Job Advice

Started by HoosierdaddyO
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HoosierdaddyO

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Ok so I’m very fortunate to be in this situation but I’m having the hardest of times trying to navigate which of these two options I should go with, and any help/advice would be truly appreciated.

Job 1: is in a city that I’ve grown to not really love… it’s a huge metropolis city with anything imaginable in regards to food/culture/events/concerts etc. the job is ideal… they have me working 9 shifts a month, 10 hour shifts (1080 hours clinically). I do have administrative duties but they are totally manageable and even fun for me. The hospital is lower acuity, ancillary is good, pay is on par with the rest of the country, colleagues are enjoyable. I also have a sweet side gig that pays pretty well. The only caveat about this place is the city. I’m a solid 3 hours away from all my family and friends, I’m single, just broke up with my significant other (who took all the friends in the breakup lol🙄)… so besides it being a solid career with low stress work and amazing hours it’s the essential loneliness that is really throwing a monkey wrench in to what would be an ideal life set up. The job security at this place is essentially Fort Knox (tenured), and the patient population is some of the nicest peoples I’ve ever known, little spoiled but otherwise perfect.

Pro: job security, clinical hours, passionate side gig, no overnights, great hospital! Solid salary plus paid side gig. Plus admin hours

Cons: I essentially hate the city and feel alone lol!


Job 2: is in my hometown city, one of the biggest cities in the United States, has everything under the sun in regards to just everything lol. The biggest attraction here is just being back with my family and close friends who I am super tight with. The hospital is a huge public city hospital with all the headaches that come along with serving that kind of population. I would be working 10 shifts, 12 hours (1440 a year and this is the reduced hours for the admin position I would be having as well). I would be working day and overnight shifts. I would have to give up my paid side gig which is fun for me. But the only true net gain is just being near all my family. The headache that I’m giving myself is that worth giving up what is otherwise a pretty sweet Cush situation that I currently have but can’t stand the city. The salary is otherwise equal for both places.

Pros: just being close to family and old friends.

Words of encouragement or advice from some of the peanut gallery would really be appreciated. Both are w-2, both are secure jobs, the 2nd job has residents that does most of the scut. But the the acuity and level of work stress would be higher as well. Just trying to figure out if needing to suck it up… or getting a fresh start on things is worth losing all that job 1 has to offer. Thanks as always 😊!!!
 
Here's ChatGPT's advice:

Based on the information provided, both job options have their pros and cons. Here's an analysis of each job and a suggestion based on the details provided:

Job 1: This job seems to offer a great work-life balance with low stress, ideal hours, enjoyable colleagues, and good pay. The hospital is lower acuity, and you have a passion for the side gig that pays well. However, the major downside is your dislike for the city and the feeling of loneliness. If you value career stability, a good work environment, and financial security, this job would be a solid choice. However, the aspect of feeling alone and disconnected from family and friends may affect your overall happiness and well-being.

Job 2: This job offers the opportunity to be close to your family and old friends, which seems to be a significant factor for you. The city has a lot to offer in terms of amenities and experiences. However, the hospital is a large public city hospital with potentially higher acuity and work stress. Giving up your paid side gig may also be a downside. If being near your loved ones and having a support system is a top priority for you, this job could provide the emotional fulfillment you seek. However, it's important to consider the potential challenges and stress that may come with a larger hospital setting.

Considering your preference for being close to family and friends, it seems that Job 2 holds a special appeal to you. The emotional connection and support system that come from being with loved ones can have a significant positive impact on your well-being. While Job 1 offers great professional perks, the sense of loneliness and disconnect you feel might hinder your overall satisfaction in the long run. Prioritizing personal relationships and finding joy in being near your family and close friends can often outweigh the advantages of a more ideal professional situation.

Ultimately, the decision is highly personal and depends on your individual priorities and values. It may be helpful to reflect on what truly matters to you in the long term and consider the potential impact on your overall happiness and well-being. Consulting with trusted friends, family, or mentors who know you well may also provide valuable insights and perspectives.
 
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Haha that chatGPT is no joke lol… better advice then my hypothetical therapist😂!

Yea job 1 has no overnights, Pph of 1.5 it’s 100% hourly and tenured.

But agree I’m incredibly close with my family and as everyone gets older the ability to be 15-20 min from everything/one is the only hurdle in having to give up all the job 1 offers.
 
HoosierdaddyO said:
Haha that chatGPT is no joke lol… better advice then my hypothetical therapist😂!

Yea job 1 has no overnights, Pph of 1.5 it’s 100 perfectly hourly and tenured.

But agree I’m incredibly close with my family and as everyone gets older the ability to be 15-20 min from everything/one is the only hurdle in having to give up all the job 1 offers.
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I know right?! I've started asking it's advice on all types of things, lol.

