Job Offer Thread

[Dr1216]

Hello everyone,

I have a question about a job offer but seeing that a post comes up every so often about specific job offers, I figured that we can make this an official job offer thread for everyone with questions to post in when they would like some advice.

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[Dr1216]

I'd appreciate any thoughts on this offer:
190k base for women's trauma focused IOP/PHP in the NE, full time, caseload of ~40 (biweekly assessments with IOP patients/weekly for PHP), required once a month weekend day call on inpatient unit rounding on average of 20-23 patients with 2 admits on average reimbursed at $100/hr (supposedly 8hr shift) . Potential for additional bonus of up to 5-7% of income. Typical benefits, though pooled allotment of vacation, sick, holiday etc hours of about 250+ hours a year.

 

[northernpsy]

The weekend call is a little more frequent than I would want to do for that money but the volume is certainly doable.
Since I expect you're probably going to have a lot of borderline personality disorder in a female trauma population, I would definitely want to know what sort of support there is for coverage of patient crises and after hours calls, etc. I can imagine this being a high burnout situation if you are constantly juggling borderline patients in crisis without adequate support. I personally feel like PHP can be more anxiety provoking than inpatient since the patients can still be fairly acute but yet don't have the same supervision, so I would definitely try to negotiate a little more on the salary (but I say that as someone who isn't in a coastal region. It's a lot easier to play hardball if you're the only psychiatrist in Podunkville than if we're talking NYC or Boston).

 

[Merovinge]

While we are at it:
CAP inpatient Chicago area - $230k, 17 pts/day, dedicated nurse, 2 SWs, 1-2 psychology trainee team. Onsite Pediatrician for medical concerns. Only call is home call for own patients re: psychiatric concerns (i.e. not called for headache, GI distress). Weekends covered by APN/PAs, you would then pickup on Monday. Can see extra patients for extra $$ if desired.

 

[michaelrack]

A full time (4o hr/week) psych job should pay at least 200k, don't settle for less

edit: for board-cert. If you take a job for less than that prior to certification, make sure that your contract specifies that your salary will be increased upon certification

 

[SmallBird]

I'd appreciate any thoughts on this offer:
190k base for women's trauma focused IOP/PHP in the NE, full time, caseload of ~40 (biweekly assessments with IOP patients/weekly for PHP), required once a month weekend day call on inpatient unit rounding on average of 20-23 patients with 2 admits on average reimbursed at $100/hr (supposedly 8hr shift) . Potential for additional bonus of up to 5-7% of income. Typical benefits, though pooled allotment of vacation, sick, holiday etc hours of about 256 hours a year.

The weekend pay setup isn't ideal, since you basically can't do anything one weekend a month and are paid $1600 - although the hourly rate isn't bad you could find places that would pay more to round on that many patients over the weekend. Still, given that base you are looking at > 200k for salaries position in the NE which is good. The caseload I would say is on the higher side of what I've seen (the range I've seen is 30-50).

Is it a good location? If this is in Boston, Providence, Burlington or Portland I'd say it's great. If it's academic in New Haven or at Dartmouth or UConn I'd also say it's great. I'd want more to work in Springfield MA, rural Connecticut, more depressed parts of MA and NH. These locations really all have opportunities to earn >200k base.

 

[wolfvgang22]

While we are at it:
CAP inpatient Chicago area - $230k, 17 pts/day, dedicated nurse, 2 SWs, 1-2 psychology trainee team. Onsite Pediatrician for medical concerns. Only call is home call for own patients re: psychiatric concerns (i.e. not called for headache, GI distress). Weekends covered by APN/PAs, you would then pickup on Monday. Can see extra patients for extra $$ if desired.

I think if you can get the patient load down to 12 per day that is an ok deal. 17 can be a lot if the acuity is high, and it probably is. When would you do treatment planning and meetings, phone calls, paper work?

 

[SmallBird]

A full time (4o hr/week) psych job should pay at least 200k, don't settle for less

edit: for board-cert. If you take a job for less than that prior to certification, make sure that your contract specifies that your salary will be increased upon certification

Most in the northeast in good locations don't. Should nobody work there then?

 

[wolfvgang22]

Most in the northeast in good locations don't. Should nobody work there then?

