Work contract stipends?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

n618ft

Full Member
15+ Year Member
Joined
Nov 13, 2006
Messages
776
Reaction score
30
I just switched from FM to EM (dream residency). Have any of you guys signed a contract to work for a group or organization in exchange for a stipend? I saw HCA offers one but not during the current period for EM. EMcare offers one too but it seems a lot less than what HCA has been offering recently. Anyone have experience with finding these? I know the area I want to work in (South FL) and don't mind committing to a place in a geographical area.

Members don't see this ad.
 
Members don't see this ad :)
Dont. Do. It.

What he said.

You're selling your freedom - and your soul to the emcare devil. Run away. Far far away.

You will rob yourself of any and all negotiating power. When looking for work, because you already made this deal with the devil. Plus, they will have you by the balls on lockdown for crappy hourly rates for 2 years! Most decent places you can sign a 1 year contract and see how things go, and renew if you like working there.

A huge percentage of EM docs change jobs in the first five years - how do you know you won't want to do it?

And trust me on this - just about ANY doctors group out there in the same location will pay better then EMCrap. Don't work for those douchebags, unless you're doing locums and getting big fat shift bonuses.


Sent from my iPhone using Tapatalk
 
Yeah doing this would be a massive mistake. They aren't offering a stipend because they're nice and they like you. They're doing it so they can pay you $15k (or whatever the current pittance is) over a few years and then screw you out of +100k in attendinghood while having you work in Armpit, OK.

Or think of it another way: do you really want to join a company that's willing to sign docs early in residency before the company actually knows the quality of doc they're getting? It's the strongest smell of desperation.


Sent from my iPhone using SDN mobile
 
  • Like
Reactions: 1 user
Yeah, BravoTwo is 95% right.

I took a stipend for my last 7 months of residency to sign on with EmSuck. Owed them a "year" afterwards. 175/hour. It wasn't bad, and I often got mad bonuses to fill in the gaps in the schedule. But I didn't know any better.

The 5% where Bravo is wrong is when it comes down to the local market conditions (gulf coast, south FL). I looked at the 'SDGs' in the area, who wanted 2 years of nightshifts at 150/hour with no guarantee of partnership. Kthxbye.

Two years later, I met some of the docs who took that bait. The cake is a lie.

Tell them politely that you're not interested. EmSuck and MeanHealth dominate the area, yes - but the stipend is laughable post hoc.

That, and you have no idea how radically life will change between now and then. Stop.
 
Essentially they are loaning you money and you almost certainly are repaying it at a pretty high interest rate in return.

There may be the rare situations where it is a reasonable option. For example, if for whatever reason you are paying 20%+ in credit card interest and you sign with the only group in the only town you are willing to work in. In that situation, it might not be a bad idea. Or if the loan sharks say they will chop off you hand if you don't pay them by next Friday.

But in the other 99.9% of cases you will be far better off sucking it up for a few more months and doing without the stipend.
 
Last edited:
If you really need the money, you may be better off trying to do moonlighting at your hospital or a local urgent care. I actually did both and built up a nice cash reserve that lasted me the whole two months between end of residency and my first attending paycheck.


Sent from my iPhone using Tapatalk
 
  • Like
Reactions: 1 user
So EM care is just one of them. HCA has one too and it's significantly more money. Are there any other groups that people have tried that offer similar?
 
So EM care is just one of them. HCA has one too and it's significantly more money. Are there any other groups that people have tried that offer similar?

It doesn't matter if it's Best Friends with Rainbows and Unicorns Emergency Specialists Inc. offering a residency stipend. It's a trap. You will reap a tiny very short term profit in exchange for getting screwed out of a far larger amount of money in your first years out.

And I'd avoid HCA like the plague.


Sent from my iPhone using SDN mobile
 
  • Like
Reactions: 1 user
Members don't see this ad :)
EmCare is Envision now, jefe. It never had anything to do with HCA actually. Two completely different entities.

Falso, hombre.

HCA and EmCare got in bed together about 3 years back with an agreement to split profits and the understanding that EmCare would get the contracts for all HCA shops. I was working at one of those shops at the time and remember all the shakedown. Since that time, there have been a few HCA shops to put out the RFP, but those are rare birds.
 
There are very few HCA shops that aren't EmCare that's true. They're in bed together, but they aren't married.
And yes, HCA doesn't employ docs. If they're giving you a stipend, it's the EM group that works there.
 
