she had a servicecommitment to the United States
(19:51):
Air Force, where she's going tobe a hand and microvascular
surgeon for four years in theUnited States Air Force in San
Antonio Texas and I was goingwith her.
I wasn't staying behind with,you know, with a family and
everything else but that meant Ihad to find a job in San
Antonio Texas.
And so and I, we knew nothingabout San Antonio Texas, never
even been there before.
So I reached out to a couple ofmy mentors, one of which was
(20:11):
one of my fellowship directors,and I said, hey, you know,
anybody in San Antonio that,like, would be willing to maybe
hire a guy, and sure enough, hewas really good friends with
Steve Burkhart, which is a namethat anybody that's done
shoulder surgery probably knowspretty well or read the books
and stuff.
And he linked me up with himand said this guy's a great guy.
Guy, you got to interview him,you got to talk to him, you know
, you got to take him all thiskind of stuff you know that
(20:32):
mentors do for you.
And then, sure enough, you know, after meeting with him a
couple of times, it worked outreally well, and so I was
fortunate to link up that way,but it really went.
It really went.
That simply is that you know,one of my mentors talked to one
of his good friends, who thenkind of linked us all up
together and made it all workand it ended up being a great
opportunity in a privatepractice in Texas.
(20:52):
And so I would just say, youknow, leaning on mentors or
trying to develop thoserelationships or utilize your
mentors or your connections thatyou have through organizations
like AOA and things like thatcould really help you.
You know, guide the job searchor guide, you know, to certain
positions that people, trustedpeople, can give you better
information about.
Speaker 2 (21:10):
Yeah, yeah, and that's something that I've
noticed through the process isand I'm going to throw out what
may seem like random commentsthrough this conversation but
authentic authenticity and beingauthentic as a person
throughout this process, nomatter what you're doing, is
huge, because that's when theopportunities really do come.
So those mentors, thosesponsors, those people are going
(21:31):
to be able to advocate for youbetter or help you find those
spots If you know at least alittle bit of what you want and
who you are.
And so that's why I've enjoyedkind of hearing your guys' paths
, because it seems like,regardless of whether it was a
push or a pull, theseopportunities came or these
changes came because of thosethings as well, and that's that
(21:52):
for me.
I just made that change myself.
It wasn't that I wasnecessarily looking, it wasn't
quite the right situation, but Ihave been very lucky to have
great, wonderful sponsors andpeople who have advocated and
pulled, which has been helpfulfor me, because I'm going to be
the first to admit I don't knowwhat I want.
I know a little bit of what Idon't want, and so that's kind
of how I've made decisions.
(22:13):
So that's part of the process.
I want to kind of work into theprocess of leaving.
And these are the hardconversations.
And, antonio, you're now chair.
I'm sure you've had to havethese conversations and we've
had them a few times now.
But how do we have theseconversations and do it without
hurting our situation wherewe're at, and doing it the right
(22:35):
way?
I guess, if there is a rightway.
Speaker 1 (22:38):
So everyone has a different path.
I would actually add somethingto the whole mentorship and
people idea.
This is a topic that peopledon't talk about.
I remember when I was lookingfor a new job and leaving I felt
like a pariah.
I feel like there was no oneopened up about it Again.
Where I was coming from,everyone was like, well, no one
leaves the Rothman Institute andyou're like, wait a second, but
if I leave then, am I weird?
What's wrong with me?
Things like that.
Speaker 2 (22:59):
So I hope you find what you're looking for is what
I kept hearing.
Speaker 1 (23:05):
I'm like find yourself.
It's a millennial topic, that'sone of the things.
But the discussions are hard,so there's a few ways to look at
this.
So I think it depends on thereason why you're leaving, right
?
So before leaving my first job,it was a discussion of the
people that are saying, hey,these are the things that I'd
want.
Is it possible to achieve these?
More clinical time or whatever.
And if they can't deliver that,then when you look for another
(23:28):
opportunity to present anotheropportunity to them, it's not a
surprise, right?
You've been asking this for aperiod of time.
They can't fulfill it, and youknow, for whatever variety of
reasons, and if they can'tfulfill it, then you have to
seek somewhere else toaccomplish that.
On the flip side, when I wasleaving Brigham, I had some job
interviews and all the jobopportunities.
I was very upfront with mychair very early on.
(23:49):
I was like, hey, I'minterviewing at these other
places, this is what I'm lookingfor.
Are these things that I canachieve here?
