Prospective Residency Contract

[Oo Cipher oO]

Now that I have completed my residency interviews I am reviewing some of the residency information and in particular I am taking a closer look at the residency contracts programs supply during the interview. I thought it would be useful to have a thread to talk about what parts you find important and may help you rank programs prior to the Match.

One part I look at is termination policy. Some programs will have a formal process of remediation and probation prior to termination. Other will have 30 day termination policy without cause or 7 day termination with cause. I think a formal process will allow for a struggling resident time to improve and not be at the whim of a falling out one staff or program director.

Another contact area that I feel is under appreciated is intellectual property. 90% of residency contracts I looked at do not make mention of this which is a good thing. Do you have an idea for a new medical device or medical app that you want to work on in residency? Maybe want to start a side gig? Be wary of contact language like this from one of my prospective contracts:

"Ownership of Work Product. All materials developed by House Staff resulting from the performance of services for which Hospital provides House Staff compensation under this Agreement, including without limitation, any practice guidelines, care paths, policies and procedures, protocols and other decision-making tools (“Work Product”) must be promptly disclosed and furnished to Hospital. Work Product shall be considered “work-made-for-hire” for Hospital as that term is defined under United States law. In the event and to the extent any Work Product is deemed not to be “work-made-for-hire” then, without limiting the generality of the foregoing, House Staff hereby assigns to Hospital all of its right, title and interest in the Work Product, and agrees to assign to Hospital all of its right, title, and interest in and to the Work Product, in perpetuity, throughout the world, in all media now known or hereafter devised, in all languages, including any and all rights of renewal, revivals, and/or extension of such rights, for use by Hospital in accordance with the terms of this Agreement."

As I understand it if you develop any product, app, website, guideline, or training material during your residency it could become property of the hospital. This is terribly restrictive. I felt positive about this program during the interview but their contract forced me to move them down my rank list.

What are some thing you look for in the residency contract?

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[GoSpursGo]

The most important parts of your contract are the city the program is located in, the pay, and the vacation/parental/medical leave policies.

Realistically, neither of these things you mentioned are worth worrying about. If a program wants to terminate you, they will dot their i's and cross their t's to make it happen. Terminating a resident is a big deal, so by and large as long as you show up and work hard you should be fine.

Not sure how you think you'll have time to have a "side gig" in addition to a job that works you 80 hours per week, but if you have an entrepreneur streak to you then maybe it's something you could care about--probably not relevant for 95+% of applicants.

 

[IMGASMD]

Now that I have completed my residency interviews I am reviewing some of the residency information and in particular I am taking a closer look at the residency contracts programs supply during the interview. I thought it would be useful to have a thread to talk about what parts you find important and may help you rank programs prior to the Match.

One part I look at is termination policy. Some programs will have a formal process of remediation and probation prior to termination. Other will have 30 day termination policy without cause or 7 day termination with cause. I think a formal process will allow for a struggling resident time to improve and not be at the whim of a falling out one staff or program director.

Another contact area that I feel is under appreciated is intellectual property. 90% of residency contracts I looked at do not make mention of this which is a good thing. Do you have an idea for a new medical device or medical app that you want to work on in residency? Maybe want to start a side gig? Be wary of contact language like this from one of my prospective contracts:

"Ownership of Work Product. All materials developed by House Staff resulting from the performance of services for which Hospital provides House Staff compensation under this Agreement, including without limitation, any practice guidelines, care paths, policies and procedures, protocols and other decision-making tools (“Work Product”) must be promptly disclosed and furnished to Hospital. Work Product shall be considered “work-made-for-hire” for Hospital as that term is defined under United States law. In the event and to the extent any Work Product is deemed not to be “work-made-for-hire” then, without limiting the generality of the foregoing, House Staff hereby assigns to Hospital all of its right, title and interest in the Work Product, and agrees to assign to Hospital all of its right, title, and interest in and to the Work Product, in perpetuity, throughout the world, in all media now known or hereafter devised, in all languages, including any and all rights of renewal, revivals, and/or extension of such rights, for use by Hospital in accordance with the terms of this Agreement."

As I understand it if you develop any product, app, website, guideline, or training material during your residency it could become property of the hospital. This is terribly restrictive. I felt positive about this program during the interview but their contract forced me to move them down my rank list.

What are some thing you look for in the residency contract?

What are you? I’d like to ask. Just a few months ago, you said you’re a military pcp, but now you’re interviewing for residency?

It’s a match. If you don’t like them, then don’t rank them. If you ranked them and matched there... no one will change anything in the contract for you. And the joke will be on you.

Sure it’s very important to understand the contract and what kind of power “they” have over you. But you’re asking “them” to take you for residency, when there are other qualified candidates who may give their left nut to just get an interview.

