Another one...which job to take?

[POCUS]

Hello All,

Truly appreciate your help deciding which job to take..

Job 1:
- Community hospital (affiliated with academic center), so it is pretty secure
- Lower acuity, not very busy but rapidly expanding (1 room after 5 pm, 1 room on weekends)
- Most days you stay till 4-5 pm
- Call: about 6 overnight calls/ month including one weekend (12 hour shifts with post-call day off) , CRNA and MD in house to cover OB/Trauma
- Compensation: salary and retirement contribution around 410-420K (around 10% of which is productivity-based) with ample opportunity to make more (work pre-call,
extra call or work on vacation). Have access to 457b in addition to 401k
- Vacation: 11-12 weeks
- Commute : 50 minutes each way!!

Job 2:
- Community hospital- PE owned, so less secure with risk of being sold, change in reimbursements, no-surprise billing ...etc
- Higher acuity but no trauma, covering 4 rooms almost all the time.
- Some early days ( done by noon ) and some late days (5-6 pm )
- Call 4-5 calls/month, in-house call with CRNA who covers OB, including one weekend/month. weekdays are 24hr call with post-call day off, weekends are 12 hr/shifts
- Compensation: salary and retirement total around 450K
- Vacation: 9 weeks
- Commute: 10 minutes each way

I really like the stability, extra vacation and not having to work pre-call in job 1 but dreading the commute (currently commute around 40 minutes each way) and don't appreciate that I don't have early days. Job 2 is decent, short commute but not as secure and also 24h call in a busy practice.

your thoughts and wisdom are greatly appreciate!

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[IMGASMD]

Do you get pre-call off at the first job?
The simplest math is your two-three week vacation is about 30-40K. Is that acceptable for you? You can probably make up that doing locum if you want.

Neither job is appealing to me, especially second one, with 1:4 all the time. Skill atrophy is real.

Move closer if is ever an option or rent a studio if necessary….

 

[POCUS]

Thank you for the response. Yes, I do get the pre-call day off at the 1st job .

 

[linkin06]

If only options, I would choose one because supervising four rooms closely is like running around w your head cut off.

 

[OTCAwesome]

Neither seem appealing me, but if I had to choose, definitely job 1

 

[deleted126335]

Job 1 and move closer.

 

[POCUS]

Thank you all for the feedback, for those who think job 1 isn’t appealing, is it mainly the commute or there’s something else ?
I thought low 400s with 11-12 weeks off and pre/post call off isn’t the best but reasonable but I could be wrong

 

[ERRES2288]

Both of these seem about average jobs from my experience in looking. Are the weekday calls 24 hour in house and busy or sleeping most of the night? Job 2 sounds like it will be very busy. 450k is not bad money but if you were a partner in a group doing that kind of work it would prob be 550-600k with good pre tax retirement

 

[POW16]

What part of the country ? I would also go with job 1.

 

[POCUS]

The 24hr in house calls aren’t too busy , CRNA covers OB and no trauma , ORs wraps up late evening!

 

[POCUS]

What part of the country ? I would also go with job 1.

South

 

[DocMcCoy]

Other than the commute, job 1 doesn’t sound too bad. I think that’s a reasonable salary with 12 weeks vacation.

 

[nimbus]

Thank you all for the feedback, for those who think job 1 isn’t appealing, is it mainly the commute or there’s something else ?
I thought low 400s with 11-12 weeks off and pre/post call off isn’t the best but reasonable but I could be wrong

6 overnight in-house calls/month is very call heavy. Especially if you’re off 11-12weeks/yr, that’s a lot of call when you’re not on vacation…..q3-q4.

 

[GassYous]

Do you guys really make that much? I think job 1 sounds just fine except the commute
I do think it's below average especially for the region but still

 

[Shimmy8]

6 overnight in-house calls/month is very call heavy. Especially if you’re off 11-12weeks/yr, that’s a lot of call when you’re not on vacation…..q3-q4.

Disagree. OP said he/she gets pre call off and “call” is only a 12 hour overnight shift.

If that’s really true…sign me up.

 

[nimbus]

Disagree. OP said he/she gets pre call off and “call” is only a 12 hour overnight shift.

If that’s really true…sign me up.

We do 1-2 overnight (14hr) shifts/month in an md only practice so 6 seems very heavy to me.

 

[IMGASMD]

Do you guys really make that much? I think job 1 sounds just fine except the commute
I do think it's below average especially for the region but still

Com’on. That’s below avg on SDN. You know that! 🤣

I make 350K + 10K (expenses)+ medical insurance (6K (?)) + vacations (10k/week if I sell) + no 401k until 2nd year (3%)

 

[patriot6]

Disagree. OP said he/she gets pre call off and “call” is only a 12 hour overnight shift.