So, for example, I wanted to bechief of arthroplasty just to
really get the leadershipopportunities there, to
understand what it's like and toreally help change the needle
of what we did in arthroplastyat Brigham and after some time
(24:16):
my chair, to his credit, gave itto me, which is really nice,
and you go.
You know, what can we do tokeep you here?
Or what can we do to?
You know, advance your careerhere.
And every time I brought upsomething.
Sometimes they could do it,sometimes they couldn't right,
and I had to ask myself is thisenough of a needle to move me to
move somewhere else or not movesomewhere else?
But I think the worst thing todo is to be clandestine and not
be upfront with your leadershipand interview at jobs.
Then all of a sudden spring ajob at them or say, oh, I'm
going to this job opportunitybecause I couldn't have that
here, and they're like well, Ididn't know you had all these
(24:36):
concerns or questions and thingslike that.
So communicating early, I think,is one thing and then
communicating with theirpatients is another thing.
That's always a tough one.
After establishing a practicefor a period of time.
It's always tough to leave them, tough to leave the people that
you've worked with.
But again, as long as you'reupfront as to why you're doing
it and what you're going to.
So here was a big pool.
Right, I was.
I got to be a chair of adepartment which is a pretty
(24:59):
cool pool.
So less of a push, really, notmuch of a push there, but much
more of a pool here.
But again some.
And then there's some thingsthat I did say to my chair.
I'm like, well, you know,here's the few things that I
would want to be able to change,and some things are not
changeable, as we know, from asystems perspective.
So, no matter, as much as mychair would love to be able to
do so, that's not necessarily afeasible thing.
So being honest with people youwork with, so that nothing's a
(25:22):
surprise, is a nice thing, Ithink.
Speaker 3 (25:24):
I love that you gave your first you know your first
spot at Rothman the opportunityto meet you at your goals and
expectations, or at least youset those expectations and you
gave them things that you werelooking for to further your
career and at least you gavethem the opportunity to do that.
At least it sounds like it andthat sometimes that may be
feasible and sometimes may not,and that's okay, right If
certain places that you justsaid can't meet you at those
(25:45):
things, but you at least gavethem that opportunity Cause then
when those opportunities didarise for you elsewhere, like
you said, they couldn't besurprised when you went to then
go take those opportunities.
I love that.
Speaker 1 (25:55):
Yeah, it makes sense, but one of those things for you
to be honest with yourself andthen honest with them, you know,
and that's not a funconversation either.
Speaker 3 (26:07):
How about for you, clay?
So if I could, I think thefirst thing I always say is if
you're thinking about leaving oreven looking into leaving
number one and we say it all thetime and it seems basic, but
it's so true and obviously we'veall heard the horror stories
Don't burn any bridges anywhere,anytime.
Like it's easy to say, it's alot harder to do, especially if
you're going to take a new jobor if you know you're going to
go somewhere else, or if youeven really don't like where
(26:28):
you're at.
Like don't burn bridges.
Like this is a small world,it's a small community, no
matter what special subspecialtyyou're in, whatever.
Like just don't burn bridgesanywhere you are, even if
somebody wronged you.
Like just take the high road ahundred percent of the time.
It's a lot easier said thandone for all of us, of course,
but like just try and keeprepeating that mantra to
yourself before, during andafter a job search or a job
(26:49):
leave.
If I could get slightly moregranular, I won't dive too far
into the weeds, but I think oneof the things that is important
is before you even sign acontract, whether it even be
your first contract or whenyou're looking for a next
contract is to.
You do have to ask some of thehard questions ahead of time,
and some of the things as simpleas like if I were to leave,
what is my tail insurance looklike?
(27:10):
Who pays for it?
Do I have to pay for it?
Does the department or theinstitution or the group pay for
it?
What about a signing bonus thatI may or may not have received?
What about some of thecompensation?
What about some of the trailingcollections?
Who gets that or does it stillcome?
And so those are maybe a littlebit more granular things that
may be beyond the scope of thisparticular general conversation,
but those are hard questions toask when you're negotiating
(27:34):
with a new job or a new place,right, because you don't want to
give the idea of I'm alreadylooking for my out before I even
sign or before I even join theplace.
But they're important thingsbecause, again, as we've stated,
the statistics half of peopleare going to leave, and so, like
you need to plan ahead for the,just in case.
It's just like getting lifeinsurance or disability
insurance, right, we all hopethat none of us ever have to use
or need any of that.
But somebody's going to, someof us are going to, someone's
(27:55):
going to need to, so you got tohave it right and so you really
got to like, get down, fine tuneall those granular details of
some of those specific thingsahead of time to prepare
yourself, if and when you doleave or you do need to leave,
that all those things are linedout and written and in contract
form well ahead of time.
