What Job offers are current residents getting?

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aimedicine

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I'm about to start PGY1 and hopefully will be in the job market in 4-5 years...and i'm hearing some "horror stories" about current job offers for anesthesiology....is 250k really the current norm???
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250-350 is pretty common with a 1-2 yr partnership track. 350-450 as a partner. This is for the MD only jobs that myself and colleagues have taken out west. I know of a Midwest job that a colleague took that is ~400k, partner from day 1, 50% supervision, home call 40hr/WK and 8 weeks vacation.
 
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aimedicine said:
I'm about to start PGY1 and hopefully will be in the job market in 4-5 years...and i'm hearing some "horror stories" about current job offers for anesthesiology....is 250k really the current norm???
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$300K is the more the norm but if you don't mind working hard then $350 is quite likely.
 
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BLADEMDA said:
$300K is the more the norm but if you don't mind working hard then $350 is quite likely.
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1) what hrs are u wrking to make 300k and what about 350k?

2) if i put in 70 to 80hrs a week, what kind of salary can i expect? my goal is to work my butt off for a few years starting out as an attending and pay off my student loans and put some money away for saving, luckily my significant other also earns close to 100k yearly.
 
aimedicine said:
1) what hrs are u wrking to make 300k and what about 350k?

2) if i put in 70 to 80hrs a week, what kind of salary can i expect? my goal is to work my butt off for a few years starting out as an attending and pay off my student loans and put some money away for saving, luckily my significant other also earns close to 100k yearly.
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70 hours per week? That is $350-$400K territory at least if not more. If you are really willing to work that much and that hard don't fret about earning $250K as you will easily surpass that amount.
 
70hrs/week x 200/hr x 44weeks = 616k

You should be at least 450-500k

You can't always work 70hrs/week because sometimes the volume is not there.
 
nimbus said:
70hrs/week x 200/hr x 44weeks = 616k

You should be at least 450-500k

You can't always work 70hrs/week because sometimes the volume is not there.
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It sounds to me (based on everything i've read on this forum) that the golden days of anesthesia is gone and never to return, so are you saying a 600k/yr salary is still possible provided one is willing to work hard? because that's really what i'm looking for, working hard is not an issue for me
 
When interviewing for a job, what are some of the less obvious but important questions to ask? (We don't get much coaching on this stuff...)
 
aimedicine said:
It sounds to me (based on everything i've read on this forum) that the golden days of anesthesia is gone and never to return, so are you saying a 600k/yr salary is still possible provided one is willing to work hard? because that's really what i'm looking for, working hard is not an issue for me
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Yes
 
I'd look at total compensation (income plus paid benefits (health care, retirement matching, cme money etc) plus paid vacation (if any paid) vs hours worked

Doesn't mean anything to me if someone says they make 300k. Same with 400k.

I probably make between 350-375k total compensation this year. Working between 45-50 hours a week. Beeper call 1:5 from home (rarely get called in, usually done around 7-9pm with cases). One weekend every 6 weeks. Post call day off 80-90% of time. If I work post call, I'll get paid extra as well. Taking 8 weeks off paid vacation (I don't count paid vacations part of my total compensation).

But if I did. That each week of vacation is estimated to be worth $7000 with our group. So if I sold all my vacation it would be worth $56k. So add that to the 350-375k I was quoting. Which means if we count paid vacation my total compensation would be 400-425k.

So look at entire package when looking at jobs. I've seen ads that quote $425-450k. Than you scroll down and see how many weeks of paid vacation and it reads "0". Which means if you want to make 425-450k you will work 52 weeks in the year. No one will kill themselves for that.
 
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Straight out I've made 430-475 depending on how much vacation I took. We get six weeks but if didn't use it all I made a little more. Overall hours aren't bad but when it sucks it sucks.... I've worked 35 hours straight and I've gone home at 2 on call and not been called in again. It's bfe. Nice thing is it's flexible... Extra vacation days just docs your pay. That said, and I know you won't believe me, money isn't everything- I did my time here and I'm getting out. Bfe and the totally unpredictable schedule are annoying but many of the non-anes Drs here are total and complete idiots.... It's not good. I can't be part of it anymore. Don't kill yourself to bank.... Think a little more long term... I wish I had... I wish I'd have listened to my staff who told me the same....
 
