Predicament and job offer. Please help!

[NewGradLyn]

First of all, let me tell you a little bit about my situation. I graduated in August of 2015, I started a job in OB/GYN in February, but it turned out not to be a good fit. I found out that I didn't have enough knowledge/hands on experience with obstetrics to feel comfortable in such a high risk specialty. My employer also said the doctor was willing to train me, but ended up having me train with the PA, who was also a new graduate and had only been working there for a month..... I was also expected to work every other Saturday from 8am-noon, where I would see about 20-25 obstetrics patients in 4 hours....that was extremely stressful, scary, and unrealistic for a new grad IMO....but I digress. After 5 weeks, I spoke with my employer, and we mutually decided that this wasn't a good fit for me and I left (on benevolent terms, at least). I feel that primary care would be a better fit for me.

 

Now I've found myself in an incredibly difficult situation. I have been out of school for nearly 9 months, have only had 5 weeks of experience as a PA, and I live in what I think might be a really saturated area with cuttroat competition (DC/northern Virginia area). I really love this area and would love to stay here. I've actually had about 7-8 interviews in the past month (which I aggressively follow-up with), but employers don't like to respond to me at all. I can only conclude that it's my lack of experience and the heavy competition in this area that is really hindering my job efforts. 

 

However, I have this job offer in southern CA, if anyone has any input. It's a family medicine clinic with some urgent care, which I thought was neat. I should also mention that this was a skype interview, and they weren't willing to pay to fly me over there to actually visit. No contract, but here's the letter of offer:

 

Compensation is $48/hour as an "exempt" employee

Performance review after 30 days

401k after 1,000 hours worked

100% coverage of medical/dental/vision insurance

Life insurance/accidental death insurance

Professional disability insurance

Paid holidays for scheduled work days (after 90 days)

PTO 80 hours (2 weeks) for vacation or illness after 90 days of service

Malpractice insurance covered (I need to ask what kind, I know)

Covered under workman's compensation policy

They said they'd "assist" with the costs of the DEA and CA license...but I am aware that this could mean they cover 10 percent of the cost. I'd need to ask for clarification.

Says they'll "assist" me with relocation costs

Will provide a hotel for me x 2 weeks upon arrival to CA

 

The schedule was explained to me verbally, but isn't mentioned in the letter of offer. I would work 9-5 M-F most weeks, but also every 5th Sunday and some Saturdays.

 

I am aware that there are problems with the letter of offer...like no mention that I will be guaranteed 40 hours of work per week, no mention of CME, the combined PTO/sick and no time for CME is horrible, but maybe they'd be willilng to negotiate. 

 

I also know it's really far (again, I'd rather be in NoVA/DC closer to family), but they are willing to train/mentor me, and I'd get to further develop my medical Spanish (which would make me more marketable later). They have low turnover-- the one PA has been there for 14 years, the other two have been there for 10. So even though the benefits aren't great, it could give me excellent experience and I could move back to the East coast after some experience. I'm also worried that I could be unemployed for another 3 months or more if I turn this down. 

 

I've also considered possibly doing a residency, but I'd rather just get a primary care position with a great mentor instead of going back to PA slave labor. (I don't mean that to be derrogatory in any way, I've just really got bills to pay, and I'm tired of being stuck in poor student mode)

 

Thoughts, advice would be much appreciated. Thank you!!!

[MT2PA]

You've gotten a lot of interviews for the area...maybe you're following up too aggressively?  Maybe your interview skills need work?  

 

Residency for primary care seems like a bad move but you're in a tough spot.  Do you really want to go to CA?  A job is better than nothing but you sound like you want us to convince you to take the CA job when you really are looking for reasons to keep looking in VA.  What about other parts of VA?  Richmond?  

[Boatswain2PA]

$48/hr ($96K/year) in SoCal doesn't get you much.

 

If you're willing to move all the way across country, try looking for some of the areas between you and there.  

 

Are there no urgent care clinics hiring in your area??

[NewGradLyn]

$48/hr ($96K/year) in SoCal doesn't get you much.

 

If you're willing to move all the way across country, try looking for some of the areas between you and there.  

 

Are there no urgent care clinics hiring in your area??

