First job offer, any thoughts?

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McDreamy911

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Hello everyone,
I want to thank this forum for being so helpful with so many aspects of a residents life.

I am currently a final year surgery resident and will be pursuing a MIS/Bariatrics fellowship next year. I came across a very interesting opportunity in the south and decided to interview. They just offered me the following contract:

Base salary: $450K (2 year guaranteed)
Relocation: $10K
Bonus: $50K
CME: 5K
Complete package with benefits etc: $550K
Malpractice with tail
Dental/Vision/Medical insurance
Short & Long term disability

What are some factors that I should be on the look out for when i sit down to negotiate the contract?
Is this at MGMA 50th percentile salary for new graduate?
Any red flags that stick out?

I would appreciate any guidance from the members.

Thank you

Members don't see this ad.
 
The numbers they've given you are pretty good. What happens to income after the 2 year guarantee?

Is this hospital employment or a private group/partnership track?

Very important to get a sense if this is a place where you can succeed, do the volume and types of cases/ subspecialty work you want to do.

Make sure you get fair pay for excess on-call time.
 
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Hello everyone,
I want to thank this forum for being so helpful with so many aspects of a residents life.

I am currently a final year surgery resident and will be pursuing a MIS/Bariatrics fellowship next year. I came across a very interesting opportunity in the south and decided to interview. They just offered me the following contract:

Base salary: $450K (2 year guaranteed)
Relocation: $10K
Bonus: $50K
CME: 5K
Complete package with benefits etc: $550K
Malpractice with tail
Dental/Vision/Medical insurance
Short & Long term disability

What are some factors that I should be on the look out for when i sit down to negotiate the contract?
Is this at MGMA 50th percentile salary for new graduate?
Any red flags that stick out?

I would appreciate any guidance from the members.

Thank you

The numbers are solid.

What size city?
Is there an rvu threshold above which you get paid more?
What’s the &/rvu
How much call? How busy is call
Back up from other surgeons?
Will the volume after your two years be enough to sustain your income or will you take a pay cut or have to work more to keep your income?
 
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Members don't see this ad :)
1. Is this an employed position or just an income guarantee? Sounds employed because of the benefits. Employed can have some benefits: somebody else deals with office staff drama, billing is managed by somebody else (double edged sword when you fall out of the 2 year guarantee), if paid by wrvu conversion factor then you don't have to worry about patient payer status, etc. With that said I favor independent private practice if feasible in your area.
2. I would get life insurance and disability on your own to stay portable. A large percentage of physicians leave their first job after 2 years.
3. You did not specify any work-like balance items. How much call do you have to take? Is call paid? Do you have weekend coverage when not on call?
4. Will there be enough volume after the 2 yr guarantee to support your salary?
4. Go in with eyes wide open. Assume you will leave within 5 years. It's been my experience that people willing to employ physicians do so only because they believe that they can make money off your work.
5. Is there a noncompete?
6. Can you work at other hospitals and surgery centers after the 2 yr guarantee period? This may become necessary to support a certain take home pay.
 
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All great advice above.

I'll add the 180 degree advice: what if you are MORE successful than your salary guarantees you? Can you get off salary guarantee early and go straight FFS (assuming not employed position)? What happens to the AR that you brought in while employed when you go FFS?
 
All great advice above.

I'll add the 180 degree advice: what if you are MORE successful than your salary guarantees you? Can you get off salary guarantee early and go straight FFS (assuming not employed position)? What happens to the AR that you brought in while employed when you go FFS?

I see you there, Ms. New Avitar.
 
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If those numbers are from a recruiter, I'd cut each one in half...even the bonus. Maybe even especially the bonus.

If you aren't married to the city, working there for two years while you pay off debts and get your sea legs about you as a young attending won't be bad. But I'd caution you not to buy a house, because after two years I lay 10:1 odds that you will want to leave. Either because the business just isn't there, or the situation is so dire that they need a recruiter to fill the position.

And get a lawyer who SPECIALIZES IN PHYSICIAN CONTRACT LAW to look over the contract. Not as a favor, either. As your legal counsel. Pay him/her an honest wage to make sure that all the ambiguity is written in YOUR favor, not the hospitals's, not the recruiter's, not the the clinic's. This ain't tiddlywinks, and these guys have cutthroats on their side. You need one on your side, as well.

If you take the job, come back six months into it and tell us what you think.
 
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Hello everyone,
I want to thank this forum for being so helpful with so many aspects of a residents life.

I am currently a final year surgery resident and will be pursuing a MIS/Bariatrics fellowship next year. I came across a very interesting opportunity in the south and decided to interview. They just offered me the following contract:

Base salary: $450K (2 year guaranteed)
Relocation: $10K
Bonus: $50K
CME: 5K
Complete package with benefits etc: $550K
Malpractice with tail
Dental/Vision/Medical insurance
Short & Long term disability

What are some factors that I should be on the look out for when i sit down to negotiate the contract?
Is this at MGMA 50th percentile salary for new graduate?
Any red flags that stick out?

I would appreciate any guidance from the members.

Thank you


From what I heard from my surgeon buddies in my hospital, those seem like solid numbers/benefits for starting.
 
Agree with the Good advice given above.
How long are you stuck there after the 2 Years. I think it can be anywhere from 2-5 or you owe the money back.

If they are offering 450. Sounds like it's middle of nowhere. There should be student loan repayment.
 
The numbers on the surface look good. I suspect this is an employed position (which most of the recruiters out there are recruiting for) and I agree with everyone else about digging deeper...

1. Call (how much, how often, trauma?, reimburse per consult, insurance, stipend)
2. Ability to tap into passive income -> Surgicenter, scanners, ancillary tests/treatments relevant to your specialty, mediolegal work, consulting, etc. Usually these can be prohibited via a non-compete provision rather than direct language so good to have lawyer look at this as wel.
3. PTO/vacation.
4. Bonus structure. Are you getting 25%/50%/75%/100% and when?
5. Partnership track - I'm assuming employed so this isn't relevant.
6. Non-compete - What happens if you want to leave before 2 years and happen to want to stay nearby?
7. OR privileges, how many hospitals, block time, etc.
8. Retirement - 401k, etc.
9. If you are hospital employed, how receptive are they to getting new equipment? Equipment that you trained with? Maybe not a big deal in GS but certainly I was lucky to partner with a hospital system that got me what I wanted/needed. Surgicenter? Not so much and that's not a bad thing since they're usually more cost-conscious and may need you to prove it to them that you're going to use what you order.

That's all I have for now.
 
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