Setting up interviews for first position (PA/NJ/DE)

[Elevencents]

Hey pals. 2nd year resident. I’m starting to think about interviewing and has a few questions for the hive mind. How do you go about setting up interviews? Cold calling? Is there a place to see who has openings? What sort of things are important not to forget when negotiating? What MUST you have in your contract? I’m planning on sticking to the Philly/NJ/Delaware area so if anyone has any opinions on the hospitals around there or knows of any openings I would be greatly appreciative. What is a fair starting wage in that area? I’m sure it’s less in the city and more as you go rural. I don’t have much interest working IN Philly.

I still have to speak to my seniors but wanted to see what information I could gather here. I also have heard that $2k stipend per month while on residency is pretty standard. Is that correct? I’m drowning in credit card debt so I’m willing to give up future income in order to get a nice stipend and/or signing bonus.

Any and all information is welcome. Thank you all

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[InternistDO]

A bunch of the North/Central Jersey ERs are hiring right now. If I remember correctly from talking to some residents, the departments near NYC (NBI, Jersey City Medical Center, etc) are about $180/hr--I think they're all Envision. Further down the shore is like 200/hr. I doubt you'd have much trouble getting in touch with anyone, apparently all the departments are desperate for people, which may be a good or bad thing.

 

[GonnaBeADoc2222]

Philly/NJ/DE is a pretty crappy market for EM. NJ is overrun with CMGs. Philly and surrounding is dominated by academic offshoots that will pay you sub 200 / hr to see 2 pph and sign midlevel charts and also predatory "small groups."

Any CMG resident stipend or signing bonus is "golden handcuffs" designed to keep you from quitting and signing on to 2-3 years.

Why do you have credit card debt?

Have you gotten disability insurance yet?

Have you been funding a Roth IRA each year during residency?

These are all questions to think about before you mortgage your first few years as an attending away for some cheap signing bonus.

 

[Elevencents]

Philly/NJ/DE is a pretty crappy market for EM. NJ is overrun with CMGs. Philly and surrounding is dominated by academic offshoots that will pay you sub 200 / hr to see 2 pph and sign midlevel charts and also predatory "small groups."

Any CMG resident stipend or signing bonus is "golden handcuffs" designed to keep you from quitting and signing on to 2-3 years.

Why do you have credit card debt?

Have you gotten disability insurance yet?

Have you been funding a Roth IRA each year during residency?

These are all questions to think about before you mortgage your first few years as an attending away for some cheap signing bonus.

I made the mistake of putting a large sum of money on my CC the year prior to starting school with the intention of paying it off and it never happened. Then I totaled my car and had to pay for the airbags to be replaced out of pocket because insurance gave me a hard time. And a bunch of other little things have contributed to it snowballing to the point I’m only able to put the minimum payment down on multiple maxed CC’s.

I do have disability. But I am not working on an IRA. I do not have an extra penny to spare after each pay check.

I was afraid you would say that about the area. Is it to the point where the entire area is a cesspool or are there diamonds in the rough to be found. I’m guessing the entire region has just been bought up and is now not optimal for employment.

 

[cyanide12345678]

Considering that I get at least 1-2 personal loan flyers a week in my mail, could you not get a personal loan around 6-7 percent interest and then pay off the credit cards which are usually at around 18-25 percent apy. That's something to think about, it might make that debt tolerable.

Second, does your residency allow for moonlighting. A Co resident of mine who has credit card debt took care of it just through moonlighting.

My point is that you might not need a residency stipend or sign on bonus to cover your existing debt. As others have said, sign on bonus comes with handcuffs. When you read the contract terms, a lot of times the cmgs will make you pay back your entire sign on bonus if you left even a day early.

The most ideal situation is to negotiate a higher rate and then eventually once the rate is negotiated, you get them to turn the sign on bonus into a hourly equivalent. For example: I was being offered 100k for 2 years, roughly equivalent to $30/hr. I eventually negotiated and converted all of my sign on into a higher hourly. This way, if I ever work more hours than scheduled, I'll work the higher hourly, and if I decide to leave, I don't owe them anything except a 90 day notice.

