Should I reject this job offer?

[img4path]

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Background -
AP/CP boarded, Heme fellow

Offer -
In desirable location
2 years to initial partnership, 5 years to full.
Moderate workload
120k starting salary + 30k benefits
350k eventual salary at 5 years

Everything but the initial salary seems ok.

 

[DarksideAllstar]

Tell them to stick it right up there @ss! Seriously, IDK. $350 at 5 years seems good to me, but is that guaranteed? I'd hate to work for $120K for 4 years and then get the axe...

 

[djmd]

It is private group correct? (people use "partner" loosely)
Is it a Heme position?

It seem a little on the light side, but you said "desirable" location, which generally means less pay...
That and the moderate workload... is it moderate work 5 days a week or 4? 3?

 

[juddson]

WTF??!!

120k to start?? That's insulting. Pediatricians earn more than that to start. CRNA's start at more than that. It seems to me that this group (corporation, whatever?) is trying to get cheap labor by working a short con. It demonstrates a profound disrespect for its new associates and, quite frankly, a lack of confidence in its ability to hire and retain good people.

I'd tell them to go **** themselves. If this represents a trend for the field, I'm out.

Judd

 

[mcfaddens]

You will be heme boarded and starting at 120K with a "moderate work load". That really sucks! Is this a J1 visa thing? Just glance at what an average starting position for heme gets on diffrent web sites such as pathology outlines (indiana job) or medhunters. Im not sure these are average #'s ( you might want some feedbac from those already in practice) but 120k seems way low for a spec boarded person in a private job. I agree with the trend that if they can get you for that cheap it reduces the salaries (if enough people take poorly paying jobs). I hope your reason on choosing that particular location is worth about the extra $80,000 + a year you could be making if you went somewhere else or looked a little harder. Also beware jobs that just fall in your lap without someone you giving you an in or telling you about the opportunity. Good luck with that.

 

[img4path]

Additional info:
Job is hemepath/surgpath
This is not a J1 visa thing - Im a US citizen
Stable private group been around for long time with solid hospital contracts
Moderate workload means a reasonable number of cases per day with shared weekend call - one day/week frozen, one weekend day/month call
Progressive increase in salary yearly from initial slavery to eventual full partner
They seem sincere in wanting a partner as someone is retiring and they only hire every 5-10 years and said it is a hassle to replace people

Additional cons:
- Regular grossing responsibility shared. I thought I was done with grossing after residency.


Some people have suggested to me to bend over for them for a few years and it will pay off in the long run, while others say the initial salary is just way too low to take them seriously when who knows what will happen in 5 years.

 

[djmd]

Some people have suggested to me to bend over for them for a few years and it will pay off in the long run, while others say the initial salary is just way too low to take them seriously when who knows what will happen in 5 years.

Yes.

That is the split. And unless you have a time machine, good luck divining which way to go.

And while I don't want you to give out info that would be too specific....
without a better sense of size of group (sounds like 5-10ish?) and the volume (what is a reasonable number of cases) annually/per person.
and the desirable location. It sounds like the group may people heavy/case light.
Some groups go for that, some like it flipped (less people/more cases=busy but more cash)

 

[LADoc00]

let me think about this, will post later.

 

[LADoc00]

Additional info:
Job is hemepath/surgpath
This is not a J1 visa thing - Im a US citizen
Stable private group been around for long time with solid hospital contracts
Moderate workload means a reasonable number of cases per day with shared weekend call - one day/week frozen, one weekend day/month call
Progressive increase in salary yearly from initial slavery to eventual full partner
They seem sincere in wanting a partner as someone is retiring and they only hire every 5-10 years and said it is a hassle to replace people

Additional cons:
- Regular grossing responsibility shared. I thought I was done with grossing after residency.


Some people have suggested to me to bend over for them for a few years and it will pay off in the long run, while others say the initial salary is just way too low to take them seriously when who knows what will happen in 5 years.

First, I still gross and I run my own show. There is nothing like cutting in placentas while you are also in a biz meeting with your attorney and business consultant.

Second, if you are an img you will get less $, no question. But this is likely just til you make partner. Honestly, it can be VERY hard for IMGs in general to get offers, and in desirable loc.'s even rarer, then throw a fairly solid partnership track, very rare.

We need to consider this.

What is your vibe from the people? Nice, mothering types? or fathering types.

How many people have they brought in and not made partner? Get names, call them, get the inside info.

Get an attorney. Always...I have 2 on retainer. Find a good contracts guy. Ask around. Your attorney will be utterly key.

Get everything they gave you in writing to the above attorney.