Ugh, no overnights? Damn....I hate to say it but that would seal job 1 for me. That's just such a high priority item. Zero overnights for the foreseeable rest of your career? HUGE. You're going to have to think that one over long and hard. How about scheduling regular trips back home every 1-2 months to hang out with family and friends? 3 hours isn't that far.... My best friend and I have been long distance for most of my adult life and probably see each other only a handful of times a year, yet we talk on the phone almost daily. I live in the same city as my parents....yet I see them probably only once a month and might talk to them once a week. It's all relative but it really depends on your personal situation. I'm not particularly close to my family so that would play less of a role in my case. Good luck.
 
If job 1 has no nights… and your home city is only 3hr away… I might be tempted to keep on at job one and structure your schedule so you go back “home” for a long 3-4day weekend every month. Or a full week every-other-month.

Obviously not the same as being there. But perhaps a transitional plan for a year or two… try to take time and find a better job than job 2 back home?
 
Residents also takes the sting out of job 2 some. It is 400 more hours a year, which can be significant since you’re adding overnights, plus you are losing more shifts with switching back and forth from days to nights. I estimate 1.5 lost days per block of overnight shifts (I have trouble with evenings not becoming overnights so I estimate the same for a block of evenings as well). So even though it’s only a little more hours per year in actual work, the fact you’re doing nights too means you will lose more time. If you also have admin work, you may not have a lot of time to spend with friends and family.

All that said, we moved from 10 hours from family to 4 hours away and that made a large difference for my wife and I. Biggest difference was family then moving to our town last year, and now we see them a lot which has been wonderful.

It’s a tough decision, maybe you can assist with convincing admin to hire or incentivize some nocturnists at job 2? If so, then it is an easier decision I think. Job 1 is a career longevity type job, and maybe you just need to give the town another chance. I’m from a town of 6k people, so anything has more amenities than we did. I’m happy in anything 40-50k or bigger, if it has a mall it’s a big town to me, so I’m easy to please that way. Job 2 is the family play, if you’re a close knit family and you’d rather spend time with them outside work than at your own home, it seems the better option.

Since you’re going through a breakup, that may be affecting things, making you yearn for the familiar. Don’t make any big or life changing decisions for at least a couple months post breakup (you didn’t say when it happened). You’re in a big city so you should be able to avoid prior SO. Get out in the sun, find some parks and walking paths locally, go fishing or biking if one of those are your thing. There might be an element of countertransference of your feelings from your ex-SO onto the city, and you might like the city more if you give it a chance. Or maybe not and I’m an idiot, but just make sure you’re giving the current city a chance and not rushing back to the “grass is greener” and familiar with your hometown.
 
Job one without any doubt it my mind. And I say this as a nocturnist. You’re only evaluating your situation due to the significant other issue and that will pass. 3hrs is so easy to go back home for a weekend. 400 extra hours, loss of side gig, worse patient population, flip flopping, etc. You’ll be miserable
 
You’re only working 9 days a month. Just go visit family a couple times a month and problem solved.

Also…. Try to grow your social circle where you are. Literally it sounds like a breakup is making you change your tenured job. Just go out more often, you’ll find people.

I’ve moved cities 6 times now. You just have to work on being social and give it time. Our last move was 1.5 years ago to a city where we knew 0 people, and now we have a social circle of 10 families with frequent game nights, poker nights, dinners etc. you just gotta work on it.
 
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With an EM salary and good control of your money you are the prize. With both friendships and relationships. I would stay in Job 1 since you are it seems like you just make more $$$ and it isn’t like a CMG

If you plan on having kids moving close to family may be worth it if they will help significantly with child care.


Also with the time you have off you can just go somewhere else on your off days
 
I also drive 3 hours...to get on a plane, to then fly 3+ hours and then drive again to see family. I'm intentionally geographically arbitraging because $$$ but still. I'd probably take #1 and drive back every now and again, do it for a couple years, see how you like it if you can maintain good relationship with the hometown hospital. The no nights thing is pretty huge.
 
I also think it’s an interesting point that a lot of us are telling them to pick job one. But in another thread, we were talking about being on our deathbed and wanting to spend more time with family.

Even if you sent me back, I would still pick job one
 
PianoMedic said:
I have trouble with evenings not becoming overnights so I estimate the same for a block of evenings as well). So even though it’s only a little more hours per year in actual work, the fact you’re doing nights too means you will lose more time. If you also have admin work, you may not have a lot of time to spend with friends and family.
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Can you expand on the bolded part?
 
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Take Job 1

The difference between 9 and 12 hour shifts might not seem significant but I promise you as you get older it definitely DOES make a huge difference
 
The answer is highly personalized. My thoughts match others suggesting option #1. Family/friend within 3 hours, is easily driveable for me (I just drove over 900 miles straight a couple of days ago). With that being said, that is my ideal, and may not be yours.

