I was just offered a job as a new grad in psych at a private practice outpatient clinic in the Houston, Tx area. My hours would be 9-6 or (10-6 with no lunch break) Tuesday - Friday and a possible Saturday shift from 9-1 which I am clarifying now as to if this is set in stone or not since it was unclear. They told me I would be shadowing the first two weeks and then after that I will slowly see my own patients while consulting with the doc after each patient. They currently have one NP who they hired as a new grad and trained.
Salary: I told them I was looking for 100k since that is the average for a new grad in Texas and they offered me this breakdown: 92k for years 1-2, 102k for years 3-4, and 113k for years 5-6. Then, a bonus set up like this: starting at 6 months, a quarterly bonus at 65% patient occupancy is a 1k bonus quarterly, at 75% patient occupancy a 1750 bonus quarterly and at 90% occupancy and greater a 3k bonus quarterly. The bonus seems okay but I have no idea how to gauge this since idk if I will even be hitting these numbers as a new grad. They told me the NP currently sees follow ups in 15 min slots or 4 an hour with a break after to chart and that new pt visits are 1 hour. They told me my follow ups would be set for 30 minutes instead of 15 since I am new.
PTO: 7 days first year (this seems very low to me and was also not broken down into CME or sick days so now I have no idea if I even get CME days so that will be in my email back with questions)
Malpractice coverage and 401k with 5% match effective after first year. It was also unclear if the 401k is not effective at ALL until the first year or if just the matching so I will be asking this as well. Need to ask if this includes tail coverage?
Overall, I am happy to have a job offer but wondering if this is a good one. I would like to counter with a base salary of 96-97 possibly since a 1k bonus for three quarters in my first year would put me at the average new grad salary in Texas of 100k. Does this seem unreasonable? I also really don't like how the salary is already structured for the next 6 years and how I do not get a yearly raise to match inflation even. Is this common? What do you all think I should include in my counter? Overall, is this a good offer and would you take it as a new grad? Is it a bad idea for me to counter? Please help!! Thank you!
Edit to add: they do not offer health insurance if this makes a difference. Thank you!
Please help me make a complete list of Pros and Cons of being a PA vs Physician.
Shorter School Less expensive Work Life Balance Lateral movement in career Doctor:
Greater Pay More Autonomy Cons__________________________________
Lower Pay Less Autonomy Doctor:
Longer Training (residency) Limited to one medical specialty
So I am applying for this cycle and I previously entered my job in experiences as current. after submitting the application I had to quit this job because it was a terrible work environment. However, it is in CASPA as current so idk what to do. I also got a new job but it doesn't start for another week and I was going to submit my apps this weekend so i am not sure how to go about this. Also is it better to apply sooner with less PCE or later with more PCE???
Should I go back to Medical school AFTER becoming a PA?
Specialties interested in: Internal or Emergency Medicine
Here are my personal thoughts:
I don't like to disparage my profession, but the way we learned medicine was through memorization of algorithms and buzz words. We were not taught the basics of science from a molecular level working upwards. We basically skipped step 1 and went straight into step 2 clinical knowledge. Doctors can see and understand things we cannot. And make connections that we cannot. I think this is what I am craving for. To be that kind of an “expert.” To understand medicine at that level and solve complex cases. I think the funny stereotypical word for this is “mental masturbation” or “intellectually stimulating” haha. I have the personality type of being the best in whatever I do. I feel limited in that sense as a PA.
Financially, I would say I am kind of lucky. I wouldn’t normally tell this to people, but just to give you guys an idea of my situation. I actually don’t have any loans or interests at the moment after PA school. I paid out of pocket. But I was given some personal loans from close families and friends. I do have to pay them back eventually, but there is no time limit. And they would understand if I decide to pursue medical school. I would still have to take the MCAT, apply, do interviews, and then start the following year (this could take 2-3 years; here I could work as a full time PA and save money for medical school). The medical schools in my state are $100k for 4 years. Which is not bad compared to the crazy $200-400k type of other medical schools.
For family life, wouldn’t it still be possible to have? Instead of working 8 hours a day, I would be studying or going to lectures. And then spend time with my family. Especially since I am not a typical pre-med student. I will be entering with a stronger background knowledge from PA school. However I do understand that the residency years will take a huge toll on my work/life balance for 3 years. (My mom or future wife would still have an income during the 4 years of medical school).
But at the end of it all, won’t I truly be knowledgeable in a field of medicine, from basics to advanced. With the reward of earning a higher income and becoming a doctor (not what I’m going for, but still a benefit). I will be done around age 35 and can work 30 more years until 65. Won’t the money gain as a doctor in that time cover any expenses I had? And then be able to teach the next generation as well, confidently. I have a desire to teach as a professor at PA or MD/DO programs. And precept as well.
This is my current thought process, BUT if you guys think that I am delusional or crazy, please call me out on it! Give me reasons why staying as a PA from age 26 will be better for my life in the long-run. And to not make the mistake of going to medical school for 7 years, with unnecessary stress. I want to hear both sides and arguments really well.
How different is the autonomy in internal or emergency medicine between PA and MD/DO? Can I learn step 1 on my own while working as a PA, and be just as knowledgeable and happy? Or is the in-depth training of medical schools and residencies unmatched? And no amount of clinical experience as a PA can ever replace that? (I have my own thoughts of course since I have done clinical rotations, I just want to hear from what you guys think).
***Here are some more of my thoughts that I just private messaged someone:***
Thank you so much for replying, I really need guidance in my life. I am confused and don't know WHAT path is actually WORTH taking.
I love medicine. I have grown super passionate about it. I also love academia. I watch a lot of medical school vlogs and wish I went through the rigorous schooling like they did. PA school felt like a joke to me. It was mainly memorizing buzz words, without understanding the "why's".
Now, I know I can learn the why's using third party resources on my own - like sketchymedical, boards and beyond, pathoma, premade anki decks, etc. However, if I am going to do that, why not do it through medical school and get rewarded with prestige, money, and autonomy?
But that does come with its cons - such as a losing lost income as a PA, family time, and basically life. For 7 years.
I am interested in Internal medicine (hospitalist) or Emergency Medicine. What I want to really know is if there is a huge difference in autonomy, day-to-day job/tasks, etc. Because if it's 90% of the same job, then I am not sure if 7 years of medical school is worth it for me. I know people recommend PA to MD if you want to go into either surgery or a specialization of some sort.
Basically, is 7 years of medical school worth it for me (I am single and 26 years old; I only need the MCAT to most likely get into this DO program in my home city; this way I can be with family and friends and not miss out on life events). It seems like a fun journey to me, something that I would look forward to.
But there is this other easier, more convenient, and relaxing path - which is to remain as a PA and practice medicine. Earning a six figure salary. Living life. And also studying step 1 material with the resources I mentioned earlier.
*sigh* Do you see my dilemma here. Like what is the right path for me - in terms of happiness, life, money, etc.
If I were to redo my years of schooling, I would 100% choose medical school. But because I finished PA school and am interested in specialties that might not be that different as a doctor, is it worth it? Because I do realize I will have to go through numerous standardized examinations - MCAT, Step 1, Step 2 CK, Step 3 CS, and residency boards. Also the stress of interviews, applications (both initial and for residency), research papers, etc.
Or will I always regret not going back for medical school?