Are there significant downsides to my earnings potential in the academic world, e.g., “hidden obligations?”

Another problem faced by many clinician-teachers is having enough time to meet their practice, research, and teaching obligations.

Typically, as you mature in your job, time is slowly eroded away by department requirements to attend meetings, join committees, and take on extra responsibilities such as interviewing student or resident applicants. Often, the extra time for these unforeseen activities is subtracted from your clinical practice time, impacting your earnings. Be aware of these “hidden obligations.” Speak with other clinician-teachers at the institution and determine to what extent this will pose a threat to your income, retention, or promotion. Based upon these conversations, negotiate up front the amount of time you will devote to these activities.