 

I've interviewed for a couple urgent cares, but the problem is, it's usually a solo provider situation and, well...well, I'm a new grad. I wouldn't feel comfortable operating completely solo out of the gate. 

[NewGradLyn]

You've gotten a lot of interviews for the area...maybe you're following up too aggressively?  Maybe your interview skills need work?  

 

Residency for primary care seems like a bad move but you're in a tough spot.  Do you really want to go to CA?  A job is better than nothing but you sound like you want us to convince you to take the CA job when you really are looking for reasons to keep looking in VA.  What about other parts of VA?  Richmond?  

 

When I said "aggressively," I just meant that I do follow up with a thank you letter and phone call within their specified time frame. Nothing unreasonable, IMO. Or maybe that's not aggressive enough. It's all relative. I've done so many interviews that I believe I've gotten good at them. I'm really personable, make a good first impression, appear confident, and always prepare well, so unless I am completely oblivious to something I'm doing or not doing, I don't think my interview skills are to blame. However, do you have any resources or recommendations that would help improve interview skills?

 

Regarding location, I think it's too big of a financial risk to take without even seeing the clinic. I was hoping the letter of offer would be reassuring, but it wasn't. And I think I'd rather just stay in NoVA, but it's hard not to be worried about how much longer it's going to take me to get a job. Thank you for your comment! 

[Guest Paula]

New grads make the mistake of thinking they need to stay in the area where they live.  Expand your horizons and look for a job in Maryland or Pennsylvania or a surrounding state.

 

As others have mentioned, it all comes down to location, pay, specialty.  You are unlikely to get all 3.

 

You will have to sacrifice one or two most likely.  So, get a job that has mentoring and training and after a year or two you will have experience and then be more competitive to get all what you want. 

 

I agree the ob/gyn job expectations were too much for  a new grad and the physician needs training on how to be an appropriate collaborating physician.  

[cbrsmurf]

$96k for a new grad in primary/UC in SoCal is decent... bigger hospital systems might pay more, but for a private/small group that's not bad.  Cost of living is high is most of SoCal, but there's a lot to do and see here.  From a professional standpoint, you don't want to be out of a job for too long or it starts throwing up flags for prospective employers.

[DizzyJ]

The offer letter seems to have a lot of unspecific information.  When you accept a job, you are accepting the terms of an agreement.  The terms are not yet defined by the offer letter.  You can accept this offer verbally and that should prompt them to provide you with a contract that states the specifics.  Then review and decide.  In the mean time never stop looking until you have a signed contract.  I would say that $48/hr is not awful for a new grad.

 

You do not want to be an exempt employee working weekends in addition to your M-F.  If you are paid hourly then you are non-exempt in most cases.  That means you get OT for working over 8 hours per day or 40 hours per week.  If you are salaried for M-F and they want you to work additional hours on weekends then negotiate a higher rate (incentive pay) for doing this.  

[NewGradLyn]

The offer letter seems to have a lot of unspecific information.  When you accept a job, you are accepting the terms of an agreement.  The terms are not yet defined by the offer letter.  You can accept this offer verbally and that should prompt them to provide you with a contract that states the specifics.  Then review and decide.  In the mean time never stop looking until you have a signed contract.  I would say that $48/hr is not awful for a new grad.

 

You do not want to be an exempt employee working weekends in addition to your M-F.  If you are paid hourly then you are non-exempt in most cases.  That means you get OT for working over 8 hours per day or 40 hours per week.  If you are salaried for M-F and they want you to work additional hours on weekends then negotiate a higher rate (incentive pay) for doing this.  

 

Yeah, that's what's scary-- the fact that it's so vague. I think they do consider these terms to be defined. They verbally explained the position and benefits to me and also prompted me to verbally accept the offer before they would give me a letter of offer. So, technically I have already verbally accepted the offer. But I haven't signed anything, so I am not legally bound in any way and can still turn this down. Is that strange that I needed to verbally accept before seeing what would be offered in writing? I've always been able to review a contract or letter of offer before accepting or declining a job.  

 

The "exempt" employee definitely caught my attention, and I need to research that, but it doesn't sound like it's in my favor from what you just said. 