Did they give you an actual contract? Letter of intent? What?

lots of ?s to ask...base salary and partnership level are only a small % of the info you need to make a good decision.

 

[RyMcQ]

They seem sincere in wanting a partner as someone is retiring and they only hire every 5-10 years and said it is a hassle to replace people

If they are sincere, then partnership should be offered within 3 years max. That should be sufficient time to know for sure if you are partner material.

The starting salary is quite low, as others have pointed out, especially since you are replacing someone. If they pay you 120k and they were paying the other guy 350k, they all stand to make extra tens of thousands by hiring you. Not saying they should pay you what they paid the other guy right off, but I think 200k/year is the minimum you should accept.

If they won't offer more, then you should consider that they aren't really interested in having you as a potential future partner...

 

[LADoc00]

Of course the salary is dirt low. Pretty much the lowest end you can possibly get.

The harsh reality is many/most IMGs never make partnership. Not in year 3, 5 or year 20. Im not saying that is right, but it is the state of affairs.

 

[macrocyte]

The harsh reality is many/most IMGs never make partnership. Not in year 3, 5 or year 20. Im not saying that is right, but it is the state of affairs.

Wow, that's depressing. Kinda makes me want to join a pod lab....We'll all go down together.

 

[djmd]

If they are sincere, then partnership should be offered within 3 years max. That should be sufficient time to know for sure if you are partner material.

Not to put word in OP mouth, but it seems like the partner offer is at 2 years. With a 3 year period of "buy in".

 

[LADoc00]

Yeah my reading is you are voting member by year 2, and years 3-5 you are using a portion of your salary to buy shares/equity. This is standard. Probably somewhere on the order of 100K total in 3 years, which you get back when you sell your shares to the next new pathologist.

Pretty standard stuff.

 

[DarksideAllstar]

Wow, that's depressing. Kinda makes me want to join a pod lab....We'll all go down together.

You didn't expect people to just look blindly past the fact that you completed med school overseas did you? I would think that a more important consideration would be where one completed residency and their performance there, but I am also not the one doing the hiring.

 

[LADoc00]

Wow, that's depressing. Kinda makes me want to join a pod lab....We'll all go down together.

who do you think work in POD labs?? Not the WASPs from the Andover-->Princeton---HMS track fo sure.

 

[macrocyte]

You didn't expect people to just look blindly past the fact that you completed med school overseas did you?

Yeah, I guess I did think they would look past it after I worked with them every day for 3 to 5 years during my provisional partnership track. The POD labs and path mills are starting to look very enticing. Hmmm... prostates or polyps...that's the big decision .

 

[yaah]

who do you think work in POD labs?? Not the WASPs from the Andover-->Princeton---HMS track fo sure.

****ing andover. I just got the alumni bulletin, my class notes are written by a total douchebag who is trying to make it in hollywood. The notes are full of people running into each other at sushi bars and tribeca lofts and mountain passes in Chile. **** them all. If I ever go to a reunion it will be with a can of mace.

 

[img4path]

I'm not sure how much going to med school overseas cost me in initial salary. I think going to med school overseas cost me Radiology and about $650K/year to be honest - those bastards. I think this group is just cheap more than taking into account where I did med school. The guy I'm replacing is an old timer who is no longer a partner, so I think he's not getting the full $350K, anyway.

Although I dislike the initial salary, this is an area I will probably stay in for the next 20-30 years, so in the long run, maybe its worth it, as I don't see very many other jobs for heme in the area. The group does admit they pay low initially but they also say that there are groups who promise partnership and never deliver and that they are definitely not one of those - if that means anything.

As someone was mentioning, I would like to make $200K with heme boards, but if that means living in hickville with Cletus and Rosco P. Coltrane and you got a nagging, bored wife at home, then that might be torture also.

Anyway, thanks for everyone's input. I'll have a lawyer check out the contract - thanks LADoc00, and I'll think it over for a few days.

 

[pathstudent]

****ing andover. I just got the alumni bulletin, my class notes are written by a total douchebag who is trying to make it in hollywood. The notes are full of people running into each other at sushi bars and tribeca lofts and mountain passes in Chile. **** them all. If I ever go to a reunion it will be with a can of mace.

What's up with all the angst? Let it go, man...

 

[djmd]

What's up with all the angst? Let it go, man...

That's not Angst, that's wrath... "Give in to your anger, Yaah!"

I bet the alumni mag is all "Scooter this" and Scooter that...

What "I. Lewis "Scooter" Libby" isn't featured heavily?

 

[mrp]

I feel EXACTLY the same way about fcuking Exeter. Bunch of ***holes. Hated that place.

