Time for a Change

R.V. Paul Chan, MD, MSc, outlines the challenges and opportunities related to leaving your first position.

By R.V. Paul Chan, MD, MSc

Leaving your first job can be a difficult decision. For R.V. Paul Chan, MD, MSc, his first position was with Weill Cornell Medical College, where he had trained. He found that an opportunity at the Illinois Eye and Ear Infirmary at the University of Illinois at Chicago (UIC) simply could not be passed up. In an interview with NRMD, Dr. Chan discusses his decision-making process and the challenges of moving forward in one’s life and career.

NRMD: When does the idea of leaving your first position come into your mind? When does it really take hold?

R.V. Paul Chan, MD, MSc: I made a choice early on to join a university-based practice and be a full-time faculty member, as opposed to going into private practice and doing academic work as part-time or voluntary faculty. Being an academic doesn’t mean you have to be a full-time faculty member in a department, but that is the path I chose.

I started thinking about the possibility of leaving when people started to approach me about other opportunities. When you are being recruited by others, it makes you pause and think. It’s hard to say no sometimes, especially when these are big departments in major institutions and jobs that are highly sought after. It’s difficult not to be curious.

You may know the system that you’re currently working in. You may be happy, or you may not be. For me, I was doing great. I had a lot of support building my academic career and was working really hard. But I didn’t know much about what life could be like working elsewhere, especially when I was working where I had completed my residency.

NRMD: You left Cornell University for UIC. What about the opportunity in Chicago attracted you?

Dr. Chan: I was thinking, “What’s the next step for me?” And part of that was personal; that’s where timing comes in. I was getting married—that was 2 years ago—and my wife and I made a commitment to each other that we would be in the same place. At the time, she was on the faculty at the Massachusetts Eye and Ear Infirmary as a uveitis specialist, and we did not want to be that couple with a long-distance marriage. When we decided to move to Chicago, it came down to having an open mind and saying, “Let’s just look at things and see what happens.”

The Illinois Eye and Ear Infirmary at UIC has a storied history of excellence in ophthalmology. There was nothing deficient with where I was. I could have stayed at Cornell for 10 or 15 more years doing the same work, but UIC was an opportunity to get out of my comfort zone. Also paramount to all of this was, “What does my wife want to do?”

UIC had a new department chair whom I trusted, and I wanted to join a department where I had faith in the leadership and faculty. The opportunity at UIC was (1) to be part of a big department with great research, clinical, and training programs, and (2) to help lead initiatives dealing with international health and pediatric retina. It also provided an environment in which others could offer me new and different perspectives.

NRMD: UIC had a bigger faculty and more opportunities. Tell us about your first year and the challenges of immersing yourself in a new place.

Dr. Chan: Coming into a new system is both challenging and fun. One of the biggest questions anyone has to deal with is how to earn the respect of the team. The faculty and staff probably didn’t know me from someone they may have just met on the street. Some people may have known me by reputation, but they wouldn’t have known if I was a good doctor. They didn’t know if I would be a team player.

I was joining a department where no one there trained me, and there’s a certain advantage to that. But because no one at UIC had any first-hand experience working with me, it was important for me to try and earn everyone’s respect and trust. Another issue is that people may think you’re getting some sort of special deal because you were recruited from the outside. That was absolutely not the case, but it may have been part of people’s perception. When you transition, you do not want to be disruptive.

NRMD: Did you bring new ideas with you, or did you defer to those who had been there longer when you first started?

Dr. Chan: It’s good that you bring a different perspective, but you have to respect the people who have been there. You have to know the past and understand it before you can really understand where you are and make progress. If you have no respect for or understanding of what’s been done before or what types of situations people have dealt with, you are just going to come in and probably offend them, giving off the impression that somehow you know better.

There’s a lot to be learned from the people who have been at an institution for years. You’ve got to respect their path. I think it’s better to listen first, be clear in your thinking and vision, and then come to conclusions and proceed as part of the group.

NRMD: You went from one academic setting to another, but that is not always the case when people change positions. What are some of the reasons that someone might consider leaving his or her first position?

Dr. Chan: There are many reasons why someone would want to leave their first job. One could be that they are not sufficiently compensated. Another is personal change—maybe their spouse wants to be in another city. It could be a change in leadership—if a new chairperson comes in and doesn’t recognize your value or you feel marginalized. Maybe the chair kept promising you something and never delivered.

There are also other reasons that have nothing to do with your current situation. Are you being recruited by another institution that offers a great opportunity elsewhere? That was the situation I was in. There are all sorts of different factors, even intangible aspects that have nothing to do with money or resources, such as whether you feel you’re being respected.

NRMD: Talk about the risks associated with leaving your first position. Does leaving damage your professional reputation?

Dr. Chan: Jumping around a lot can be seen as a red flag. People don’t necessarily want to hire somebody who won’t stay long term.

There are many questions one should ask before leaving a position. Do I really want to leave? Is what I’m doing now going to be reproducible at another institution? Are there things that I could be doing better somewhere else? By taking a new position, you run the risk of a promise unfulfilled versus the risk of losing what you have if you stay where you are. There is always risk in transitions.

There is also risk in burning bridges. But I think a lot of things come down to transparency. You have to be honest with those you work with about what your needs are and whether they are being fulfilled.

NRMD: Is there a limit to the number of times an ophthalmologist should change positions?

Dr. Chan: I don’t know. I don’t think there is any, but, again, you want to hire somebody who is going to be invested in building with you. My philosophy is that we want people who are invested in the mission of the department, not just the mission of themselves.

NRMD: What advice can you offer young doctors when they are considering a career change?

Dr. Chan: First, be true to yourself. Understand who you are, what you want long term, and what your family wants. Second, and just as important as the first point, is to be honest. Be honest with your current leadership.

I always told my chair when I was seriously looking at another position. But I never used an offer from another institution as a bargaining tool to try to get more from my current position. Also, be honest with whoever is recruiting you. Don’t do the dance just because they are treating you special. Explore new opportunities, but, if you aren’t serious about it, just walk away.

Ultimately, in my opinion, it’s not all about money. At the end of the day, it’s a journey, and there is no perfect job. Wherever you go, I think it’s important to have the attitude of, “How can I make this place better?” as opposed to only asking yourself, “What can I get from this place?”

R.V. Paul Chan, MD, MSc, FACS
• professor of ophthalmology and visual sciences; vice chair for global ophthalmology, director of pediatric retina and retinopathy of prematurity service, and co-director of the vitreoretinal fellowship program, department of ophthalmology and visual sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago
• member of the Retina Today editorial advisory board
• financial interest: consultant, Alcon, Allergan, B+L; scientific advisory board, Visunex Medical Systems


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About New Retina MD

New Retina MD delivers cutting-edge content to retina specialists in their first 15 years of practice. Each issue provides fresh insight from younger physicians plus established mentors on clinical and nonclinical issues affecting ophthalmologists in the earlier stages of their careers. NRMD features surgical pearls, clinical research endeavors, practice management, medical reimbursement and policy, continuing educational requirements, financial planning, innovations, and more.