In the end, create a pro and con list for each place and weight them with what is most appropriate for you, then calculate. When I was young, overnights were not a big deal (longest shift I ever did was 41 hours straight without sleep....different occupation). Now nights are challenging.

Figure out what works best for you.


Wook
 
HoosierdaddyO said:
Ok so I’m very fortunate to be in this situation but I’m having the hardest of times trying to navigate which of these two options I should go with, and any help/advice would be truly appreciated.

Job 1: is in a city that I’ve grown to not really love… it’s a huge metropolis city with anything imaginable in regards to food/culture/events/concerts etc. the job is ideal… they have me working 9 shifts a month, 10 hour shifts (1080 hours clinically). I do have administrative duties but they are totally manageable and even fun for me. The hospital is lower acuity, ancillary is good, pay is on par with the rest of the country, colleagues are enjoyable. I also have a sweet side gig that pays pretty well. The only caveat about this place is the city. I’m a solid 3 hours away from all my family and friends, I’m single, just broke up with my significant other (who took all the friends in the breakup lol🙄)… so besides it being a solid career with low stress work and amazing hours it’s the essential loneliness that is really throwing a monkey wrench in to what would be an ideal life set up. The job security at this place is essentially Fort Knox (tenured), and the patient population is some of the nicest peoples I’ve ever known, little spoiled but otherwise perfect.

Pro: job security, clinical hours, passionate side gig, no overnights, great hospital! Solid salary plus paid side gig. Plus admin hours

Cons: I essentially hate the city and feel alone lol!


Job 2: is in my hometown city, one of the biggest cities in the United States, has everything under the sun in regards to just everything lol. The biggest attraction here is just being back with my family and close friends who I am super tight with. The hospital is a huge public city hospital with all the headaches that come along with serving that kind of population. I would be working 10 shifts, 12 hours (1440 a year and this is the reduced hours for the admin position I would be having as well). I would be working day and overnight shifts. I would have to give up my paid side gig which is fun for me. But the only true net gain is just being near all my family. The headache that I’m giving myself is that worth giving up what is otherwise a pretty sweet Cush situation that I currently have but can’t stand the city. The salary is otherwise equal for both places.

Pros: just being close to family and old friends.

Words of encouragement or advice from some of the peanut gallery would really be appreciated. Both are w-2, both are secure jobs, the 2nd job has residents that does most of the scut. But the the acuity and level of work stress would be higher as well. Just trying to figure out if needing to suck it up… or getting a fresh start on things is worth losing all that job 1 has to offer. Thanks as always 😊!!!
Click to expand...

But seriously…am i the only cold hearted person who thinks friends, bfs/gfs are just replaceable. Wife/husband replacement costs a little and aren’t as easily replaced.

Go on a few tinder dates or something.

As a side note, when we moved to this completely new city, my wife literally posted in a fb Muslim community group of our city declaring that we are new here and wanting to get to know people - she ended up a couple dozen messages with people inviting us to their homes. We started off by going to a few birthday parties, got to know dozens of other people at these birthdays and just developed a core group of friends.

Put in effort, download a dating app if you need to, go out to bars. Enjoy the freedom of the single life 😉
 
Yeah even with the 2-4 hours drive it should be easy to see the family at least 2-4 times a month with a chill schedule.

To be honest even back home it would be hard to see them more than a few times a month with a normal schedule.
 
HoosierdaddyO said:
Ok so I’m very fortunate to be in this situation but I’m having the hardest of times trying to navigate which of these two options I should go with, and any help/advice would be truly appreciated.

Job 1: is in a city that I’ve grown to not really love… it’s a huge metropolis city with anything imaginable in regards to food/culture/events/concerts etc. the job is ideal… they have me working 9 shifts a month, 10 hour shifts (1080 hours clinically). I do have administrative duties but they are totally manageable and even fun for me. The hospital is lower acuity, ancillary is good, pay is on par with the rest of the country, colleagues are enjoyable. I also have a sweet side gig that pays pretty well. The only caveat about this place is the city. I’m a solid 3 hours away from all my family and friends, I’m single, just broke up with my significant other (who took all the friends in the breakup lol🙄)… so besides it being a solid career with low stress work and amazing hours it’s the essential loneliness that is really throwing a monkey wrench in to what would be an ideal life set up. The job security at this place is essentially Fort Knox (tenured), and the patient population is some of the nicest peoples I’ve ever known, little spoiled but otherwise perfect.

Pro: job security, clinical hours, passionate side gig, no overnights, great hospital! Solid salary plus paid side gig. Plus admin hours

Cons: I essentially hate the city and feel alone lol!