My mom for some reason gave them my current email address a year or two ago, saying I "needed to network". So, now I get a little bit of joy every time I mark one of their gd money grubbing emails as "spam".

Sorry for the off topic post.

 

[DarksideAllstar]

In my graduating class, there are very few that have accomplished anything beyond getting their diploma. 5 (that I know of) of our girls went on to work a couple of the local strip clubs here (most likely making upwards of 6 figures). A couple of guys I know are bartenders down on the strip, also pulling in >100K/yr. Maybe one other guy went to med school, and like a handful of people got engineering/CS degrees and now make a decent living. Score one for public schools!

 

[LADoc00]

In my graduating class, there are very few that have accomplished anything beyond getting their diploma. 5 (that I know of) of our girls went on to work a couple of the local strip clubs here (most likely making upwards of 6 figures). A couple of guys I know are bartenders down on the strip, also pulling in >100K/yr. Maybe one other guy went to med school, and like a handful of people got engineering/CS degrees and now make a decent living. Score one for public schools!

The most financially successful early 20 somethings Ive met in my journeys have ALWAYS been strippers. Stripping is just way too lucractive with no tax controls. A couple of good years on the pole could pay for undergrad and med school. A stripper making 100-120K is like a doc grossing 500K.

BY FAR, stripping is the best early career move, if got the "equipment".

 

[DarksideAllstar]

The most financially successful early 20 somethings Ive met in my journeys have ALWAYS been strippers. Stripping is just way too lucractive with no tax controls. A couple of good years on the pole could pay for undergrad and med school. A stripper making 100-120K is like a doc grossing 500K.

BY FAR, stripping is the best early career move, if got the "equipment".

I totally agree, and if I had been a hot chick, would definitely have considered it. BTW, if you ain't got the "equipment", you can get the "equipment"--a wise investment. One of my friends (bartender, not stripper) owns three houses here in Vegas, each worth more than double what he paid for them (like $400-500k). He rents two of them out, lives in the third. He works 4 or 5 six hour shifts a week, the other two nights he is paid to go out, party (on the bar's dime), and try to talk up and bring business back to his bar. He is 27. I have made some questionable decisions in my life, but not becoming a bartender was probably up there. F intellectual stimulation, I need me one of these:

 

[LADoc00]

I dont care as much about material things as I do about paying off student debt, having a reasonable home and focusing on doing things with my life other than just pathology/medicine. Most importantly, I want to decrease the overall level of stress in my life, maybe spend 20 or so weeks/year working and the rest of the time travelling, focusing on spiritual calmness and enjoying my personal interactions with the rest of the human race...that isnt cut into pieces or already dead.

 

[sirus_virus]

I dont care as much about material things as I do about paying off student debt, having a reasonable home and focusing on doing things with my life other than just pathology/medicine. Most importantly, I want to decrease the overall level of stress in my life, maybe spend 20 or so weeks/year working and the rest of the time travelling, focusing on spiritual calmness and enjoying my personal interactions with the rest of the human race...that isnt cut into pieces or already dead.

AKA

 

[Cloaca]

Of course the salary is dirt low. Pretty much the lowest end you can possibly get.

The harsh reality is many/most IMGs never make partnership. Not in year 3, 5 or year 20. Im not saying that is right, but it is the state of affairs.

Huh??? Is this some sort of regional thing??? I know of plenty of IMGs in the midwest, granted in my parents' generation, who are partners, or for god's sake, are the FOUNDING partners of large private groups.

You are saying to me that even though someone went to a solid residency program, got great fellowships, published plenty, and has good contacts BUT graduated from medical school in another country, this person has NO chance of being a partner or at least expecting equal pay as their AMG colleagues? Does everyone agree that this is true?

I'm just asking because if this is true, then I have been living with my head up my *** for the last several years and I need someone to help me.

 

[LADoc00]

Huh??? Is this some sort of regional thing??? I know of plenty of IMGs in the midwest, granted in my parents' generation, who are partners, or for god's sake, are the FOUNDING partners of large private groups.

You are saying to me that even though someone went to a solid residency program, got great fellowships, published plenty, and has good contacts BUT graduated from medical school in another country, this person has NO chance of being a partner or at least expecting equal pay as their AMG colleagues? Does everyone agree that this is true?

I'm just asking because if this is true, then I have been living with my head up my *** for the last several years and I need someone to help me.

this is one guys' experience. take it for what it is worth. Not that all IMGs get screwed, but recent grads from foriegn med schools end up getting less offers, less starting salary and a more difficult chance to partnership. Personally, I know of 20+ groups in California and know of ZERO IMGs that are founding fathers types, so maybe it is regional. When I say IMG I dont mean some guy who grew up in Germany on an AFB either.