Yeah, yeah.
Speaker 2 (28:14):
Yeah, that's not completely part of the part of
this, but it is.
I mean, these are part ofhaving the conversations, is
being prepared to have theseconversations and you don't want
to go into it with looking forthe out, but this is, it's part
of the job, it's something thatI, like I felt awful trying to
go and have these conversationswith my chair.
It was someone that I still, tothis day, consider a game
(28:36):
changer for me, not just mentor,but kind of that next level, if
you will.
So, like you said, I was veryupfront with him from the start.
I got mixed information on kindof how to approach that.
Some people were like you don'thave to talk to anybody, you can
just kind of explore and see,but to me it just didn't feel
(28:58):
truthful and so, again, justgoing back to just not burning
bridges in the way that I wantedto be perceived Like, is it me
to kind of go behind back andlook for jobs or do I want to
kind of be upfront and gothrough the process with them?
It also gave me the opportunityto talk about the things that I
was having trouble with, andthat conversation needs to be
ongoing.
It's part of optimizing thatfirst job and optimizing your
situation and I'm not the bestat that and we're still working
(29:19):
on it, but learned a lot fromthe first process, so I love
that.
Yeah, I think that's important.
That first contract or thatsecond contract, whatever
contract you're in beingcomfortable and safe in your job
is great.
It takes a lot of pressure offof you too as far as just kind
of focusing on the work.
Speaker 1 (29:37):
How do you like what?
Something that Clay said, and Ireally do like to emphasize,
like don't burn bridges anddon't burn bridges from
residency, don't burn bridgesfrom med school, don't burn
bridges from fellowship.
I ended up my job at Brighambecause my chair was my
residency attending.
You know, and that's crazy howsmall of a world we had.
Right, clay's.
Back to you know, it's allright, like it's.
There's reasons that thingshappen and if you had burn
(29:59):
bridges then it'd be a verydifferent discussion.
Orthopedics is a very smallworld.
Private, academic, doesn'tmatter what it is.
It's a small world.
So don't piss people off, youknow, and there's obviously
reasons and when to you know,obviously not to burn bridges
but to bring things to lightthat are wrong, but to have you
know things that I didn't likein my last practice but I wasn't
(30:33):
just like this is dumb, this isstupid, you guys stink for
having it this way or making medo this for the last four years.
Speaker 3 (30:39):
I said, hey, like this is a situation, this is
something that's kind ofdifficult.
This is not why I'm leaving I'mleaving for different reasons
but this is something you guysmay want to look at as a group
moving forward, or this issomething that could, you know,
potentially be an opportunity toimprove.
And they took that to heart,like they took what I said.
You know, I had an exitinterview with a bunch of the
folks in the group and I saidthis is all the things that I
love about this place.
You guys are doing awesome inso many ways.
(31:00):
Here's a few things that youknow were difficult for me while
I was here and that could bebetter, and they since changed
almost every single one of thosethings for the new partners
that they've added, and it'smade it a better opportunity for
the surgeons that have comebehind me, and so and I still
have great relationships withall those people.
I think, at least in partbecause of that, because they
feel like they've gotten betterin some respects just from
learning and from some of thoseconstructive parameters that you
(31:23):
know that I gave them beforeeven leaving Awesome.
Speaker 2 (31:27):
Yeah, yeah.
I think that's incrediblyimportant and to that end, I
went to medical school here inNew York and did not want to
stay for residency, which manypeople would be like, oh, like
there's no way they would everbring you back, you know.
But that's kind of how thisopportunity came back was
(31:47):
mentors and sponsors whorecalled that, even with me
being like I really don't wantto be here, coming back and
asking that question.
I thought was pretty, prettycool.
So just to follow up on that,those points of the not burning
those bridges, keep things openand have kind of truthful
conversations.
But we're running a little bitlow on time.
I think this has been exactlywhat I think people need to hear
(32:11):
and people should talk about.
Hopefully it will kind of leadto more conversations and more
openness about these discussionsbecause it is a real thing, a
real common thing, definitelynot advocating for job change,
but it's part of the career,part of the process.
I guess any kind of closingwords of wisdom from you guys
before we sign off.
Speaker 1 (32:31):
Reach out anytime is what I would say.
You know, we've gone through it.
You'll be surprised at how manypeople have gone through the
process of changing jobs, and ifone person can't relate to the
reason why you're changing a job, find someone else.