Job 2: is in my hometown city, one of the biggest cities in the United States, has everything under the sun in regards to just everything lol. The biggest attraction here is just being back with my family and close friends who I am super tight with. The hospital is a huge public city hospital with all the headaches that come along with serving that kind of population. I would be working 10 shifts, 12 hours (1440 a year and this is the reduced hours for the admin position I would be having as well). I would be working day and overnight shifts. I would have to give up my paid side gig which is fun for me. But the only true net gain is just being near all my family. The headache that I’m giving myself is that worth giving up what is otherwise a pretty sweet Cush situation that I currently have but can’t stand the city. The salary is otherwise equal for both places.

Pros: just being close to family and old friends.

Words of encouragement or advice from some of the peanut gallery would really be appreciated. Both are w-2, both are secure jobs, the 2nd job has residents that does most of the scut. But the the acuity and level of work stress would be higher as well. Just trying to figure out if needing to suck it up… or getting a fresh start on things is worth losing all that job 1 has to offer. Thanks as always 😊!!!
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I’d say job 2. Do you want to be a part of your family and friends lives and watch their kids grow up? Maybe you want your future kids to be Bffs with their kids and hang out with the aunties and uncles?

As you can tell I value family and money can’t buy time and relationships with family

20 yrs down the line
Job one gives you lots of Money to fly anywhere
Job 2 will give you lots of “remember when we…” and inside jokes with family and friends
 
slchino said:
I’d say job 2. Do you want to be a part of your family and friends lives and watch their kids grow up? Maybe you want your future kids to be Bffs with their kids and hang out with the aunties and uncles?

As you can tell I value family and money can’t buy time and relationships with family

20 yrs down the line
Job one gives you lots of Money to fly anywhere
Job 2 will give you lots of “remember when we…” and inside jokes with family and friends
Click to expand...
There's definitely truth in that.

But, with working 9 shifts per month it wouldn't be difficult to do 2 long weekends home every month and schedule a few days during the week for family things - birthdays, nieces'/nephews' sports stuff, recitals, whatever.

Over the years reading this forum, the things that seem to lead to burn out among you EPs boil down to a few main areas: circadian rhythm issues, frustrating patient populations, too many/too long shifts, issues with employer, or low pay.

Job #1 for the OP has none of those things and enough nonworking days to stay in fairly close contact with family within a very reasonable driving distance.
 
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sloh said:
Can you expand on the bolded part?
Click to expand...

Our night shifts are 1700-0100 or 1700-0200. I have an hour drive from the site that goes to 0100, so it’s essentially always til 0200 at the earliest, I then usually eat and have to wind down a bit. It’s usually 0330 or 0400 when I get to bed and then awhile after to sleep. At that point, my body starts readjusting to it basically being an overnight and I struggle to flip back to days afterwards, and our scheduler gives less time to flip back after evenings because they’re “easier”. So I just work nights only now and have a consistent schedule. It sucks, but it’s consistent. If OP has that difficulty and one site requires evenings, that would increase their number of nights essentially. Hope that clears it up.
 
I’m going to hijack this thread with my own dilemma possibly coming up.

I am about 80% of the way through partner track of a group I truly enjoy however, I live far from the main sites (~1 hr) and even farther from their rural sites, but 75% of my shifts are 1 hr there and 1 hr back. The medicine portion of the job is great, colleagues are great. Money-wise partners do well, however operations are fairly limited to EM, any other business has been locked to previous partners as separate LLC for partners at that point in time.

New group is very close to home, similarly long partner track, slightly more difficult medicine due to boarding/EMR etc. The group is very pro business, and has group wide ancillary income for all partners including incoming partners. It was my number #1 choice but due to other circumstances wasn’t available at that time. I think partners do similar money wise , maybe better with better long term contract stability.

My main concern is regretting leaving an almost sure fire thing (partner) where the medicine/hospital component is not bad for a closer job, that may be slightly more difficult, but way closer to home. I’m still very early in my career, so I’m not too invested in one route that will be that detrimental. my biggest fear is that I would be making a huge mistake leaving my current group and feel bad for all the relationships i have built thus far. However, the new group i think would offer the same if not better ability for future work relationships.
 
A minimum 1 hour commute there and another 1 hour commute back would have been a non-starter for me. I assume you won’t have any committee and/or leadership roles or else that’ll just be more salt in the wound making that commute on your days off.
 
I’d also be curious with your current job

1) the nature of these exclusive deals
2) number of OG partners vs new partners

Basically in the event of a buyout offer or some other contractual stuff will they have wildly different motivations and can they outvote you new guys
 
bravotwozero said:
Are you willing to relocate closer to your current gig?
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No due to family reasons…can potentially move to a site that is ~40 minutes away.

