2/
Wrong: You'll have "all the resources you need"
What are these? Stats, research cores, coordinator pools...
These are...people!
You cant promise a person!
Right: Meet X, 25% of their effort will be directed towards your work if you gel. Or here is $$$ to hire Y.
3/ Wrong: we expect you to do research, quality, etc
Right: we will support your research for X years
The week is 10 1/2 day sessions. Anything not clinical needs protection. 7 sessions is 30% protected. I was protected 3 years by the dept
Then I needed a grant for protection
4/ Integrate time and $ when comparing jobs
Wrong: Job X offered me $100 and job Y offered me $90
Right:
Job X expects me to be 80% clinical (8 sessions), valuing my time at $100/0.80 = $125
Job Y expects me to be 60% clinical, valuing my time at $90/0.60 = $150
5/
Wrong: Something super weird (or uncomfortable) happened during the interview process but it wasnt with someone I will work with directly so it is no prob
Right: Interviews hide dysfunction. If they couldnt do that, it needs to be considered seriously
Wrong: They want me to come in as a lecturer instead of assistant professor to keep the 7 year 'tenure clock' from starting
Right: All your accomplishments as lecturer will not be applicable when you go from assistant to associate. You are an assistant professor, my friend
8/
Wrong: They say I dont need extra startup money because my mentor has money they will use to help me
Right: Mentors come and go. Mentor grants come and go. If you need start up, it goes to you and is specified in your contract
9/
Wrong: Their offer is fixed and cannot be negotiated
Right: Everything is negotiable.
Wrong: They will be upset if I ask for more
Right: Everyone negotiates. If you dont ask, you cannot receive
How do you negotiate? Let me summarize that book you bought: you need multiple offers. Call it "BATNA" or call it rational thought.
1⃣Ask for the anything but unless you can get it (or something close) at job y, job x wont budge
2⃣Multiple offers help you know your market value
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It’s an enzyme that transfers amino acids to proteins. It's found anywhere things need transferring (liver cells, bile ducts, kidneys, heart....)
No big deal, right?
Wrong!
3/
It did not take long to figure out that while lots of conditions raised the GGT, liver disease and biliary obstruction were the best at making high GGT
First, I have mentors to thank. Dr Michelle Lai who gave me my start and launched me. @SenguptaNeil who taught me everything I know. And the reason I moved my family from Boston to a suburb of Detroit known away from good food, Dr Lok, the greatest mentor I will ever know
Second, I have advice. Find a place where you are surrounded by greatness and absorb it. It has been the great fortune of my life to work alongside and learn from people like JMellinger, @AkbarWaljee, and above all @NDP1001
We find that a clinicians' pre-test probability of HE is the same as the post-test probability. But! not only does Nh3 add nothing diagnostically, when high it leads to excess lactulose use even when tested in people without #cirrhosis
Now we need to design the QI intervention
I have always wanted to do this study. Huge thanks to @juanjgonMD 4 doing it. Even if u dont care about Nh3, we are very proud of our design, which allowed us to assess the value of a test using the clinician's real-time reasons for testing and prior probability