Attending job offers?

[J ROD]

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I just went on my first interview for an attending position in Psychiatry. Everything went as expected in terms of normal questions but they never brought up compensation package. CEO basically told me I had the job so I do not believe it is because they did not like me. I asked physician recruiter and she told me to ask another lady I spoke with for 30 min who did not bring up the subject at all during that time. Was I supposed to ask? I worked in HR before and hired folks before and we always spoke about compensation package. Is this standard for attending positions or was this just a weird place? I do not have any more seniors residents to ask right now so I am coming here as I trust most of you have plenty of experience.

 

[dl2dp2]

There's not really any reason to ask IMO. They'll eventually tell you. Generally speaking, you can get a good sense of the plausibility of the range from some low-level HR person. Institutional jobs in general have low negotiability--best case scenario you can get yourself another 5-10%.

 

[finalpsychyear]

I just went on my first interview for an attending position in Psychiatry. Everything went as expected in terms of normal questions but they never brought up compensation package. CEO basically told me I had the job so I do not believe it is because they did not like me. I asked physician recruiter and she told me to ask another lady I spoke with for 30 min who did not bring up the subject at all during that time. Was I supposed to ask? I worked in HR before and hired folks before and we always spoke about compensation package. Is this standard for attending positions or was this just a weird place? I do not have any more seniors residents to ask right now so I am coming here as I trust most of you have plenty of experience.

Usually the first step is that they like you and or vice versa. The compensation/contract discussion is a whole another animal. I would continue to keep interviewing at other places so you have multiple offers and contracts to compare and ask for more sorta thing. I think i went once for a 1099 job and it took them 3 weeks to get back to me on an hourly rate which was like 110/hr which i countered with 200. They then emailed me weeks later that i please reconsider the 110 offer...

 

[mymembernames]

Usually the first step is that they like you and or vice versa. The compensation/contract discussion is a whole another animal. I would continue to keep interviewing at other places so you have multiple offers and contracts to compare and ask for more sorta thing. I think i went once for a 1099 job and it took them 3 weeks to get back to me on an hourly rate which was like 110/hr which i countered with 200. They then emailed me weeks later that i please reconsider the 110 offer...

$110 as an attending?

 

[Ironspy]

I just went on my first interview for an attending position in Psychiatry. Everything went as expected in terms of normal questions but they never brought up compensation package. CEO basically told me I had the job so I do not believe it is because they did not like me. I asked physician recruiter and she told me to ask another lady I spoke with for 30 min who did not bring up the subject at all during that time. Was I supposed to ask? I worked in HR before and hired folks before and we always spoke about compensation package. Is this standard for attending positions or was this just a weird place? I do not have any more seniors residents to ask right now so I am coming here as I trust most of you have plenty of experience.

They will send over a contract with salary and terms. You negotiate from there. In writing. No real point in asking salary during interview bc it’ll come up in the job offer and you want all terms in writing.

 

[J ROD]

Ok. I guess I have never interviewed for a job this important before. I figured they would give me a ballpark or at least mention basics. Even as a pharmacist I was given details.....but ok I will sit back and see what and if they say.

 

[splik]

Ok. I guess I have never interviewed for a job this important before. I figured they would give me a ballpark or at least mention basics. Even as a pharmacist I was given details.....but ok I will sit back and see what and if they say.

If you have a minimum that you would absolutely not consider anything less, and it's not your dream job, then it is worthwhile to ask the rough the compensation early on (e.g. even before formally interviewing). some places will tell you up front "this is what we offer, it's non-negotiable" (e.g. kaiser, county, state etc). Other places will tell you "we cant pay too much so what are you looking for" (e.g. college mental health, cmhc). Personally, I would not bring this up in the formal in person interview, because if you do, you run the risk of finding yourself being asked what compensation you want/think is fair and then you've already lost. It's hard to know how to respond in person, and as a resident it can still feel like there is a power differential since we have been trained into accepting a hierarchy. You really want them to make the first move/offer from which you can then negotiate.