HemeOncHopeful19 said:
I’d also be curious with your current job

1) the nature of these exclusive deals
2) number of OG partners vs new partners

Basically in the event of a buyout offer or some other contractual stuff will they have wildly different motivations and can they outvote you new guys
Click to expand...
every partner is equal (in both groups)…without getting into all the details, old guys ended up retiring now. However, I agree I am not a fan of the deals for some, but not for all
 
always.chillin said:
I need some advice as well. I currently commute 50 minutes to work each way and make 275/hr (inclusive of bonuses). I need to relocate which would add roughly 30 minutes each way to my current drive. I have found an alternative site however I would make roughly 225/hr here (bonuses included). Drive would be considerably less around 20 minutes each way. Site seems fine in regard to expectations and consultants and ancillary staff.

What would you guys do if this were your situation? Everything is very smooth at my current site and the only drawback is the drive. I probably would have to start occasionally staying in town if I were to stay at my current site (hospital gives hotel allowance). It is a considerable pay cut and the thought of leaving an otherwise good gig makes me nervous. But I won't lie, the thought of a 20 minute drive and more time with my family sounds quite nice.
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Thinking strictly about the dollars and cents, since the commute time delta is 2 hours between the jobs, add that to your shift length and current job (recognizing you don't get paid for those 2 hours) and do the math.

Assuming a 10h shift, $2750/12h (including shift time + commute time) = $229/h.

So you need to ask yourself if current job (with it's known good and bad qualities) is worth less time with family for what in the end is a $4/h difference in pay, compared to new site (with it's unknown good and bad qualities).
 
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All things being equal when you factor in drive time, I'd go with the closer shop. Being close allows you to open yourself to being on a committee, directorship, community outreach etc, as opposed to GTFO because I have a 90min drive.
 
Is part time, mix of the two an option? I worked 2/3 full time at a rural hospital 80 minute drive away which I didn’t mind while the pay was good ($280ish/hr) and job was OK but it became intolerable when the pay was cut and job worsened. I left a close by CMG and took the part time job as the pay was better at 2/3 full time (with benefits) than full time at the CMG. This was 8-9 shifts 10 hours per month. If you have a nice car and a good selection of podcasts/music, a long commute maybe 6-7 times per month can be tolerable.

I will add, I’ve had some pretty ****ty commutes in bad weather and snow on back country roads. Once it took me 3 hours to get to work in the snow.
 
I'd take the new job with the 20 minute commute. You can make more money, but you can't make more time. Maybe you can pick up an extra shift occasionally if necessary. I think most families would rather have you there at least for a little while each day rather than only in large chunks that are several days apart.

I've done very short commutes, 1-hour commutes, a 5-hour commute (3 shifts in a row, stayed in town, obviously, and it was a cool place that I got to enjoy during the day because I was working slow overnights and often got some sleep), and out-of-state locums. The 1-hour commute was the hardest because it turned a 10-12 hour shift into 12-14 or more, depending on whether I left on time. That means a day completely dedicated to working/driving, with very little hope of catching even part of whatever's going on with friends/family and very little time to recover (sleep/shower/eat) for the next day. Even locums shifts weren't as draining because I wasn't trying to juggle home and work on the same day.
 
I'll bump this thread rather than making a new one, since I *also* want to get job advice. My posting history here makes me identifiable if anyone wanted to put in the leg work and as such anything I write is only semi-anonymous - so I'll try to keep some details a bit vague to not talk about things that aren't public yet.

Was previously offered a director job at a place I worked locums. I turned it down because it was a bad move for my family at the time. My buddy became the director. Its in suburban/urban area of Florida but it is culturally redneck florida. I am more of a "I am from NYC and now I live in Miami because I love everything a city brings to the table" sort of guy. The area itself has enough (i guess) resources for me to not get bored, its just more spaced out and culturally very different and even if it is technically urban its much "smaller" than anywhere I have lived before. The good news is for me I can blend in fine and have for years as a locums there because I do originally come from rural upstate NY, just channel my childhood and its close enough. My wife would have a much harder time adjusting but thinks she can get used to it.

as you might guess from my prefacing in the above paragraph, my friend might be switching to a different site which would be a big pay raise for him. Its been unofficially floated by higher ups that maybe I just move there and take over if he does indeed switch jobs. Unofficially because he doesnt have the new position yet, but also because if he *does* get the position they want me to make my decision to replace him quickly so they know if they need to look for a new director externally or not.

