Pros
The reputation of Duke carries alot of weight with outsiders, including vendors and/or possible collaborators. Benefits are better than most, including accrued time off, but this is offset by the generally lower-than-industry base pay and limited, if any, merit bonus opportunities. If you're looking for a place to punch in and then punch out after 8 hours, this is the place for you.
Cons
Power still resides with doctors. Hierarchy is very evident with top-down decision-making/communication. Little continuing education/development unless required for re-certification. Alot of "good old boy" networking. Low pay with single digit yearly salary increases. Little differentation between raise percentages based on performance; ie., exceeds performance raise percentage may be less than a 1% different than "meets" performance. Depending on when you are hired, you may not be eligible for a raise for over a year. When negotiating your compensation package, many of the benefits are non-negotiable; ie., time off is set based on years of service and cannot be modified.