New Grad- Outpatient OB/GYN Offer

[SarcastiKate]

Hi all,

 

New grad here, considering an offer in OB/GYN.  It's outpatient- though we've vaguely discussed adding on hospital duties at some point, including rounding, surgical assisting, etc- Nothing specific though.  The Doc just sent me a letter of intent, but it's a little light on details.  I was thinking I should send back a list of follow-up questions and want to make sure I'm not missing anything before I do.

 

Here's what he outlined:

 

Salary: 83,500/yr

PTO: 2 weeks first year, 3 weeks thereafter

Non-contractual, but requires 8 weeks notice if leaving

3 month initial probationary period

 

Here is the list of follow-up questions I have so far:

 

1. CME: time/monetary allowance?
2. Liability insurance: my responsibility or yours?  If yours, is the policy occurrence coverage or claims-made?  If claims-made, do you cover tail, or is that my responsibility?
3. Licensure, DEA, and delegation agreement filing fees: my responsibility or yours?
4. Patient load: initial expectation?  Ultimate expectation and expected time frame for getting there?
5. Hospital duties: what is the expectation and time frame for taking these on?
6. Other benefits: e.g. medical, dental, 401k, etc?

 

So...  First of all, are any of these questions unreasonably forward? (Not looking to offend the guy by grilling him, lol).  And second, are there any other questions I need to add before I respond?

 

And just FYI, I have 2 other serious offers on the table.  He knows this and has upped the initial salary offer from 80k already, so I'm a little hesitant to push, but don't want to be stupid either.

 

Thanks everyone- this helpless newbie is eternally grateful!

 

 

[EMEDPA]

sounds like a good offer if you can flesh out the stuff on your list. is he a good teacher and willing to teach? will you be doing colposcopy, assisting/performing unassisted deliveries, placing iuds, etc?

[SarcastiKate]

So I sent my list of questions and the SP got back to me today - if anyone is willing to take a look at the full details of the offer below and give me an idea of whether you see any red flags, or think of any other follow-up questions I should ask before I decide, I'd really appreciate it.

 

• $83,500/yr
• 2 weeks PTO the first year, 3 weeks every year thereafter - this includes CME time
• $500 annual CME allowance, may increase to $1000/yr depending on productivity
• They pay licensing/DEA/delegation agreement filing fees
• Malpractice insurance - corporate occurrence policy covers anything I do in office, and won't require tail if I leave.  He's checking with their insurance agent to see if this will also cover me for hospital duties, so I may have to carry my own occurrence policy if it doesn't.
• Hospital duties will include 1st assisting on all of his GYN surgeries and C-sections, assisting with vaginal deliveries, and we will split rounds
• He is willing to train me for advanced procedural credentialing in culposcopy, and minor ASC cases, e.g. cervical/endometrial biopsy, endometrial ablations, etc
• Expected patient load is 24-30 per day - his exact words, "I don't expect that overnight, you'll work up to it over time.  As long as you're generating enough revenue to cover your own overhead by the end of the first year, everyone's happy."
• No health/dental coverage offered through office (not that big of a deal to me since I have these benefits through my husband's employment)
• No retirement benefits currently, but willing to add 401k after first year.

 

And to answer your question EMEDPA, yes he's a good teacher.  I did my OB/GYN clerkship there and had a great experience.  Good learning environment and working relationship with SP are really important to me for the first job- which is why I'm leaning toward this offer over the other two (Hospitalist and Family Med).

[queenofhearts]

 I just wanted to follow up on this thread @ SarcastiKatie...how are things going in your ob/gyn job? Have you had opportunities to assist in surgeries/delivers quite yet? Thanks!

[SarcastiKate]

I haven't started yet.  Just got my license last week and now waiting on the official acknowledgement of the delegation agreement before I start in a couple of weeks.  I'll start seeing pts in the office right away, but it will probably take another month or so before the hospital credentialing is done.

[SarcastiKate]

Just wanted to update this post, since I did end up accepting the position and have now been on the job for 7 months.  At this point, I'm seeing patients in the office 4 days a week and I spend 1 day a week with my SP at the hospital assisting with GYN surgical cases and deliveries (C-sections and vaginal deliveries).  I do get to do Colpos, IUD insertions/removals, and ASC cases in the office as well - although in Maryland, there's a long process to go through before you can do them without direct supervision, so I always have my SP keeping an eye on me for the time being.  (Kind of comforting actually, since I'm a relative newb, lol).  I also go into the hospital to round on our post-op and postpartum patients.  It's been a very, ummmm... let's say "interesting..." transition getting into the hospital setting, since there weren't any other OB/GYNs bringing their own privately-employed PAs into the hospital prior to us, but overall the experience has been a positive one.  I do wish there was a stronger PA presence in the L&D department at our hospital, as the few that are there are employed directly by the hospital and mostly limited to C-section assisting.  It's kind of tough being the only one coming in as an employee of a private SP - mostly just because it's relatively uncharted territory in this specialty.  

 

Overall, I'm happy with my choice-  and for any future peeps reading this who are considering OB/GYN - highly recommend asking for hospital/OR exposure when negotiating your employment.