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Pursuing an Academic Career Track

Published on: Jan 21, 2020


As a neurologist, or neurologist-in-training, you are likely aware that pursuing a career in academics is one of your choices. But do you know how many different ways you might build that career path? Ralph F. Józefowicz, MD, FAAN, has given that a lot of thought. Having established his own career as a globally recognized academic and educator in the field of neurology, he has devoted his professional life to training neurologists, many of whom go forward on a similar path. Józefowicz’s current roles include clerkship director, associate chair for education, residency program director, course director for a second-year course, and tenured professor of neurology, all for the University of Rochester in New York. He also holds standing roles as a visiting professor for universities in both Spain and Poland. More details on Józefowicz’s career path will follow in a moment but for now, read on to learn his advice for residents and fellows who might want to create a career for themselves on this pathway.


To begin, for a neurologist to be on an academic path professionally means that you’re affiliated with a university. As Józefowicz explains, an academic’s roles in the university setting typically involve one or more of four aspects: research, clinical care, education, and administration. “Traditionally,” Józefowicz says, “it was expected that an academic would be a triple threat—clinical, research, and education, with everyone doing some administration. Now it’s more likely that you’ll be a specialist in one of the tracks.” To get an idea of what the different tracks might be at different universities, try shuffling the words around: You could be a clinician-educator, for example, or an educator-researcher, etc. The actual emphasis will likely vary according to the university’s needs, and the academic’s particular goals.

One thing that is fairly standard across various universities is the progression of titles. A very common process is to be employed as an instructor while completing your fellowship at a particular university. From there you would advance to assistant professor, then to associate professor, and then to full professor, with perhaps one more level to senior professor or tenured professor. In each case, Józefowicz says, expect the transition from one level to the next to take about five years.


Józefowicz has both general and specific counsel when it comes to succeeding in this career path. Generally, he advises all neurologist-scholars that they need three things to succeed: focus, communication skills, and good mentoring. As he explains, focus means knowing what you want to pursue, communication means writing and speaking well at all levels, and mentorship means surrounding yourself with people who will help you—and avoiding those who won’t.

To build on this general advice, Józefowicz also notes that different things are needed for success at the different levels of the academic career path. For example, as an assistant professor, you need to concentrate on being a local expert and demonstrate that you will be successful in an academic setting. Once you’re appointed to associate professor, your department is showing a commitment to you, and wants to see that you’re developing a national expertise. A full professor would be expected to show both national and international expertise.

If you’re wondering how expertise would be demonstrated or measured at each level, Józefowicz has an answer for that: For researchers, success will be evaluated according to their peer-reviewed articles and research; for educators, it means developing courses and creating curriculum that is disseminated broadly; and for clinicians, success means building an outstanding reputation and gaining referrals from other neurologists. Tenure is another form of promotion and a marker of success. Although tenure used to be granted more typically to researchers, Józefowicz says it is now more common for educators as well.

“Obviously,” Józefowicz says, “It takes lots of hard work to succeed. You have to be better than average and you have to be patient to keep building your career.” Józefowicz recommends that neurologists on this track make the commitment to attend national AAN meetings in order to meet others who can extend invitations to give talks, or perhaps write letters of recommendation for you. As he says, “You need to be a citizen of our society, of your profession, your institution. You have to do things to help other people.”


Józefowicz explains that in the past, everybody on the academic track did research, largely because the money was available: “Sixty years ago, it was easy to get research grants. Sputnik was launched, the competition between countries was strong, the NIH was expanded and the money was flowing to research. Now it’s getting very competitive to do research.” According to Józefowicz, the funding pendulum has shifted to clinical care, which is leading to a trend of university hospitals purchasing private practices. “Fifty years ago,” he notes, “most faculty in large departments did a large amount of research. Now they do the clinical care. It used to be that residents did most of the clinical care but now the faculty need to be able to bill, so they’re much more involved.” The fact that medicine is more complex than ever also contributes to the need for academic-clinicians, Józefowicz says.

So where will the academic career track lead in the future? Józefowicz isn’t making a specific projection, except to say this: “Follow the money, because everything is dictated by money. There’s still a lot of money in research and in clinical. There’s never enough money in teaching but departments know they have to have strong teaching so they figure out ways to support it.”


Talk to Józefowicz for any length of time and it becomes clear that the information he shares about academic careers comes directly from his personal experience, and from 30 years of helping others succeed in these professions. He built his own career one layer at a time, keeping singularly focused on academics from the moment he decided he wanted to be an educator. In some ways, his path was almost the textbook version of what he describes for others: First he was an instructor at the University of Rochester while finishing his neurology fellowship. Then he was brought on board as an assistant professor, advancing to associate professor, then full professor, then finally to his current status as professor with unlimited tenure. He also joined several professional associations such as the AAN early on and almost immediately began participating in sections and committees.

In each position at the University of Rochester, he followed two mantras. First was to be indispensable. For Józefowicz, that meant stepping into leadership roles whenever possible and doing what he could to ensure his department would excel. As a result, he has participated on 19 committees for the department, and chaired nine. He also brought national and even international acclaim to the university by developing strong academic programs. As noted earlier, Józefowicz currently holds four major roles for the university’s neurology department: clerkship director, associate chair for education, residency program director, and course director. In addition, he initiated an international training partnership with Jagiellonian University in Krakow, Poland, and an ongoing teaching relationship with the University of Navarra Pamplona in Spain. “I had very little difficulty getting promoted and gaining tenure,” he says. “My programs, by outcomes data, are some of the best in the country. I’ve been able to create excellent neuroscience programs because I organize well, pay attention to detail, and follow very high standards.”

Which leads to the second mantra guiding Józefowicz’ career: Be the best. “I always wanted to be the best,” he says. “I wanted to have the best committee, the best curriculum, the best program. I set the bar high and I set it high for everyone I work with. Everyone wants to be part of a winning team; I always thank people because no one has to do anything—so when they do, I’m very gracious.”


At this point, following an academic path might sound very appealing, but there’s something you should know: According
to an abundance of sources, neurologists in academics are the near the lowest end of the pay scale for their level of training. This is a reality that may deter some, but Józefowicz thinks that might be short-sighted. As he notes, “The issue has to do with the other perks you get. My salary would be better if I were in private practice but here I get to travel to Poland for a month every year, and to Spain for a few weeks. I can pick up and go to other institutions; I have variety in my job.”

To help balance the question of financial versus psychic rewards, Józefowicz says neurologists need to identify what gives them satisfaction in life. “For some, the money matters, but for me being a neurologist is like a vocation,” he explains. “I get my satisfaction out of the people that I teach, the students and residents that I work with, the colleagues I meet around the world. That’s why I’m happy. I have the best job in the world for me.”