Disappointment with pediatric salary offer

[zeppelinpage4]

Just got my first job offer for a general pediatrics private practice in PA and they offered 130k/year. I'm shocked. I know peds pays less, but the MGMA average for gen peds was 220k/year and AAP lists average starting salaries for fresh grads to be around 150k/year and I have friends making 150k/year in academic positions which normally should pay less than a private practice. I was expecting minimum 150k/year in North East to start and ideally want 200-250k/year if I do private practice. But should I recalibrate my expectations? Is this normal? Or is the private practice low balling me and I can hold out for better offers if I'm patient and search?

I considered doing a second residency or jumping ship from peds all together...and this is reaffirming much of that.

[Drsan1]

Is this the current offer because of the COVID slump. Interview multiple places and try to get multiple offers so you can compare what the market is doing.

[VagabondMD]

Well, that is your first job offer. If I were you, I would keep looking. If it is a tough job market, you may either have to go to a location or situation that you would not have previously considered or accept less money. It’s your choice.

[GastroMastro]

Just got my first job offer for a general pediatrics private practice in PA and they offered 130k/year. I'm shocked. I know peds pays less, but the MGMA average for gen peds was 220k/year and AAP lists average starting salaries for fresh grads to be around 150k/year and I have friends making 150k/year in academic positions which normally should pay less than a private practice. I was expecting minimum 150k/year in North East to start and ideally want 200-250k/year if I do private practice. But should I recalibrate my expectations? Is this normal? Or is the private practice low balling me and I can hold out for better offers if I'm patient and search?

I considered doing a second residency or jumping ship from peds all together...and this is reaffirming much of that.

Is this within 30 miles of philly??

[Peds]

Just got my first job offer for a general pediatrics private practice in PA and they offered 130k/year. I'm shocked. I know peds pays less, but the MGMA average for gen peds was 220k/year and AAP lists average starting salaries for fresh grads to be around 150k/year and I have friends making 150k/year in academic positions which normally should pay less than a private practice. I was expecting minimum 150k/year in North East to start and ideally want 200-250k/year if I do private practice. But should I recalibrate my expectations? Is this normal? Or is the private practice low balling me and I can hold out for better offers if I'm patient and search?

I considered doing a second residency or jumping ship from peds all together...and this is reaffirming much of that.

its low ball. sounds like academic pay (for the prestige.....)....
keep looking. dont get discouraged. know your worth.

[zeppelinpage4]

Is this the current offer because of the COVID slump. Interview multiple places and try to get multiple offers so you can compare what the market is doing.

I'm not sure truthfully. I asked about COVID affecting the practice and they said things are mostly back to normal now in terms of patient volumes.

Well, that is your first job offer. If I were you, I would keep looking. If it is a tough job market, you may either have to go to a location or situation that you would not have previously considered or accept less money. It’s your choice.

Yeah, it just feels cruddy that that's the reality after all this schooling and debt. I knew I'd make less in peds, but I know PAs and friends with just college degrees who are earning 150-160k/year now, so I expected at least more than that.

Is this within 30 miles of philly??

I'm not sure actually, will have to check google maps.

its low ball. sounds like academic pay (for the prestige.....)....
keep looking. dont get discouraged. know your worth.

Thanks, I hope my worth comes through. I often beat myself up for choosing pediatrics, seeing friends with less years and time and debt easily making 150k/year just a few years out of college and then seeing friends in peds barely making that feels like a slap in the face. I'm not competitive enough to get into a higher paying subspeciallty so I've been feeling a bit trapped financially and this job offer hasn't helped.

What's really perplexing is this is academic pay but it's a private practice. I always thought private practice payed more than academic but clearly this does not.

[oysterblues]

I remember you posting last year when you were considering fellowship. Sorry to hear about the offer. That seems low, even for pediatrics. I think you should look at other jobs and see if you can get better offers.

You also have a good chunk of student loans, 275k? If I was in your position, I would consider two options: retrain vs nonprofit with pslf. You could retrain in IM, work for academics for four years, get PSLF and move on with your life. The other fine option is academic pediatrics going for PSLF. You would always be stuck with a lower salary if you remained in pediatrics.

[CordMcNally]

I often beat myself up for choosing pediatrics, seeing friends with less years and time and debt easily making 150k/year just a few years out of college and then seeing friends in peds barely making that feels like a slap in the face.

Nothing good can come from being envious of friends that make more with less education. The world isn't fair and pay doesn't necessarily correlate with the amount of education a job needs.

[Brains428]

So you have to be in the northeast? Or this is just the first offer?

I'm not sure what your family situation is, but this sounds like a situation where geographic arbitrage may be good for a few years- at least until you get out of debt, or feel more financially secure.

Any chance you did well enough in residency to land a peds cards, peds GI or peds EM spot?

[PedsFIRE]

Gen Peds pay can be quite variable.
-How many days a week?
-How many patients a day?
-How often are you on call? Is there nurse triage? Nurse triage is very expensive
-Do you go to the nursery or attend deliveries?

