job interviews & offers

[terrordome47]

Last year of training here. Started looking at jobs a couple months ago and have a few interviews lined up. Each job has positives/negatives. For those with experience, and those doing the hiring, a few questions:
- If a you extend an offer to an applicant, how long do you typically give them to accept/decline the offer?
- It sounds like some places require a response in a short period of time (i.e. 1 week) or they will move on. Thus, is it a good idea to schedule all interviews in a short window? I'm worried one group may offer, but require a response before I hear back (or even interview with) from another group I might be more interested in. Obviously that would be a good problem to have. Just curious if anyone has advice on how to approach this.

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[deleted171991]

Last year of training here. Started looking at jobs a couple months ago and have a few interviews lined up. Each job has positives/negatives. For those with experience, and those doing the hiring, a few questions:
- If a you extend an offer to an applicant, how long do you typically give them to accept/decline the offer?
- It sounds like some places require a response in a short period of time (i.e. 1 week) or they will move on. Thus, is it a good idea to schedule all interviews in a short window? I'm worried one group may offer, but require a response before I hear back (or even interview with) from another group I might be more interested in. Obviously that would be a good problem to have. Just curious if anyone has advice on how to approach this.

The same way you would approach used car salesmen and their "limited time deals": walk!

Any employer who can't wait more than a week (so far ahead of the start date) is just looking for a body and using pressure tactics. The solution to this is to apply first to the groups you are most interested in, and take the first good offer after you have met ~40% of the total number of groups you were planning to interview with.

 

[pjl]

1 month is reasonable, remember, as a group we need to hire someone. Many times we are looking at new grads for ~1 year out, and by the time we offer (then wait and dont interview others) we can miss the window for good new grads because someone else snags them.

If the supply is out there and the need is more urgent (unplanned exit or whatever) then a shorter timeframe may be offered, never less than 2 weeks at my group.


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[Man o War]

One of the really good groups I interviewed with but didn't end up working with gave me a month.

 

[psychbender]

My first offer is giving me me several months to think about it, because they made the offer a week before I started fellowship and knew I wouldn't be there for a year, anyway.

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[Robotic Wis-Hipple]

From my experience in one hiring cycle, most gave 30 days. One group gave 2 weeks before they said while they'd keep the offer on the table they would move on to interviewing and potentially offering other candidates the job as well.

While I can see the position of a group trying to get the best candidate they can while the pool is rich, I think 2 weeks is too short when you're a year out. By the time you get the "offer" which is not the actual contract, to getting hands on the contract, getting a lawyer to review etc, 2 weeks goes fast.

And I know this is going to rile up some of the experienced private practice guys, but I definitely think the average group tries to take advantage of a new grad. They play the hurry up and commit game, they don't negotiate as much as I think they would an experienced guy, and they low ball. Not all do, and I also understand a new Grad likely isn't worth what a guy with 5 years experience is, but there's a difference between paying for experience and taking advantage of inexperience.

Don't be pressured into signing. That's the benefit of starting early. Just my 0.02

 

[GravelRider]

It's unlikely they will extend you an offer on the spot, especially as a new grad. Just try to gather as much information as you can during your initial phone conversation and subsequent first visit. Taking a job is an investment for you as well as them. Anyone who rushes that decision deserves some degree of suspicion.

My other advice is if there is a specific area you want/need to be in, don't tell them your desire for an area beyond some superficial ties. It may be counterintuitive, but if a job knows you have to be in a certain area then they will be less willing to negotiate. Don't show your hand right away.

 

[deleted162650]

Unwillingness to negotiate isn't necessarily a sign of a douchy group. Look at it from the other side: Lets say a group has been around for 20 years. In that time the employment contract has remain essentially unchanged. All the new hires since the time you were in grade school have had the same partner track/salary/vaca etc. it wouldn't be seen as fair to suddenly change it up just for you.

 

[Robotic Wis-Hipple]

Unwillingness to negotiate isn't necessarily a sign of a douchy group. Look at it from the other side: Lets say a group has been around for 20 years. In that time the employment contract has remain essentially unchanged. All the new hires since the time you were in grade school have had the same partner track/salary/vaca etc. it wouldn't be seen as fair to suddenly change it up just for you.

Absolutely, and especially if it's a large and/or well established group. I'm not self absorbed enough to expect a group to give me anything they haven't given someone else, certainly they aren't going to give the new guy something that initiates unrest within the rest of the group. But every group ever will also use this line. "You're getting the same contract I signed when I started" etc, and I can tell you, I know that's not true in some cases.

