Early Job Offer

[jfoxcpacfp]

antheus wrote:

So I am about to accept an offer that was not the initial academic offer this thread was posted about and I figured I’d post an update.

After the initial discussion about the academic job I took the advice in this thread and went through the job search. My SO and I narrowed down some areas we may be interested in and I applied to several jobs in those areas. I also attempted to make contact with some of the private groups in my current city. We were pretty selective in that we really only applied to cities we would want to live in and so I wound up doing 2 phone interviews at places that weren’t really for me and going on 2 other on site interviews in the northeast. I also made contact with several private groups in town and wound up speaking to one that wasn’t really looking for someone but realized that it was time for them to look to the future.

I was honest and open with my home program and told them I was looking into other opportunities. It wasn’t even until December when I finally went through a formal interview process (they were literally my last interview). I got a total of 4 job offers (2 in my current town and 2 in the northeast) at varying times. I turned down one job in the northeast about a month ago because it wasn’t for me and, after receiving a formal offer from my home program and a program in town in rapid succession in the middle of January I decided to turn down my home program. This past Friday I received and decided to accept an offer in a major urban center in the northeast.

Before going through this process I would have never expected to get the offer I did in the city I did. The whole process also gave me a lot of perspective, made me realize what my priorities were, and put me in a position to actually choose a place that I felt was best for me rather than feeling like I settled. The opportunities really ran the gamut.

1) Easy academic job in a system i knew and a city I was happy in with fairly good compensation (mid 300s) but with some sense of inertia and perpetually low morale, not much growth potential, and not a long term prospect

2) Private practice job in a city I wasn’t excited about but with a group of people I really liked working with, a competitive starting salary (low 300s) and good long term prospects (500s)

3) An eat what you kill private practice job in a city I was happy in that wasn’t really looking for someone, I wasn’t super enthusiastic about, no mentorship, unknown starting salary, poor benefits, vague vacation, and I would need to hustle but very high income potential (600s-800s)

4) An easy private practice job in a city I will love, closer to family, in a practice I love, with a decent salary (mid 300s) and fair long term prospects (probably low 400s)

I wound up choosing #4 knowing that if i decide it’s not for me in a few years, #1 and #3 will probably still be available for me. I decided that the only attractive thing about #3 was the money and it wasn’t an ideal opportunity for me as a new physician. Overall, I’m ecstatic with the opportunity I have and am really happy I went through the process if for no other reason than to see what else is out there and feel like I was the one making the decision rather than just falling into something easy. I just wanted to thank you all for the advice here!

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Thank you for taking the time to report back. I am sure this post detailing your thought process and experience will help many who follow the forum who are at the same point in their careers. It helped me understand better, also.

[VagabondMD]

Sounds like you did a good job exploring the opportunities and made a wise choice. Well done.

[Zaphod]

antheus wrote:

So I am about to accept an offer that was not the initial academic offer this thread was posted about and I figured I’d post an update.

After the initial discussion about the academic job I took the advice in this thread and went through the job search. My SO and I narrowed down some areas we may be interested in and I applied to several jobs in those areas. I also attempted to make contact with some of the private groups in my current city. We were pretty selective in that we really only applied to cities we would want to live in and so I wound up doing 2 phone interviews at places that weren’t really for me and going on 2 other on site interviews in the northeast. I also made contact with several private groups in town and wound up speaking to one that wasn’t really looking for someone but realized that it was time for them to look to the future.

I was honest and open with my home program and told them I was looking into other opportunities. It wasn’t even until December when I finally went through a formal interview process (they were literally my last interview). I got a total of 4 job offers (2 in my current town and 2 in the northeast) at varying times. I turned down one job in the northeast about a month ago because it wasn’t for me and, after receiving a formal offer from my home program and a program in town in rapid succession in the middle of January I decided to turn down my home program. This past Friday I received and decided to accept an offer in a major urban center in the northeast.

Before going through this process I would have never expected to get the offer I did in the city I did. The whole process also gave me a lot of perspective, made me realize what my priorities were, and put me in a position to actually choose a place that I felt was best for me rather than feeling like I settled. The opportunities really ran the gamut.

1) Easy academic job in a system i knew and a city I was happy in with fairly good compensation (mid 300s) but with some sense of inertia and perpetually low morale, not much growth potential, and not a long term prospect

2) Private practice job in a city I wasn’t excited about but with a group of people I really liked working with, a competitive starting salary (low 300s) and good long term prospects (500s)

3) An eat what you kill private practice job in a city I was happy in that wasn’t really looking for someone, I wasn’t super enthusiastic about, no mentorship, unknown starting salary, poor benefits, vague vacation, and I would need to hustle but very high income potential (600s-800s)

4) An easy private practice job in a city I will love, closer to family, in a practice I love, with a decent salary (mid 300s) and fair long term prospects (probably low 400s)

I wound up choosing #4 knowing that if i decide it’s not for me in a few years, #1 and #3 will probably still be available for me. I decided that the only attractive thing about #3 was the money and it wasn’t an ideal opportunity for me as a new physician. Overall, I’m ecstatic with the opportunity I have and am really happy I went through the process if for no other reason than to see what else is out there and feel like I was the one making the decision rather than just falling into something easy. I just wanted to thank you all for the advice here!

