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So I wanted to throw out there a job I just accepted. It was for a position that was not open to new graduates.

 

However, my prior HCE got me in the door...and I haven't even graduated yet.

 

A quick thanks to the purists out there.

 

Base $56/hr.

10 hour shifts.

Guaranteed 14 shifts/mo (minimum of 12)

Only days to start, double coverage with another PA.

Fast track (yeah yeah I hear you already Emedpa) with some crossover to main ED with experience gained.

Nights = 20% more per hour (but won't be there until year 2 at least).

 

Full med, dental, vision mal and life.

401k matched up to 6% at 100+%.

4 weeks PTO with cash out option at base hourly rate.

1500 CME (no days off, just work schedule around it) and company provides free online CME hours.

License, DEA, etc covered with CME money.

2 weeks sick leave

3 guaranteed bonuses at approx 10% of base, with yearly increase.

No non-compete clause

 

Some other stuff I'm probably forgetting, but I've had a few beers and I'm celebrating.

 

Screw off. Just kidding.

 

Moral of the story, market your prior HCE if you've got it and don't settle.

Another moral is don't believe everything you hear about new grads in the PA market.

 

In the words of Just Steve, "just do you"

 

 

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Sounds good to me. Your working essentially three of four weeks a month at a traditional 40 hr./wk schedule if you only did the 12 shifts. What are hours of PA coverage, and in what state? Personally, I preferred the 10 hr. shifts. Just realized your licenses, etc. come out of your CME. What the heck. Do the Hawaii CMEs and see if you have enough expenses to itemize!

 

 

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Sounds good to me. Your working essentially three of four weeks a month at a traditional 40 hr./wk schedule if you only did the 12 shifts. What are hours of PA coverage, and in what state? Personally, I preferred the 10 hr. shifts. Just realized your licenses, etc. come out of your CME. What the heck. Do the Hawaii CMEs and see if you have enough expenses to itemize!Sent from my iPad using Tapatalk

Yes licenses come out of CME but they offer free CME online if so inclined. That was a sticking point with me, but I felt the other bennies outweighed it. Hawaii sounds fantastic right now!

 

 

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Awesome! What state? Glad to see those with REAL prior HCE be rewarded. I've seen way too many low ball offers accepted because a new grad only had experience as a "scribe" and didn't know any better. Not bashing scribes, but prior medics and nurses run circles around them as new grads.

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Congrats on the offer!  Definitely encouraging to see that there are jobs like this that can happen for new graduates.  I lack the kind of experience that would have gotten me in the door unfortunately.  But that's why I'll be applying to a fellowship.

 

Again, congrats and enjoy!

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Awesome! What state? Glad to see those with REAL prior HCE be rewarded. I've seen way too many low ball offers accepted because a new grad only had experience as a "scribe" and didn't know any better. Not bashing scribes, but prior medics and nurses run circles around them as new grads.

 

I don't see how being a nurse or paramedic vs. a scribe makes you a more qualified contract negotiator.

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I don't see how being a nurse or paramedic vs. a scribe makes you a more qualified contract negotiator.

I think he's suggesting that one could leverage extensive pre-PA school experience in a job bid for better results vs. a PA grad with less prior HCE.

 

The issue I take with this is that come graduation and PANCE passage, everyone walks out a certified PA. The schools are the ones accepting the "scribes", it's not the students' fault for applying and getting accepted. Anyone who holds animosity should direct it at the institutional level, not the individual.

 

And while experience means a lot; very smart people with less experience exist and cannot be easily discounted.

 

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The position is in CA. They considered me because My HCE was a lot more hands on. Not discounting scribes at all. And contract negotiation is variable person to person. I'm simply implying that even if a job "isn't open to new grads" or says "experience required", the traditional route of the PA got me an interview. From there, it's all individually based.

 

 

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"3 guaranteed bonuses at approx 10% of base, with yearly increase."

 

So is this saying you get an additional 30% of your base salary per year?? Holy smokes!!

Sorry, a better way of saying it would be 3 bonuses, at a TOTAL of 10% base. I wish it was 30% base...that'd be unreal.

 

 

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And while experience means a lot; very smart people with less experience exist and cannot be easily discounted.

Absolutely. But it all comes down to how you look on paper that gets you that initial interview, or piques the interest of somebody reviewing CV's.

 

I'm just trying to put some new grads at ease that fear there are no jobs for them because they've never worked as a PA. And not to avoid the jobs that say "no new grads."

 

 

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That's good to know. While I'm a few years off from this concern, I've seen quite a few perils unique to the new grad PA on here.