There are other ways to negotiate as well, and maybe this is me thinking things are different than they are, but you hear about signing bonuses or moving expenses and I just didn't see those things as prevalent. The way I see it, if you're looking at joining a 20 partner group, it'd literally be $500 each out of their check to throw you a $10k bone to move, get settled, and not have to live on Ramen for 30 days before you see a check (and that's if they aren't 1099/eat what you kill). It's the small things that go a long way imo.

With that said, I also saw a group that typically had a 2 yr partner track and as a fellowship trained guy they gave you credit for 1 year right off the bat. So the variance is quite large from my limited experience.

 

[deleted126335]

Thorny issue. I have been on both sides of this one. The reality of the world is that one does what they perceive of as in their own best interest and what the market allows you to get away with.

 

[Robotic Wis-Hipple]

Thorny issue. I have been on both sides of this one. The reality of the world is that one does what they perceive of as in their own best interest and what the market allows you to get away with.

Regarding the possible signing bonus, I'm interested in the views of the experienced guys who have taken and offered jobs.

As a new grad my interpretation of groups just flat out telling you no signing bonus includes these possibilities;

- I'm not as desirable as I think
- The practice and/or locale is so desirable they don't have to offer a signing bonus because they'll get someone regardless
- the group isn't as financially stable as I'd like and they don't feel they can afford to throw money at a new hire
- the partners would just rather have that money for themselves.

So 2 options are reasonable to me, the other two not so much. And again, I'm not some high powered orthopod expecting a 75k bonus or loans repaid. It's hard for me to believe any group that is well run can't afford 10-20k to send all the right signals.

 

[deleted171991]

Signing bonuses are for losers. Like the $0 down deals for cars. Look at the entire package. The bonus is irrelevant, just the frosting on the cake.

Most signing bonuses I see belong to crappy AMC jobs. If anything, a signing bonus is a turn off for me. It usually means that they are having trouble finding somebody for the job, and there is always a reason for that. Same goes for groups that continuously advertise (either they are very picky, or nobody wants to work for them, or they have a high employee turnover rate). And if the group really wants you, forget the bonus, ask for a higher salary or shorter partnership track.

Also, usually the so-called "signing" bonus is just an incentive after 12-24 months on the job. And if a group needs to incentivize people to stay on, it's bad.

Always follow the money. The employer will never give you more money than they have to, to fill the position. Always know why (hint: it's not because they are nice people).

 

[Robotic Wis-Hipple]

Well, look, nobody here is talking about taking a crappy job or crappy package so they can get 20k up front. I certainly wouldn't prioritize a signing bonus over a good group with an otherwise competitive package. So I agree, it's frosting.

I agree with you in regards to "retention bonuses" and that groups that have problems recruiting offer signing bonuses. 100% agree with that.

 

[deleted171991]

Well, look, nobody here is talking about taking a crappy job or crappy package so they can get 20k up front. I certainly wouldn't prioritize a signing bonus over a good group with an otherwise competitive package. So I agree, it's frosting.

I agree with you in regards to "retention bonuses" and that groups that have problems recruiting offer signing bonuses. 100% agree with that.

I have seen retention bonuses disguised as "signing" bonuses. Always get everything in writing, even if the group has had a "standard" contract "for the last 20 years". Otherwise, all the nice stories they tell you can be just fairy tales.

Oh, we promised 1:8 call? Sorry, it's 1:5. And a $20K 401k match? Sorry, that's only after 12-18 months. And we'll pay your tail? Sure, if you're a partner. Etc.

They may be very nice while they are courting you, but don't fool yourself: when about money, most groups are sharks, the PP ones sometimes even more than the AMCs. When contract time comes, if they give you a hard time about anything they had promised before, walk. That's why a deal is not closed until the contract is signed; sometimes, you can get shunted even after that.

 

[GravelRider]

Thorny issue. I have been on both sides of this one. The reality of the world is that one does what they perceive of as in their own best interest and what the market allows you to get away with.

In the end, this is what it all comes down to. The only fair group in a desirable area for a 200 mile radius with 10 applicants for 1 opening can say 2 weeks or we move on. The group that needs 5 people and struggles to find candidates may keep contacting you for months until you give a definitive answer.