There are very few HCA shops that aren't EmCare that's true. They're in bed together, but they aren't married.
And yes, HCA doesn't employ docs. If they're giving you a stipend, it's the EM group that works there.

It must be through the EM groups then. For sure it's not through EMCare. The local group here isn't through them although the peds group is through the same parent company. I for sure want to live in a certain area (family) and they're 2 year agreements.
 
With that said, how do you go by finding groups in the areas you're interested in? Just call them up?
 
So EM care is just one of them. HCA has one too and it's significantly more money. Are there any other groups that people have tried that offer similar?
So, people are taking their time to offer good advice, gratis. This is all you got from that? "Any other groups"?

This is something I've seen
With that said, how do you go by finding groups in the areas you're interested in? Just call them up?
The White Coat Investor got his unicorn job that way - just cold calling.

(For some reason, I can't tag him.)
 
It's not clear to me why someone would try any other method other than cold calling. If the place is desperate enough to hire a recruiter or be staffed by a CMG, cold-calling still works. If they're not, cold-calling may be the only way!

At any rate, I agree that you probably need to be somewhat desperate for cash or VERY sure you want that job long-term to sign a contract early in residency. I don't see why a job with EmCare would be attractive enough to do that.

FWIW- My larger group staffs HCA facilities (although my division does not). HCA still contracts with multiple groups to staff their EDs, although the number of groups is definitely shrinking. As I recall, perhaps 5 or 6. I think it's clear they don't want to contract with 20 groups, but I'm not convinced they want to only contract with 1.
 
I got my job by cold calling, and have another offer on hand just by doing the same. It is definitely the way to go aside from knowing people on the inside.


Sent from my iPhone using Tapatalk
 
Cold calling FTW. There are certain things that don't pay to outsource. Where your first job is should be one of them.
 
Although cold calling probably yields you better quality jobs...don't write off the CMG in your area that's advertising. I'm a total CMG zombienaut and have been pretty happy. I do agree though that the stipend is not worth it, nor are sign on bonuses for that matter. Its classic poisoned fruit, at least most of the time.
 
I turned down a unicorn job offer that I found cold calling for a CMG job with a stipend and have no regrets. It comes down to location and what works for you.

The other job was a SDG, coastal Atlantic, with partner salary ~450-500k, really nice group, stable x 30 years. I turned it down because my wife and I spent a week there and didn't like it as much as we thought we would, and because it was a rough road to partnership: 2 years with ~150K lost in "sweat equity" over that time compared to a standard CMG job. The partners in that group were ballers but I had some concerns about the stability of the contract (nothing is certain), we didn't love the area (although it was definitely very nice) and after residency I was ready to immediately make a "real" salary.

Ended up taking a job I knew a lot about with a ~$35k bonus (only had to pay taxes on $10k so not an insignificant amount) and am happy with the decision.
 
It's not clear to me why someone would try any other method other than cold calling. If the place is desperate enough to hire a recruiter or be staffed by a CMG, cold-calling still works. If they're not, cold-calling may be the only way!

At any rate, I agree that you probably need to be somewhat desperate for cash or VERY sure you want that job long-term to sign a contract early in residency. I don't see why a job with EmCare would be attractive enough to do that.

FWIW- My larger group staffs HCA facilities (although my division does not). HCA still contracts with multiple groups to staff their EDs, although the number of groups is definitely shrinking. As I recall, perhaps 5 or 6. I think it's clear they don't want to contract with 20 groups, but I'm not convinced they want to only contract with 1.
What's this "division" talk? Did your SDG sell to a CMG?
 
So, people are taking their time to offer good advice, gratis. This is all you got from that? "Any other groups"?

This is something I've seen

The White Coat Investor got his unicorn job that way - just cold calling.

(For some reason, I can't tag him.)

What planet do you live on where subjective bashing without any objective first hand accounts is good advice? "EMCare sucks" isn't advice.
 
What planet do you live on where subjective bashing without any objective first hand accounts is good advice? "EMCare sucks" isn't advice.
Good job, buddy. This is the gracious way to take this. /sarcasm

Edit: and, to be honest, I didn't realize I'd posted the first part of that. I didn't mean to, as I thought that it wasn't the best thing for me to say. However, that's what happens when one doesn't look - the client that SDN uses auto saves drafts. But, at the same time, I gotta own it.
 
If you really need the money, you may be better off trying to do moonlighting at your hospital or a local urgent care. I actually did both and built up a nice cash reserve that lasted me the whole two months between end of residency and my first attending paycheck.