Here's the reality: I just joined a group that pays well. Quite well. Well enough to cover all my expenses, all my investment plans, and still leave a small amount left over after working 150 hours a month (I dont enjoy working less than that), and often has opportunities to work 180+ hours a month (>180 is probably too much, but I can do it for a few months in a row and the money is nice). This new job opportunity would pay essentially the same hourly rate but obviously working 150 hours as director is likely as tough as 180 as not-director so I'd probably cut back to 120. Which is actually nice because I can see my wife and kid more. It is offset by a "greater than 25k" director bonus monthly. Which is a lot of money even if you account for ~30 less hours of working clinical. I already save money like crazy for retirement and my future (in my late 30s and already have $1 mil in invested funds for retirement, a $3 mil whole life plan that hopefully I live to collect, and a house with ~$500k in equity in it) so the extra money would essentially go towards the things I would like to do and/or making sure both my parents and my wife's parents are set for the last few decades of their life. BUT ALSO, the extra money is all just that - extra. I already have enough income to just mildly break positive with maximum investment into my future (and student loans come off the books next year, so thats +$3500 per month).

Everyone, including my wife, are encouraging me to do it if the opportunity does come. But everyone also knows it will be really isolating for my family. My in-laws are very enmeshed in our lives and our kids life and they, honestly, are poor immigrants who do benefit from us being nearby and helping them regularly. Also my wife isnt exactly a strong cultural fit for the area - but neither was my friend and his wife but they thrived well enough. Plus, it is fun to live in Miami and have great restaurants and cultural things nearby instead of many chain restaurants no cultural things. It is objectively a great move for my career. I also feel like I'd be abandoning the new group I just joined recently who was struggling for hour coverage and is lauding me for stepping up and being a sponge for hours for them. It is objectively a very rough change for my wife and kid (thankfully she's 2 so she doesnt have a social life to disrupt, just less time with grandparents). If I needed the money or had any personal expenses I'd like to save for it would be a 100% no brainer "lets do it" decision. Whats holding me back is that I don't need the money, but I would love the promotion and would love to be able to help my inlaws and parents have more financial security they dont have.... but I could likely do this by just saving less aggressively or working >150 hours regularly as well. My wife is being super supportive of me, but she is also anxious AF about the decision and we both agree it feels like something we would choose to do and not something we have to do, which is why our subjective concerns are driving us nuts.

Anyway just hoping someone could tell me that either I'm crazy to overthink it and just be happy to have the opportunity or that they think the culture shock would be rough and to be happy that I already have a good setup. My issue is everyone I know that's medical is either 1) conflicted because they have incentive to want me to take the job or 2) I can't talk about this stuff with because of business-ethics reasons.
 
It sounds like money is not part of the decision. It sounds like location, “promotion,” and sense of abandonment are the drivers of the decision.

Location - you will likely have the same life

“Promotion” - this might get you out of clinical medicine more, but this might offer more headaches

Sense of abandonment - you owe them nothing, and it sounds like you already know the other group

Bonus - you will be getting away from the in-laws?

Questions:
If you live in Miami, how long to travel to get to “redneck Florida” hospital?
What’s the sign on and relocation bonus?
Is there a difference in school quality for your kid?
Can you and your family (wife) handle hot humid long Summers?
 
DocEspana said:
I'll bump this thread rather than making a new one, since I *also* want to get job advice. My posting history here makes me identifiable if anyone wanted to put in the leg work and as such anything I write is only semi-anonymous - so I'll try to keep some details a bit vague to not talk about things that aren't public yet.

Was previously offered a director job at a place I worked locums. I turned it down because it was a bad move for my family at the time. My buddy became the director. Its in suburban/urban area of Florida but it is culturally redneck florida. I am more of a "I am from NYC and now I live in Miami because I love everything a city brings to the table" sort of guy. The area itself has enough (i guess) resources for me to not get bored, its just more spaced out and culturally very different and even if it is technically urban its much "smaller" than anywhere I have lived before. The good news is for me I can blend in fine and have for years as a locums there because I do originally come from rural upstate NY, just channel my childhood and its close enough. My wife would have a much harder time adjusting but thinks she can get used to it.

as you might guess from my prefacing in the above paragraph, my friend might be switching to a different site which would be a big pay raise for him. Its been unofficially floated by higher ups that maybe I just move there and take over if he does indeed switch jobs. Unofficially because he doesnt have the new position yet, but also because if he *does* get the position they want me to make my decision to replace him quickly so they know if they need to look for a new director externally or not.

Here's the reality: I just joined a group that pays well. Quite well. Well enough to cover all my expenses, all my investment plans, and still leave a small amount left over after working 150 hours a month (I dont enjoy working less than that), and often has opportunities to work 180+ hours a month (>180 is probably too much, but I can do it for a few months in a row and the money is nice). This new job opportunity would pay essentially the same hourly rate but obviously working 150 hours as director is likely as tough as 180 as not-director so I'd probably cut back to 120. Which is actually nice because I can see my wife and kid more. It is offset by a "greater than 25k" director bonus monthly. Which is a lot of money even if you account for ~30 less hours of working clinical. I already save money like crazy for retirement and my future (in my late 30s and already have $1 mil in invested funds for retirement, a $3 mil whole life plan that hopefully I live to collect, and a house with ~$500k in equity in it) so the extra money would essentially go towards the things I would like to do and/or making sure both my parents and my wife's parents are set for the last few decades of their life. BUT ALSO, the extra money is all just that - extra. I already have enough income to just mildly break positive with maximum investment into my future (and student loans come off the books next year, so thats +$3500 per month).