My experience (somewhat limited being only 2 years out of residency) is that these interviews are more like dating. A group that gives me an offer immediately on the first interview seems a bit desperate (you have to wait 5 days to call after a first date, duh). You're more likely to hear something like "we like you and think you'll be a good fit, so we'll be in touch soon." It's at that point you should be seriously evaluating a job even before an official offer. You should walk away from a first phone call/interview with a general sense of department culture, workload, pay, benefits, vacation, and partnership track, should one exist, before an official offer. The offer/contract is when you look for specifics and see if there is any "catches" or clauses that make you wary.

 

[deleted162650]

Also, don't be afraid to communicate (this goes for both sides). I don't think there's anything wrong with telling a group that you have another interview set up 2 weeks from now with the group across town, and you'll let them know one way or another once you've gone on that interview. The group should be open with you too regarding other interviews and how long they're willing to wait.

My group tries our best to be open and honest with applicants, and we expect the same. Last year we had one guy really string us along for a solid month or two after he told us he would give us an answer. That left a really bad taste and can get an offer rescinded if you're not careful. It also reflects poorly on your program and those that recommended you.

 

[terrordome47]

Thanks everyone for all the insight. Very helpful!

 

[Man o War]

Good points here. My current job was super laid back with me interview wise because we interview based on referrals only, no advertising. So if you get an interview it's pretty much understood that the job is yours. I guess someone could show up and be a weirdo and we would say no, but we do our homework before we even interview so we don't waste anyone's time. I got a signing bonus and relocation, and we give them as a rule to everyone.....we think it shows good faith and how serious we are about a particular candidate. This is an excellent job in an excellent location with a very easy partner track, so not hiding anything by offering those things. So I think this all just depends on the dynamics of the group and how they hire.

 

[pjl]

We give 5k moving to all (I think), and offer a signing bonus to residents. However, it is really just an advance of some of their salary, and sort of a retention bonus. It is prorated to be paid back if they leave before a year. If they take it, year 1 if 25k lower.

The whole point of it is to be nice, they are poor and moving. Shifting 25k to upfront is really not a big deal, costs me 2.5k pretax now that I get back by paying them a little less during year 1. Year 1 salary is low, but year 2 is 90% partner. It was by far my lowest year 1 offer, but long term has been far better than the others I turned down.

New grads get 25k less first year than experienced, and fellowship is worth 25k.

Our contact is virtually unchangeable on our end, lawyer gets all pissy when we do anything different.

 

[chocomorsel]

I love the whole "interview ONLY by referral" thing. Is that all of medicine or just anesthesia?
I think it just Keeps the Good old Boys club alive and well. But I guess we all need to play that game to get ahead in this profession.

 

[Man o War]

I love the whole "interview ONLY by referral" thing. Is that all of medicine or just anesthesia?
I think it just Keeps the Good old Boys club alive and well. But I guess we all need to play that game to get ahead in this profession.

Why do you assume that's the reason? The fact is there are a ton of lazy people in our line of work. There's also a lot of folks with malignant personalities. We want neither because we like our contract and want to keep it.

 

[anbuitachi]

I love the whole "interview ONLY by referral" thing. Is that all of medicine or just anesthesia?
I think it just Keeps the Good old Boys club alive and well. But I guess we all need to play that game to get ahead in this profession.

thats every field... outside of medicine too.

 

[pgg]

I love the whole "interview ONLY by referral" thing. Is that all of medicine or just anesthesia?
I think it just Keeps the Good old Boys club alive and well. But I guess we all need to play that game to get ahead in this profession.

It's the same for all people in all professions. Networking and connections matter.

The people who complain it's unfair like to tell themselves that it's a rigged game, that the only things that should matter are objective job qualifications. But that's not true. Beginning every job is joining a community, and the success and health and general happiness / job satisfaction of the rest of that community depend on subjective personal factors. Reliability, honesty, temperment, teamwork, flexibility, on and on and on. And how do the people doing the hiring know an applicant has these qualities and will be a good fit? References.

All new hires in all industries carry risk! Hiring someone has a cost well beyond the salary and benefits paid. It's time in recruiting, time in orienting, time in credentialing, and most of all - potential opportunity cost and lost time if the new hire doesn't work out and they have to start the process over.

Don't kid yourself and pretend that groups that reduce that risk by preferring candidates from known programs, recommended by trusted people, is some kind of distasteful good old boys club.