You know everyone has differentreasons for it, and maybe your
mentor for something is not yourmentor for changing your job,
and that's okay.
It's okay to have mentors inmultiple different spots.
(32:53):
I like what Clay said abouthaving your mentorship leaning
on people.
The AOA is a great foundationfor that.
There's multiple different waysthat you can do that, and so
finding your people, to talk toit, that you can be candid with
and honest with, and to get areally good assessment of
whether or not you should leave,what you should leave for, if
the opportunity is really thereason to leave, those are
important things to have.
Speaker 3 (33:12):
I always tell our folks don't be afraid to ask for
anything or within scope ofreason, of course, but don't be
afraid the worst that any placeor any new place or any
different place, the worst thingthat can happen is they say no
or no, we just can't do thathere.
But don't be.
I think when people are lookingfor jobs especially their first
job, but even their second joblike people are afraid to ask
for something or afraid tonegotiate something because
(33:33):
they're like, oh, I don't wantto come across as a greedy
person or I don't know if theywould even be able to do it.
Like the worst thing that canhappen is they say we can't do
that, like, right, like so,don't be afraid to ask, and if
you don't ask, you may nevereven have the chance to get it
Right.
This is what I always tell ourfellows and residents.
Like if you really wantsomething, or even if you think
you want something but you don'task, they're probably not just
going to come out and give it toyou, or just come out and say,
(33:55):
oh, how about we give you thisextra day of our time?
Or how about we give you thisor that Right?
Or how about we give you justtwo academic days of paid time.
You know, whatever it may be,you can name the situation.
So not they may be able toaccommodate you, or maybe
something else may not workquite as well, but they
accommodate you for what the askis or what the ask was.
(34:18):
And especially if you arechanging jobs, it's important to
know to think about the factthat, like, you're in a little
bit different situation thanwhen you're just coming out of
training, right, like whenyou're first coming out of
training, a lot of people arejust hoping to get a good job.
Right, once you've been inpractice, especially if you've
been in practice for a few years, or especially if you're board
certified, or especially if youknow you've established yourself
in research space or academicspace or clinical volume,
(34:40):
whatever it may be.
Now you hold a few more cards alittle bit right, like you've
established yourself as aquality surgeon, hopefully, or
whatever, in different places,and so you hold a little bit
more cars and a little bit moresway, and so your negotiating
power is a little bit better.
Not that, again, that it's allabout negotiating power.
It should be about finding thebest opportunity and the best
fit for you.
But don't be afraid to ask forthings, and if a place is
(35:02):
looking at you once you've beenin practice for a few years
already it's probably becausethey have a need and because
they want you, hopefully andpotentially in many cases.
So don't be afraid to like kindof push the envelope a little
bit again, within reason.
Like we've said before, youdon't want to be a jerk to
anybody or anything, but likedon't be afraid to ask for
things and push the envelopeAwesome.
Speaker 2 (35:22):
Yeah, I mean that's perfect.
You even kind of referencedback to that starting practice.
You definitely have to optimizeand do your best in that first
job, like if it turns into yourcareer job, wonderful, but it
still is going to affect theprocess moving forward.
So just taking advantage ofthat optimizing and then I love
it.
I think that asking thosequestions, utilizing programs
(35:43):
like the AOA, is huge.
It's leaders, it's people allover the country that want to
help and want to be a part ofthat process and want to have
conversations like this Likewhat other organization is going
to breach subjects like thisopenly?
So utilize those resources,join the AOA, become an emerging
leader, kind of all thesedifferent things, because you're
(36:03):
going to have these networks towork from.
I wrote down so much stuff formyself from you guys today.
This was an awesome discussion.
I think it's really going to behelpful to people.
So thank you both for your time.
Please look out for the nextrecordings, the next episodes of
the Emerging Leader Podcast and, if this is the first one
you're kind of listening to, wehave one on starting practice
(36:25):
earlier, as well as a coupleothers in queue.
So thank you again for yourtime.
This was wonderful and I'll seeyou at the next meeting.
Speaker 1 (36:33):
Thanks so much for organizing this, Aaron.
Speaker 3 (36:35):
Oh yeah, Thank you very much, Aaron.
Thanks for inviting usAppreciate it.
Speaker 1 (36:45):
Yeah, thank you.
Popular Podcasts
United States of Kennedy
United States of Kennedy is a podcast about our cultural fascination with the Kennedy dynasty. Every week, hosts Lyra Smith and George Civeris go into one aspect of the Kennedy story.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com