[loliz]

 

...like no mention that I will be guaranteed 40 hours of work per week, 

 

As an exempt employee you are guaranteed 40 hours in every week that you work, even if you do not meet 40 hours on the clock. The down side is that "overtime" is paid at the same rate, no time and a half for exempt status.

[DizzyJ]

The exempt status could all be fine if you had a set schedule.  It can be in your favor or not.  You can be salaried for 32 hours per week for instance.  You might work 30 hours or 35 hours, but you get paid your set salary.  If this is the case then you decide on an hourly amount for extra shifts beyond your salary.  I am non-exempt and work in Cali.  I happen to work 32 hours a week, but if I'm done early and leave I don't get paid.  On the flip side if I stay over my 8 hours I get 1.5 times pay.  In Cali its both over 8 hours per day/40 hours per week.  So, that why non-exempt is to my liking.  

 

At my last job I was exempt.  They gave me a salary for 30 hours per week, but then required you to work 35 hours average per week.  So, this was their way of screwing us......basically haha....in my opinion.  

[ventana]

In this case it might be a good or bad offer

 

You will need to have things spelled out in type in the contract for specifics

 

Ie exact schedule, and # patients a day

PTO is way low - would ask for 5 weeks if lumped together - CME, Vaca, personal, sick

You need EVERY little detail in the contract

 

They pay for all licenses and DEA and controlled sub

They pay $2000 for CME to be spent at your discretion

They pay $10,000 for moving on the first day you are arrive (not some 6 months later

One year contract

No early cancel penalties - explain it is in both your interests to have a successfull relationship

 

 

Might be good (4 day work week and limited OT)

Might be bad - 5 day work week, 30+ patients a day, no comp time for weekends......

[NewGradLyn]

In this case it might be a good or bad offer

 

You will need to have things spelled out in type in the contract for specifics

 

Ie exact schedule, and # patients a day

PTO is way low - would ask for 5 weeks if lumped together - CME, Vaca, personal, sick

You need EVERY little detail in the contract

 

They pay for all licenses and DEA and controlled sub

They pay $2000 for CME to be spent at your discretion

They pay $10,000 for moving on the first day you are arrive (not some 6 months later

One year contract

No early cancel penalties - explain it is in both your interests to have a successfull relationship

 

 

Might be good (4 day work week and limited OT)

Might be bad - 5 day work week, 30+ patients a day, no comp time for weekends......

 

Thanks for your input! This is helpful. I actually asked about CME time off...and they said I'd qualify for CME time off in the second year. I still think that's odd. Wouldn't they want me to go to a conference and increase my knowledge? 

[nds1111]

You should call some of the places where you interviewed and just ask for humble feedback.

 

 

Sent from my iPhone using Tapatalk

[Boatswain2PA]

I've interviewed for a couple urgent cares, but the problem is, it's usually a solo provider situation and, well...well, I'm a new grad. I wouldn't feel comfortable operating completely solo out of the gate. 

That's good thinking.

 

There are thousands of PA jobs out there.  If you're in a saturated area then you will likely need to move.  You don't need to necessarily move all the way across the country.  Just expand your search area.  Look at western VA or PA, or look down to NC.  I always see scores of job opportunities in Florida.  All of these places would likely give you better pay than $48/hr, and be in much, much lower cost of living areas.  

[ventana]

Thanks for your input! This is helpful. I actually asked about CME time off...and they said I'd qualify for CME time off in the second year. I still think that's odd. Wouldn't they want me to go to a conference and increase my knowledge?

 

Very odd response

 

If you hire PA and NP as new grads you realize CME is key

Restricting CME in my mind shows that don't care about providers, just $$$$

 

Still might be a worthwhile offer - just get EVERYTHING in writing

[NewGradLyn]

Hi guys, thank you so much for all the comments/advice/ wisdom. The input really helped me. I talked with them last night, and they weren't willing to negotiate much with me, so I decided that I couldn't justify a cross-country move for this deal and so many "what ifs." I had to listen to my gut. I'm going to keep looking in NoVA/DC/MD.  

[Katera]

$48/hr ($96K/year) in SoCal doesn't get you much.

 

If you're willing to move all the way across country, try looking for some of the areas between you and there.  

 

Are there no urgent care clinics hiring in your area??

 

 

^^^

 

THIS.