Many surgeons who are entering the market have envisioned themselves doing a fellowship and entering an academic position. Often the traditional academic positions are extremely competitive, if even available with your timeline. Thus, assessing nonacademic practice opportunities is important. Many practice settings afford clinical teaching responsibilities. This could range widely, including options such as functioning as a preceptor for medical student required or elective rotations, physician assistant students, or even residents or fellows. Sometimes, residents can do elective rotations in community settings, making for a mutually advantageous opportunity if you are interested in teaching. Some teaching environments include the operating room, while others may only include the outpatient clinic.

If there is an existing arrangement with your employer to host trainees, do not assume that these students will necessarily be allowed or able to work with you. Obtaining clarification about this is crucial, if you are interested. If you prefer not to teach, also make this clear with your employer.

Occasionally, it is possible to do clinical research within a private practice setting, although this is not often a priority for practitioners or facilities. Administrative burden, including Institutional Review Board approval, study oversight, and any grant accounting, will likely need to be managed by you without help or with very little help. Today large research consortiums exist for many specialties, which may afford opportunities for study administration to be managed collectively, making it possible to engage in high quality studies, with less infrastructure.