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If you want to work hard, look for a production based (so called "eat what you kill") group with good volume.
 
what does BFE mean? boondocks forever? pardon my ignorance im new to this
 
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Paid vacation means you get paid even though you don't work. I get 10 weeks unpaid. If I sell it I get paid a lot more. Above poster is wrong.
 
If you care more about location and work environment than salary, how difficult is it to crack the competitive locales? I'm interested in small mountain towns in places like CA, WA, OR or CO. Seems like a lot of the groups have only a handful of FTE positions in these smaller hospitals, and maybe some locums prn. Is locums a good way to 'get a foot in the door' with these groups?
 
Koan said:
If you care more about location and work environment than salary, how difficult is it to crack the competitive locales? I'm interested in small mountain towns in places like CA, WA, OR or CO. Seems like a lot of the groups have only a handful of FTE positions in these smaller hospitals, and maybe some locums prn. Is locums a good way to 'get a foot in the door' with these groups?
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Northern cali has some good mountain locations with good jobs. Salt lake city or boulder is going to be tougher.
 
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...if i had to di it again i would look at reno. Bad reputation as a town but actually an outdoor paradise. Kayak park in town and 45 min to tahoe. No state income tax!!
 
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I don't know about those eat what you kill places.... Who makes the schedule? A couple friends had these kinds of jobs and some anes would schmooze the high rvu case Drs. For requests etc. everyone I know who has done that kind of thing hates it except for one who's in paradise for him so he doesn't care.... Oh n I think chocomorsel on here does eat what you kill and is happy.... It's not for me.
 
pjl said:
Paid vacation means you get paid even though you don't work. I get 10 weeks unpaid. If I sell it I get paid a lot more. Above poster is wrong.
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Please clarify. If u aren't getting paid for ur vacation. How exactly sell something you don't get paid for?
 
amyl said:
I don't know about those eat what you kill places.... Who makes the schedule? A couple friends had these kinds of jobs and some anes would schmooze the high rvu case Drs. For requests etc. everyone I know who has done that kind of thing hates it except for one who's in paradise for him so he doesn't care.... Oh n I think chocomorsel on here does eat what you kill and is happy.... It's not for me.
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Look for a more blended units system. More more fair for the type of work.

True eat what you kill can screw a lot of young naive new grads where senior partners cherry pick the best paying insurance mix. Those senior partner end up out the door around 1pm just in time for a late lunch making twice as money as you are still stuck in Medicare cases till dinner time. Always be sure to ask how cases are divided. Who makes the schedule? If it's true eat what you kill and fair. There should be a rotating number system where each MD is afforded equal opportunity to pick cases.

Blended unit system is more insurance blind so that those who choose the tougher or more units generating cases (or just plain do more volume to generate units)
 
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And when you interact with other members of the group besides those that are formally interviewing you be sure to ask about the fairness of case allocation and the relationship with the surgeons.
 
Do anesthesiologist bill patient separately for their service, or do they get a cut from the Surgeon pay?
 
amyl said:
I don't know about those eat what you kill places.... Who makes the schedule? A couple friends had these kinds of jobs and some anes would schmooze the high rvu case Drs. For requests etc. everyone I know who has done that kind of thing hates it except for one who's in paradise for him so he doesn't care.... Oh n I think chocomorsel on here does eat what you kill and is happy.... It's not for me.
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You are correct that such a system can be gamed. It needs to be set up so that gaming is more difficult.

We have a blended unit and we pick our own lineup for the following day based on our position on the call list. The night call guy comes in at 4pm and calls the others going down the call list for the following day. Some people choose to pick lineups with as many units as possible. Others choose to work with their friends. If your day blows up the following day, you have only yourself to blame. We allow patient requests but not surgeon requests. We are very happy with this system.
 
