ladyinred22 Posted February 28, 2017 Share Posted February 28, 2017 I'm about to graduate in the Spring and I'm having difficulty deciding between a couple possible career paths: 1.) Cardiology: -have a job offer -would be rounding at 2 hospitals close to each other and possibly rehabs as well -did a rotation there and loved it -favorite topic of medicine -ideal location - relatively local -based on speaking to their PA I would start below average in compensation but the growth potential is large there - this is based on the fact that their PA makes >$200k (on call half the weekends in the year but still made about ~$150k before taking call). Furthermore, one of the owners of the practice mentioned that becoming a partner is not out of the realm of possibility. -possible to do procedures down the line: PA there used to do EP studies and pacemaker/AICD battery changes. Also, diagnostic caths a possibility according to the PA -standard benefits package -would have to work 8 weekends a year and 2-3 holidays 2.) ER: -in a position to potentially obtain a job offer -high volume/low acuity ER -heard from a reliable source that there's good mentorship there -ER was always my goal prior to the cardiology rotation. I have 2 years experience as an ER tech at a very busy community hospital and already know I enjoy emergency medicine. -urban setting: twice as long of a drive as the above location -start all PAs at $85/hour BUT no benefits except malpractice insurance Any advice would be much appreciated. Thanks! Link to comment Share on other sites More sharing options...
DizzyJ Posted February 28, 2017 Share Posted February 28, 2017 For no particular reason...I would choose cardio. I went into ER right after school and have spent most of my 10 years in ER/UC. If you can make >$200 and have benefits, that is outstanding. However, if you ever get board with it, you will likely take a pay cut going elsewhere. Link to comment Share on other sites More sharing options...
beattie228 Posted March 1, 2017 Share Posted March 1, 2017 As a new grad, high pay isn't as important as having good mentorship. Additionally, ER and UC jobs are ever-present because there can be quite a bit of turnover for providers who get burned out from shift work. If cards is your interest and the team is as great as painted, I'd jump at that opportunity. You can always find a PRN or Part Time ED gig pending your call schedule once you're established if it's still something of interest to you. Link to comment Share on other sites More sharing options...
ladyinred22 Posted March 1, 2017 Author Share Posted March 1, 2017 OK, great. Thank you for your feedback! Link to comment Share on other sites More sharing options...
south Posted March 3, 2017 Share Posted March 3, 2017 Wow, we're like the same guy, er, person. Vote goes to the Cards job. Couple years in, you can pull some PRN at UC or ED shifts to get your foot in the door and go from there. All chest pain workups go to you! Link to comment Share on other sites More sharing options...
ladyinred22 Posted March 6, 2017 Author Share Posted March 6, 2017 Wow, we're like the same guy, er, person. Vote goes to the Cards job. Couple years in, you can pull some PRN at UC or ED shifts to get your foot in the door and go from there. All chest pain workups go to you! Would it be easy to obtain a PRN ED/UC job with experience only in Cards? Link to comment Share on other sites More sharing options...
south Posted March 6, 2017 Share Posted March 6, 2017 I don't know about easy, but I hear of people doing it - and technically Cards is Internal Medicine, so...easier than new grad, I think. Just a guess on my part but maybe someone chime in. Link to comment Share on other sites More sharing options...
ladyinred22 Posted March 9, 2017 Author Share Posted March 9, 2017 Right, makes sense. Thanks for your input! Link to comment Share on other sites More sharing options...
ladyinred22 Posted April 4, 2017 Author Share Posted April 4, 2017 Hi, just a little update plus more request for advice: So I decided to sign on with the Cards practice. Through verbal agreement via phone call I was able to negotiate a 95k starting salary + q6 weekend coverage. They said that they would send me the contract in a week or so. After not hearing them for two weeks I reached out to them and they said things have changed. They started thinking that 95k was too high - plus they have another "candidate" that is willing to start at 85k BUT if I was willing to accept 85k the job is 90% mine. Now it's speculation but I'm fairly certain that this "candidate" is my classmate who was rotating with them at the time. I talked to this classmate (we're all very close so I trust him) and he said that on his last day he had a brief conversation where they asked if he was interested in a position there and it starts at 85k. He said he didn't want it if it he would be competing with me and they said that's not the case - they would likely create another position. However, when they spoke to me they never made any mention of another position and instead implied that this "candidate" was undercutting me by 10k. I've put off giving them an answer for a week and half now because I've diversifying my eggs after quickly realizing I had them all in one basket so I've been aggressively applying and looking into multiple ER positions (my initial goal). I'm even going to send my CV to their direct competitors (another major cards practice in the area) to see if there's any opportunity there. My question is: Should their side games and backtracking on an initial offer be a complete deal breaker? For the last week and a half I was committed to writing them off out of principle/mistrust. Or should I swallow my pride and understand this is a business after all and this is common business practice. P.S. - I'm currently in talks to be considered for the 85/hour position from my original post. With refreshing transparency the director of that ER said all his spots are filled at the moment but one hasn't gotten back to him so he'll let me know if something's available in the next week. Plus he's very highly regarded by one of my former preceptors. Link to comment Share on other sites More sharing options...