Not at all! Some people value geography or being near family/friends there more than $$. It depends on your needs. It bears noting the salaries are probably lower in that area because there are more psychiatrists who want to live and work there for a variety of reasons.

 

[SmallBird]

While we are at it:
CAP inpatient Chicago area - $230k, 17 pts/day, dedicated nurse, 2 SWs, 1-2 psychology trainee team. Onsite Pediatrician for medical concerns. Only call is home call for own patients re: psychiatric concerns (i.e. not called for headache, GI distress). Weekends covered by APN/PAs, you would then pickup on Monday. Can see extra patients for extra $$ if desired.

The salary is good but 17 patients is a lot for it... I have just finished interviewing for CAP inpatient and jobs ranged from 190k for 8-9 patients to 210k for 12 although the first included call. The first included RVU based productivity bonuses and if one had seen 17 patients you would have doubled your pay. I interviewed in the Northeast which typically offers lower pay than the Midwest.

 

[northernpsy]

Most in the northeast in good locations don't. Should nobody work there then?

I think in general new graduates tend to sell themselves short. If you do take a low paying job make sure that it makes up for the pay in other ways such as an easy schedule or desirable location.
When you work for a health system where your discharges from inpatient can't get in to see an outpatient psychiatrist for 6 damn months, it definitely makes you realize that psychiatrists who are willing to work for someone else hold the cards here. Most places are desperate for psychiatrists and when they do get a hold of one they often try to work you to death because of the great need, so there's no reason not to ask for what you think you're worth. The worst that can happen is they might say no. I was surprised at what I was able to get some places to agree to in negotiations though.

 

[Dr1216]

The weekend pay setup isn't ideal, since you basically can't do anything one weekend a month and are paid $1600 - although the hourly rate isn't bad you could find places that would pay more to round on that many patients over the weekend. Still, given that base you are looking at > 200k for salaries position in the NE which is good. The caseload I would say is on the higher side of what I've seen (the range I've seen is 30-50).

Is it a good location? If this is in Boston, Providence, Burlington or Portland I'd say it's great. If it's academic in New Haven or at Dartmouth or UConn I'd also say it's great. I'd want more to work in Springfield MA, rural Connecticut, more depressed parts of MA and NH. These locations really all have opportunities to earn >200k base.

Thanks for the response! I'd definitely prefer a position with no call so that I can choose to take call somewhere for more money should I want to. But I figure if it's required for the job, I should at least be compensated outside of my base salary. And it's only 1 day in the weekend and not both. Location is not a city but close enough and associated with an academic hospital. I am a bit curious about the caseload because I have no experience with IOP/PHP with my program so I am not sure what is a reasonable caseload.

The weekend call is a little more frequent than I would want to do for that money but the volume is certainly doable.
Since I expect you're probably going to have a lot of borderline personality disorder in a female trauma population, I would definitely want to know what sort of support there is for coverage of patient crises and after hours calls, etc. I can imagine this being a high burnout situation if you are constantly juggling borderline patients in crisis without adequate support. I personally feel like PHP can be more anxiety provoking than inpatient since the patients can still be fairly acute but yet don't have the same supervision, so I would definitely try to negotiate a little more on the salary (but I say that as someone who isn't in a coastal region. It's a lot easier to play hardball if you're the only psychiatrist in Podunkville than if we're talking NYC or Boston).

Thanks for the advice! These are factors that I'm really torn about and I probably should inquire more about. While I don't truly mind working with borderlines, as my first job, I wonder if the frequent crisis potential may be overwhelming in this setting. But I agree, if I do take it, I will definitely be negotiating for more. There are other jobs that I'm considering with better salaries. I just don't know how to evaluate this job in light of it's requirements.

 

[st2205]

Outpatient gig 4 days per week. Base salary is 210k but after you exceed RVU threshold you go to straight production. They've set RVU in the system as a bit over $50 and you collect all RVUs you bill for, plus getting 18% bonus. Call is inpatient unit maybe 14 patients q6-8 weekends. Overnight call q7-10 days (given something like $120/night). 75k student loan repayment over 3 years. ~45k sign on. Between pension and 401k match, up to 16% salary annually. Can take sort of as much time off as you want so long as you're meeting goals. Flexibility scheduling how you want.

