Sign on bonus and stipends.

[heysexylady]

Is it possible to ask for a stipend in addition to getting a sign on bonus during residency/fellowship. If so what would be the average monthly stipend and average sign on bonus for the Midwest?

Thanks you in advance.

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[wolfvgang22]

I assume you are asking about attending positions? Because residency programs don't give sign on bonuses to my knowledge.

Anyway, it can vary a lot based on the job! Factors like benefits, responsibilities, performance incentives, salary, stipend amount all figure in. Also, do you have to return the sign on bonus if you don't stay a certain amount of time? Is there some stupid non-compete clause? Don't sign one of those. Will they pay for your relocation?
I start at $10,000 and go up from there, that seems standard and not uncommon. I generally recommend you start seriously looking for positions 6 to 9 months before the end of residency.

We can give you better feedback if you describe the details of the position without naming the organization or exact location.

 

[heysexylady]

I assume you are asking about attending positions? Because residency programs don't give sign on bonuses to my knowledge.

Anyway, it can vary a lot based on the job! Factors like benefits, responsibilities, performance incentives, salary, stipend amount all figure in. Also, do you have to return the sign on bonus if you don't stay a certain amount of time? Is there some stupid non-compete clause? Don't sign one of those. Will they pay for your relocation?
I start at $10,000 and go up from there, that seems standard and not uncommon. I generally recommend you start seriously looking for positions 6 to 9 months before the end of residency.

We can give you better feedback if you describe the details of the position without naming the organization or exact location.

It's for attending position. I'm currently a fellow and doing a job search ways than the 6 to 9 months you posted.


It's for the Illinois area 2.5 hours outside of Chicago. Outpatient mix adult and child 40 hour work week for 250000 plus. Sign on is 30 grand and if I stay after 2 years they will kick in another 30 grand. There's no stipend but I am thinking of asking for one. Up 10 grand relocation fee. May have to supervise a nurse practitioner. No call. No sick days and 15 to 20 days vacation.

They did offer me another position that would have been so child but inpatient in the am and outpatient in the pm for 220 to 230 grand guaranteed plus production. Up to 10 grand relocation. 20 grand sign on for 2 years, if I leave early will have to pay back some of it depending upon how long I stayed. No sick and I think 15 to 20 days vacation time. Call every 3 to 4 days and one weekend call a month.

I feel like they a few lowballing me since I know the Midwest should be higher. I'm only interested in the Midwest.

I'm not sure which one I want.

What should I counter offer?

 

[wolfvgang22]

The first job actually sounds pretty good to me if the work load is reasonable. How many patients per day would you have to see in clinic? If it is 12 patients per day or less I might even take the position as is, though it is never wrong in my opinion to negotiate and get whatever more you can, and a stipend can be framed as a way to enhance your skills for the good of the clinic. No harm in asking! I'd ask for a $5k stipend and see what they say, maybe you can get $4k.

Chicago area is probably going to be more expensive than KC, for example.

Any way you can find out what others there make there in that organization? Will you have other psychiatrists to share the patient load and cover your vacation? What about nursing and therapists?

The second job sounds like a lot of work for less money to me. I would rather do outpatient child all the time than be on call that much, but that's this child psychiatrist.

 

[heysexylady]

The first job actually sounds pretty good to me if the work load is reasonable. How many patients per day would you have to see in clinic? If it is 12 patients per day or less I might even take the position as is, though it is never wrong in my opinion to negotiate and get whatever more you can, and a stipend can be framed as a way to enhance your skills for the good of the clinic. No harm in asking! I'd ask for a $5k stipend and see what they say, maybe you can get $4k.

Chicago area is probably going to be more expensive than KC, for example.

Any way you can find out what others there make there in that organization? Will you have other psychiatrists to share the patient load and cover your vacation? What about nursing and therapists?

The second job sounds like a lot of work for less money to me. I would rather do outpatient child all the time than be on call that much, but that's this child psychiatrist.

First one I will have my own case load but there is another psychiatrist there. I'm not sure about the max patients I will see a day and it's out in the country and so super cheap. They won't schedule patients if I'm on vacation but the other doc will check meds. There's sw for therapy and I will share two nurses with the other psychiatrist.

I don't think it's possible to have a cap if it's production based. How much more should I ask if If I'm going to monitor a NP and teach students or residents. I was thinking of asking for paid sick days and more vacation time.

Do you mean 5k stipend per month in addition to the sign in bonus. I just started my fellowship in July.

 

[wolfvgang22]

I meant $5k annual stipend. That is actually good. If you want $5k more a month just add that to your requested salary, and good luck!

I get 12 paid sick days a year and they roll over to the next year if I don't use them and that is pretty good in my opinion. I get 26 vacation days per year and 11 clinic holidays. Many doctors don't get that much.

Supervising students and an NP won't usually get you more money. Heck, academic psychiatrists make less!

 

[Ahamis]

I don't think it's possible to have a cap if it's production based.

How much are they going to pay per RVU? Are you ready to see follow-up every 15 min?
I have seen positions that have a base salary plus 'annual productivity bonus' (such as 20K). So, they want you to see 25+ patients per day and pay you a total salary of +-270k.

 

[heysexylady]

How much are they going to pay per RVU? Are you ready to see follow-up every 15 min?
I have seen positions that have a base salary plus 'annual productivity bonus' (such as 20K). So, they want you to see 25+ patients per day and pay you a total salary of +-270k.

I don't know about the evidence... I just assumed that it is standard and can't be negotiated. They said I should hand at least 36 to 40 hours patients contact hours to be considered full time. I can schedule fu 15 min if it's a simple adhd or med check up to 30 min amc they said my intake could be 60 to 90 min depending on my preference.