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Congrats and great work doing all this and really exploring your options. Very few do that.

Number 3 feels risky as a new physician, but you will never have less obligations than now. Those vague jobs with no real benefits often turn out to be the best opportunities. Who knows how these salary ranges in any of the PP opportunities really pan out of course, and family in the area is super important.

[ENT Doc]

Congratulations!

[antheus]

So I am about to accept an offer that was not the initial academic offer this thread was posted about and I figured I'd post an update.

After the initial discussion about the academic job I took the advice in this thread and went through the job search. My SO and I narrowed down some areas we may be interested in and I applied to several jobs in those areas. I also attempted to make contact with some of the private groups in my current city. We were pretty selective in that we really only applied to cities we would want to live in and so I wound up doing 2 phone interviews at places that weren't really for me and going on 2 other on site interviews in the northeast. I also made contact with several private groups in town and wound up speaking to one that wasn't really looking for someone but realized that it was time for them to look to the future.

I was honest and open with my home program and told them I was looking into other opportunities. It wasn't even until December when I finally went through a formal interview process (they were literally my last interview). I got a total of 4 job offers (2 in my current town and 2 in the northeast) at varying times. I turned down one job in the northeast about a month ago because it wasn't for me and, after receiving a formal offer from my home program and a program in town in rapid succession in the middle of January I decided to turn down my home program. This past Friday I received and decided to accept an offer in a major urban center in the northeast.

Before going through this process I would have never expected to get the offer I did in the city I did. The whole process also gave me a lot of perspective, made me realize what my priorities were, and put me in a position to actually choose a place that I felt was best for me rather than feeling like I settled. The opportunities really ran the gamut.

1) Easy academic job in a system i knew and a city I was happy in with fairly good compensation (mid 300s) but with some sense of inertia and perpetually low morale, not much growth potential, and not a long term prospect

2) Private practice job in a city I wasn't excited about but with a group of people I really liked working with, a competitive starting salary (low 300s) and good long term prospects (500s)

3) An eat what you kill private practice job in a city I was happy in that wasn't really looking for someone, I wasn't super enthusiastic about, no mentorship, unknown starting salary, poor benefits, vague vacation, and I would need to hustle but very high income potential (600s-800s)

4) An easy private practice job in a city I will love, closer to family, in a practice I love, with a decent salary (mid 300s) and fair long term prospects (probably low 400s)

I wound up choosing #4 knowing that if i decide it's not for me in a few years, #1 and #3 will probably still be available for me. I decided that the only attractive thing about #3 was the money and it wasn't an ideal opportunity for me as a new physician. Overall, I'm ecstatic with the opportunity I have and am really happy I went through the process if for no other reason than to see what else is out there and feel like I was the one making the decision rather than just falling into something easy. I just wanted to thank you all for the advice here!

[antheus]

Thanks for all the advice everyone. I've spoken to a lot of others and the prevailing sentiment has been the same. It's very nice to have a plan B that I would be very happy with, even if only as a short term situation. I've reached out to a lot of practices in the area, some of which have expressed interest though it's still very early for most of them to give me anything concrete. Still, I'm glad I'm going through the process/motions and I'm definitely learning a ton by doing so.

[treesrock]

Adding to the chorus, you would be crazy not to apply to and interview for other jobs.  I would even go so far as to interview for other academic jobs to see what offers are out there.  At the very least you can use these as a comparison for your current offer to see if you feel inclined to negotiate anything.  And considering your field seems small, I would definitely keep it to yourself regarding what field/specialty you are applying to.  Be as anonymous as possible, its a small world out there, especially in academics.

And I would say there is almost always room for negotiation, even if its just a signing bonus, relocation fees, etc.  For an academic job, there is no negotiation in terms of the insurance coverage, employer matches, etc, but you can always ask for more money, bonuses, and demand more protected time.

[SpanishMoss]

Phantasos wrote:

I would recommend that you not respond (neither confirm, deny, or acknowledge in any way) to any speculation about your chosen field. It is a very small world. The internet is less anonymous than one might hope.

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Point taken. My response has been edited to remove any speculation regarding the OP's specialty.

[PHANTASOS]

I would recommend that you not respond (neither confirm, deny, or acknowledge in any way) to any speculation about your chosen field. It is a very small world. The internet is less anonymous than one might hope.

[SpanishMoss]

I think this is a better than average starting academic position. You could do better in PP, however in good locations along the coasts probably not dramatically better (at least for the pre-partnership phase or 1st contract as an employed physician). I know of many PP starting salaries in my small, competitive specialty that are less than your offer, but of course they come with the expectation of a significant increase in income with partnership. Jobs at the high end of the salary range for new grads will be pp/employed positions in more rural/less "desirable" locations as you mentioned.

