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Hi all. Got offered an FP (with occasional urgent care coverage in another office) job in the anchorage area which is kind of me and my wife's dream living spot.  The practice seems very nice and I really like the SP.  She has worked with new grads before. 


Want to see if you all had any thoughts.


4 days a week, 10 hour days weekdays only unless I cover in the UC office.  Providers see 16-20 pts in a 10 hour day, but I will not be expected to do that initially.


40$ per hour (83,200 year). There are overtime opportunities when covering. Call is 1x a week only monday-thursday (weekend call covered elsewhere) and there is no hospital coverage.  There are generally very few if any calls.  This pay is about right for the area with a new grad in FM.


70% healthcare coverage, no spousal coverage.  They are switching coverage atm, so detail are pending about the plan. I don't expect it to be great, as the previous plan was not great.


3 weeks PTO, 6 Paid holidays, 1 paid personal day, 48 hours paid sick leave.


3000$ CME and 50 hours of paid time off for CME


Malpractice and Tail coverage 100% covered


All licencing (DEA, state, bls) and state org (AKAPA) covered.


401k after 1 year.  Matching is variable based on practice income.  I don't hold my breath on much from this.


Contract is for 2 years.


I countered the offer by asking 42$ (87ish a year) an hour after the first 3 months, and a 3k sign on/moving expense bonus.  The biggest bummer is the crummy health insurance, but it is a small privately owned practice so I am not really surprised and I am sure it is not negotiable.


The hardest thing about this is that I have an offer for an ED in OR that is is 50 an hour (104k) with about 16k in guaranteed bonuses, great insurance and 401k, no nights,  and the opportunity to do advanced ED procedures. Cost of living is also a good bit lower. The problem is that it is not anywhere near as an exciting location! It will also be challenging for my wife to find work in this semi-rural area.


As it stands, I think I am going to take the job in AK, as it seems like the opportunity of a lifetime to go live up there, and it has been a dream for both of us.  I could also see being very happy doing FM and UC, but won't know until I do it I think.


That said, it is so hard to turn down a chance to start out in EM (while making an extra 35k)! At the moment I figure if we hate AK or I am bored/dislike with FP/UC we can move back the lower 48 and I can move into EM. There is one ED that uses PAs in anchorage, so it is possible that I could work in the ED there eventually, if FM ends up not being my home forever.


Dunno. I know no one can do our calculus for us, but I would be interested in hearing opinions.

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If it was me, I'd take the Oregon position although you didn't say much about it.  I think your heart is saying AK but your brain is saying OR (purely assumption on my part).  OR is only 3.5hrs by plane to Anchorage.  You can always visit and I'm sure you'll be able to afford it with the higher wage and bonus you'll be getting :).  Hey, you can be a snow bird! Worse thing that could happen, you dislike OR and you'll eventually move to AK but the experience and the wage makes up for it IMO (just flip side of what you said ;).  Also consider the cost-of-living which is of course is higher in AK.  

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Guest Paula

I say take the OR job too.  Get the experience with learning procedures in the ER and then after two years or so move to AK.  By then you will have the EM experience and could get hired for a much higher wage in AK.  The AK salary seems awfully low.  Are you a new grad?


But then, the best advice is to listen to your wife.  Happy wife, happy life. 

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I am a new grad.   According to AAPA salary report (which was based on a very small sample for AK) for less than 4 years in primary care bottom 25% is around 80, middle 50% is 89.   Since this sample is of people of up to 4 years experience, I figure 83 is an "OK" starting point and 87 would be good.


The biggest negative for OR may be that my wife may be unable to find work.  My income will make up for it, partially... but it might kill her career and we would not be bringing in the 70-90k a year she makes. If it was just my career to think about, it would be a no brainer.  

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Doc got back to me 3k moving expenses and raise guaranteed raise to 42.50 at 6 months. Decided to take the AK job, as it is going to give my wife a much better chance to stay employed and not torpedo her career.   Also, I am giddy excited about moving to AK.  


Thanks for the thoughts all.

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Anchorage is great



HAving said that there is no way I would go there (lived there for 4 years in the USAF) at under 100k in the salary and full health insurance


It is not all that cheap to live there - but well worth it





first job the big issues is mentoring and teaching - your offer is a low ball offer and I think the doc is aware that they still want to make money off you

I would recommend on written contract with step raises for the two years


ie 6 months go to 90k, 12 months to 95k, 24 months to 105k


The health insurance sucks - expect to pay about $300/month for family coverage.... maybe your wife can work for the hospital and get better bennies



The PTO is lame- 5 weeks and 2 days total PTO is crap


should be something like this


4 weeks vacation

1 week personal/sick

1 week CME

2 weeks (ten days) Holiday


that all adds up to 8 weeks and she is at a little over 50% of this...... you will work hard and need time off.... and in ANC you want time off as there is a ton-o-stuff to do!!!!!!!!!!!!!!!!!!!



come up with a reasonable counter - sell yourself and that you are excited and that it is your first choice, but that the financial package needs to be better




Last time I looked the COLA for Anchorage was something like 24%.......  this is old data..... but the point is it is and EXPENSIVE place to live.... and the salary should be higher

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Currently as it written I will be at 88,500 at 6 months (so close to 90, and I will make 90 with my starting bonus in the first year.)  I will have to negotiate at 12 months and 2 years.


You have the PTO wrong though because I am on 4 day 10 hour work week.  I get 7.2 weeks of PTO by 8 hour day standards.   120 hours vacation, 48 hours sick, 50 hours CME, 10 hours personal, 60 hours of holidays. This is equivalent to 36 eight hour days, or 7.2 weeks.    Not to mention 3 day weekends almost every week (52 extra full play days).  I should have plenty of time to play!


My wife is a healthcare admin and has a couple of good prospects atm, and is likely to get good bennies. We should be in the 160-180K income range as long as she finds a job.  Even without, we always set our bills to one person's income and have already done the budgeting (and had AK locals look over it to see if our budget is reasonable) The other's income is all savings and fun. 


Thanks for the thoughts ventana.

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