zacleejohnson Posted July 3, 2015 Share Posted July 3, 2015 Hi everyone, I’m looking for some advice on a 2 different offers I just received. I am a recent grad and this will be my first position out of school. One is in ortho and the other is in general surgery. The ortho job is part of a private, large and well-established ortho clinic. I would be working mostly with a hand/upper extremity doc with 50/50 split of OR and clinic. I would also cross train with a sports med and a total joint doc the first year or so in order to have a more broad skillset. Hours are pretty normal business hours Monday-Friday depending on cases booked. The general surgery job would be for a local hospital that I’m pretty sure qualifies as underserved and HIS, even though it is in a good sized city. Duties would be mostly inpatient post of care, 3-6 hours of clinic per week, with some potential OR time (though less than ortho as there are residents present). Ortho offer Base salary: $100,000 – I was told an annual raise of $5,000 is pretty normal with a cap on the base salary of $130,000 Bonus: discretionary for the first 2 years, 5% of collections after that, was told that all of the current PAs easily collect 300K+, making a $15K bonus attainable. Profit sharing after first year. Call: $50 to carry pager, $100 per case while on call Vacation: 7 paid holidays, 4 weeks vacation Health insurance: $28/paycheck, looking into the cost of adding my wife Retirement: 401K Roth and traditional available after 1 year. Was told that the docs tend to contribute to this even without an employee contribution in order to max out their own accounts, typically contributing 5-8% of my base (though I admittedly don’t completely understand this). Malpractice, licenses, dues, and cell phone paid for by the group General surgery offer I haven’t yet gotten an official letter from them but the chief surgeon told me he asked HR to extend an offer, so I’ll give all the info I know and fill it in as I get it. Salary: easily 6 figures, and I’ve heard upwards of $130K (though that sounds surprisingly high to me, but maybe I’ll get pleasantly surprised), flat rate with no bonus Retirement: 403b available, not sure of match The hospital does not offer loan repayment, but qualifies for multiple federal loan repayment programs (NHSC, IHS, etc.) that have to be applied for. One of the current PAs receives this now and gets $40k every 2 years. So, while this is not guaranteed it is encouraging as I have significant student loans. Call: none due to residents taking all call. Possible need to cover weekends when residents are transitioning rotations but would get compensated with time off the next week Vacation: accrue 6 hours per pay period, I think starting with 4 weeks Health insurance: medical paid roughly 75% which would be about $200 per month for me and my wife depending on plan chosen. Vision and dental fully covered. Licensing and malpractice covered by the hospital. In all honesty, I feel like I would be happy with either job. The ortho position definitely has more room for growth financially, but is much more specialized and I’m a little nervous about becoming ortho-dumb, even though I’m sure I would be happy in ortho. The general surgery position doesn’t have the same earning potential down the road, but the potential loan repayment is appealing. Also, I would still medically manage patients and not loose all of the medical knowledge I spent the last 2 years for, and the skills learned in general surgery would probably be more transferrable 5-10 years down the road if I ever choose to change jobs. Thank you for reading this long post and for any advice or thoughts. Cheers Link to comment Share on other sites More sharing options...
JMann Posted July 3, 2015 Share Posted July 3, 2015 Seems you gave yourself good advice in your last paragraph. Do you plan to live in your area for some time? If so, the ortho job might be okay then. The money is good on both. Guess you have to decide if you want to practice a broader medicine base via the surgery job or specialize more via the ortho job. Only you can answer that... I do have to say that the surgery job sounds like it might have more of a suck factor due to not getting OR time. Most of the work of surgery is outside of the OR, but getting into the OR seems to be the trade off that makes that work worth it. Link to comment Share on other sites More sharing options...
cinntsp Posted July 3, 2015 Share Posted July 3, 2015 The hospital does not offer loan repayment, but qualifies for multiple federal loan repayment programs (NHSC, IHS, etc.) that have to be applied for. One of the current PAs receives this now and gets $40k every 2 years. So, while this is not guaranteed it is encouraging as I have significant student loans. You really need to do your due diligence to make sure that's true before making any decisions. "Inpatient hospital settings (except CAHs) are not eligible NHSC service sites. Thus, clinicians who are employed in an inpatient setting in a full time capacity are not eligible for an NHSC LRP award. Hospitalists do not qualify for the NHSC LRP unless they can consistently meet the required minimum number of hours per week in an approved outpatient setting, as set forth in the clinical practice requirements below." https://nhsc.hrsa.gov/loanrepayment/lrpapplicationguidance.pdf From what I can tell, the IHS may not have that requirement and is 20k/year. Obviously this has to be at an IHS site. Link to comment Share on other sites More sharing options...
