When you’ve worked so hard for so long to get to the stage where you are ready to start full-time employment as a physician, getting a job offer can feel like your crowning achievement. Getting two or three offers can make you feel on top of the world. But before you can celebrate, you have one final, tough decision to make—which job offer to accept. It’s not always easy or obvious, but by using this article as a guide, we hope you will be able to make the right decision to suit your situation.
How does the pay stack up?
While you have most likely accumulated a large amount of student debt, salary will always be a big consideration when it comes to choosing between jobs.
Salary isn’t always straightforward to compare, particularly when employers can pay physicians in four ways
: a straight salary (fee for service), pay for performance, a bundled payment model, and a comprehensive care model.
Understand the difference between all four and, if you have a preferred model, consider asking the employer if the model is flexible. If it isn’t, this might be one way of choosing between different job offers, particularly if the total compensation package between the jobs is similar.
If your future pay is performance-based
, you should also explore not just which metrics will be used to determine compensation, but how well equipped the organization is to help physicians achieve their targets.
Try not to get too fixated on the guaranteed salary amount. While this is important for the first few years of your role, particularly if you have a dependent family, Tom Dobosenski, president of the American Medical Group Association consulting practice, believes that it is much more important to consider what happens to the compensation structure when the guarantee stops. This typically happens around year three.
Nevertheless, it’s important to understand whether your initial pay is comparable to industry averages. For this, consult
the Medical Group Management Association Compensation Survey.
Where will you be living?
The geographic location of the job is, unsurprisingly, one of the top considerations for junior physicians. Where you live has a huge impact on your life, your future, and your happiness. While some may enjoy the challenge of relocating to a new city, others will want to stay close to their family. The cost of living can differ hugely between states, thereby having an impact on your compensation, and even the basis of your work.
Where you work has an impact on how you work. Particularly if you are one of the few medical school graduates planning to work in the countryside. The differences can be huge. While urban work will provide you with greater support, a chance to specialize and a higher salary, practicing in a rural environment may offer greater opportunity to become a central figure in the community and take on broader, more diverse work. The kind of physician you become will, in part, be shaped by where you live.
When you take into account where you live, a larger salary doesn’t necessarily mean more money to spend. If compensation is a huge driving factor for you, take time to consider how where you are going to be living will affect that. A slightly smaller salary may go a lot further in a state with a low cost of living compared to a higher salary in a larger state like New York or California. Sperling’s
Best Places offers insight into how far your salary is likely to go.
Do you fit the culture?
You may think that the type of work and your remuneration package are the most important factors to consider when choosing between job offers. While these are incredibly important and go a long way in determining your future happiness, of equal importance is the way in which you fit into the hiring organization. Does your personality fit their culture? Research by Cejka Search
showed that poor cultural fit is the main cause of voluntary physician turnover. Which goes to show that even if you love the work, it’s important that you feel at home within the organization, too.
If you’ve completed a residency or interned at one of the organizations offering you a full-time job, you will probably know if you were a good fit. Did you enjoy collaborating with other staff members? Did you look forward to going to work every morning? Did you socialize with staff members outside of work hours? If you can’t see yourself working at the organization for the next five years of your life, it might not be the right choice for you.
If you haven’t worked at one or a few of the organizations offering you a role, take some time to investigate the culture of the organization. Use your school’s alumni network, as well as other connections you have made within the industry to find someone working within the organization.
Consider the fine print
A job offer is more than just an invitation to work at a particular practice for a particular salary. There is also a contract involved and comparing contracts should be a final step in your decision. This can be particularly decisive if you have narrowed it down to two or three job offers. While not immediately relevant, the fine print
of a contract—things like the malpractice tail coverage and non-compete clauses—can be incredibly important years down the line. Don’t get trapped into believing that non-competes aren’t enforceable. They are legally binding in the vast majority of states. As a result, you should be wary of any contract that has a particularly restrictive non-compete clause. When it comes to malpractice, it is important to understand which party is responsible for Tail coverage and under what circumstances. Finally, make sure you are comfortable with the amount of notice that both parties have to give when the contract is terminated. While you may want to move onto a new opportunity quickly, you’ll also want time to find a new job if the organization closes down your practice area or makes redundancies.
Choosing between job offers isn’t easy, but it’s a good problem to have. When you’ve dedicated a decade or more of your life to reach this stage in your career, it is worth spending time deliberating a decision that will have a huge impact on your future. Think about your short-term and long-term goals, use the advice in this article and talk to your mentor, professional network, friends and family. The right choice will become clear soon enough. Use this article as a guide to make the right decision to suit your situation.