 

[wolfvgang22]

Another good thing to consider is how much time you are allowed to do documentation, medication refills, phone calls, etc.

 

[Trismegistus4]

Another good thing to consider is how much time you are allowed to do documentation, medication refills, phone calls, etc.

How common are jobs with time blocked out to do those things? I recently encountered someone on another forum who said he had such a job, but it was the first I'd heard of such a thing. In my current job, I'm scheduled with patients 8-12 and 1-5, non-stop. I have to try to squeeze medication refills and phone calls in between appointments and, with documentation thrown in, am there late almost every day. It's so frustrating that I've told myself I would never take another outpatient job again unless it had slots blocked out periodically throughout the day for admin work, but I have no idea what the likelihood is of actually finding such a job.

 

[nowaysanjose]

First one I will have my own case load but there is another psychiatrist there. I'm not sure about the max patients I will see a day and it's out in the country and so super cheap. They won't schedule patients if I'm on vacation but the other doc will check meds. There's sw for therapy and I will share two nurses with the other psychiatrist.

I don't think it's possible to have a cap if it's production based. How much more should I ask if If I'm going to monitor a NP and teach students or residents. I was thinking of asking for paid sick days and more vacation time.

Do you mean 5k stipend per month in addition to the sign in bonus. I just started my fellowship in July.

Do positions exist where you wouldn't have to work with NPs let alone monitor them? Can that sort of thing be negotiated?

 

[hamstergang]

How common are jobs with time blocked out to do those things?

I don't know how common it is, but at my current job I was given by default 6.5 hours of patient time and 1.5 hours of administrative time in every 8 hour day.

 

[wolfvgang22]

It is very common to have some blocked off administrative time. Not having any is straight up abuse by an employer in my opinion.

You don't have to supervise NPs or students. Sometimes I do, sometimes I don't. Everything is negotiable. Know your worth. If you are easily replaced, you don't have much leverage. Psychiatrists are not easily replaced in most of the nation. Don't let anyone pull the wool over your eyes because they are X university or in beautiful New Jersey or whatever other bull.

 

[heysexylady]

Do positions exist where you wouldn't have to work with NPs let alone monitor them? Can that sort of thing be negotiated?

Yes there are jobs that you don't have to work with nps but this place they are actively trying to hire one np.

 

[heysexylady]

It is very common to have some blocked off administrative time. Not having any is straight up abuse by an employer in my opinion.

You don't have to supervise NPs or students. Sometimes I do, sometimes I don't. Everything is negotiable. Know your worth. If you are easily replaced, you don't have much leverage. Psychiatrists are not easily replaced in most of the nation. Don't let anyone pull the wool over your eyes because they are X university or in beautiful New Jersey or whatever other bull.

Would it be possible to ask for higher pay once I become board certified in child psych which would be in 2020.

I really don't want to come off to greed but I want my money. I'm fully aware that minorities and women get paid less even when working full time and I don't want that to happen to me.

 

[FlowRate]

come off to greed

Calling rational self interest "greed" is an employer-side tactic. Be greedy. It's good for you.

 

[Trismegistus4]

I don't know how common it is, but at my current job I was given by default 6.5 hours of patient time and 1.5 hours of administrative time in every 8 hour day.

It is very common to have some blocked off administrative time. Not having any is straight up abuse by an employer in my opinion.

Well, I do have one half day a week, but it's an entire half day at once, not spread out. So, if all my patients show up on Friday, having had Wednesday afternoon off doesn't help me get out of there on time.

I suppose I could ask for that time to be distributed in smaller chunks throughout the week, but I'm loath to give up that solid entire afternoon to go to my own appointments and such. And, being exactly one half day, it's 4 hours per week, not 7.5 (1.5 x 5) like hamstergang has.

 

[hamstergang]

Well, I do have one half day a week, but it's an entire half day at once, not spread out. So, if all my patients show up on Friday, having had Wednesday afternoon off doesn't help me get out of there on time.

I suppose I could ask for that time to be distributed in smaller chunks throughout the week, but I'm loath to give up that solid entire afternoon to go to my own appointments and such. And, being exactly one half day, it's 4 hours per week, not 7.5 (1.5 x 5) like hamstergang has.

I forgot to add that lunch is also part of that 1.5 hours. I couldn't imagine not having time for phone calls each day. Some calls can't wait for that 1 available day each week, so do you either make the patients that show up wait or call back on your own dime?

 

[wolfvgang22]

Would it be possible to ask for higher pay once I become board certified in child psych which would be in 2020.

I really don't want to come off to greed but I want my money. I'm fully aware that minorities and women get paid less even when working full time and I don't want that to happen to me.

Most employers won't offer to pay you more just because you are board certified or less because you aren't. They either require certification or not.
That said, definitely use board certification as a reason they should pay you more. Nothing wrong with marketing your skills.

 

[Trismegistus4]

I forgot to add that lunch is also part of that 1.5 hours. I couldn't imagine not having time for phone calls each day. Some calls can't wait for that 1 available day each week, so do you either make the patients that show up wait or call back on your own dime?

Oh, so you're only there for 8 hours per day, 9 to 5 or 8 to 4? That makes a difference in and of itself.

I rarely call patients on the phone. Usually our MA calls them back. I'd be very afraid of creating boundary issues and winding up with a cohort of people who expect to be able to spend half an hour on the phone with me whenever they feel like it.

I do get multiple no-shows almost every day, but I realize I shouldn't have to count on that, nor do I want to.