Residency benefit negotiations?

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tegs15

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First off, I searched SDN and was unsuccessful.

This is a questions for PDs or anyone in leadership of EM residency programs, all other input will also be appreciated.

So my top two programs are separated by benefits only. The program I would most like to go to and whose ED chairman has said they would rank me high are lacking on health benefits. It will cost over $600 per month to cover my family for health/dental! If it wasn't for this I would definitely rank them #1.

It has been suggested by a fellow to call and speak with the PD, who I have worked some shifts with, and discuss my concern. The fellow believed that many times if programs really want you they can make some changes to facilitate a residents need. My concern is that I might burn a bridge by broaching the subject, otherwise I think it is a very honest way to approach the match.

Does anyone have any thoughts or suggestions? :confused:

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Generally your benefits are determined by the hospital's HR people and cover all residents equally. Unless a lack of benefits has been a major recruiting issue for all the programs at the hospital and the administration is receptive, then it's a dead issue. I don't think you'd necessarily burn any bridges (although a PD may drop you on the rank list if they really care about how far down they have to go to fill), but I don't think a PD is going to be able to help much.
 
That seemed like the case, but this program actually get its funding from the state and the residents are actually state employees. As a state system its probably even harder to get additional funds or changes made?

As far as recruiting difficulties due to this problem, a current resident on the residency board mentioned that via their organization it is the only change that has been requested by current residents of all specialties and has been brought forward on several occasions, most recently this week again.

I guess I'll think about it, but is still might be worth just discussing it with the PD, she might know if any changes are on the horizon?
 
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hmmm . . . that's kind of a tough call. Have you thought about other things like cost of living in that particular city. Even if it's $600/mo for health care, it might be in a city that costs far less than the program that fully covers health care?

Also, consider if a program has internal or external moonlighting. I've seen a few places with internal moonlighting for $50/hr (i.e. a 12 hour shift=$600) or external starting in 3rd year that could be $100-200/hr.

As has been stated, health insurance and benefits seem like they're standardized for a particular health system, so I don't know how much good it would do.
 
hmmm . . . that's kind of a tough call. Have you thought about other things like cost of living in that particular city. Even if it's $600/mo for health care, it might be in a city that costs far less than the program that fully covers health care?

Both cities are almost the same.

Also, consider if a program has internal or external moonlighting. I've seen a few places with internal moonlighting for $50/hr (i.e. a 12 hour shift=$600) or external starting in 3rd year that could be $100-200/hr.

Good thing to consider, both programs have moonlighting 2nd year and beyond, actually one of my requirements, but that mean that first year is just going to be really tight, not impossible however. I have much to think about.
Thx for everyones input so far.
 
I don't think you are in a position to negotiate benefits. The pd has no control over benefits. You could be shooting yourself in the foot. Asking for special treatment even before you have a spot would piss me off and drop your rank if I were the PD. As my kids say,"you get what you get and you don't throw a fit."

Just rank the program with better benefits first. You have no guarantee of a spot at either place. Don't risk matching at neither.
 
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I don't think you are in a position to negotiate benefits. The pd has no control over benefits. You could be shooting yourself in the foot. Asking for special treatment even before you have a spot would piss me off and drop your rAnk if I were the PD. As me kids say,"you get what you get and you don't throw a fit."

Of course I understand this sentiment, but everything is negotiable! My life before and outside of medicine has always consisted of asking for what you want, you can always be turned down but you can never get what you truly want without asking for it.

Could this bite me in the behind, of course! But I do find it interesting that three years from now negotiating will be expected and encouraged with respect to my occupation but now it could be perceived as seeking special privileges and look poorly. Funny what a couple years can do.;)

The only reason I originally posted this thread was because a current fellow thought I might be able to get somewhere with it. He had seen some things done in his own program to address the needs/wants of individual residents. Thanks for everyones continued input and advice.
 
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That seemed like the case, but this program actually get its funding from the state and the residents are actually state employees. As a state system its probably even harder to get additional funds or changes made?

This.

At least from my experiences interviewing at county hospitals (hospitals owned by the County of XXX where you become an employee of the County of XXX,for example), their benefits are set in stone, meaning that every employee with a family, from a PGY-6 Neurosurg resident to the dude that cleans toilets is on the same health care plan, with monthly premiums based on your annual salary (aka you pay 600 while janitor bob might pay 125 for the same coverage).

Rank the program with the better bennies first. Being poor sucks.
 
Of course I understand this sentiment, but everything is negotiable! My life before and outside of medicine has always consisted of asking for what you want, you can always be turned down but you can never get what you truly want without asking for it.

As you realize, residency positions are structured completely unlike any other job you would ever encounter. Keep your expectation low.
 
Medical students leave med school spectacularly unsuited to practice medicine independently and in a lot of debt. This leaves you in a pretty weak position to bargain for benefits. The chance that you're going to be more productive for the residency then other applicants who occupy a similar position on the residency's rank list isn't great. If you're a strong enough candidate, you may be able to leverage a couple's match but that's going to be about it.
 