If that’s really true…sign me up.

the length of shift isn't the problem for me; it's the (at least) 6 nights away from home.
too much for my taste.

 

[Shimmy8]

Eh I do that now. Guess I’m used to it. But mine are 24 and pre-call working. All about perspective.

That schedule would cut my hours by at least 1/3. I currently care about total time in hospital, I guess that could change in future.

 

[ERRES2288]

Com’on. That’s below avg on SDN. You know that! 🤣

I make 350K + 10K (expenses)+ medical insurance (6K (?)) + vacations (10k/week if I sell) + no 401k until 2nd year (3%)

I mean it’s tough to know without more info but if not academics and assuming average work hours this is low pay

 

[coffeebythelake]

Hello All,

Truly appreciate your help deciding which job to take..

Job 1:
- Community hospital (affiliated with academic center), so it is pretty secure
- Lower acuity, not very busy but rapidly expanding (1 room after 5 pm, 1 room on weekends)
- Most days you stay till 4-5 pm
- Call: about 6 overnight calls/ month including one weekend (12 hour shifts with post-call day off) , CRNA and MD in house to cover OB/Trauma
- Compensation: salary and retirement contribution around 410-420K (around 10% of which is productivity-based) with ample opportunity to make more (work pre-call,
extra call or work on vacation). Have access to 457b in addition to 401k
- Vacation: 11-12 weeks
- Commute : 50 minutes each way!!

Job 2:
- Community hospital- PE owned, so less secure with risk of being sold, change in reimbursements, no-surprise billing ...etc
- Higher acuity but no trauma, covering 4 rooms almost all the time.
- Some early days ( done by noon ) and some late days (5-6 pm )
- Call 4-5 calls/month, in-house call with CRNA who covers OB, including one weekend/month. weekdays are 24hr call with post-call day off, weekends are 12 hr/shifts
- Compensation: salary and retirement total around 450K
- Vacation: 9 weeks
- Commute: 10 minutes each way

I really like the stability, extra vacation and not having to work pre-call in job 1 but dreading the commute (currently commute around 40 minutes each way) and don't appreciate that I don't have early days. Job 2 is decent, short commute but not as secure and also 24h call in a busy practice.

your thoughts and wisdom are greatly appreciate!

both meh jobs.
okay, not spectacular.
#1 is better than #2, especially if u can find a place to live closer to the hospital

 

[BobLoblaw78]

And the winner is... #1. More secure, more predictable time off, more vacation to enjoy or work if you want more salary. I'd say the second is actually a good job. Not all jobs can be a top 10% type job.

 

[kidthor]

Ugh. No perfect option. 1:4 is awful - I don't know if I'd ever take a job at that ratio unless I was in 7 figures of pay and willing to sell my soul (both unlikely). But a 50 min commute both ways is also not awesome.

I vote for job 1, see how it goes, consider moving closer if you like it?

 

[POCUS]

Disagree. OP said he/she gets pre call off and “call” is only a 12 hour overnight shift.

If that’s really true…sign me up.

I mean it’s tough to know without more info but if not academics and assuming average work hours this is low pay

It is affiliated with an academic center but no residents/teaching as of yet .
Call on weekdays is from 5 pm-7 am , weekend is 7p-7am .
I agree that 6 overnight calls a month is a lot but i thought If call isn’t not too busy and you get pre and post-call off with 12 weeks off ..it would tolerable!

 

[IMGASMD]

I mean it’s tough to know without more info but if not academics and assuming average work hours this is low pay

It’s not a top job?
Just sharing my job, and wishing I have the opportunity to make 750+.

2 yr partnership. Pushing 500k. With everything around here, I am content.

AMCs will have me start probably close to 425ish. but I am allergic to corporate medicine, supervision all the time and paying part of my health insurance.

 

[coffeebythelake]

It is affiliated with an academic center but no residents/teaching as of yet .
Call on weekdays is from 5 pm-7 am , weekend is 7p-7am .
I agree that 6 overnight calls a month is a lot but i thought If call isn’t not too busy and you get pre and post-call off with 12 weeks off ..it would tolerable!

For early career anesthesiologist the overnight call schedule isn't bad (I'm early to mid career and I take about 2x 24h shifts a month) Is that built into the base comp, or is there extra pay for it?

 

[POCUS]

For early career anesthesiologist the overnight call schedule isn't bad (I'm early to mid career and I take about 2x 24h shifts a month) Is that built into the base comp, or is there extra pay for it?

The 6 calls are part of the base comp!

