Another "which job" question

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patriot6

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Both jobs in the Southeast.

1. Employed. 600k. Medical direction model. 9 weeks off. Basic benefits, including HSA, 401K, 457b, partial employer paid health coverage. 8-10 weekends a year (12 hour shifts on SAT/SUN, alternates between AM/PM). No weekday overnight call which is covered by a full time "nocturnist" rotation. All cases. Busy trauma program. Busy place, not uncommon to be running 4 rooms on the weekend.

2. Employed. 530K. Medical direction model. 17 weeks off. Social security replacement plan, 401k, 457b, HSA. No cardiac, neuro, or trauma; mostly routine cases. Schedule goes like this: one week you're on call MWFSaSu, following week you're on call Tues/Thurs. OFF the third week. 12 on, 9 off rotation. On non call days, you're typically out by 9am. OR typically wraps up by 5pm on call days with infrequent call back. Weekend schedule is light... sometimes no work, though can have occasional busy weekend days (maybe 8h of work).

Thanks!
patriot
 
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Posting for a member wanting to remain anonymous. Both jobs in the Southeast.

1. Employed. 600k. Medical direction model. 9 weeks off. Basic benefits, including HSA, 401K, 457b, partial employer paid health coverage. 8-10 weekends a year (12 hour shifts on SAT/SUN, alternates between AM/PM). No weekday overnight call which is covered by a full time "nocturnist" rotation. All cases. Busy trauma program. Busy place, not uncommon to be running 4 rooms on the weekend.

2. Employed. 530K. Medical direction model. 17 weeks off. Social security replacement plan, 401k, 457b, HSA. No cardiac, neuro, or trauma; mostly routine cases. Schedule goes like this: one week you're on call MWFSaSu, following week you're on call Tues/Thurs. OFF the third week. 12 on, 9 off rotation. On non call days, you're typically out by 9am. OR typically wraps up by 5pm on call days with infrequent call back. Weekend schedule is light... sometimes no work, though can have occasional busy weekend days (maybe 8h of work).

Thanks!
patriot
Neither!

I’m serious. The daytime job will kill u being there 7-3(5p) most days. You need to force them today n-Friday is 40 hours) and anything more is $350hr

You need days off in the week to be honest. I’d tell them to have weekends as optional and separate the pay (base 550k) with no weekends. It works out the same but you choose when you want to work on weekends.

The other job needs to be 26 weeks off in my opinion. Too much calls sounds similar to my current job but I get 30 weeks off. For similar pay. 30k less.
 
Posting for a member wanting to remain anonymous. Both jobs in the Southeast.

1. Employed. 600k. Medical direction model. 9 weeks off. Basic benefits, including HSA, 401K, 457b, partial employer paid health coverage. 8-10 weekends a year (12 hour shifts on SAT/SUN, alternates between AM/PM). No weekday overnight call which is covered by a full time "nocturnist" rotation. All cases. Busy trauma program. Busy place, not uncommon to be running 4 rooms on the weekend.

2. Employed. 530K. Medical direction model. 17 weeks off. Social security replacement plan, 401k, 457b, HSA. No cardiac, neuro, or trauma; mostly routine cases. Schedule goes like this: one week you're on call MWFSaSu, following week you're on call Tues/Thurs. OFF the third week. 12 on, 9 off rotation. On non call days, you're typically out by 9am. OR typically wraps up by 5pm on call days with infrequent call back. Weekend schedule is light... sometimes no work, though can have occasional busy weekend days (maybe 8h of work).

Thanks!
patriot
Job 1 between the two. Pay is solid, No weekday call is nice, kind of a lot of weekends but only 12 hour shifts is doable.

the second job depends on how bad call actually is, but I’d hate being on call that much. I never sleep well when on the clock. And if you get roasted overnight on MW, would make the weekend miserable despite how “light” it is.
 
Posting for a member wanting to remain anonymous. Both jobs in the Southeast.

1. Employed. 600k. Medical direction model. 9 weeks off. Basic benefits, including HSA, 401K, 457b, partial employer paid health coverage. 8-10 weekends a year (12 hour shifts on SAT/SUN, alternates between AM/PM). No weekday overnight call which is covered by a full time "nocturnist" rotation. All cases. Busy trauma program. Busy place, not uncommon to be running 4 rooms on the weekend.