Let me correct this. If you really need the money, you are better off taking up prostitution or robbing a bank than taking a stipend deal from a group.
 
  • Like
Reactions: 1 users
What's this "division" talk? Did your SDG sell to a CMG?

No, we've always had divisions. It's a pretty cool structure really. Many SDGs banded together to negotiate with insurers and benefits companies but still able to make all the important decisions (hiring, firing, holiday schedule, how to split up the income, staffing etc) as a small group. I think we're about 150 docs in the entire group, but my division is only 18.
 
What planet do you live on where subjective bashing without any objective first hand accounts is good advice? "EMCare sucks" isn't advice.

It might not be advice, but it is true. The planet is called "EM" and on planet EM, it is a well-known fact that EmCare sucks. It's like the opposite of a unicorn job.
 
  • Like
Reactions: 2 users
SDGs and CMGs all have their pluses and minuses. To Throw a blanket as one is bad or good is quite a reach.

I know SDGs who abuse their docs and lied to them to work for slave wages with rainbow partner benefits to just screw them.
At least the CMGS tell you they will screw you early on and you accepted the pain.

I know CMGs paying more than SDGs in the same city with better work environments.

Its your job to do what is best for yourself by arming yourself with the most information before choosing. No one will look out for you other than yourself. CMGs and SDGs can care less about you outside of what you can do to increase the profits. You are worth alot only if they can't find someone who can do the same at better rates.

To OP, smarten up. These stipends have red flags all over them. If the place you are signing on is even average, they could find doctors tomorrow to work in these hospitals. There is a reason they can't staff it with experienced docs and have to find docs in residency with a stipend.

If you do end up signing up for a stipend, just realize that your first shift will either be in a terrible work environment and/or the doctor working next to you is making $1-200 more an hr than you are. If you are ok with this, take the 20K stipend.

Just like the military scholarships. When they come to your school and promise the world, there is always a catch. And that catch is possibly going to the middle east and training in family medicine eventhough you hate the heat and family medicine.
 
SDGs and CMGs all have their pluses and minuses. To Throw a blanket as one is bad or good is quite a reach.

I know SDGs who abuse their docs and lied to them to work for slave wages with rainbow partner benefits to just screw them.
At least the CMGS tell you they will screw you early on and you accepted the pain.

I know CMGs paying more than SDGs in the same city with better work environments.

Its your job to do what is best for yourself by arming yourself with the most information before choosing. No one will look out for you other than yourself. CMGs and SDGs can care less about you outside of what you can do to increase the profits. You are worth alot only if they can't find someone who can do the same at better rates.

To OP, smarten up. These stipends have red flags all over them. If the place you are signing on is even average, they could find doctors tomorrow to work in these hospitals. There is a reason they can't staff it with experienced docs and have to find docs in residency with a stipend.

If you do end up signing up for a stipend, just realize that your first shift will either be in a terrible work environment and/or the doctor working next to you is making $1-200 more an hr than you are. If you are ok with this, take the 20K stipend.

Just like the military scholarships. When they come to your school and promise the world, there is always a catch. And that catch is possibly going to the middle east and training in family medicine eventhough you hate the heat and family medicine.


A lot of truth in this post.

The only caveat that I'd add is that when I took my signing bonus, the rate for me was the same as it was for all the docs already signed and working. Everyone there was working for 175/hour, minus the director, who got his stipend and then worked what he worked. Still, it was a mistake - I would have left that gig and given the money back. The job has changed now, but back then - it was pretty poisonous.
 
Everyone there was working for 175/hour, minus the director, who got his stipend and then worked what he worked.
At least, that was their contracted rate. But if they're paying a stipend for people to come there, that means they're paying bonuses for people to work there. So, often, many of the people beside you are getting paid more, just like you were on your bonus shifts over your contracted ones.
I never saw residents moonlight by plane until recently. EmCare is so desperate that they'll fly doctors in training into other states to work.
 
A lot of truth in this post.

The only caveat that I'd add is that when I took my signing bonus, the rate for me was the same as it was for all the docs already signed and working. Everyone there was working for 175/hour, minus the director, who got his stipend and then worked what he worked. Still, it was a mistake - I would have left that gig and given the money back. The job has changed now, but back then - it was pretty poisonous.

Even if they paid you 250/hr, and it was a terrible environment, the doctor wells eventually dries up and they have to hire locums at a higher rate who doesn't have to show up for meetings while your stuck at a lower rate dealing with all the admin crap. Never sign up for more than 1 yr. They can fire you anytime they want so why take a 2 yr commitment?
 