 

[Southpaw]

definite NO on Job 2. if you're supervising 4 rooms all the time you should make around 550 at a minimum. i would not recommend this job for the new grad as skill atrophy will be real. the crnas are doing OB. you're supervising 3-4 rooms all the time. What skills, other than people management and 'getting along', are you practicing and developing? This is not why you did an anesthesiology residency.

Job 1 - the 5p-7a shift will get old if you're really doing it 6 times a month. that shift will be close to 1/3 of your total shifts per month. put another way, you're on call q3ish when working. you get ample time off but you'll need it in my opinion. it's a far superior job to job 2, but in my opinion if I were in that job I'd need 3ish calls a month and on call every 6th weekend or so. You're sleeping in the hospital A LOT in this job so i think you should be making north of $500 for this. Not to mention all the driving. I guess if you end up liking the work and the people you'll be okay.

 

[circleK]

#1 unless the commute is that much of a dealbreaker.

Avoid PE. Their interests are in direct conflict with your interests and the job will likely change within 3-5 years. That is the nature of private equity.

 

[POCUS]

definite NO on Job 2. if you're supervising 4 rooms all the time you should make around 550 at a minimum. i would not recommend this job for the new grad as skill atrophy will be real. the crnas are doing OB. you're supervising 3-4 rooms all the time. What skills, other than people management and 'getting along', are you practicing and developing? This is not why you did an anesthesiology residency.

Job 1 - the 5p-7a shift will get old if you're really doing it 6 times a month. that shift will be close to 1/3 of your total shifts per month. put another way, you're on call q3ish when working. you get ample time off but you'll need it in my opinion. it's a far superior job to job 2, but in my opinion if I were in that job I'd need 3ish calls a month and on call every 6th weekend or so. You're sleeping in the hospital A LOT in this job so i think you should be making north of $500 for this. Not to mention all the driving. I guess if you end up liking the work and the people you'll be okay.

Thank you for your input, that’s one of my main concerns , for the overnight call to get old despite the pre/post off and vacation.
I have been out of practice for more than 10 years and currently only do 3 overnight calls/month..so it will be a big change for me !!

 

[GassYous]

It’s not a top job?
Just sharing my job, and wishing I have the opportunity to make 750+.

2 yr partnership. Pushing 500k. With everything around here, I am content.

AMCs will have me start probably close to 425ish. but I am allergic to corporate medicine, supervision all the time and paying part of my health insurance.

That's worth it

 

[anbuitachi]

agree with others, neither job is great. if i had to choice #1 for sure.

Your Job #1 sounds pretty similar to my job. I do 4 overnight calls, i would die doing 6 a month!. especially if you get 11 weeks vacation, thats about 1 week off a year. meaning you have 6 calls crammed into 3 weeks every month. that is BRUTAL.

Best part about #1 is vacation time. how much per hour do they pay you if you work precall/vacation?

 

[Hoya11]

Hello All,

Truly appreciate your help deciding which job to take..

Job 1:
- Community hospital (affiliated with academic center), so it is pretty secure
- Lower acuity, not very busy but rapidly expanding (1 room after 5 pm, 1 room on weekends)
- Most days you stay till 4-5 pm
- Call: about 6 overnight calls/ month including one weekend (12 hour shifts with post-call day off) , CRNA and MD in house to cover OB/Trauma
- Compensation: salary and retirement contribution around 410-420K (around 10% of which is productivity-based) with ample opportunity to make more (work pre-call,
extra call or work on vacation). Have access to 457b in addition to 401k
- Vacation: 11-12 weeks
- Commute : 50 minutes each way!!

Job 2:
- Community hospital- PE owned, so less secure with risk of being sold, change in reimbursements, no-surprise billing ...etc
- Higher acuity but no trauma, covering 4 rooms almost all the time.
- Some early days ( done by noon ) and some late days (5-6 pm )
- Call 4-5 calls/month, in-house call with CRNA who covers OB, including one weekend/month. weekdays are 24hr call with post-call day off, weekends are 12 hr/shifts
- Compensation: salary and retirement total around 450K
- Vacation: 9 weeks
- Commute: 10 minutes each way

I really like the stability, extra vacation and not having to work pre-call in job 1 but dreading the commute (currently commute around 40 minutes each way) and don't appreciate that I don't have early days. Job 2 is decent, short commute but not as secure and also 24h call in a busy practice.

your thoughts and wisdom are greatly appreciate!

i think job 2 sounds way better

50 minutes commute for job 1? that is un-doable... especially with that call burden.
yes you get 11 weeks vacation but the other weeks your life sucks and your driving home for hours tired, plus the compensation is lower than average

your concerns about job 2 - "less stable" and "busy 24h call" - unless there is an eminent threat towards job 2 i wouldnt worry about it being less stable just because its not an academic affiliate. And how busy can that call be at job 2 with no trauma? plus i dont mind being busy on call, its not like im living it up in the call room otherwise. i just want to get out of there.. job 2 would be my choice..