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My group got bought out by the hospital before I got here but before they were eat what you kill. One of my partners actually had his wife call the scheduling office, claim to be the patients and request him. He eventually got caught when one of the patients was like I didn't request him.... He's been a bad actor before I got there... Been on probation. Nurses alleged he smelled like alcohol on night on call and said he was acting weird but we're scared to go against him and suggest a BAC.... So he got away with it. Another night he was on call he called the ER n OB, etc. to make sure nothing was cooking. About 2am he got the call for an emergency case. He allegedly came in, saw they weren't ready, put his pager and phone in his locker (whoops) and went to go nap in his car and couldn't be found until the next am. He's also not board certified or eligible and uses LMAs in lap gyn trendelenberg cases that last 2 hours or so. Admin won't ever fire him bc he does pain procedures, without a fellowship, that brings in extra $.... Even though we supposedly pool our RVUs he jacks with the schedule all the time, makes sure surgeons request him as much as he can and throws a fit when one of us is requested on a daily basis.... I'm so above this ****.... Counting the days until I can go!
 
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nimbus said:
You are correct that such a system can be gamed. It needs to be set up so that gaming is more difficult.

We have a blended unit and we pick our own lineup for the following day based on our position on the call list. The night call guy comes in at 4pm and calls the others going down the call list for the following day. Some people choose to pick lineups with as many units as possible. Others choose to work with their friends. If your day blows up the following day, you have only yourself to blame. We allow patient requests but not surgeon requests. We are very happy with this system.
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This is pretty much a carbon copy of how we do it at my current gig as well. It works out nicely and I appreciate being able to pick my room everyday. We have a few other obscure rules in place as well to make "gaming the schedule" extremely difficult (even though a few still try) but for the most part it's about as fair you can make it. Everyone from the brand new hire to old old timers get an equal crack at things.

The biggest factor is always gonna be the quality of the individuals in the practice. If all the partners are stand-up dudes then things will be fair regardless of what the "system" is. If you work with a bunch of douchenozzles they will always find a way to try and screw you for their own personal gain regardless of how "fairly" things are structured. Getting a feel for the culture of the practice and the quality/integrity of the partners is vitally important. Remember that you are interviewing the practice just as much as they are interviewing you. Spend as much time with as many people as you can on interview day. Don't be afraid to walk if something smells fishy or your spider sense goes off.
 
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The way that job offer reads to me is 425k or whatever for 46 weeks of work. meaning you have 6 weeks where you are unpaid. At least that is how our group does it. Basically, at the end of the year there is a value per day of work and everyone gets their days worked times that value in pay.

I get XXX for 42 weeks of work. If I "sell" my vacation, the guy who takes it pays me 1/42 or so of a regular salary, or one weeks worth of pay. So my final yearly salary is XXX + 1 week worth of salary. You are selling your time off for money.

So your read that you would never hit 425 unless you didnt ever take vacation is wrong. actually you may be able to make 425+9 if you only took 5 weeks off, or if you truly didnt have any vacation = 480.
 
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Also, Amy, that job blows, get out of there, or get that clown out of there if the rest of the group is good. You dont need to be a part of that.
 
SaltyDog said:
The biggest factor is always gonna be the quality of the individuals in the practice. If all the partners are stand-up dudes then things will be fair regardless of what the "system" is. If you work with a bunch of douchenozzles they will always find a way to try and screw you for their own personal gain regardless of how "fairly" things are structured. Getting a feel for the culture of the practice and the quality/integrity of the partners is vitally important. Remember that you are interviewing the practice just as much as they are interviewing you. Spend as much time with as many people as you can on interview day.
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This goes without saying but I'm glad you said it. The system doesn't matter if you have this. Surgeons and staff have a huge impact too. It trumps almost everything else in terms of your total job satisfaction.
 