Everyone, including my wife, are encouraging me to do it if the opportunity does come. But everyone also knows it will be really isolating for my family. My in-laws are very enmeshed in our lives and our kids life and they, honestly, are poor immigrants who do benefit from us being nearby and helping them regularly. Also my wife isnt exactly a strong cultural fit for the area - but neither was my friend and his wife but they thrived well enough. Plus, it is fun to live in Miami and have great restaurants and cultural things nearby instead of many chain restaurants no cultural things. It is objectively a great move for my career. I also feel like I'd be abandoning the new group I just joined recently who was struggling for hour coverage and is lauding me for stepping up and being a sponge for hours for them. It is objectively a very rough change for my wife and kid (thankfully she's 2 so she doesnt have a social life to disrupt, just less time with grandparents). If I needed the money or had any personal expenses I'd like to save for it would be a 100% no brainer "lets do it" decision. Whats holding me back is that I don't need the money, but I would love the promotion and would love to be able to help my inlaws and parents have more financial security they dont have.... but I could likely do this by just saving less aggressively or working >150 hours regularly as well. My wife is being super supportive of me, but she is also anxious AF about the decision and we both agree it feels like something we would choose to do and not something we have to do, which is why our subjective concerns are driving us nuts.

Anyway just hoping someone could tell me that either I'm crazy to overthink it and just be happy to have the opportunity or that they think the culture shock would be rough and to be happy that I already have a good setup. My issue is everyone I know that's medical is either 1) conflicted because they have incentive to want me to take the job or 2) I can't talk about this stuff with because of business-ethics reasons.
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I’m not reading all that but based on your first (edit: second) paragraph alone I would avoid moving to that area because you sound like a really annoying person to have as a neighbor for the people in that area
 
Porfirio said:
It sounds like money is not part of the decision. It sounds like location, “promotion,” and sense of abandonment are the drivers of the decision.

Location - you will likely have the same life

“Promotion” - this might get you out of clinical medicine more, but this might offer more headaches

Sense of abandonment - you owe them nothing, and it sounds like you already know the other group

Bonus - you will be getting away from the in-laws?
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awww. but I love them. But I get that most people would definitely view that as a bonus.
Porfirio said:
Questions:
If you live in Miami, how long to travel to get to “redneck Florida” hospital?
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8 hour drive. This is gonna be a flight to relocate
Porfirio said:
What’s the sign on and relocation bonus?
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to be negotiated, but likely no sign on bonus and likely yes a relocation bonus but who knows how much.
Porfirio said:
Is there a difference in school quality for your kid?
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ehhhh she was going to private school no matter what. Wife used to work for one in miami. I wanted public school but wasnt going to turn down that connection. Would need to be a private school in the new locale, but there is a nice one there so its a wash.
Porfirio said:
Can you and your family (wife) handle hot humid long Summers?
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Heh. Wife is from the tropics originally and Miami is (somehow) less hot and humid than the new location but only by a little bit so its a change for me but not a big one. no issues there.
 
HemeOncHopeful19 said:
I’m not reading all that but based on your first (edit: second) paragraph alone I would avoid moving to that area because you sound like a really annoying person to have as a neighbor for the people in that area
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<shrug> Definitely cuts both ways, my friend. Been working there as locums for a while. The neighbors view me as almost like a zoo animal because I have an italian last name. Had to warn my wife that she will be asked, often, about what its like to be catholic because 1-3 patients per shift would interrupt me mid H&P to ask me that. Its a sufficient novelty that people think the abdomen exam is the right time to ask me about if I ever considered "actually reading the bible" * before and being told with genuine shock that they are surprised I went to medical school with "the stereotypes and all, you know <finger guns> bang bang" **. Cultural changes are real and I cant change that my name itself becomes a talking point that identifies me as an outsider while I'm just one of millions of irrelevant white guys with vowels in their name in NYC or Miami. I dont care because its the same way that a black person would have been regarded where I grew up, so I get the "its cultural and they dont know how bizarre it sounds to me". And its not like they mean it with hate in their heart.... but culture shock is real.

*every single shift. Every. single. one.

** this one is admittedly only been like every month or so, but thats still 10+ more times than it is funny to hear.
 
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I think your family will want to spend more time with you
Your children won't be 2 forever
What does your wife think?
You can't take it when you go so as long as you have enough, the money doesn't really matter.
 
As a guy who grew up in FL, moving from Miami and Latin American in-laws to the redneck riviera in the panhandle is very much moving from NYC to Scranton. Or Miami to Biloxi.