2. Employed. 530K. Medical direction model. 17 weeks off. Social security replacement plan, 401k, 457b, HSA. No cardiac, neuro, or trauma; mostly routine cases. Schedule goes like this: one week you're on call MWFSaSu, following week you're on call Tues/Thurs. OFF the third week. 12 on, 9 off rotation. On non call days, you're typically out by 9am. OR typically wraps up by 5pm on call days with infrequent call back. Weekend schedule is light... sometimes no work, though can have occasional busy weekend days (maybe 8h of work).

Thanks!
patriot
I’m looking at 26 week jobs for around 480k. Job 2 maybe workable depending on your effective hourly rate on actual hours worked. Otherwise more cash for both imo
 
Posting for a member wanting to remain anonymous. Both jobs in the Southeast.

1. Employed. 600k. Medical direction model. 9 weeks off. Basic benefits, including HSA, 401K, 457b, partial employer paid health coverage. 8-10 weekends a year (12 hour shifts on SAT/SUN, alternates between AM/PM). No weekday overnight call which is covered by a full time "nocturnist" rotation. All cases. Busy trauma program. Busy place, not uncommon to be running 4 rooms on the weekend.

2. Employed. 530K. Medical direction model. 17 weeks off. Social security replacement plan, 401k, 457b, HSA. No cardiac, neuro, or trauma; mostly routine cases. Schedule goes like this: one week you're on call MWFSaSu, following week you're on call Tues/Thurs. OFF the third week. 12 on, 9 off rotation. On non call days, you're typically out by 9am. OR typically wraps up by 5pm on call days with infrequent call back. Weekend schedule is light... sometimes no work, though can have occasional busy weekend days (maybe 8h of work).

Thanks!
patriot

1, but a big aspect of either job for me is whether or not you're covering OB which wasn't mentioned
 
1, but a big aspect of either job for me is whether or not you're covering OB which wasn't mentioned
Tons of light ob places. 300 deliveries a year.

Those places tend to be easier than no ob calls hospitals to be honest. In my experience.

Now once the ob volume goes over 600. It can get to be cumbersome with beeper. (In my experience)
 
job 2 especially if a noncompete is not present. 17 weeks off, if you need the extra money, you can make some real bucks or just hang out.

But you have to also consider the type of cases your doing cause they are totally different jobs, if you enjoy high level acuity, cardiac or neuro than job 2 may not give you the satisfaction.
 
The night float docs have the better schedule for the first job by the way.

They still require docs to do days and nights on weekend. It’s a bad deal. Do not take that “day job” with 9 weeks off.

Bad bad deal
 
Neither!

I’m serious. The daytime job will kill u being there 7-3(5p) most days. You need to force them today n-Friday is 40 hours) and anything more is $350hr

You need days off in the week to be honest. I’d tell them to have weekends as optional and separate the pay (base 550k) with no weekends. It works out the same but you choose when you want to work on weekends.

The other job needs to be 26 weeks off in my opinion. Too much calls sounds similar to my current job but I get 30 weeks off. For similar pay. 30k less.
Do yourself a favor, don’t listen to this guy.
 
Do yourself a favor, don’t listen to this guy.
I tell the truth. I have been around the block.

The day doc position unless it’s a true 7-3 with no weekend and or 4 (10 hr) days week will get you. If you are providing anesthesia services 43 weeks out of the year.

The weekends need to pay paid extra with that type of contract. I know 3 hospitals with that type of similar day doc /night doc arrangement within a 80 min drive of me.

Guess which docs leave?? The day docs are leaving. Because the night time job is way more attractive giving 26 weeks off for less work.

The times are changing. People don’t even want a 500k (5 day a week) surgery center job for 50 hours a week these days. With 8 weeks off and no weekends

People want time off.

You got to be an idiot to be working 42-44 weeks and being available 5 days a week plus a weekend every 5 or so weekends these days for even 600k.

700k I may flinch. And that’s why I said to make weekends optional. To make that extra money for those who want the extra cash.

Each weekend 12 hr shift is worth $5000 in my option. So if you are doing 12 of those shifts a year That immediately means they are underpaying you 60k.
 
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The schedule for #2 is fine if light call back, but working 17 72-hour weekends a year is a LOT!

I’d be fine with that schedule if paid >650k.
 