 

From rotation sites gobbling up eager, fresh grads just to churn them out as quick, to predatory contracts; it seems that new PAs face dilemmas not posed to physicians.

 

That's a lot to handle/avoid while trying to continue your learning in practice.

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I don't see how being a nurse or paramedic vs. a scribe makes you a more qualified contract negotiator.

 

For an EM PA job? As a new grad? If we were talking family practice.... No it wouldn't matter. But as the OP is stating: he knows his value and is confident in his ability to work in EM, even as a new grad. I know PA's who had never stepped foot into an ER until their four week rotation in EM. Four weeks in an ER and you expect them to see more than 10/pts a shift? Forget about it, they get slung over in fast track, very little supervision, and bad things happen to those patients. Hospitals see PA's as money savers. It's all about the $$'s. We are half the cost of an EM boarded doc and they will try to suck ever penny out of new grads. A common trend with those with no HCE applying for EM... They take significantly less money because they don't know any better and they really don't have the skills to be working in EM. Maybe two years as a generalist and then start looking into supervision in fast track or in urgent care.

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For an EM PA job? As a new grad? If we were talking family practice.... No it wouldn't matter. But as the OP is stating: he knows his value and is confident in his ability to work in EM, even as a new grad. I know PA's who had never stepped foot into an ER until their four week rotation in EM. Four weeks in an ER and you expect them to see more than 10/pts a shift? Forget about it, they get slung over in fast track, very little supervision, and bad things happen to those patients. Hospitals see PA's as money savers. It's all about the $$'s. We are half the cost of an EM boarded doc and they will try to suck ever penny out of new grads. A common trend with those with no HCE applying for EM... They take significantly less money because they don't know any better and they really don't have the skills to be working in EM. Maybe two years as a generalist and then start looking into supervision in fast track or in urgent care.

 

I'm sure there are plenty of former paramedics and nurses accepting lowball offers out there.  Stating that a scribe would understand less about contract negotiation or PA salaries simply because they are a scribe does not compute.  The person that would know best is the one that actually reads about this stuff...like the posters on this forum.

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I'm sure there are plenty of former paramedics and nurses accepting lowball offers out there.  Stating that a scribe would understand less about contract negotiation or PA salaries simply because they are a scribe does not compute.  The person that would know best is the one that actually reads about this stuff...like the posters on this forum.

So you are saying that someone with years in the medical field has the exact same understanding about contract negotiations as someone who is more than likely getting their first job making > $24k a year? I'm not just talking scribes here-- we all know the trend at many of these PA schools is accepting students with excellent GPA's and little to no medical experience. Most going from high school-->undergrad--->>PA school. Do they still make great PA's... Absolutely! Are they at a disadvantage when it comes to what they look like "on paper" as the OP was stating... Yes. THIS thread is on EM. I'm only talking about EM. Experience is the key in EM. Go read the posts in the EM section on this forum about new grad PA's struggling in EM right out of school. I've seen several in the past few months. Why should a hospital start paying higher salaries in EM if they keep getting inexperienced providers struggling their way through their first job? I'm passionate about EM because it's what I love and it's what many posters on this forum love. I'm just afraid PA's are trending in the wrong direction when it comes to this specialty...

 

Experience has everything to do with contracts in EM. Maybe someone else with EM experience wants to chime in, but if you put on your resume that you are going to run codes, intubate, throw some chest tubes, catch that MI and PE that snuck it's way into fast track, you might just know how much your worth and it sure isn't $38/hr like I've seen some PA's take (but then again, those PA's are getting their hand held by their supervisor). I wouldn't be surprised if the charge nurse was making more than them.

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I'm sure there are plenty of former paramedics and nurses accepting lowball offers out there. Stating that a scribe would understand less about contract negotiation or PA salaries simply because they are a scribe does not compute. The person that would know best is the one that actually reads about this stuff...like the posters on this forum.

I'm not really sure where the "who's better at contract negotiation" came from, but that was never my intention with this post. I actually tried to negotiate and got rejected. It was still a good offer, so I quickly accepted.

 

Being prior military, I can't tell you the first thing about contract negotiations except what the googles told me.

 

The intention was that those with extensive pre-PA HCE should advertise that experience and play it to their advantage-And apply for all jobs, regardless of experience.

 

FWIW, another EM job I interviewed at said they weren't interested in new grads, because they hired a new-grad NP that they had to teach how to suture. They "let them go" rather quickly. I've sutured since day one in the military, so I obviously played that experience up to my advantage. PA school wasn't the first time I ever touched some 5-0. That's all I'm getting at. Value your worth, and don't be afraid to exploit it for your benefit no matter how humble you are.