 

[POCUS]

Thanks you all again, your input is definitely helping me make a better decision.

Job 1 is very flexible with scheduling and I have the option of just doing straight 24hr calls, basically 8 24h calls a month and that's it (including a Saturday and a Sunday), that also adds about 30-40K to the compensation.
I don't know what to make of that option, It sounds attractive because it will cut down on my commute significantly and the extra income is nice but not sure how I feel about 8 24hr calls/month (calls will need to be covered in 3 weeks if I want to have a week off)!

Thoughts ?

 

[Guillemot]

Thanks you all again, your input is definitely helping me make a better decision.

Job 1 is very flexible with scheduling and I have the option of just doing straight 24hr calls, basically 8 24h calls a month and that's it (including a Saturday and a Sunday), that also adds about 30-40K to the compensation.
I don't know what to make of that option, It sounds attractive because it will cut down on my commute significantly and the extra income is nice but not sure how I feel about 8 24hr calls/month (calls will need to be covered in 3 weeks if I want to have a week off)!

Thoughts ?

Sounds like a lot of call. I think that would f' up my sleep wake cycle too much, but otherwise it could give you a lot of free time.

 

[coffeebythelake]

Thanks you all again, your input is definitely helping me make a better decision.

Job 1 is very flexible with scheduling and I have the option of just doing straight 24hr calls, basically 8 24h calls a month and that's it (including a Saturday and a Sunday), that also adds about 30-40K to the compensation.
I don't know what to make of that option, It sounds attractive because it will cut down on my commute significantly and the extra income is nice but not sure how I feel about 8 24hr calls/month (calls will need to be covered in 3 weeks if I want to have a week off)!

Thoughts ?

If u decide to do a heavy call burden like this and have less regular days, might be worth getting a pied a Terre close to the hospital

 

[IMGASMD]

Thanks you all again, your input is definitely helping me make a better decision.

Job 1 is very flexible with scheduling and I have the option of just doing straight 24hr calls, basically 8 24h calls a month and that's it (including a Saturday and a Sunday), that also adds about 30-40K to the compensation.
I don't know what to make of that option, It sounds attractive because it will cut down on my commute significantly and the extra income is nice but not sure how I feel about 8 24hr calls/month (calls will need to be covered in 3 weeks if I want to have a week off)!

Thoughts ?

Where’s that extra money coming from?
You’re 10 years out? Early 40s? Family?

It’s not horrible set up, if your nights are reasonable. But 48 hours in the hospital…. Cabin fever is real.

 

[ERRES2288]

It’s not a top job?
Just sharing my job, and wishing I have the opportunity to make 750+.

2 yr partnership. Pushing 500k. With everything around here, I am content.

AMCs will have me start probably close to 425ish. but I am allergic to corporate medicine, supervision all the time and paying part of my health insurance.

Well ya you didn’t mention you were on a track. That changes everything and worth it for 500k

 

[IMGASMD]

Well ya you didn’t mention you were on a track. That changes everything and worth it for 500k

Now I understood what @GassYous was referring to….

TBH, I am probably okay even staying for 350 with all the same benefits with full 401K contribution. ~ 400K ish. What can I say? I am cheap

 

[POCUS]

Where’s that extra money coming from?
You’re 10 years out? Early 40s? Family?

It’s not horrible set up, if your nights are reasonable. But 48 hours in the hospital…. Cabin fever is real.

I am mid 40s with family/kids, so I don't think spending 6-7 nights at the hospital and commuting 50 minutes each way is something I want to do at this point in my life or later for sure
I am considering job 2, I am ok with the salary and supervising CRNAs but my main concern is the security of a job that's owned by a PE. If the practice is sold, is it likely for the new owner to make dramatic changes, I would think they can't afford a mass exodus!
Anybody with experience being part of a PE owned practice that was sold to another entity (PE or another AMC), any significant change in compensation and/or culture ?

 

[IMGASMD]

I am mid 40s with family/kids, so I don't think spending 6-7 nights at the hospital and commuting 50 minutes each way is something I want to do at this point in my life or later for sure
I am considering job 2, I am ok with the salary and supervising CRNAs but my main concern is the security of a job that's owned by a PE. If the practice is sold, is it likely for the new owner to make dramatic changes, I would think they can't afford a mass exodus!
Anybody with experience being part of a PE owned practice that was sold to another entity (PE or another AMC), any significant change in compensation and/or culture ?

Good luck.
I never worked for PE. But for AMCs, when the gravy is good, everything is good. When it’s not, then everything is shlt. I’d imaging everything is about the almighty dollar.