Tons of light ob places. 300 deliveries a year.

Those places tend to be easier than no ob calls hospitals to be honest. In my experience.

Now once the ob volume goes over 600. It can get to be cumbersome with beeper. (In my experience)
Look man I get your point about salary but that cannot be the only motivator. Some people want to sleep in their own bed at night with their family, have a sense of community, and are restricted to certain areas of the country.

700k weekends optional is coming from a pure locums man in a competitive city with multiple anesthesia sites.

Those jobs he posted about are reasonable jobs.
 
I tell the truth. I have been around the block.

The day doc position unless it’s a true 7-3 with no weekend and or 4 (10 hr) days week will get you. If you are providing anesthesia services 43 weeks out of the year.

The weekends need to pay paid extra with that type of contract. I know 3 hospitals with that type of similar day doc /night doc arrangement within a 80 min drive of me.

Guess which docs leave?? The day docs are leaving. Because the night time job is way more attractive giving 26 weeks off for less work.

The times are changing. People don’t even want a 500k (5 day a week) surgery center job for 50 hours a week these days. With 8 weeks off and no weekends

People want time off.

You got to be an idiot to be working 42-44 weeks and being available 5 days a week plus a weekend every 5 or so weekends these days for even 600k.

700k I may flinch. And that’s why I said to make weekends optional. To make that extra money for those who want the extra cash.

Each weekend 12 hr shift is worth $5000 in my option. So if you are doing 12 of those shifts a year That immediately means they are underpaying you 60k.
Not everyone has the opportunity, ability or circumstances to be where you are. I understand you want to share your wisdom, but it’s always couched in absolutist ways that are quite frankly, a little on the weird side.
I’ve heard enough of your spiel to basically know what you are always going to say. Some of it is actually good advice, but after awhile you start to sound like an Amway salesman. For young docs seeking advice, they should hear from you, but with a grain of salt. You sir, are not a grain of salt.

Make your own post full of your “advice”, and just reference that in your future posts. It’s getting weird bro.

Blessings.
 
Not everyone has the opportunity, ability or circumstances to be where you are. I understand you want to share your wisdom, but it’s always couched in absolutist ways that are quite frankly, a little on the weird side.
I’ve heard enough of your spiel to basically know what you are always going to say. Some of it is actually good advice, but after awhile you start to sound like an Amway salesman. For young docs seeking advice, they should hear from you, but with a grain of salt. You sir, are not a grain of salt.

Make your own post full of your “advice”, and just reference that in your future posts. It’s getting weird bro.

Blessings.
Been weird actually.
 
Not everyone has the opportunity, ability or circumstances to be where you are. I understand you want to share your wisdom, but it’s always couched in absolutist ways that are quite frankly, a little on the weird side.
I’ve heard enough of your spiel to basically know what you are always going to say. Some of it is actually good advice, but after awhile you start to sound like an Amway salesman. For young docs seeking advice, they should hear from you, but with a grain of salt. You sir, are not a grain of salt.

Make your own post full of your “advice”, and just reference that in your future posts. It’s getting weird bro.

Blessings.
Of course there are many factors for one to take jobs and “settle”.

I wish people would be more specific with their situation “I need to be in X place due to parents, spouse’s work” or “daycare/child care”

But when people post vague jobs without any other factors. I tell it like it is. Those aren’t great jobs. Now if they tell me those are there only two options, than I can give a much more concise evaluation of both those jobs.

Look at my response for the med student/potential resident about the Minnesota program. I basically told them to rank the program.

So I tell it the way it is.

I have tons of people DM me about this job and that job. I give them the same advice.


As for the current above poster I wanted to add

The Op should his tell his friend if he/she were to take one of those jobs. They need to insist on a LeBron James 1 plus 1 deal.

Ask for a 100k sign on bonus over 2 years but make it 50k for one year and another 50k for the second year. So don’t take the 100k up front. It’s gets whacked with 35% taxes anyways.

That way they can bail after one year or renegotiate. So you control your own narrative and not let the employer dictate it.
 
2. Employed. 530K. Medical direction model. 17 weeks off. Social security replacement plan, 401k, 457b, HSA. No cardiac, neuro, or trauma; mostly routine cases. Schedule goes like this: one week you're on call MWFSaSu, following week you're on call Tues/Thurs. OFF the third week. 12 on, 9 off rotation. On non call days, you're typically out by 9am. OR typically wraps up by 5pm on call days with infrequent call back. Weekend schedule is light... sometimes no work, though can have occasional busy weekend days (maybe 8h of work).