Guest HanSolo Posted April 4, 2017 Share Posted April 4, 2017 They agreed to one thing then quickly changed their mind. I would consider that a red flag. Who knows what else they might freely change their mind on down the road. My advice: keep looking unless you absolutely love this position. Their loss. Link to comment Share on other sites More sharing options...
greenmood Posted April 4, 2017 Share Posted April 4, 2017 Tell them you were in agreement with the original offer, and that if they are not able to honor the details of that offer you will respectfully and regretfully decline. Wish them luck with their search for the right candidate. If they're playing games that will end it right quick. If they are serious, then maybe it's not a good match after all. Keep hunting. Link to comment Share on other sites More sharing options...
cbrsmurf Posted April 4, 2017 Share Posted April 4, 2017 Big red flag. If they treat you that way in the beginning, they will treat you that way or worse why you are working for them. IMO, it's better for new grads should start their careers in general medicine (ie family practice, hospitalist, ED etc) to provide a good clinical foundation, then subspecialize if that's what you want. Link to comment Share on other sites More sharing options...
mgriffiths Posted April 4, 2017 Share Posted April 4, 2017 I turned down what may have been a great job in ortho due to a sort of similar situation. Thankfully was able to find another that I think is even a better fit, even though I probably make slightly less money. I would do exactly what greenmood stated. Tell them that you are in agreement with the initial agreed upon offer. If they want to decrease the salary, then they need to decrease the amount that you are on-call or similar. But, overall I would be very wary. It could work out great, but this is definitely a red flag to not ignore. Link to comment Share on other sites More sharing options...
WeBuyAndSellJunk Posted April 4, 2017 Share Posted April 4, 2017 This sounds like the first of very many similar situations you would likely encounter by accepting the cardiology position. It may be business, but you can choose if you want to work for someone who is a bit more morally and ethically sound or not. Link to comment Share on other sites More sharing options...
BruceBanner Posted April 4, 2017 Share Posted April 4, 2017 Anyone who rescinds an offer for a lower offer should never be your employer. End of story. Link to comment Share on other sites More sharing options...
sas5814 Posted April 4, 2017 Share Posted April 4, 2017 First you have to identify what about any job is most important to you. Money? Benefits? Hours? Mentorship? Once you have sorted out your priorities clearly make a 2 column list and rank each job based on what you have decided is most important to you. Weigh them...and choose. Link to comment Share on other sites More sharing options...
ladyinred22 Posted April 5, 2017 Author Share Posted April 5, 2017 Everyone seems to have echoed my own thoughts/intuition on the matter - that their behavior is a big ol' red flag. Thank you all for the feedback! Link to comment Share on other sites More sharing options...
sas5814 Posted April 5, 2017 Share Posted April 5, 2017 Hi, just a little update plus more request for advice: So I decided to sign on with the Cards practice. Through verbal agreement via phone call I was able to negotiate a 95k starting salary + q6 weekend coverage. They said that they would send me the contract in a week or so. After not hearing them for two weeks I reached out to them and they said things have changed. They started thinking that 95k was too high - plus they have another "candidate" that is willing to start at 85k BUT if I was willing to accept 85k the job is 90% mine. Now it's speculation but I'm fairly certain that this "candidate" is my classmate who was rotating with them at the time. I talked to this classmate (we're all very close so I trust him) and he said that on his last day he had a brief conversation where they asked if he was interested in a position there and it starts at 85k. He said he didn't want it if it he would be competing with me and they said that's not the case - they would likely create another position. However, when they spoke to me they never made any mention of another position and instead implied that this "candidate" was undercutting me by 10k. I've put off giving them an answer for a week and half now because I've diversifying my eggs after quickly realizing I had them all in one basket so I've been aggressively applying and looking into multiple ER positions (my initial goal). I'm even going to send my CV to their direct competitors (another major cards practice in the area) to see if there's any opportunity there. My question is: Should their side games and backtracking on an initial offer be a complete deal breaker? For the last week and a half I was committed to writing them off out of principle/mistrust. Or should I swallow my pride and understand this is a business after all and this is common business practice. P.S. - I'm currently in talks to be considered for the 85/hour position from my original post. With refreshing transparency the director of that ER said all his spots are filled at the moment but one hasn't gotten back to him so he'll let me know if something's available in the next week. Plus he's very highly regarded by one of my former preceptors. run. you just got a live lesson in how they treat people. Link to comment Share on other sites More sharing options...
south Posted April 6, 2017 Share Posted April 6, 2017 ^^^ agreed. Run. Ain't nobody got time for that. Working for them would be "we just started thinking" about your vacation that was approved for next week or "just started thinking" that you aren't pulling enough call. Well, I "just started thinking" that it would be a crappy place to work. Link to comment Share on other sites More sharing options...
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