Now the lack of having med school debt from a place like China will probably offset ALOT of that decreased wage amount, so there is a trade off.

An IMG with stellar residency credentials and outstanding interpersonal skills and recs would be the exception, but honestly I havent met that person yet. Even those from Western Europe have some socialization issues and cultural mismatch that can make climbing the political ladder of path groups difficult.

Also realize that many hospitals are religious and/or ethnic. E.g. a SDA hospital would be unlikely to hand a path contract over to athiest IMG anymore than Hezbollah serving up pork carnitas at a rally in Lebanon.

 

[LADoc00]

Just to cover my bases, I pulled up some of the bigger midwest private path labs:
RML:
http://www.rmlonline.com/physCen.asp?id=sp200


UNIPATH:
http://www.unipathllc.com/physicians.html

hmmm yes there are rare IMGs in there from England and Ireland tho.

NOW,
Ameripath, mill lab (corporate lab, no partnership):
http://www.ameripath.com/aboutus/lab_locations.htm#

look through it, huge difference.

 

[yaah]

That's not Angst, that's wrath... "Give in to your anger, Yaah!"

Yeah, it isn't angst. It's mere annoyance although there is a little bit of wrath for them partially ruining what should have been a few good years of my life. It certainly isn't jealousy, they can have their bizarre unfulfilling lives.

 

[img4path]

Well, I'm not sure how this thread turned from analyzing a job offer to strippers, marijuana and lynching IMGs, but here's my two cents based on my recent experience job hunting.

1. Applying to jobs in California is definitely not like applying to jobs in the rest of the country. Not only do you have to go to a U.S. med school, but your name has to be as vanilla as Jim or Bob and your skin shade has to be lighter than their Mocha Frappacino - unless you're trimming the bushes outside the lab of course. It seems many Cali jobs are about showing they have someone from a big name like Harvard or Stanford as a marketing ploy. They'd probably reject Kathy Foucar because she's from a hole like New Mexico.

2. Going to med school outside the U.S. definitely hinders you all around - from getting residency spots to fellowships to jobs. It's only fair since signing out bone marrows is related to whether I read Biochemistry 8 years ago on American soil or not. Although I'm not sure if groups are actually giving lower starting salaries based on your med school. Maybe the offer would have been 180K if I went to Howard University.

3. Although being an IMG may hurt you in some parts of the country, like Cali, I have seen many IMGs as successful partners in groups - So, where there's a will, there's always a way.

4. Some criticism of IMGs is valid. I don't have a problem with communication skills, but even I get annoyed talking to some IMGs and hearing them give presentations when they can't pronounce simple words.

 

[1Path]

but your name has to be as vanilla as Jim or Bob and your skin shade has to be lighter than their Mocha Frappacino - unless you're trimming the bushes outside the lab of course. It seems many Cali jobs are about showing they have someone from a big name like Harvard or Stanford as a marketing ploy. They'd probably reject Kathy Foucar because she's from a hole like New Mexico..

There's this unspoken "rule" among the people of color I know that says that you do yourself a diservice doing ANYTHING that places you at a disadvantage careerwise. Still some of the smartest pathologists I know who are also people of color, just happen to be DO's and IMG's. Bottom line suck it up. YOU Made a choice, so it's YOUR job to make the best of it. Bitchin about how much "color" may be playing a role in your employment opportunities is something you should have thought about BEFORE studying medicine outside the US. Then again, you could always go back to the country where finished med school and get a job there............

Maybe the offer would have been 180K if I went to Howard University

I'm sure WTF you're trying to imply here, but perhaps if you had applied/been accepted to HOWARD UNIVERSITY, your current job offer, which I would have easily topped being an MS scientist in the US 3 years ago, wouldn't exist.

 

[LADoc00]

The "man" holds us all down.

 

[DarksideAllstar]

Can't have a good discriminatory thread w/o tossing in the race card. Not to say that it doesn't happen, but I was expecting it alot sooner. I am very disappointed in all of you.

 

[yaah]

Bias is everywhere, especially if you look for it.

If I don't get a fellowship/job/opportunity, I can blame other races, bias against people from my area of the country, my med school, my race, favoritism for people who have certain qualifications that I don't have, etc. Or I could just say that they didn't pick me and be done with it. I tend to go with the latter. In conjunction with that, I tend to feel that there are a lot of dinguses in the world. While I am not too much of a conspiracy theorist to believe that they are all out to get me, I am enough of a pessimist to believe that they all don't give a **** about me unless they develop a reason to.