[Lordosis]

I am FP and when I was looking 5-7 years ago in pennsylvania and ny I had offers from 130k - 220k. The 220 also came with a 45k sign on bonus. But the area sucked and they were desperate.
The funny thing is that the 130k job was by far the worse job I looked at in the worst area.

Usually though the more an area needs the specialty the better the salary so look around.

I believe we are starting our peds and new FPs at 200k but it is a hospital owned practice not pp. I think their production model is similar to ours which makes it pretty easy to get into the upper 200s.

PM me if you have any interest in western ny and want me to get more details.
Good luck!

[zeppelinpage4]

I remember you posting last year when you were considering fellowship. Sorry to hear about the offer. That seems low, even for pediatrics. I think you should look at other jobs and see if you can get better offers.

You also have a good chunk of student loans, 275k? If I was in your position, I would consider two options: retrain vs nonprofit with pslf. You could retrain in IM, work for academics for four years, get PSLF and move on with your life. The other fine option is academic pediatrics going for PSLF. You would always be stuck with a lower salary if you remained in pediatrics.

Yup 275K, it's high but I thought it was surmountable with good planning. I was going to either do PSLF (I have ~3 years of payment from my residency already) and go the academic route for 7 years, OR take a private practice job and pay off the loans while making a high income to compensate for not getting loan forgiveness.

But now that gen peds private practice may not pay as high as I had expected, what you outlined may be the next option.

I made a thread asking if I should do a second residency or fellowship, but most folks said it made more sense to take a well paying gen peds job (assuming average gen peds payed 220k/year) not delay tackling the loans now and building up savings/investments. But if gen peds will only offer 130-150k/year, I'm rethinking that plan.

One possible alternative to retraining completely is trying to match into a higher paying subspecialty, the best one being Allergy/Immunology which would raise my income and it's only a 2 year fellowship and I can see myself enjoying the field (did multiple rotations with them). It would let me see adult patients and be the simplest way out of pediatrics and into the IM world. However, it's highly competitive and I'm honestly unsure I can match (no research, low board scores) but I know there's less competitive programs so it might be worth a shot at least. The 2 years in fellowship could count towards PSLF as well, and I could work academic for the remaining 5 years if need be.

Nothing good can come from being envious of friends that make more with less education. The world isn't fair and pay doesn't necessarily correlate with the amount of education a job needs.

Yeah, that is true. Comparing to others is never helpful or productive.
I do want to be compensated for what my training is worth and earn in the ballpark of MGMA and medscape averages though.

So you have to be in the northeast? Or this is just the first offer?

I'm not sure what your family situation is, but this sounds like a situation where geographic arbitrage may be good for a few years- at least until you get out of debt, or feel more financially secure.

Any chance you did well enough in residency to land a peds cards, peds GI or peds EM spot?

My spouse and I were planning to get out of the Northeast and move midwest or south for higher salaries but with COVID and all the uncertainties with it, we opted to wait 1-2 years and stay close to family in the north east. But I may need to rethink that.

I was not a strong resident and had poor board scores, so sadly most fellowships seem out of reach which is partly why I'm frustrated. I'm happy to work hard and put in the hours to put myself in a better spot but I don't know if I can do much to make up for my poor record.

Gen Peds pay can be quite variable.
-How many days a week?
-How many patients a day?
-How often are you on call? Is there nurse triage? Nurse triage is very expensive
-Do you go to the nursery or attend deliveries?

The one I applied for is standard 4 days/week with pretty light call schedule and occasional weekends. 20-30 patients/day which is on the light side for a private practice. Maybe the low salary is due to the practice being very lifestyle friendly, but it's still a fulltime private practice position and I expected more.

[zeppelinpage4]

I am FP and when I was looking 5-7 years ago in pennsylvania and ny I had offers from 130k - 220k. The 220 also came with a 45k sign on bonus. But the area sucked and they were desperate.
The funny thing is that the 130k job was by far the worse job I looked at in the worst area.

Usually though the more an area needs the specialty the better the salary so look around.

I believe we are starting our peds and new FPs at 200k but it is a hospital owned practice not pp. I think their production model is similar to ours which makes it pretty easy to get into the upper 200s.

PM me if you have any interest in western ny and want me to get more details.
Good luck!

Thank you so much, that's really helpful to know. And I'd definitely be interested, PM sent.

[Sundance]

You’re resigning yourself to a life of poverty based on one offer. I know nothing of peds but I do know first hand one can make 2.5-4x the amount at one job as compared to a different job.

chin up and start looking harder. There are some peds guys somewhere making 400-500k+ and I’m sure a bunch making 300k plus

[Tuxedo]

Partially echoing what other posters have said:
You need more job offers to compare.
Look farther from big cities.
Clarify if this is a partnership where the potential for 200k is a couple of years down the road.
200k+ is attainable as a new grad in pediatrics. It will be both inpatient and outpatient. It will be in a town you've never heard of in a state you've never been to.
Pursuing additional training is not the answer.