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pjl said:
The way that job offer reads to me is 425k or whatever for 46 weeks of work. meaning you have 6 weeks where you are unpaid. At least that is how our group does it. Basically, at the end of the year there is a value per day of work and everyone gets their days worked times that value in pay.

I get XXX for 42 weeks of work. If I "sell" my vacation, the guy who takes it pays me 1/42 or so of a regular salary, or one weeks worth of pay. So my final yearly salary is XXX + 1 week worth of salary. You are selling your time off for money.

So your read that you would never hit 425 unless you didnt ever take vacation is wrong. actually you may be able to make 425+9 if you only took 5 weeks off, or if you truly didnt have any vacation = 480.
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It's all in the details. That's why no one should trust any ads posted. If ads says $425k and writes paid vacation. And it's "zero" listed. Than those are red flags.

Does your contract say you will be paid x Amount for 46 weeks? Than that means you have 6 weeks paid off.

We are both looking at
pjl said:
The way that job offer reads to me is 425k or whatever for 46 weeks of work. meaning you have 6 weeks where you are unpaid. At least that is how our group does it. Basically, at the end of the year there is a value per day of work and everyone gets their days worked times that value in pay.

I get XXX for 42 weeks of work. If I "sell" my vacation, the guy who takes it pays me 1/42 or so of a regular salary, or one weeks worth of pay. So my final yearly salary is XXX + 1 week worth of salary. You are selling your time off for money.

So your read that you would never hit 425 unless you didnt ever take vacation is wrong. actually you may be able to make 425+9 if you only took 5 weeks off, or if you truly didnt have any vacation = 480.
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You are obviously looking at working for 46 weeks at X amount and the other 6 weeks as "unpaid" in a glass full/empty way.

Most of us don't look at it that way. Your group does this to increase the value of their work day/week in case someone needs to sell it.

Is your 6 weeks off mandatory? Meaning if no one can trade with you, are you still obligated to take those weeks off?

Look we can get into semantics about paid vs unpaid vacation. But at the end of the day, if you can't find a trading parter to sell your "unpaid week off", are you forced to take those weeks off? Yes or No?

The reason I like to point this out is some companies like Apollo MD like to inflate their figures to applicants. Now not all their jobs and contracts are the same. But you gotta read into the line how to determine max income. Often times its based on 52 weeks working and zero vacation. Another smaller private group in Baltimore area (non AMC) does this as well. Same with many California practices when looking at max income.

My read on never hitting the max is correct in a lot of situations. Maybe not correct with your group. But it's correct with a lot of models out there.
 
My contract is a partnership. I get what we take in minus expenses divided by days worked. I suppose I could be "forced" to take days off, but that would just mean that I was at 100% of the listed income rather than 125%.

I agree that it is semantics, and there are a lot of tricky ways to write it out there, but I would not automatically assume that you can never get to max.
 
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I was more or less asking if anyone had recently been offered anything in this area.
 
kortneeluv said:
I was more or less asking if anyone had recently been offered anything in this area.
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Tennessee is a very long state. It's literally a 6 hour drive from the east side to the west side of the state.

So saying "rural TN" means nothing.

Most of the urban TN groups have sold out to AMCs and taken the cash.

Rural TN is pretty poor compared to the urban centers. U will be dealing with a lot of Tenncare type of population.
 
Can more current residents (or attendings that are recrutiting) comment on Job offers they are getting?

thanks.
 
aneftp said:
Tennessee is a very long state. It's literally a 6 hour drive from the east side to the west side of the state.

So saying "rural TN" means nothing.

Most of the urban TN groups have sold out to AMCs and taken the cash.

Rural TN is pretty poor compared to the urban centers. U will be dealing with a lot of Tenncare type of population.
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Yes I know very well how "long" TN is and I know their population intimately. I'm a TN native. I was hoping to actually get a response from someone who had an answer to my question. But thanks.
 