Anyways. Good luck.

 

[Oo Cipher oO]

The most important parts of your contract are the city the program is located in, the pay, and the vacation/parental/medical leave policies.

Realistically, neither of these things you mentioned are worth worrying about. If a program wants to terminate you, they will dot their i's and cross their t's to make it happen. Terminating a resident is a big deal, so by and large as long as you show up and work hard you should be fine.

Not sure how you think you'll have time to have a "side gig" in addition to a job that works you 80 hours per week, but if you have an entrepreneur streak to you then maybe it's something you could care about--probably not relevant for 95+% of applicants.

On mobile so I apologize for any misspellings/autocorrect.

I agree that the pay and vacation/medical leave portions are more broadly relevant to most people. Everyone should look at those. I wanted to highlight other parts of these prospective contracts that may be overlooked.

Termination policy and procedure is relevant to every resident applicant. No one goes into residency expecting to struggle. No one can predict a personal, family, or mental health crisis. I would prefer to sign a contract that affords me a remediation process rather than one that gives leeway for a program to cancel your contract without cause in 30 days.

The intellectual property part is probably more of a personal gripe. I have been working on an app and website idea for a year or so and I would hate either not work on it at all during residency or risk losing my rights to the hospital. I think is it oppressive and crazy that the program would care enough about what I would do with my limited free time that they would include such restrictive language in a residency contract.

Once we match these contracts are essentially non-negotiable. Residents cannot just quit and find a new job or residency easily. I think it is worthwhile to read the perspective contracts and use that to help inform your rank list.

 

[Oo Cipher oO]

What are you? I’d like to ask. Just a few months ago, you said you’re a military pcp, but now you’re interviewing for residency?

It’s a match. If you don’t like them, then don’t rank them. If you ranked them and matched there... no one will change anything in the contract for you. And the joke will be on you.

Sure it’s very important to understand the contract and what kind of power “they” have over you. But you’re asking “them” to take you for residency, when there are other qualified candidates who may give their left nut to just get an interview.

Anyways. Good luck.

I am a residency applicant for the upcoming match. I think the rest of my life story, as interesting as it may be, isn’t really relevant to the topic.

I agree that we have no leverage or power to negotiate these contracts. The only thing we can do is read and understand them and them use that to help inform our rank lists.

Would I rather match into a residency with a restrictive contract rather then not match? Yes. But I don’t have to put that program at the top of my rank list.

 

[RangerBob]

The contracts are non-negotiable even before you match. Your contract is typically the exact same as the one every other resident at the medical center signs.

Honesty I found some comfort in knowing you can’t do anything about it. So just take your pick of your first choice program, with the knowledge of what their vacation policy is/etc, and sign.

When you’re an attending (or if you unionize as a resident) is when you can negotiate your contracts, and quite a bit.

 

[mvenus929]

Intellectual property being under the ownership of the hospital is pretty standard for most employed positions.

The termination cause is likely more for egregious concerns (like patient harm, etc) rather than just being a struggling resident. Residency programs in general have a vested interest in the success of their residents, as failure to pass boards or firing a bunch of residents causes the program to come under scrutiny and potentially lose their accreditation. You're more likely to get information about remediation and probation by talking to the GME office than by reading the contract--my residency contract was a single page and didn't include much beyond my salary and reference to the GME handbook.

 

[Angus Avagadro]

Faculty jobs very frequently have ownership of intellectual property rights defer to the employer for anything developed while in their employ. If you have an ongoing project, then maybe they might reconsider it. Don't hold your breath. Residency programs will have the same requirements. Call, vacation, electives, family leave, compensation for conferences, dues, etc., will be most important to you. You should worry more about how the program will fulfill you professional goals and make you attractive to future employers rather than how they might get rid of you.

 

[LunaOri]

I wouldn't worry about the termination policy. Residency programs don't want to fire residents, because it's nearly impossible to replace a resident in the middle of the year, and nobody wants to work short-staffed.

 

[Wordead]

Faculty jobs very frequently have ownership of intellectual property rights defer to the employer for anything developed while in their employ. If you have an ongoing project, then maybe they might reconsider it. Don't hold your breath. Residency programs will have the same requirements. Call, vacation, electives, family leave, compensation for conferences, dues, etc., will be most important to you. You should worry more about how the program will fulfill you professional goals and make you attractive to future employers rather than how they might get rid of you.

The specifics of IP and profit sharing does vary from employer to employer. I did interview at some places where you would receive up to 1/3 of the proceeds from a patent developed while working for them. Which could potentially be pretty lucrative. Although I think the number of residents who would realistically benefit from this policy is miniscule.