It sounds like the only draw is promotion / money. Some people would thriving being wealthy in a redneck (beach accessible?) region, some will miss Miami.

I would be a hard no, reading your tone, except-
“It is offset by a "greater than 25k" director bonus monthly”

So uh 300k+ director stipend on top of clinical shifts? Maybe give them my name when you turn them down…
 
Janders said:
As a guy who grew up in FL, moving from Miami and Latin American in-laws to the redneck riviera in the panhandle is very much moving from NYC to Scranton. Or Miami to Biloxi.

It sounds like the only draw is promotion / money. Some people would thriving being wealthy in a redneck (beach accessible?) region, some will miss Miami.

I would be a hard no, reading your tone, except-
“It is offset by a "greater than 25k" director bonus monthly”

So uh 300k+ director stipend on top of clinical shifts? Maybe give them my name when you turn them down…
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EXACTLY! My next point to you applies to the next comment too, so read it as well
GassYous said:
I think your family will want to spend more time with you
Your children won't be 2 forever
What does your wife think?
You can't take it when you go so as long as you have enough, the money doesn't really matter.
Click to expand...
My wife wants to do it because she knows it will be hard but she also knows that this much extra money means I can help my inlaws and my own parents to get through some money difficulties they have. My parents made some bad investments and had to delay retirement by ~10 years because they have to rebuild that retirement fund (but theyll be okay) and my in-laws are immigrants working three jobs at once and stay afloat on that but have no savings beyond their house being an asset and I want to make sure they arent left working until their 80 either. this would basically let us solve a bunch of their problems quite quickly just with the excess money we can put towards things that will ultimately help them (invest in their current business ventures, pay for some discretionary stuff for them, get the house with the in law house in the back rather than without it)

Plus I think I'll spend much more time at home and with my kid if I make this move just because less hours is less hours. Most admin stuff is zoom calls nowadays.
 
My reading is the tone of your email is such that you dont want to do it. If you are happy with your current set up i wouldnt upset the apple cart. Sounds like you have a good set up with family etc. I wouldnt screw that up.
 
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GassYous said:
You aren't responsible for your parents and inlaws. Their mistakes shouldn't guide your decisions. In the end, their lives are up to them.
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True, you are not responsible. But perhaps some people want to help their parents/in-laws out of a sense of filial piety. I can understand and sympathize with both viewpoints.

@DocEspana I'm going to echo everyone else's sentiments that it seems you don't want to move, the only reason is for the money. I wouldn't do it if I were in your shoes, but it boils down to what you and your wife and agree/settle on.
 
GassYous said:
You aren't responsible for your parents and inlaws. Their mistakes shouldn't guide your decisions. In the end, their lives are up to them.
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ouch

In laws, meh, but I keep my parents comfy. They gave me a couple of decades of security/safety/love at clear significant time/financial expense to themselves, no brainer to me...

Also I'm modeling all of this behavior in front of my own kids with a (hope) that they'll possibly care about me someday. I might not need their money but want them to at least wanna hang out....
 
GassYous said:
You aren't responsible for your parents and inlaws. Their mistakes shouldn't guide your decisions. In the end, their lives are up to them.
Click to expand...
Most parents sacrifice more for their kids than anyone else. Some pay for their college education. Some help them throughout life. They sacrifice their retirement so kids can have.

To turn your back when they need help or made some poor life decisions seem harsh when you are able to help.

I am bullet proofing my retirement so my kids do not need to confront this decision. Another decision we choose to make for our kids. But if for some reason we had some unforeseen catastrophe, it would be sad if I am in the medicare nursing home watching the paint try when they are living in mansions taking high end vacations.

Inlaws falls into the same company b/c it is my wife's family. Her Parents are my parents
 
DocEspana said:
EXACTLY! My next point to you applies to the next comment too, so read it as well

My wife wants to do it because she knows it will be hard but she also knows that this much extra money means I can help my inlaws and my own parents to get through some money difficulties they have. My parents made some bad investments and had to delay retirement by ~10 years because they have to rebuild that retirement fund (but theyll be okay) and my in-laws are immigrants working three jobs at once and stay afloat on that but have no savings beyond their house being an asset and I want to make sure they arent left working until their 80 either. this would basically let us solve a bunch of their problems quite quickly just with the excess money we can put towards things that will ultimately help them (invest in their current business ventures, pay for some discretionary stuff for them, get the house with the in law house in the back rather than without it)

Plus I think I'll spend much more time at home and with my kid if I make this move just because less hours is less hours. Most admin stuff is zoom calls nowadays.
Click to expand...
Do not take the job.
Admin sucks.
Unhappy wife is not okay
Stick w fam
Don’t do it


You are welcome
 
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