Thanks!
patriot

What do you all think this job is worth?
With a directorship, this could get to 650-675k compensation (before any additional employer retirement contribution)
I think this would be like 90% percentile total comp MGMA for the South? Not sure how accurate MGMA data is.
 
What do you all think this job is worth?
With a directorship, this could get to 650-675k compensation (before any additional employer retirement contribution)
I think this would be like 90% percentile total comp MGMA for the South? Not sure how accurate MGMA data is.
Hca pays around 600k for similar job like that in Florida. 17 weeks off. Beeper with crna covering Or and OB
 
I tell the truth. I have been around the block.

The day doc position unless it’s a true 7-3 with no weekend and or 4 (10 hr) days week will get you. If you are providing anesthesia services 43 weeks out of the year.

The weekends need to pay paid extra with that type of contract. I know 3 hospitals with that type of similar day doc /night doc arrangement within a 80 min drive of me.

Guess which docs leave?? The day docs are leaving. Because the night time job is way more attractive giving 26 weeks off for less work.

The times are changing. People don’t even want a 500k (5 day a week) surgery center job for 50 hours a week these days. With 8 weeks off and no weekends

People want time off.

You got to be an idiot to be working 42-44 weeks and being available 5 days a week plus a weekend every 5 or so weekends these days for even 600k.

700k I may flinch. And that’s why I said to make weekends optional. To make that extra money for those who want the extra cash.

Each weekend 12 hr shift is worth $5000 in my option. So if you are doing 12 of those shifts a year That immediately means they are underpaying you 60k.

How does the Friday before a weekend look? Are you off on Monday after a weekend shift?

I agree, nights + weekend coverage need to be paid at a premium.
 
I tell the truth. I have been around the block.

The day doc position unless it’s a true 7-3 with no weekend and or 4 (10 hr) days week will get you. If you are providing anesthesia services 43 weeks out of the year.

The weekends need to pay paid extra with that type of contract. I know 3 hospitals with that type of similar day doc /night doc arrangement within a 80 min drive of me.

Guess which docs leave?? The day docs are leaving. Because the night time job is way more attractive giving 26 weeks off for less work.

The times are changing. People don’t even want a 500k (5 day a week) surgery center job for 50 hours a week these days. With 8 weeks off and no weekends

People want time off.

You got to be an idiot to be working 42-44 weeks and being available 5 days a week plus a weekend every 5 or so weekends these days for even 600k.

700k I may flinch. And that’s why I said to make weekends optional. To make that extra money for those who want the extra cash.

Each weekend 12 hr shift is worth $5000 in my option. So if you are doing 12 of those shifts a year That immediately means they are underpaying you 60k.
Not exactly crazy talk if we’re being honest with ourselves. Most people are favor time off if it comes with a half decent wage. As the quote post is saying, if you’re going grind someone the job needs to be ready to pay for it. I think even the certain much disdained AMC in the northeast is claiming. 40-45 hr work weeks for 500k. (Not sure of the reality that’s being advertised)
 
How does the Friday before a weekend look? Are you off on Monday after a weekend shift?

I agree, nights + weekend coverage need to be paid at a premium.
it varies. Usually day off before weekend
 
Both jobs in the Southeast.

1. Employed. 600k. Medical direction model. 9 weeks off. Basic benefits, including HSA, 401K, 457b, partial employer paid health coverage. 10 weekends a year (12 hour shifts on SAT/SUN, alternates between AM/PM). No weekday overnight call which is covered by a full time "nocturnist" rotation. All cases, except cardiac which is covered by fellowship trained docs. Busy trauma program, busy place, not uncommon to be running 4 rooms on the weekend.

2. Employed. 650K. Medical direction model. 17 weeks off. Social security replacement plan, 401k, 457b, HSA. No cardiac, neuro, or trauma; mostly routine cases. Schedule goes like this: one week you're on call MWFSaSu, following week you're on call Tues/Thurs. OFF the third week. 12 on, 9 off rotation. On non call days, you're typically out by 8am. OR typically wraps up by 5pm on call days with some call back, usually for labor epidurals or c-sections. They do about 800 deliveries a year. Weekend schedule is light to moderate... rarely no work, usually 8h of work total, sometimes more than that.