In my life, I have seen people who are less qualified than me picked for things I was trying to do (instead of me). I have also been picked for things ahead of people who were perhaps more qualified, or better suited for it. Since I am an american and my self esteem is ingrained to be through the roof, the former occasions outnumber the latter. But since I am only a third generation american and I have a moderate amount of self loathing, I at least admit to the latter. But what does it say about me that I admire the fact that I have this bit of self loathing?

I really don't like whining though, especially when it is whining about something that either you can't do anything about, or something that you could have done more about (i.e. whining about not getting a fellowship if you didn't do any projects).

 

[sapience8x]

****ing andover. I just got the alumni bulletin, my class notes are written by a total douchebag who is trying to make it in hollywood. The notes are full of people running into each other at sushi bars and tribeca lofts and mountain passes in Chile. **** them all. If I ever go to a reunion it will be with a can of mace.

LOL! i went to a new england boarding school too and it is amazing how many people don't work! gotta love the trust funds...

 

[sirus_virus]

I hope this is not true, because aside from discrimination being ignorant, hiring discrimination creates a very dangerous byproduct-> CHEAP LABOR. Cheap labor is the enemy of prosperity for everyone. That is probably why you are seeing that job offer posted by OP.

The last thing you need is a group of IMGs or minority pathologists running arround pissed, and desperate enough to want to undercut everyone else. Take for example, if some IMG accepts the above offer and performs well on the job(very likely), guess how much they are going to offer the next applicant regardless of where they went to medschool. IMO, those that are practicing discrimination might be doing more damage to the entire specialty than they realize.

 

[1Path]

The last thing you need is a group of IMGs or minority pathologists running arround pissed, and desperate enough to want to undercut everyone else. .

Interesting quote. I know a few minority pathologists and the ONLY one I know making under 200K is the one working with the feds, fresh out of residency. And that INCLUDES the minority DO pathologist I know and a HOWARD Med school graduate I know of.🙄

 

[pathstudent]

who do you think work in POD labs?? Not the WASPs from the Andover-->Princeton---HMS track fo sure.

IMGs and academics.

 

[gungho]

Yeah, it isn't angst. It's mere annoyance although there is a little bit of wrath for them partially ruining what should have been a few good years of my life. It certainly isn't jealousy, they can have their bizarre unfulfilling lives.

yaah,
sorry to continue the hijacking of this thread, but as one who is completely unfamiliar with the prep scene except as presented in the movies (and we know how accurate they are), how did andover partially ruin those few years of your life? just curious.

 

[yaah]

yaah,
sorry to continue the hijacking of this thread, but as one who is completely unfamiliar with the prep scene except as presented in the movies (and we know how accurate they are), how did andover partially ruin those few years of your life? just curious.

I spent three years at Andover (freshman year I was somewhere else - and FYI this is pretty common, the class doubles in size between 9th and 10th grades - or should I say "Junior and Lower years," because using common terms like "freshman" or "9th grade" is abominable). It was the worst three years of my life. Not to say I didn't get a good education. I did, I learned a lot, the classes were akin to college classes. But aside from that I didn't meet anyone there that I stay in touch with to this day. The elitism was astounding. And by elitism I don't just refer to silver spoon, upper class, trust fund elitism although that was certainly there. I refer to intellectual and social elitism. Those who think they are better, more knowledgable about everything, or have all the answers at the advanced age of 16. There was more of a sense of entitlement there than anywhere I have ever been. There wasn't really an undercurrent of money, that wasn't a problem as much as the snobbery. I just didn't like it. People wanted to be children the rest of their lives (but to be called adults of course) and have no real responsibility (while at the same time thinking the world depended on their thoughts and actions, paradoxically). It was like a mini Ivy league college. I graduated at the top of my class yet I felt immature and unprepared for the world when I left. What also bothered me is that everyone's opinion had to be respected and glorified, even if meant they were in love with mind altering drugs or ditching intellectual talents in favor of slacking off.

 

[PathOne]

Going back to OP: Salary partly reflects on perception & circumstance. 120K/year seems VERY low for someone who's sub-boarded, in a private partnership-type setting. However, those 120K/year would seem more resonable in a academic research-oriented setting.

Obviously, most people can - get by - on 120K/year, even with student loans. Personally, I'd be liable to take it if it was my first job, and in an amazing academic setting. However, in a money-oriented private setting, I don't think I would. For obvious reasons, there's seldom a PROMISE of getting a partnership, and even if you take another higher-paying job in a place that wouldn't hold out the same prospect of partnership (which many do, btw), there's nothing that'll prevent you from joining another group at a partnership level later on in your professional life.

However, I think the bottom line is: Do you like the place? Better to earn less, but be in a good environment, than slave away for scrooges, and make a bundle.