zacleejohnson Posted July 3, 2015 Author Share Posted July 3, 2015 You really need to do your due diligence to make sure that's true before making any decisions. "Inpatient hospital settings (except CAHs) are not eligible NHSC service sites. Thus, clinicians who are employed in an inpatient setting in a full time capacity are not eligible for an NHSC LRP award. Hospitalists do not qualify for the NHSC LRP unless they can consistently meet the required minimum number of hours per week in an approved outpatient setting, as set forth in the clinical practice requirements below." https://nhsc.hrsa.gov/loanrepayment/lrpapplicationguidance.pdf From what I can tell, the IHS may not have that requirement and is 20k/year. Obviously this has to be at an IHS site. Link to comment Share on other sites More sharing options...
zacleejohnson Posted July 3, 2015 Author Share Posted July 3, 2015 Thank you for the responses and for the heads up with the NHSC requirements, I'll definitely look into that. For whatever reason, I was told that the job was considered outpatient though I honestly have no idea how. HR indicated there were 3 or 4 different programs to apply for and the position qualified for some and not others. It is an IHS site. Thanks again! Link to comment Share on other sites More sharing options...
PennPA4 Posted July 4, 2015 Share Posted July 4, 2015 If you don't mind me asking where about ( at least which state) are those positions. It is really good numbers for new grad and specialty in general. Link to comment Share on other sites More sharing options...
zacleejohnson Posted July 4, 2015 Author Share Posted July 4, 2015 I agree,I was pleasantly surprised with the numbers. This is in Alaska. Again, I don't have definite numbers for the general surgery job. Believe it or not, I actually got those numbers from the person who offered me the position for the ortho job, as they have hired other PAs from the hospital. Link to comment Share on other sites More sharing options...
BridgetJameson Posted July 15, 2015 Share Posted July 15, 2015 Hi everyone, I am a new grad and have been offered a position at an orthopedic practice. After verbally accepting the job, they told me that I would be considered as a sole practitioner responsible as the physicians for "overhead and expenses" and while they expect losses in the first 2 years, I will be filing a schedule C tax form. School never mentioned anything like this. Is this common? Any advice would be greatly appreciated. Also before signing any contract = has anyone sought legal aid to look it over and does anyone know of legal aid in Massachusetts for things like this? Because I would be considered sole practitioner within the practice should i also take out personal liability insurance in addition to the malpractice I'm covered under by the hospital? Thanks in advance, Bridget Link to comment Share on other sites More sharing options...
Dynamo24 Posted July 15, 2015 Share Posted July 15, 2015 Hi everyone, I am a new grad and have been offered a position at an orthopedic practice. After verbally accepting the job, they told me that I would be considered as a sole practitioner responsible as the physicians for "overhead and expenses" and while they expect losses in the first 2 years, I will be filing a schedule C tax form. School never mentioned anything like this. Is this common? Any advice would be greatly appreciated. Also before signing any contract = has anyone sought legal aid to look it over and does anyone know of legal aid in Massachusetts for things like this? Because I would be considered sole practitioner within the practice should i also take out personal liability insurance in addition to the malpractice I'm covered under by the hospital? Thanks in advance, Bridget My advice is to not jack someone else's post. Just go ahead and make your own and people will respond to it and you won't have to shift through the responses to the OP. Link to comment Share on other sites More sharing options...
MT2PA Posted August 13, 2015 Share Posted August 13, 2015 NHSC is VERY competitive. Definitely don't consider this when making your decision unless you have already applied and been accepted/offered. Assume you won't get it and then if you do, it's a pleasant surprise. Link to comment Share on other sites More sharing options...
Glorious_Ignoramus Posted August 15, 2015 Share Posted August 15, 2015 From what I understand, the NHSC full scholarship is extremely competitive. The loan repayment program less so. Link to comment Share on other sites More sharing options...
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