Thanks!
patriot

bumping this because I find myself in a mini dilemma; always appreciate insight here.
edited the quoted post to more accurately reflect the jobs I'm debating.

I actually left job 1 for job 2. I've been in this position for about a month, and I'm struggling with the adjustment to call. I mean, I'm home a lot more. Heck, I've got 17 weeks completely off. I've got small kids so the time is valuable. Plus, even on my "on" weeks, I've got plenty of time at home on my post call days. But, I'm just dreading being on service. I don't really enjoy the low acuity work. Old facility.

I'm wondering if i would be better off buying some more vacation in job 1, maybe taking 12 weeks.
The work there was much more stimulating and rewarding; though, less time at home.
I suppose it's all pros and cons.

Any thoughts?

Thankful in advance.
 
I agree a lot with what @aneftp says. I am in a competitive desirable area where envision dominates the market and their jobs are all basically 500k with 8 weeks off and working everyday and 1 weekend every 4-5 weeks. You get maybe 3-4 post call days a month also. Recently they opened up a new position with 17 weeks off but without pre or post call days. It is not always easy working 5 real days in a row but the extra time off is way more valuable. I can take more vacation or go do locums and make crazy money with those extra 9 weeks off. I will wish there was more weeks off or more pay but I am tied to this area. Anesthesiologists need to move away from working everyday 45-50 hours a week with 8 weeks vaca. That is where these hospitals and companies take advantage of you.
 
Honestly that type of job the op just started should be close to a 26 weeks off job

There is job in Florida (with 100% supervision) 6a-7p (17 weeks of work for entire year) (7 calls in a row) 2 weeks off.

35 weeks off.

For 500k. Plus generous hospital benefits and retirement matching. And ability to defer up to 60k pretax a year

I value the job the OP is doing at 650k a year a min with 17 weeks off with that many calls.

9 weeks extra off is worth easily 120k or more.

That’s how I came to my calculation based on the OP 530k base salary.
 
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400k no calls no weekends
7 weeks off. Usually done by 2pm

Crna only brothers (and sisters)


From Joe Rodriguez crna guide anesthesia company. The crna from Arizona.

And u got suckers MD working q4/5 calls and 8 weeks off and 1 weekend a month for 500k w2 in many parts of the country these days and “overtime” w2 pay to pickup extra shirts taxed at 35/37%

Vs 1099 jobs
I do think the way the job is advertised by Joe is illegal 1099 status since it’s a “full time 1099” and doesn’t meet the 1099’irs guidelines.

But Joe Rodriguez crna is not Donald Trump so doesn’t have Alvin Bragg up his butt prosecuting Joe for illegal tax avoidance tactics.
 
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Honestly that type of job the op just started should be close to a 26 weeks off job

There is job in Florida (with 100% supervision) 6a-7p (17 weeks of work for entire year) (7 calls in a row) 2 weeks off.

35 weeks off.

For 500k. Plus generous hospital benefits and retirement matching. And ability to defer up to 60k pretax a year

I value the job the OP is doing at 650k a year a min with 17 weeks off with that many calls.

9 weeks extra off is worth easily 120k or more.

That’s how I came to my calculation based on the OP 530k base salary.

updated jobs in my quoted post on my bump.
job 2 is actually 650k.

there's something about no weekday call that fits well with family life though, even though it's less time off. sleeping in your own bed, always home for dinner, no disruptions once home. idk. there's some value in that too. additionally, job 1 has an OFF list with some early out days mixed into the weekday schedule -- out by 9a, 10a, noon, but mostly out by 3p with rare days til 5, extremely rare later than that.
 
updated jobs in my quoted post on my bump.
job 2 is actually 650k.

there's something about no weekday call that fits well with family life though, even though it's less time off. sleeping in your own bed, always home for dinner, no disruptions once home. idk. there's some value in that too. additionally, job 1 has an OFF list with some early out days mixed into the weekday schedule -- out by 9a, 10a, noon, but mostly out by 3p with rare days til 5, extremely rare later than that.
The beeper call sucks. Are u doing 24 hr beeper. Or coming in say 5/6pm than beeper after being off the whole day.
 