Down side it's a huge organization. Agreed to deal in principle on the big financials above but not sure what to really negotiate in contract. With it being big organization, very slow moving. Thought about negotiating being able to bill company for non-billable time at a flat rate for a minimal amount per week or month. Offer overall is really good and gives a lot of flexibility with very good benefits. My thought is really just sign and not delay the process with small things, but I'm not sure. I figure seeing 12 patients a day, 4 days per week, 46 weeks per year (with call) nets you 300k after bonus.

 

[Merovinge]

I think if you can get the patient load down to 12 per day that is an ok deal. 17 can be a lot if the acuity is high, and it probably is. When would you do treatment planning and meetings, phone calls, paper work?

Dedicated SW to you do all family meetings and most phone calls. I would want to call each family once on admission for collateral and med consent, but many attendings do not do this. Billing department tries to keep P2P calls to a minimum and they fill out prior authorization for you. Progress notes are handwritten on a template and admission/discharge are dictated.

The salary is good but 17 patients is a lot for it... I have just finished interviewing for CAP inpatient and jobs ranged from 190k for 8-9 patients to 210k for 12 although the first included call. The first included RVU based productivity bonuses and if one had seen 17 patients you would have doubled your pay. I interviewed in the Northeast which typically offers lower pay than the Midwest.

Are you doing any family meetings, therapy, or major treatment planning at these places? As a fellow I was seeing 8-9 patients in 3.5 hours with 0 experience with inpatient private practice so that pace seems slow to me unless support staff is limited.

 

[Information Underload]

A full time (4o hr/week) psych job should pay at least 200k, don't settle for less

Keep the bonus structure and other perks in mind. My gig pays slightly less than 200k in base pay, but with bonus and other add-ons, I pretty much doubled that last year. Not so much this year, but at least 50% more than base.

 

[michaelrack]

Keep the bonus structure and other perks in mind. My gig pays slightly less than 200k in base pay, but with bonus and other add-ons, I pretty much doubled that last year. Not so much this year, but at least 50% more than base.

good point

 

[ChildPsychiatrist]

Now I'm worried that I'm late to start looking now...

I am interested in inpatient child psych, but can't seem to find any availability in my area. I've tried cold-calling but end up speaking to random people in HR who all say "if it's not listed on the website then the job isn't offered" without skipping a beat. Not sure how to find out what's out there without a recruiter (really hesitant to send any recruiter my CV).

Smallbird, where in the NE specifically are you looking??

All others, how do you find openings??

 

[Merovinge]

Now I'm worried that I'm late to start looking now...

I am interested in inpatient child psych, but can't seem to find any availability in my area. I've tried cold-calling but end up speaking to random people in HR who all say "if it's not listed on the website then the job isn't offered" without skipping a beat. Not sure how to find out what's out there without a recruiter (really hesitant to send any recruiter my CV).

Smallbird, where in the NE specifically are you looking??

All others, how do you find openings??

Because I still have a year, I started with contacting an internal recruiter that another fellow used last year (which is how I posted the details above). People recommend cold calling, I did that once and had the same experience as you, although I need to 10x my "n" to draw any conclusions. My next step is talking to attendings already in the field, I have had a lot of interest but nothing definitive, which is a bit frustrating since they are real connections in a small field and through people I genuinely like. I have not given any external recruiter a CV either but might consider it in 6 months if I don't have anything cemented. All I can say is that Im glad I started the process 11 months prior to a desired start date since it seems like things move quite slow.

 

[Dr1216]

[QUOTE="ChildPsychiatrist, post: 17932554, member: 629804"

All others, how do you find openings??[/QUOTE]

I've just been searching various sites that post physician employment opportunities: locumtenens, nejm, apa, practicelink, physicianjobboard, monster, indeed, glassdoor....pretty much wherever I can find postings.

 

[Igor4sugry]

1. Can anyone provide examples of how they countered their initial offer and what was the outcome?
2. Any other items that are negotiable (besides salary and sign-on bonus) (assuming a no-call job)?

 

[PistolPete]

I'd like to know the above as well!

 

[keifernny2]

1. Can anyone provide examples of how they countered their initial offer and what was the outcome?
2. Any other items that are negotiable (besides salary and sign-on bonus) (assuming a no-call job)?