 

[RustedFox]

I made the mistake of putting a large sum of money on my CC the year prior to starting school with the intention of paying it off and it never happened. Then I totaled my car and had to pay for the airbags to be replaced out of pocket because insurance gave me a hard time. And a bunch of other little things have contributed to it snowballing to the point I’m only able to put the minimum payment down on multiple maxed CC’s.

I do have disability. But I am not working on an IRA. I do not have an extra penny to spare after each pay check.

I was afraid you would say that about the area. Is it to the point where the entire area is a cesspool or are there diamonds in the rough to be found. I’m guessing the entire region has just been bought up and is now not optimal for employment.

I got stuck in the nickel-and-dime trap during residency, too - but I was lucky enough to just pay in cash either upfront or in installments.

I hear you, amigo.

Its a shame that the Philly/NJ/DE area is such a wasteland when it comes to "good" EM jobs.
I hate how dirty Philly is (I am a staunch environmentalist), but it is a fun city.
I lived in NJ for two years. Hated the filth and the traffic. Loved the attitude of "we get $hit done here".
Don't have much experience in Delaware.

Good luck.

 

[carbonizedeyesockets]

Hey pals. 2nd year resident. I’m starting to think about interviewing and has a few questions for the hive mind. How do you go about setting up interviews? Cold calling? Is there a place to see who has openings? What sort of things are important not to forget when negotiating? What MUST you have in your contract? I’m planning on sticking to the Philly/NJ/Delaware area so if anyone has any opinions on the hospitals around there or knows of any openings I would be greatly appreciative. What is a fair starting wage in that area? I’m sure it’s less in the city and more as you go rural. I don’t have much interest working IN Philly.

I still have to speak to my seniors but wanted to see what information I could gather here. I also have heard that $2k stipend per month while on residency is pretty standard. Is that correct? I’m drowning in credit card debt so I’m willing to give up future income in order to get a nice stipend and/or signing bonus.

Any and all information is welcome. Thank you all

There are only 3 hospitals in Philadelphia left that don't have residents (Roxborough, Chestnut Hill, and Nazareth). One of those will be getting residents (Naz). Roxborough is a CMG owned by a former ACEP president and the hospital is owned by a highly suspect company. Avoid it. Chestnut Hill isn't a CMG, but isn't an SDG. They work you hard. Base pay is low, but they're big on RVU bonuses, i've heard. Outside the city, there are a few democratic groups (Doylestown Hospital, Grandview, Lankenau, Bryn Mawr, Paoli, Chester County Hospital, Phoenixville, Abington). Almost no SDG will hire a new grad. All of Crozer just went to Team Health. St Mary's is Team Health. Lower Bucks is the same garbage company as Roxborough. The same group that staffs Chestnut Hill staffs Pottstown. Southern NJ has 3 SDGs (ACMC, Cape Regional, and the group that staffs Inspira except the old Underwood). Cooper also staffs the ED in Salem County. Everything else is either Envision or Team Health, even Al Sachetti's shop (OLOL in Camden), which rides ED docs hard and puts them away wet. The 2 Capital Health hospitals are CMG. The other Trenton hospital is some CMG-lite. The pay at the academic places has gone up in the past few years, but certainly lower than SDGs or similar shops outside the region. When not with a resident there is usually PA staffing. I'm at place where I rarely see more than 1.5/hr on my own (frequently less) and thus can see most, if not all, of the PA pts.

Generally, the SDG jobs are great (both in pay and workload) from what I've heard, but landing a job with them is not easy.

 

[Elevencents]

Thank you all for the wealth of information. Really helps. My current hospital is staffed by Alteon and we have had recruiters from Team Health at our shop so those are the only two I’m familiar with. Really appreciate your candor, carbon. I’m trying to convince my wife to stay in the area for a couple years just to get my feet wet but she is dead set on moving to the Philly area which I am unfamiliar with. From what I have heard on here and from people along the trail it is not the best environment.

I was speaking to one of my attendings and was also surprised to find that loan repayment is actually uncommon. I thought it was more common than not.