 

 

 

 

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  • 2 weeks later...

Late to this discussion.

This is a good offer, lets dissect to provide insight and education to others:

 

Base $56/hr

>>Based on a 2080 work year that is just over $116k, so looking at 2013 AAPA salary survey you are likely above 75% for salary given geography, experience and specialty

10 hour shifts.

>>Nice. 12 hr shifts mean you work even less but those last 2 hours can be draining. Question will be: can you get out at the end of 10 hours?

Guaranteed 14 shifts/mo (minimum of 12)

>>Love guarantees. Is it in your contract?

Only days to start, double coverage with another PA.

>>Sounds like potential for mentoring. Needed for anyone starting new. Is there a planned endpoint?

Fast track (yeah yeah I hear you already Emedpa) with some crossover to main ED with experience gained.

>>Nothing wrong with this. Got to learn on the easier stuff before you move on. Pay attention to triage. Never know when that bronchitis is actually a PE.

Nights = 20% more per hour (but won't be there until year 2 at least).

>>This is ok. I think 25-30% is better. Nights kick your a$$ no matter who you are and should be made to be worthwhile.

Full med, dental, vision mal and life.

>>Full as in employer pays full amount of premium or is there premium sharing? Any disability?

401k matched up to 6% at 100+%.

>>6% is a good match, take advantage of that free money. If you can save to the full amt allowed, 17500 this year, do it. your 55 y/o self will thank you.

4 weeks PTO with cash out option at base hourly rate.

>>Seems standard. Keeping in mind you will only work 14 days a month gives you a lot of time off compared to the sheeple. Does this increase with longevity? Does this roll over year to year? Or use or lose? Speaking from the veiwpoint of cashing out 2 large eto banks in my career, both greater than 300 hours, the cash was great.....but no one on their deathbed says i wished i worked more.

1500 CME (no days off, just work schedule around it) and company provides free online CME hours.

>>Too low. Only upside is that you are in CA and conferences abound so travel cost is not that big of a deal for you. But the gap between MD and PA costs at a conference is closing. You wont get a PA discount from Southwest nor the Hilton. I think double this amount is good, $4-5k is better. And you need CME time, 5-7 days. Never understand or understood why everyone else gets to go on vacation and I get to sit in a conference hall. And what is the free online CME? You have a login to up to date and can log those hours?

License, DEA, etc covered with CME money.

>>Ouch. You will be out over $900 your first year getting licence and DEA. Any money for national, state or specialty organizations?

License and DEA should be a separate line item, open to negotiation next time around. Remember this CME money will likely be prorated. So if you join the group in last half of year, you will only have $750 or less available to you.

2 weeks sick leave

>>You are not allowed to be ill.

Really, is there robust staffing that you can actually use this? What is the mechanism? Can you just call and say I am puking, I cant come in? Or do you need a Drs note (no kidding). Does this roll over year to year, or accrue and can be used as a poor man's disability policy?

3 guaranteed bonuses at approx 10% of base, with yearly increase.

>>This sounds like deferred compensation under another name. So you get this just for showing up? Or is there a metric you need to meet? The reality is that you will get whacked with taxes on this, 30-40% to the IRS. Instead of 5k you will see 3K or less. See if you can defer this into your 401k entirely or partially.

No non-compete clause

>>Good for you. Non competes are detrimental to careers and financial well being. When you work your per diem gig, remember to ask for 20-30% greater than your current hourly rate since they wont pay you bennies.

 

Good luck to you, you are on your way.

G Brothers PA-C

 

 

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Also late in responding as I was on vacation when posted. Looks like a pretty good offer. I got a similar "no new grads" job as a new grad due to extensive medic experience. No problem with starting with mostly fast track as long as you do get some chance to work main as well.

1500 is low for cme. >2k would be better. It would be nice if they paid state license and dea. my job didn't when I started and I made a big stink because every other local group did so they changed the policy and now cover this. we also get aapa dues. GeoBrothers is right about CA. Lots of options for local cme like Mel Herbert's Essentials of EM conference, etc.

I don't get any sick days or days off for cme, just a pto account of 2 weeks(14 eight hr days/yr). I take off a lot more time than this though by creative scheduling. work 10 days in a row and take 20 off for example without docking vacation. this works in larger groups. when we are fully staffed we have 15 PAs and a few on call folks so trades or just giving away shifts usually works. The way our schedule works out I usually get 4-5 days off in a row at least once/mo randomly. I generally don't have a problem getting a week or 2 off for vacation, medical missions, school, cme, etc a few times/yr without docking my PTO.

