Guys, the one piece of advice I would give to any PGY4 is : "What do you love?" Because if you chase the money for a deal that is too good to be true, it is because it is. If you want to make money in medicine in 2010, you had better be willing to work VERY hard. OR, you could do something less desirable. Many (not all) "pain" docs pay a lot for new grads, cause the new guy becomes the narcotic doc. Imagine for a minute seeing 30 patients/day all of whom are chronic painers on narcotics. If you are seeing 4-5/day, that is doable, but 30+, you will want to commit hari-kari in about 6 months.
Look at a 3-5 year projection when you negotiate a contract. My first job was in a major metro area with a guarantee of 200K/yr. I made my bonus in year 1 but worked >80hrs/wk. My collections exceeded 800K! After a few years of this (working for someone else, so the partners could buy a new Porsche every 2 years), I bailed to take a MUCH lower paying job. I needed to regroup, and discover what I loved. Now I am in the sticks, in solo practice and love my job. I still work 7d/wk, 60+hrs/wk, but I am my own boss.
The advantage to being solo is that you can controll your patient population, and work less or more if you want. This week I did 2 IMEs, 10 EMGs, saw 10-15 chronic pain pts., a boatload of MSK back and shoulder pain, and am doing BoTox on a C5 quad over the weekend at a LTAC for his elbow flexor spasticity. I have 15 inpatients (consults/rehab pts) spread over 3 hospitals. Oh, and I am flying to Houston tonight for a Pfizer meeting (since I am a speaker for them) and coming home tomorow night. I am never bored!