{"doi":"10.1101/2025.09.05.25334955","title":"Variability in First Academic Medicine Job Offers in Pulmonary and Critical Care Medicine","abstract":"Background: A minority of Pulmonary and Critical Care Medicine (PCCM) graduates pursue careers in academic medicine. Although compensation is only a portion of the career decision, job negotiations remain shrouded in ambiguity and inconsistency. Additionally, while role-level salary tables exist through the Association of American Medical Colleges (AAMC), to our knowledge there is no resource that includes important non-salary information such as start-up packages, full-time equivalent (FTE) breakdown, and bonus ranges. Objective: We sought to describe key components of first PCCM academic job offers for both physician scientists and clinician educators, including salary, start-up packages, non-clinical FTE, and bonuses. Methods: An electronic survey was distributed via a snowball method between May - June 2025. PCCM graduates between 2020-2025 who accepted a job in academic medicine were included. Mann-Whitney Wilcoxon tests were used for ordinal comparisons. Qualitative analysis of free text responses was performed with a social cognitive career theory framework. Results: There were 60 respondents who provided information about 103 job offers, with 50% (14/28) of physician-scientists and 66% (21/32) of clinician-educators reporting more than one job offer. Physician-scientists received lower salary offers compared to clinician-educators (respective median ranges: $150,000-$199,999 vs $250,000-$299,999, p<0.001). 35.7% physician-scientists (10/28) received a career development award prior to negotiation, which was associated with a higher start-up package offer (p<0.05). For all clinician-educator jobs (n=59), 42.4% had non-clinical FTE in the initial offer. Many respondents commented on the lack of negotiating power. Conclusion: PCCM physician-scientists and clinician-educators experience wide variability in their initial job offers. Recognizing differences is essential to improve transparency in job negotiations in academic medicine.","journal":"medRxiv","year":2025,"id":574440,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.952,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":373820,"name":"Matthew Modes","orcid":"0000-0002-1568-1393","position":1,"is_corresponding":false},{"id":1481806,"name":"Timothy J. Rowe","orcid":"0000-0003-2186-4513","position":2,"is_corresponding":false},{"id":420205,"name":"Patrick G. Lyons","orcid":"0000-0002-1557-2787","position":3,"is_corresponding":false},{"id":387530,"name":"Nicholas E. Ingraham","orcid":"0000-0002-0292-0594","position":4,"is_corresponding":false},{"id":1039182,"name":"Nandita R. Nadig","orcid":"0000-0001-8694-4704","position":5,"is_corresponding":false},{"id":614994,"name":"Clara Schroedl","orcid":"0000-0003-3280-4997","position":6,"is_corresponding":false},{"id":560525,"name":"Catherine A. Gao","orcid":"0000-0001-5576-3943","position":7,"is_corresponding":false},{"id":1393962,"name":"Emily M. Olson","orcid":"0000-0003-4933-7598","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:57:40.686992Z","pmid":"40950455","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}