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Low to mid 3's was my observation 6-8 yrs ago. Very few partnership opportunities remained (almost none in cities) and some following that track got swooped by AMC's, which are quickly gaining ground. Avoid Mira, a subsidiary of Northstar.
 
kortneeluv said:
Yes I know very well how "long" TN is and I know their population intimately. I'm a TN native. I was hoping to actually get a response from someone who had an answer to my question. But thanks.
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Every rural contract is different. Because most of it involves significant federal funding. It all boils down to how much the hospital and their administrators want to "kick back" to anesthesia.

Hardly anyone will respond to your question because it's a a vague question. What specific location are you looking at.

My wife is from Chattanooga area and I've worked in Memphis area before. I've also looked at various jobs from "eastern TN (Bristol/tri cities) to Outside of Nashville as well.

I can tell you rural contracts are so variable. The actual rural contract for an MD being on call 24/7 for 52 weeks is often times worth close to 900-1 million.

My buddy covers a doc for 12 weeks out of a year. The doc gives him $200k. And so the doc gets paid $700k being on call 24/7 (backup) for 40 weeks out of a year. Crnas are hospital employees.

So if management companies comes in and steals that contract. They most likely will other some md $400k and shave the rest off the top in terms of profits.

True rural hospital. Around 20-30 cases a week.
 
aimedicine said:
Can more current residents (or attendings that are recrutiting) comment on Job offers they are getting?

thanks.
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About to graduate. Starting at $370k and bumped to $440k once board certified. We cover one hospital and one surgery center for a total of 16 ORs plus BUSY OB and outside locations. No hearts (unfortunately, I love CV), no transplants, lots of pedi from birth on up but in general they are healthy babies. We have several docs and several CRNAs. The MD on call makes the next day's schedule and you can pick your room and decide to be solo or supervise. Cases done by 7-9pm. We are home call and rarely get called in but we do work post call but usually as extra set of hands and obviously first to go home. We work about every 6th weekend or so. Eight weeks vacation plus two more for CME and stuff like that. I got a moving allowance ($20k) and a signing bonus ($20k). The location for me is great. The town is ~350k people in the mountains with two ski resorts very close by. I signed a few months ago and my patience for the BS and grind of residency dropped off severely and remains barely intact for me to smile and nod through the rest of the academic year.
 
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caligas said:
...if i had to di it again i would look at reno. Bad reputation as a town but actually an outdoor paradise. Kayak park in town and 45 min to tahoe. No state income tax!!
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Sevoflurane just took a job out there. You should ask him how he likes it. (Don't ask me how I know this. Suffice it to say it's a small world. ;) )
 
IveGotTwins said:
About to graduate. Starting at $370k and bumped to $440k once board certified. We cover one hospital and one surgery center for a total of 16 ORs plus BUSY OB and outside locations. No hearts (unfortunately, I love CV), no transplants, lots of pedi from birth on up but in general they are healthy babies. We have several docs and several CRNAs. The MD on call makes the next day's schedule and you can pick your room and decide to be solo or supervise. Cases done by 7-9pm. We are home call and rarely get called in but we do work post call but usually as extra set of hands and obviously first to go home. We work about every 6th weekend or so. Eight weeks vacation plus two more for CME and stuff like that. I got a moving allowance ($20k) and a signing bonus ($20k). The location for me is great. The town is ~350k people in the mountains with two ski resorts very close by. I signed a few months ago and my patience for the BS and grind of residency dropped off severely and remains barely intact for me to smile and nod through the rest of the academic year.
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Congrats, that sounds like a great job. Hospital employed or private practice?
 
IveGotTwins said:
. The town is ~350k people in the mountains with two ski resorts very close by.
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First, congratulations.

I'm a ways off from truly -needing- to know, but I wonder how you land these types of opportunities (good location [for me = mountains], good pay)? Do you train locally?

In Northern California, anyway, many of the guys in PP (at least Kaiser, where you can easily check out folks' training online) it seems like many come west from top programs on the East coast.

Bottom line: can a regular grad of a solid but low-name-recognition residency land one of these gigs straight out of training?
 
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