Often you will receive an offer letter sometime afterwards spelling out the pay etc. In academics, this may not be for some months. With the VA, you may never get one or it could be only after you start working!! In the private world you should get an offer letter or asked to sign a letter of intent much more quickly, but there are often talks that go on with leadership, HR, bean counters etc that can mean there is a few weeks' delay.

I definitely recommend sending effusive thank you emails to all the people you interviewed with. I know there is some controversy about this during the residency process, but during the job process you may be considered disinterested/rude if you don't do so. The only places I didn't do this was where I was annoyed at them for wasting my time (sham interviews), but in hindsight I still should have followed up. Being respectful and corteous goes a long way. Our field is still small and you may find yourself having a professional relationship with some of these people in the future.

 

[Merely]

Usually the first step is that they like you and or vice versa. The compensation/contract discussion is a whole another animal. I would continue to keep interviewing at other places so you have multiple offers and contracts to compare and ask for more sorta thing. I think i went once for a 1099 job and it took them 3 weeks to get back to me on an hourly rate which was like 110/hr which i countered with 200. They then emailed me weeks later that i please reconsider the 110 offer...

110 as a 1099? LOL

 

[Sushirolls]

Its frustrating but the contract and salary comes at the end for these larger entities interview process. Its frustrating. I remember when I was employed for one that the candidates who'd come thru for the open position would learn of the pay rate, and pursue their other higher paying options. Yet the admin and medical director optimistically (or magically?) just assumed these people would come simply because they interviewed. My feedback about the lower pay not being market competitive fell on deaf ears. When you put years to the gossip circle I was able to learn from some of these interviewees it really was just the low pay.

So, sit tight, and wait for the contract.

 

[ksharp33]

Usually the first step is that they like you and or vice versa. The compensation/contract discussion is a whole another animal. I would continue to keep interviewing at other places so you have multiple offers and contracts to compare and ask for more sorta thing. I think i went once for a 1099 job and it took them 3 weeks to get back to me on an hourly rate which was like 110/hr which i countered with 200. They then emailed me weeks later that i please reconsider the 110 offer...

110/hr? Is that some kind of sick joke?

 

[dl2dp2]

Its frustrating but the contract and salary comes at the end for these larger entities interview process. Its frustrating. I remember when I was employed for one that the candidates who'd come thru for the open position would learn of the pay rate, and pursue their other higher paying options. Yet the admin and medical director optimistically (or magically?) just assumed these people would come simply because they interviewed. My feedback about the lower pay not being market competitive fell on deaf ears. When you put years to the gossip circle I was able to learn from some of these interviewees it really was just the low pay.

So, sit tight, and wait for the contract.

Right. The "correct" way to get the pay information early is to ask some third person not involved directly in the hiring process (i.e. gossip). This could be an "agent" (i.e. HR person or recruiter). I think what you are describing is that people who interview generally made the assumption that the applicant already did this ("did your homework"). Unfortunately these are in general the unwritten rules in the US employment system for executive level hiring. In practice, things are variable. Smaller more intimate systems often have more direct interactions. Larger systems are in general more opaque and less performance driven.

A different way to think about this is that employers generally want to complete the hirings of candidates for reasons other than salary, because especially in big systems, salary numbers are often not directly under their control, and people who pick a job for salary often have poor retention. IMO one ought to similarly and assume that there's not a room for negotiation, pick the job based on content/process fit, and treat salary negotiation as a separate process. This is stylistic though, some people are much more aggressive and that style works better in some systems but not others.

 

[NickNaylor]

I will be working at my current institution for a faculty gig, and my very first of a series of interviews was essentially focused on compensation. At an outside moonlighting gig, compensation was also clearly stated early on in the process. Of course, in both of these situations the compensation itself was non-negotiable so perhaps that's why it came up early.