Work hours.. E.g 4-10s vs 5-8s vs 9s with every other Friday off.
Contract vs employed status (very useful if the benefits are subpar).
Appointment lengths.
Admin time
Loan repayment / completion bonuses.
Non compete clause
Working elsewhere in off time.




Sent from my iPad using Tapatalk

 

[Jules A]

Most in the northeast in good locations don't. Should nobody work there then?

Actually if no one worked there the rates would get better.

 

[nexus73]

Now I'm worried that I'm late to start looking now...

I am interested in inpatient child psych, but can't seem to find any availability in my area. I've tried cold-calling but end up speaking to random people in HR who all say "if it's not listed on the website then the job isn't offered" without skipping a beat. Not sure how to find out what's out there without a recruiter (really hesitant to send any recruiter my CV).

Smallbird, where in the NE specifically are you looking??

All others, how do you find openings??

If cold calling, you want to get in contact with the medical director for the psych unit. This is the psychiatrist running the place. Call the nurse's station, introduce yourself as "Dr. ______" and ask for the medical director, tell them you're interested in a possible job. Sometimes no job is posted even though there is a desire for another doctor (e.g. they tried to find a doctor for the last year and stopped advertising because it was costing $$ and producing nothing). Sometimes the job is posted in an obscure place you wouldn't expect (this is what happened with my job, I suspect the site they used was cheaper than the APA job postings). Depending on the site, there is high likelihood you will at least find work as a weekend on call doc with potential to get hired full time.

 

[Extralong]

MONEY MONEY MONEY! Lol

 

[calvnandhobbs68]

Interesting thread, kind of reinforces the fact that doctors have a bad distribution problem. The fact that there are a couple people on here who are having issues even finding a job opening in child psych (which has one of the most severe shortages in all medical specialities nationally) while in much of the middle and southern areas of the country kids wait months for an appointment and every child psych unit in the state is completely full with waiting lists is very telling in terms of the distribution problem.

Good thing to consider when considering future prospects in the job market.

 

[Merovinge]

Interesting thread, kind of reinforces the fact that doctors have a bad distribution problem. The fact that there are a couple people on here who are having issues even finding a job opening in child psych (which has one of the most severe shortages in all medical specialities nationally) while in much of the middle and southern areas of the country kids wait months for an appointment and every child psych unit in the state is completely full with waiting lists is very telling in terms of the distribution problem.

Good thing to consider when considering future prospects in the job market.

Well for me, there is no problem finding a job. I would have 10+ offers tomorrow if I wanted. Its just about maximizing my worth while also being able to provide the best care for my patients and given how non-transparent medicine is, its not an easy feat to pull off.

 

[ChildPsychiatrist]

Does anyone feel it's still early to look? I've been calling some places who all seem confused by why I'm calling now, almost a year from when I expect to start working.

 

[st2205]

Does anyone feel it's still early to look? I've been calling some places who all seem confused by why I'm calling now, almost a year from when I expect to start working.

Not for the places that are proactive. Those are likely the places that will value you more, too.

I got a mixed bag when I called. The places that seemed like better places to work at and that paid more definitely were more accommodating and cordial. The others weren't. View it as a way they screen themselves out. I locked down a really good gig that I signed on a year out (they were willing to wait two years). Same place would wait 3 years for child psych.

 

[nexus73]

Does anyone feel it's still early to look? I've been calling some places who all seem confused by why I'm calling now, almost a year from when I expect to start working.

Takes 3 months at best to get an interested doctor hired and working. 1 year is not too far out.

 

[ChildPsychiatrist]

I must be doing something wrong... or maybe my CV is bad?? Did anyone use CV editing services?

One place I called said, "Ohh, if you want a job here, a good way in is to take all the weekend calls as moonlighting this year. Then maybe by next year there will be an opening." Pretty much hung up on them.

 

[TexasPhysician]

One place I called said, "Ohh, if you want a job here, a good way in is to take all the weekend calls as moonlighting this year. Then maybe by next year there will be an opening." Pretty much hung up on them.

. That's funny.

 

[Ψ-117]

Did anyone use CV editing services?

