Does anyone have any general advice about the types of things it is reasonable to ask for in negotiations for a first job out of residency/fellowship? (I know that the specifics depend on where exactly you are looking, but I would appreciate some guidance so I just don't look ridiculous in what I am asking for)
I assume that the things that are open to negotiation are different if you are looking at an academic job vs. a private hospital organization. Correct?
For example, if you are working for a place that offers you a salary, I would of course expect you would want to focus on asking for more in terms of salary. But what about a place where the compensation is mostly/entirely based on RVUs? Are there certain benefits that I might not think of asking for that I should?
Well, everything depends on your local market. But if you are going to start a job where compensation is based on RVUs,
and if you are being offered a minimum salary the first year or so, then I recommend asking to have it put in writing that the RVUs will be reconciled against salary after the first 6 months of your employment and then again after the 2nd 6 months, and after that, annually or whatever their normal practice is. During your first few months on the job there is little chance your RVU's will exceed any minimum salary they offer. After a few months, you'll be more productive, and you will exceed their minimum. If you let them reconcile all your RVUs from the first 12 months, the extreme highs and lows will average each other out and converge towards the minimum salary. So ask for 6 month reconciliations. (If you succeed in this, then schedule all your optional vacation days during the first 6 months! You want to take your vacation when you're on salary and not when you're on productivity.)
I would also ask lots of questions. Get things put in writing if they are important to you. I've had 2 jobs out of residency now, and at both, the perks promised during recruitment ended up differing to varying extents from reality. Especially where time flexibility is concerned.
And if you have specific questions, let us know. PM me or others if you don't want to post publicly. When I interviewed 2 years ago in the state I am in now, I was totally confused. The job market was very different from where I did residency. Early on, I was offered a "Medical Director" position in a hospital in a remote small town. I turned down that job, with a huge salary, because I was intimidated by the title. I assumed that "Medical Director" meant a huge amount of responsibility, like it did in my residency, where people trotted their titles around all over campus. I assumed that the
salary was high because the
responsibility was high; and did not appreciate that salaries and titles rise with desperation, not duties, in non-academic psychiatry. Later on I learned that "Medical Director" means: "Person who comes to work." So ask! And when you're looking at a local market, figure out what their strengths and weaknesses are, and play to that.