  • Like
Reactions: 1 user
At least, that was their contracted rate. But if they're paying a stipend for people to come there, that means they're paying bonuses for people to work there. So, often, many of the people beside you are getting paid more, just like you were on your bonus shifts over your contracted ones.
I never saw residents moonlight by plane until recently. EmCare is so desperate that they'll fly doctors in training into other states to work.

Oh yeah, I remember getting a $2500 shift bonus for one particular nightshift during my "freshman year" where I slept for four hours.
 
Even if they paid you 250/hr, and it was a terrible environment, the doctor wells eventually dries up and they have to hire locums at a higher rate who doesn't have to show up for meetings while your stuck at a lower rate dealing with all the admin crap. Never sign up for more than 1 yr. They can fire you anytime they want so why take a 2 yr commitment?

Truth in this, too.

99% sure that I owed them a year. Could have been "14 months" or twice as many months as I got in stipend. Didn't matter; I wasn't going to find other work anywhere, given everything else going on in my life at the time. I wasn't exactly a motivated individual looking to take a bite out of the CMGs, I just wanted a steady paycheck and to sort out the rest of my life.
 
Truth in this, too.

99% sure that I owed them a year. Could have been "14 months" or twice as many months as I got in stipend. Didn't matter; I wasn't going to find other work anywhere, given everything else going on in my life at the time. I wasn't exactly a motivated individual looking to take a bite out of the CMGs, I just wanted a steady paycheck and to sort out the rest of my life.


The HCA one would have me owing them 2 years for 2-3 years of stipend. I won't discuss specific stipend pay on here. It's certainly through the groups - asked some attendings today. This is why I ask on here - but an extra few K in residency while I'm still young and without a family seems like a great opportunity to pay off some loans, remodel my house, and still have money left over to invest.
 
The HCA one would have me owing them 2 years for 2-3 years of stipend. I won't discuss specific stipend pay on here. It's certainly through the groups - asked some attendings today. This is why I ask on here - but an extra few K in residency while I'm still young and without a family seems like a great opportunity to pay off some loans, remodel my house, and still have money left over to invest.

Why in the world would you take money to remodel your house? Especially if you're not 100% debt free. You're talking about trading your long term career happiness for a new bathroom....
 
  • Like
Reactions: 1 users
The HCA one would have me owing them 2 years for 2-3 years of stipend. I won't discuss specific stipend pay on here. It's certainly through the groups - asked some attendings today. This is why I ask on here - but an extra few K in residency while I'm still young and without a family seems like a great opportunity to pay off some loans, remodel my house, and still have money left over to invest.


(???)

[RustedFox Faints!]

WhiteCoat, GO!
 
  • Like
Reactions: 1 users
The HCA one would have me owing them 2 years for 2-3 years of stipend. I won't discuss specific stipend pay on here. It's certainly through the groups - asked some attendings today. This is why I ask on here - but an extra few K in residency while I'm still young and without a family seems like a great opportunity to pay off some loans, remodel my house, and still have money left over to invest.

With this statement, you have much more to worry about than taking a stipend. Take a step back and reread your statement.

"Let me take 20K for the next 2 yrs so I can live a nicer life in residency in order to get a crappy job in 2 yrs making over 100K less than the guy next to me".

Talk about mortgaging your future for alittle immediate gratification.

My Locums site right now averages $450/hr this year while the full timers get $250/hr. For this better rate, I get to pick the days I want to work and not have to go to any meetings. I don't have to put in schedule requests and avoid weekends if I like. Also, every metric that comes to my box gets immediately deleted and no one gives me flack over it.
 
  • Like
Reactions: 2 users
Oh yeah, I remember getting a $2500 shift bonus for one particular nightshift during my "freshman year" where I slept for four hours.
With this statement, you have much more to worry about than taking a stipend. Take a step back and reread your statement.

"Let me take 20K for the next 2 yrs so I can live a nicer life in residency in order to get a crappy job in 2 yrs making over 100K less than the guy next to me".

Talk about mortgaging your future for alittle immediate gratification.

My Locums site right now averages $450/hr this year while the full timers get $250/hr. For this better rate, I get to pick the days I want to work and not have to go to any meetings. I don't have to put in schedule requests and avoid weekends if I like. Also, every metric that comes to my box gets immediately deleted and no one gives me flack over it.


Great advice. I'll PM you with one detail.
 
Top