Early Job Offer

[antheus]

Hey all,

I'm currently in my last year of residency in a small and fairly competitive field (both from a job standpoint and the specialty itself). I'm in residency in the south but grew up on the east coast and that's where my small family is (we're immigrants but my parents and sister are in the southeast and my girlfriend's family is in the northeast). I was offered a position to stay on as faculty at my current institution for a competitive salary, especially when one considers cost of living.

The initial offer is as follows:

Base Salary: $300k, 35k bonus, 25k employee contribution to a 403b

All told compensation amounts to roughly $360,000. There's also a 457b, excellent insurance etc. (strong university system). Haven't yet negotiated anything.

Overall I feel like it's a pretty strong offer. I know the system and know what the job entails, there's excellent work life balance, some prestige associated with it, and an excellent starting job from a support standpoint. I like working with residents and there's minimal publishing requirements. However, I don't see myself in academics medium-long term and I have a hard time believing that this will be my forever job. I always thought I'd wind up in private practice and that's where I'd ultimately like to end up. It's still very early and I haven't even applied anywhere else at this point 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 but I could use some guidance as to what to do next. Is it worth going through the time and effort of a job search just to see what's out there?

[childay]

antheus wrote:

Is it worth going through the time and effort of a job search just to see what’s out there?

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Well yeah!  You're telling me you think this academic position pays better than non-academic (seems unlikely)?  And that you don't see yourself in academia long-term.. Shop around!  If you don't want to post the specialty then it's gonna be hard for us to give much specifics.  Have you checked salary surveys?  Do you actually like your current town?

[q-school]

Unless you just have a year or two to kill while girlfriend finishes up something or you get another certification or degree, you are crazy not to interview in places you would want to live.

It's that simple.

Interview now, thank us later

[Dr. Mom]

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

[VagabondMD]

Certainly you should look, but if you stay in academics for a while, you can wait for your job/location of choice to open up. In my field, staying at the University makes you more desirable than hopping from one private practice to the next.

[SValleyMD]

Agree with vagabond- staying in academia keeps options open. Once u leave tough to get back in.

I also wouldn't get your heart set too until u look around a bit though

It's also obviously hard to know what the dollars mean without sharing the specialty. Seems like a high demand niche specialty in the south would be pulling in more than 360k but maybe it's endocrinology or something.

[antheus]

Thanks for the responses so far. For some comparison, there is a survey sent out annually to graduating residents and the results are as follows:

2016 - starting salaries entering private practice:

Avg: 320k

Median: 300k

Range: 290k to 490k

Second year salary:

Avg: 356k

For academics the median starting salary is 300k.

 

Obviously this is just from people who respond to that survey. I know of starting positions making 750k in Minnesota and 500k in rural Texas, neither of which interest me, and unfortunately the big cities are particularly competitive. For some more specifics it's a big city in Texas and I would ideally like to be in another big city or just outside of one. Both my girlfriend and I are very happy here and would definitely be happy for a few more years, would probably be happy long term. My family is in South Florida and New York, both of which are brutal markets especially starting out.

As I've said, I've been told that I have a pretty generous amount of time to make a decision but there's some anxiety associated with not accepting it because they will be interviewing other candidates which is why I posed the question.

[LizOB]

You have absolutely nothing to lose by going on interviews for other jobs! You'd be crazy to accept a job after your first interview, if nothing else so you can make comparisons among your actual options (as opposed to hypothetical options or salary averages). You may find that you like another option better. You may also find that your current institution really is the right fit, which will help you feel better during those inevitable moments of job frustration down the road. They've given you the time, you need to use it!

[EJ at Dads Dollars and Debts]

I recommend interviewing but from someone who was in academics for 4 years and then jumped to private practice, I can tell you the pay is better in private practice (not that this is a surprise). Also be aware of skills that can atrophy if you are in a super subdivided space in your academic job.

 

For instance I stopped doing diagnostic angiograms. Could I do one now? Sure, but not as well as 5 years ago. Could I learn again? Of course but it makes you less marketable.

 

[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.

[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.

[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.

[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?

Click to expand...

 

[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.

[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!