I have this question, too. I modeled mine after some examples I found online, and I think that I have a good CV. My wife used to work for a recruiter and she says it looks better than many of those she encountered. (Interestingly, she also said some doctors would submit messy handwritten CVs, which I still find surprising.) But I wonder if I'd be better off having someone review mine.

 

[TexasPhysician]

I've see the CV's of my friends. They look awful. It's never hurt them.

 

[PistolPete]

I've see the CV's of my friends. They look awful. It's never hurt them.

In your opinion what makes a CV awful, out of curiosity?

 

[ChildPsychiatrist]

Another question! Let's say you see a job listing, and it says to contact a particular recruiter to submit your resume. But you don't want to send your resume to any outside recruiters. Are you just out of luck with that particular job?

 

[Doctor Bagel]

I've see the CV's of my friends. They look awful. It's never hurt them.

I think all they care about is psychiatrist with an active license. I'd be surprised if recruiters even look at CVs. I know there are regional variants, but there are a ton of jobs where I live.

 

[Doctor Bagel]

Another question! Let's say you see a job listing, and it says to contact a particular recruiter to submit your resume. But you don't want to send your resume to any outside recruiters. Are you just out of luck with that particular job?

Can you figure out where the job listing is and contact someone at the hospital directly? Or you could contact the recruiter for more information but not send your CV.

 

[Doctor Bagel]

I'd appreciate any thoughts on this offer:
190k base for women's trauma focused IOP/PHP in the NE, full time, caseload of ~40 (biweekly assessments with IOP patients/weekly for PHP), required once a month weekend day call on inpatient unit rounding on average of 20-23 patients with 2 admits on average reimbursed at $100/hr (supposedly 8hr shift) . Potential for additional bonus of up to 5-7% of income. Typical benefits, though pooled allotment of vacation, sick, holiday etc hours of about 250+ hours a year.

So I don't get NE salaries at all, but $100/hour for weekend rounding is super low for where I am. Of course $190k for full-time work also seems low. Here, I could make $100/hour working in a walk in clinic where lots of time no one comes in for an evaluation or at least $1600/day doing inpatient weekend work.

 

[Ψ-117]

Another question! Let's say you see a job listing, and it says to contact a particular recruiter to submit your resume. But you don't want to send your resume to any outside recruiters. Are you just out of luck with that particular job?

I learned about one particular job through word of mouth (it wasn't being advertised), and made a cold call to the contact person. They were very happy to hear from me but they also had me speak with their organization's recruiter. This was their own recruiter, though, rather than a third party. Perhaps the one you're looking at has some kind of contract with the recruiter that requires the employer to hire everyone through them? I don't know, just a guess.

 

[nitemagi]

Put yourself on linkedin. I literally get asked every day to be "connected" (their version of friended) by recruiters. I had to start saying no because connecting to them means you'll be spammed with recruitment offers from all over.

 

[Mapplicant]

I've see the CV's of my friends. They look awful. It's never hurt them.

Is it the sparse content or a too plain layout...or just bad formatting/spelling errors?

I have a plain Word document CV typed up...still need to make sure everything is lined up correctly and better organized/structured. I'll need to see if there are good templates for CVs....

In your opinion what makes a CV awful, out of curiosity?

Would be interesting to know as well.

Man I feel so behind with everyone already looking at jobs starting their PGY4 year.

I'm slightly busy with getting an abstract to the APA for next year's meeting and also have got a grand rounds to do in 3 months so feeling quite hectic and have barely looked at some jobs here and there.

One question I had: my GF will still have 2 years of schooling in Denver and I'll be looking to work there for 2 years and then follow her to where-ever she matches for residency.

Are contracts usually 1-2 years long? Or is it better to look for locum positions if you know you'll likely to stay just 1-2 years in that city?

 

[hamstergang]

Are contracts usually 1-2 years long?

Yes.

 

[latuda]

Hello everyone,

I have a question about a job offer but seeing that a post comes up every so often about specific job offers, I figured that we can make this an official job offer thread for everyone with questions to post in when they would like some advice.