You will not negotiate better benefits out of a residency program. It just won't happen because you have nothing to leverage right now. You have worked 4 years to have a foundation upon which to learn how to be a doctor. You are not yet a doctor. Sorry. You probably won't burn a bridge, but will come off pretty naive by trying to bargain with the PD.

Make sure that the benefits will actually cost you out of pocket at the one place, as opposed to some sort of flex-spending or untaxed slush fund that the county programs use. My benefits cost an enormous amount, but I don't "pay" for them. If they are out of pocket my advice is to not mess around with uninsured wife + kids. Don't even rank the program. It is a recipe for disaster. An unhappy family makes residency impossibly hard and completely unrewarding.
 
Of course I understand this sentiment, but everything is negotiable! My life before and outside of medicine has always consisted of asking for what you want, you can always be turned down but you can never get what you truly want without asking for it.

What you did before, and outside of, medicine doesn't matter. The above statement shows that you don't get it yet, and it makes anyone who understands the residency system cringe.

DO NOT ASK for anything from a residency PD - accept that which you are offered with graditute. You can always get a credit card and use it to finance your health coverage.
 
Of course I understand this sentiment, but everything is negotiable! My life before and outside of medicine has always consisted of asking for what you want, you can always be turned down but you can never get what you truly want without asking for it.

Could this bite me in the behind, of course! But I do find it interesting that three years from now negotiating will be expected and encouraged with respect to my occupation but now it could be perceived as seeking special privileges and look poorly. Funny what a couple years can do.;)

The only reason I originally posted this thread was because a current fellow thought I might be able to get somewhere with it. He had seen some things done in his own program to address the needs/wants of individual residents. Thanks for everyones continued input and advice.

You can always try, but residency contracts are negotiated years in advance as are benefits such as the ones you describe. It will take them at least a year to make such a change and given how frequently it's come up as a topic of discussion it doesn't seem that they are all that motivated or able.

I've heard rumors (I'm pretty sure they were urban myths) of residents being wooed with special treatment relative to their classmates, but I've not ever seen any evidence that this actually does happen.

Thus, I'm inclined to agree with everyone else. This is something that is, in all likelihood, non-negotiable. Trying to negotiate it for yourself only marks you as someone who wants special treatment and is potentially damaging.
 
I'd only try to negotiate if this was a true make or break point.
As in, if they don't change this, you aren't going to rank the place.

As others have said, you have no leverage.
I just couldn't see it happening.

This happens all the time in the real world, but that doesn't apply here.
 
I'd only try to negotiate if this was a true make or break point.
As in, if they don't change this, you aren't going to rank the place.

Wrong. You can negotiate this in the setting of deciding to accept the position of hospital president, dept. chair...or maybe (but unlikely) the PD. Anything else you will be laughed at behind your back (if you're lucky, more likely in your face) and your app/file/ROL position will be quietly used to line the hospital CEOs bird cage.
 
You being married is not th PD's problem. I was married with 2 kids and had a third in residency. I lived in a crappy part of town and had a lower standard of living than my fellow residents. That was my problem, not the program's.

If I were a single resident, I would be infuriated to find out thAt another resident got more benefits than i did. "Equal work for equal pay", not "More pay than others, just because I'm special."
 
Let me be the next in a long list of other posters to tell you this is a bad idea. Every med student is indeed a beautiful and unique snowflake, but at the end of the day you're all being hired to do the same job. As a chief I was on the rank list committee for my program and I can tell you with utmost confidence that any applicant who asked for extra benefits or special treatment would at best have fallen sharply down the list and at worst been completely removed from the list. Not trying to be too harsh, just trying to warn you of how this could possibly be received.
 
Nah, I want to tell him to go for it, just to see how quickly the flame burns out.

Remember, it's a small community, and unfortunately, if you really burn one bridge, that island can call all the others out there as well. It's rare, but some people really do make DNR status at multiple places.

Sorry, but the cards are dealt. Rank them as you want them, not as you want them to be. To add to the list of things you can't negotiate, the schedule, number of shifts, off-service rotations, pay, pager number...
 
Nah, I want to tell him to go for it, just to see how quickly the flame burns out.

I decided against a stronger warning because I thought this forum was decidedly libertarian... I'm frankly surprised at the outpouring of good advice... compassionate conservatives, I guess. :D
 
Wrong. You can negotiate this in the setting of deciding to accept the position of hospital president, dept. chair...or maybe (but unlikely) the PD. Anything else you will be laughed at behind your back (if you're lucky, more likely in your face) and your app/file/ROL position will be quietly used to line the hospital CEOs bird cage.


Did you even read my post?
You are saying the same thing.
 
Did you even read my post?
You are saying the same thing.

No. Also...no. At least, no more so than anyone else posting in this thread. And the way I said it was funnier.

On an unrelated note, the OP seems conspicuously absent in this discussion after everybody with an ounce of sense brought up what a douche move his plan was.
 
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