 

[Duloxetini]

Usually the first step is that they like you and or vice versa. The compensation/contract discussion is a whole another animal. I would continue to keep interviewing at other places so you have multiple offers and contracts to compare and ask for more sorta thing. I think i went once for a 1099 job and it took them 3 weeks to get back to me on an hourly rate which was like 110/hr which i countered with 200. They then emailed me weeks later that i please reconsider the 110 offer...

I mean... Psych 'providers' are all the same right? That's probably what they pay their NPs.

 

[nrmp]

I would have an estimated idea of base before walking in for an interview and not waste time if it's not in your range and not much negotiable.

 

[notdeadyet]

I’ve asked directly for a range at the interview and have never had resistance. Some folks have hemmed because they didn’t actually know but they always introduced who would know and they always came back with a range.

I don’t set up interviews without getting an idea of a salary range. For those of you at APA, wander around all those booths from employers and ask directly the salary. I did that on Monday and everyone gave me a salary figure or range. I do this at every APA not because I’m actively looking for a new job but because I can’t estimate well how much I’m being underpaid unless I know how much other similar jobs are paying.

 

[ksharp33]

I’ve asked directly for a range at the interview and have never had resistance. Some folks have hemmed because they didn’t actually know but they always introduced who would know and they always came back with a range.

I don’t set up interviews without getting an idea of a salary range. For those of you at APA, wander around all those booths from employers and ask directly the salary. I did that on Monday and everyone gave me a salary figure or range. I do this at every APA not because I’m actively looking for a new job but because I can’t estimate well how much I’m being underpaid unless I know how much other similar jobs are paying.

Can you share the range or salary figures
you have been told at the APA? You can PM me.

 

[notdeadyet]

$150K to $350K.

I’d say this is accurate for about the middle 90% of jobs out there. Any less and you’re working like an angel, any more and you’re working like a devil.

Seriously, the salaries are largely dependent on how hard you’re willing to work and where.

 

[finalpsychyear]

$150K to $350K.

I’d say this is accurate for about the middle 90% of jobs out there. Any less and you’re working like an angel, any more and you’re working like a devil.

Seriously, the salaries are largely dependent on how hard you’re willing to work and where.

350 is unheard of in my area in the midwest and we are in a shortage area.

If your doing 40 hours no call then 240-270 w2 is what your going to find inpt or outpatient in my area and the inpt will come with some wknd rounding included. In the middle of nowhere spots i see the higher offers. Maybe the west coat inflation of salaries.

If you look close at the 2019 medscape data you see the average salary went down 13k to 260k vs 2018 data. The foreign trained ones are working like super crazy (pun intended) and driving up salaries. Also, 80+% of psych docs are employed so your not going to break those numbers unless your out in the boonies. Of course being self employed you work more just like any other field the ceiling is much higher because those people usually push harder and work more.

I tell everyone going into psych 250k for 40 hours in an employed model is more or less the norm and it matches the medscape us trained data, the job offers i see in my area, and my colleagues job offers. Don't mistake the 300k salary which forgets to mention a 30k signing bonus and 10 k relocation bonus.

 

[AD04]

If you look close at the 2019 medscape data you see the average salary went down 13k to 260k vs 2018 data.

The 2019 compensation report is now based on a formula Medscape came up with that shows what each specialty should get. It isn’t based on actual survey data anymore. I doubt psychiatrists are making less now than a year ago.

 

[ksharp33]

Medscape is not as accurate as MGMA. 2018 MGMA median shows higher numbers for psych.

 

[finalpsychyear]

Medscape is not as accurate as MGMA. 2018 MGMA median shows higher numbers for psych.

Yes, that is true. The total compensation data from the 2-3 years ago i have access to showed median psych salary was 245k, 75th percentile 300, and 90th percentile 382 with avg psych salary 264 roughly.

Nearly all the jobs I ever interviewed at if they were going to use mgma data it was median numbers they went by.

 

[Mad Jack]

Medscape is not as accurate as MGMA. 2018 MGMA median shows higher numbers for psych.

MGMA is more accurate for total compensation. This is salary plus benefits, which makes the salaries look higher than medscape, but the actual salary is about the same, give or take, if you look at the MGMA breakdown where it takes out benefits. At least that's how it was last I checked.