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Experience has everything to do with contracts in EM. Maybe someone else with EM experience wants to chime in, but if you put on your resume that you are going to run codes, intubate, throw some chest tubes, catch that MI and PE that snuck it's way into fast track, you might just know how much your worth and it sure isn't $38/hr like I've seen some PA's take (but then again, those PA's are getting their hand held by their supervisor). I wouldn't be surprised if the charge nurse was making more than them.

 

I'd say you're pretty spot-on.  And yes, a charge nurse who worked just a little bit of overtime could easily make more than some PA's straight out of school who accepted crap offers.

 

FWIW, with my new job, I didn't negotiate but I was given a great offer at the outset, so there was no need for negotiation

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FWIW, with my new job, I didn't negotiate but I was given a great offer at the outset, so there was no need for negotiation

they knew that as an experienced em pa residency grad if they gave you a low ball offer you would have no problem finding another job elsewhere within a week.

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1500 is low for cme.

I don't get any sick days or days off for cme, just a pto account of 2 weeks(14 eight hr days/yr). I take off a lot more time than this though by creative scheduling. work 10 days in a row and take 20 off for example without docking vacation. this works in larger groups. when we are fully staffed we have 15 PAs and a few on call folks so trades or just giving away shifts usually works. The way our schedule works out I usually get 4-5 days off in a row at least once/mo randomly. I generally don't have a problem getting a week or 2 off for vacation, medical missions, school, cme, etc a few times/yr without docking my PTO.

That's pretty much the set up I'll have. Larger group, easy to schedule multiple days off in a row for stuff without using PTO.

 

Yeah 1500 is low for CME, but it's one of those "that's what all PAs get" type deals. Plus, the online CME through the group is an incentive to leave that CME money for other things.

 

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Late to this discussion.

This is a good offer, lets dissect to provide insight and education to others:

 

Base $56/hr

>>Based on a 2080 work year that is just over $116k, so looking at 2013 AAPA salary survey you are likely above 75% for salary given geography, experience and specialty

 

10 hour shifts.

 

Guaranteed 14 shifts/mo (minimum of 12)

>>Love guarantees. Is it in your contract?

 

---yes it's in writing

 

 

Only days to start, double coverage with another PA.

>>Sounds like potential for mentoring. Needed for anyone starting new. Is there a planned endpoint?

 

---when I feel comfortable, and when they feel comfortable with me, I may transition to different shifts, etc.

 

 

 

Full med, dental, vision mal and life.

>>Full as in employer pays full amount of premium or is there premium sharing?

 

---full as in full, nothing out of my pocket.

 

Any disability?

---yes, that too

 

401k matched up to 6% at 100+%.

 

>>6% is a good match, take advantage of that free money. If you can save to the full amt allowed, 17500 this year, do it. your 55 y/o self will thank you.

 

----will do. They also throw in some extra change at years end to the 401k account (% of base salary)

 

 

4 weeks PTO with cash out option at base hourly rate.

 

>>Seems standard. Keeping in mind you will only work 14 days a month gives you a lot of time off compared to the sheeple.

Does this increase with longevity?

-------yes, up to 7 weeks depending on years worked.

 

Does this roll over year to year?

 

------yes, capped at ~380 hours though.

 

And what is the free online CME?

 

-----it's free web based CME modules that can be done during off time, paid for by group

 

2 weeks sick leave

>>

Really, is there robust staffing that you can actually use this?

 

------yes there is a lot of staffing.

 

What is the mechanism? Can you just call and say I am puking, I cant come in? Or do you need a Drs note (no kidding). Does this roll over year to year, or accrue and can be used as a poor man's disability policy?

 

-----find your replacement type deal. Use or lose.

 

 

3 guaranteed bonuses at approx 10% of base, with yearly increase.

>>This sounds like deferred compensation under another name. So you get this just for showing up?

 

----one of them yes just by showing up full time. The others are under a productivity matrix at the discretion of ED director that all PAs have received since he's been in charge.

 

Or is there a metric you need to meet? The reality is that you will get whacked with taxes on this, 30-40% to the IRS. Instead of 5k you will see 3K or less.

 

See if you can defer this into your 401k entirely or partially.

----great idea.

 

 

Good luck to you, you are on your way.

G Brothers PA-C

Thanks G Brothers for the fine tooth comb. Great questions. Unfortunately some of them are non-bargaining points, and until the group as a whole demands (for example) 2k CME and licenses/renewals as a separate line item, not much can be done.

 

Thanks again for all the input!

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