Any thoughts on this offer from the experts on the forum..
Midwest hospital in average size city..General psych inpatient..
40 hrs week..
260k base salary...
12 to 13 pts cap per day...
15k sign on bonus....I negotiated this from $0 initial offer
10k quality compensation annually...
wRVU bonus after 4561 annually...
will pay $57 per rvu after 4561..
Call 1 weeknight per week
1 weekend call and rounding per month ...will get extra pay if I do more calls than this..

How does this look?

 

[st2205]

Any thoughts on this offer from the experts on the forum..
Midwest hospital in average size city..General psych inpatient..
40 hrs week..
260k base salary...
12 to 13 pts cap per day...
15k sign on bonus....I negotiated this from $0 initial offer
10k quality compensation annually...
wRVU bonus after 4561 annually...
will pay $57 per rvu after 4561..
Call 1 weeknight per week
1 weekend call and rounding per month ...will get extra pay if I do more calls than this..

How does this look?

That's actually not bad. What matters more is how comfortable you are with taking call. Also, if they're paying you for call what is it and, more importantly, are you also keeping those RVUs? The $57/RVU is good and just run those numbers because if you're generating 25-30 RVUs/day you're going to make significantly more, especially if you're keeping your weekend RVUs.

The sign on bonus sucks though. Any student loan repayment?

In an unrelated note, I got an email today about a St. Louis job paying $250k for seeing 35 nursing home patients per day. Yeah, no.

 

[Jules A]

That's actually not bad. What matters more is how comfortable you are with taking call. Also, if they're paying you for call what is it and, more importantly, are you also keeping those RVUs? The $57/RVU is good and just run those numbers because if you're generating 25-30 RVUs/day you're going to make significantly more, especially if you're keeping your weekend RVUs.

The sign on bonus sucks though. Any student loan repayment?

In an unrelated note, I got an email today about a St. Louis job paying $250k for seeing 35 nursing home patients per day. Yeah, no.

Are weekends still commonly included in most contracts? In my area a perk many hospitals are offering is no weekend requirement which the Docs, especially the younger ones, seem to appreciate.

 

[st2205]

Are weekends still commonly included in most contracts? In my area a perk many hospitals are offering is no weekend requirement which the Docs, especially the younger ones, seem to appreciate.

If a place has an inpatient unit then what I'm seeing is there's usually a weekend responsibility. I'd imagine this varies mostly geographically as places with fewer psychiatrists are stretched more thin. If you're close to a training program then they may have bigger pool of moonlighters. State and federal gifs usually offering M-F.

 

[latuda]

That's actually not bad. What matters more is how comfortable you are with taking call. Also, if they're paying you for call what is it and, more importantly, are you also keeping those RVUs? The $57/RVU is good and just run those numbers because if you're generating 25-30 RVUs/day you're going to make significantly more, especially if you're keeping your weekend RVUs.

The sign on bonus sucks though. Any student loan repayment?

In an unrelated note, I got an email today about a St. Louis job paying $250k for seeing 35 nursing home patients per day. Yeah, no.

Thanks!!!
They pay $2000 for weekend rounding seeing 8 to 10 pts on each day...and being on call is separate 400 per day.
I m not sure if I keep weekend RVU towards total or not..but I will make sure before moving forward..
No loan repayment as I don't have one and I m local so no relocation as well

 

[st2205]

Thanks!!!
They pay $2000 for weekend rounding seeing 8 to 10 pts on each day...and being on call is separate 400 per day.
I m not sure if I keep weekend RVU towards total or not..but I will make sure before moving forward..
No loan repayment as I don't have one and I m local so no relocation as well

Sounds like a good deal if you like the job. $2k is pretty decent for only 8-10 patients. If they're letting you keep those RVUs then those weekends are gems and I would sign up for as many of those as possible for a while. Should take a couple hours, tops.

Is it $400 for overnight call? That's also good. How many beds are you covering and are they just calling for admission orders or questions from multiple EDs?

 

[Jules A]

Thanks!!!
They pay $2000 for weekend rounding seeing 8 to 10 pts on each day...and being on call is separate 400 per day.

$400 for call is reasonable. I'd investigate that the 8-10 is an accurate representation. Thats an unusual census for an acute unit. If you are supposed to split with another Doc I've seen 8-10 turn into 15-18 with consult liaison on med floors and ED duties. Adding any of those scenarios would blow your $1,000 a day out of the water.