The beeper call sucks. Are u doing 24 hr beeper. Or coming in say 5/6pm than beeper after being off the whole day.

24h beeper call. OB isn't a lot, but enough to be disruptive. 700-800 deliveries a year.
Schedule usually done by 5p, but call back for CSs and epidurals.
Post call days I start a few cases and out by 8a at the latest.
 
24h beeper call. OB isn't a lot, but enough to be disruptive. 700-800 deliveries a year.
Schedule usually done by 5p, but call back for CSs and epidurals.
Post call days I start a few cases and out by 8a at the latest.
Not great. Need to come in much later on call.
Most of the work even at smaller hospitals is from 630a-2pm.

No wonder why you are tired. 7 x 24 hr calls beeper equal 168 hrs “on the clock” in a 2 week period plus coming on 1-2 hrs post call potentially

Like I had. Another friend. In the southeast just left a 550k 1099 gig with 26 weeks off. 7 (24 hr calls) very similar schedule to u as well.

He wanted 600k. They said no. He said. See ya. And that’s with 26 weeks off
 
bumping this because I find myself in a mini dilemma; always appreciate insight here.
edited the quoted post to more accurately reflect the jobs I'm debating.

I actually left job 1 for job 2. I've been in this position for about a month, and I'm struggling with the adjustment to call. I mean, I'm home a lot more. Heck, I've got 17 weeks completely off. I've got small kids so the time is valuable. Plus, even on my "on" weeks, I've got plenty of time at home on my post call days. But, I'm just dreading being on service. I don't really enjoy the low acuity work. Old facility.

I'm wondering if i would be better off buying some more vacation in job 1, maybe taking 12 weeks.
The work there was much more stimulating and rewarding; though, less time at home.
I suppose it's all pros and cons.

Any thoughts?

Thankful in advance.
I think people underestimate the mental toll that comes with being on call all the time - even if it's light. Plus employers vastly underpay for it. If I understand you right with job 2 you're on call one third of the entire year!? That's a lot of call.

For job 1 running four rooms at a time on the weekend sounds rough too. Also what happens when/if that nocturnist burns out - are you then on the hook for call?

Anyway both sound like meh options. I like your idea of negotiating with job 1 for more time off. If it were me I'd negotiate for less call too. I wonder if job 1 would let you do M-F only (or even M-Th only) with no call - then have you add on a call here and there when they need it?
 
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I think people underestimate the mental toll that comes with being on call all the time - even if it's light. Plus employers vastly underpay for it. If I understand you right with job 2 you're on call one third of the entire year!? That's a lot of call.

For job 1 running four rooms at a time on the weekend sounds rough too. Also what happens when/if that nocturnist burns out - are you then on the hook for call?

Anyway both sound like meh options. I like your idea of negotiating with job 1 for more time off. If it were me I'd negotiate for less call too. I wonder if job 1 would let you do M-F only (of even M-Th only) with no call - then have you add on a call here and there when they need it?
This is reason 101 I charge almost the full $400-hr beeper call rate or else I don’t take call. I may take a discount and do $350/hr beeper call rate flat x12 or 24 hrs

Ur time is very valuable. Not for some perceived $80/100/hr beeper rate plus time called in.

164 hr of call is insane over a 11 day period for only 17 weeks off for w2.

Now tell them to get ur a crna to cover or and ob in house. Ur job would be way more tolerable on beeper.
 
This is reason 101 I charge almost the full $400-hr beeper call rate or else I don’t take call. I may take a discount and do $350/hr beeper call rate flat x12 or 24 hrs

Ur time is very valuable. Not for some perceived $80/100/hr beeper rate plus time called in.

164 hr of call is insane over a 11 day period for only 17 weeks off for w2.

Now tell them to get ur a crna to cover or and ob in house. Ur job would be way more tolerable on beeper.
But if the crna is in house you still get called in for everything right? A little easier but not really saving that much time…
 
Personally, I would go for job 1 if it is intellectually stimulating to you. I would just negotiate a part time position to get some breathing room.

.8 FTE should get you some good balance w extra vacation or extra week days off- and you’ll still be taking home 520k.

Difference btw 650k and 520k after taxes is not that much. Anesthesia is a marathon career. Pacing yourself and avoiding burnout is important- especially as you get into mid career and beyond.
 
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