It sounds like you are not sold on academics as a long term career, so I would view this position as a safe backup option if a PP opening in a location you like isn't available. As others have said, you probably don't hurt your future prospects with most private practices by doing a short stint in academia, and who knows you may love it and stay in and climb the academic ladder. Sure, if your eventual goal is PP you may delay partnership and thus give up some earning potential but I dont think it would be a significant loss.

I was in a similar situation during my job search and was on the fence about academics vs PP with a gut/lean towards PP. I chose to go that route and have found that it really suits me well. I am pleased with the decision and have no regrets even though I had academic options that were very appealing as well. You have to know yourself and what matters to you - the prestige that comes with academics is mostly in your own head until you make it at the level of a chair or a full professor at a highly regarded institution, with of course the exception of very active junior faculty who publish a ton and get their name out there (and will soon be chairs   ). Doesn't mean it isn't a legitimate factor, but you have to assign it an accurate value.

All in all, this is a good problem to have. Also, while I am sure they will pressure you, you can probably drag your feet on the offer more than you think. This is early in the hiring cycle for summer 2018 and if they have offered you the job already they will likely wait. This is particularly early for academic gigs which often come open later.

Regardless of specialty, I'm sure some of these principles still apply. Good luck!

[antheus]

I appreciate all the advice. I'm going to go ahead with the job search as everyone has suggested and will keep you all posted. As it is I still have plenty of time to make a decision and it's nice to have a solid backup plan in hand.

[adventure]

antheus wrote:

All told compensation amounts to roughly $360,000.

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99% change that offer is low. Which is why they are trying to get you to stay, now. Why do they need someone? Are they expanding? Who left? or who is leaving? Politics? Why are they in a rush to hire you now? What % clinical vs teaching vs etc etc? Is the bonus a signing bonus? Is there productivity? Is that salary guaranteed? What would the hospital down the road offer? Are there really enough patients to share?

You need to interview elsewhere. Remember, until you have a signed contract, you don't have a job, so your job is to look around. You also won't have as much energy or interest in exploring jobs as you do now. Look around, practice interviewing. Understanding what is out there can help you learn too. It also helps network. This is awesome in academia and business. Also, get other offers - clearly you have time on your side... So, find and leverage a better offer!

Also, I know you said:

antheus wrote:

I know of starting positions making 750k in Minnesota

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Perhaps you should move there. Minneapolis is actually a pretty cool place. Yeah, it lacks the summer heat of Texas, but it's pretty nice. Also, maybe this is the time to work there for 2 years, bank it, and then move with the SO.

antheus wrote:

but I’m having a hard time convincing myself that I’m going to find something better. Thankfully I’ve been given a generous amount of time to think about things

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Life doesn't always hand you the time to find a better offer. Use it. You have a job offer. It isn't special, you just happen to have it. You can't know it's good or bad until you compare it. Does it let you meet your financial goals? do you have said goals outlined? Are you ready to compare this offer vs another offer when they come? Is this really the work you want to do now? Do you like the people there? Do you hate the politics there? Does the MGMA (or other) salary data agree this is a good offer?

All that aside, I agree with this: As tempting and as large as the #'s sound now... What if you sign the contract today, and find out in 6 months the next guy starts at 400? Or find out you'd really like an offer in NY instead?

Dr. Mom wrote:

Could you really be happy settling for this job without knowing what other options are available?

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[resident_1]

They want to keep you so they gave you an early offer hoping you wont look around.
I recommend to go where family for you and your girlfriend is (or closest). Find some nice place near water in Florida or Carolinas and move on.

I was offered a job also in our academic center and did work briefly until we moved. There is a strong feeling of comfort to stay in place where you trained. I think others here can attest to that. Its OK to look elsewhere, they know that.

[Donnie]

It can't hurt to interview around as most are saying.  Right now you may think your first job will only be short term, but inertia can be strong and you may end up there a lot longer than you expect - job market could dry up, you could establish roots there, etc.  Given the conservative nature of most people on this board, I am sure a lot of people have worked in a job a lot longer than they may have expected (myself included).  With that in mind I recommend trying your best to find a job that you think could have for a long time.  Changing jobs every few years can be tough on you and on your employer.

[Craigy]

They offer you a job early because they want to lock you up early.  Before you start thinking the grass is greener elsewhere.  And the grass might be greener.

If you really wanted to move to New York or Florida, look for jobs there.  But if you don't have any particular place in mind, it might not be worth the bother, aside form doing your research to see if it's really a good offer or not, and carefully negotiating the terms of whatever contract they offer you.

Texas is nice.  Most cities in Texas are nice.  No state income tax is awesome.

The fact that your own program wants to keep you is also nice, and refreshing that they didn't string you along and drag their feet with their offer.  Other programs aren't all that way.  You should already know how it is to work there, and whether or not you like it.  Another job would be a roll of the dice.

If you don't have a non-compete, you can eventually leave for something else if it suits you.  And if a job opens up in Florida you could always take it. But now, bird in the hand, and all of that.