 

[Stagg737]

350 is unheard of in my area in the midwest and we are in a shortage area.

If your doing 40 hours no call then 240-270 w2 is what your going to find inpt or outpatient in my area and the inpt will come with some wknd rounding included. In the middle of nowhere spots i see the higher offers. Maybe the west coat inflation of salaries.

If you look close at the 2019 medscape data you see the average salary went down 13k to 260k vs 2018 data. The foreign trained ones are working like super crazy (pun intended) and driving up salaries. Also, 80+% of psych docs are employed so your not going to break those numbers unless your out in the boonies. Of course being self employed you work more just like any other field the ceiling is much higher because those people usually push harder and work more.

I tell everyone going into psych 250k for 40 hours in an employed model is more or less the norm and it matches the medscape us trained data, the job offers i see in my area, and my colleagues job offers. Don't mistake the 300k salary which forgets to mention a 30k signing bonus and 10 k relocation bonus.

I'm also in the midwest in an urban shortage area and I'd say 350k is far from unheard of. From what I've seen the 40 hr without call jobs are around what you quoted, probably a bit higher (my academic program's base salary is supposedly in the 230k's before some ridiculous benfits), but if you're willing to take call and potentially go a little over 40 hours you can hit that 350k in my area, especially if you're factoring in benefits.

 

[finalpsychyear]

I'm also in the midwest in an urban shortage area and I'd say 350k is far from unheard of. From what I've seen the 40 hr without call jobs are around what you quoted, probably a bit higher (my academic program's base salary is supposedly in the 230k's before some ridiculous benfits), but if you're willing to take call and potentially go a little over 40 hours you can hit that 350k in my area, especially if you're factoring in benefits.

If your willing to do a a few monthly call weekends and weekday then sure you can make 50-75k extra per year or even more. Most people don't want to do that or want the numbers prior to that being factored in. The cool thing in medicine is your income is really not limited if your willing to work more hours. But yeah if we are looking at the "lifestyle" 9-5 4 or 5 day 40 hour work week with no call and with benefits then the range we discussed is about right.

 

[Stagg737]

If your willing to do a a few monthly call weekends and weekday then sure you can make 50-75k extra per year or even more. Most people don't want to do that or want the numbers prior to that being factored in. The cool thing in medicine is your income is really not limited if your willing to work more hours. But yeah if we are looking at the "lifestyle" 9-5 4 or 5 day 40 hour work week with no call and with benefits then the range we discussed is about right.

Question for all, how common are inpatient gigs where one wouldn't have to take weekend or overnight call? Everywhere I've rotated so far, the attendings had to do overnight and weekend call at least occasionally. So is reasonable to find a position like that or are these positions hidden gems?

 

[Sushirolls]

hidden gems

 

[Shufflin]

inpatient work almost assumes overnight and weekend work across the board

in rare cases, one can escape one of the two ~ i'm in that kind of position actually so it is possible

 

[VA Hopeful Dr]

Question for all, how common are inpatient gigs where one wouldn't have to take weekend or overnight call? Everywhere I've rotated so far, the attendings had to do overnight and weekend call at least occasionally. So is reasonable to find a position like that or are these positions hidden gems?

State hospital near where I did my FP residency. Weekends were covered by residents moonlighting (and a psych program has been started nearby since I graduated which may allow for weeknight coverage).

 

[Merovinge]

MGMA is more accurate for total compensation. This is salary plus benefits, which makes the salaries look higher than medscape, but the actual salary is about the same, give or take, if you look at the MGMA breakdown where it takes out benefits. At least that's how it was last I checked.

Just so you know this is not how total compensation is defined by MGMA. It simply means total take home $. For example, Base play +amortized loan repayment +amortized signing bonus +incentive bonus +medical director bonus are the 5 most common factors. Benefits are 100% NOT included in MGMA data. Happy to talk more on the subject if anyone has questions about it.