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Internal Medicine Practice new grad offer

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Hi guys, I am a new grad and I interviewed at a private practice internal medicine clinic that currently has 3 PA's and 2 MD's I really liked the practice a lot. The environment was everything that I was looking for. I interviewed the first day and they asked me to come back the next day and shadow them and see how we work together. The also asked me how much I wanted to make - which I said 80K. The next day they gave me the job offer letter and here it is:


83K and 2 K relocation

1500 for CME and 5 days off, benefits eligible after 90 days probation. 

7 Day holidays, 3 weeks PTO, Malpractice covered by them (unsure if it is tail?)

Life Insurance - 50K, dental insurance

NO health insurance :(

retirement - simple IRA CFP will match 3%

up to 6 paid lab coats per year license and permit renewal fees paid by employer


There is clinic call 1 - 2 days per week and 1 weekend per month with "days may increase in a coworker is ill, takes vacation time, maternity leave, etc" And it doesn't say anywhere about being paid for that. 


Also there is a agreement I need to sign that says I will see an average of 30 patients a day. 

There's nothing in here about bonuses for productivity but the SP did say "at 6 months you can talk with me again and we can look at the numbers and you can get a raise" which kind of sounded like a productivity bonus but nothing was on paper.


What do you think? I dont like how there's no health insurance, no compensation for call, and no bonus structure in the paper work. However I am a new graduate so i understand they want to see how I do first before they put some sort of bonus structure in place. 



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No health insurance, no call compensation, no bonus structure, low-average salary, are all detractors. Even more than that, 30 patients per week for a new grad is not really feasible, even at 6 months this would probably be difficult. Many experienced outpatient clinicians max out at less than 30 per day. I wouldnt sign anything with that stipulation. Also you may have lowballed yourself saying that you wanted a salary of 80k.

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How are bonus structures normally made? I countered for 85K and to have a bonus structure written in the contract but I'm not sure what I should request? Since they're requesting that i see 30 patients a day is it fair to say that if I see 30 patients a day I will get X amount of money at 6 months? 


Asking for 80k, getting an offer for 83k and then countering for 85k will probably get your resume tossed in the trash.  The first rule of negotiation is to not be the first one to give a number.  If 80k isn't enough for you then you will likely need to keep looking at this point.  

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Those averages are skewed.

Texas pays well. You could get a job at a county hospital system in primary care at $90k+ with good benefits. decent PTO, and CME$ and time off. 


Since you threw out the first number, you are kind of stuck. Use health insurance, PTO to negotiate. And the "days may increase" part of the contract needs to be specified with a monetary amount for compensation. Or keep looking and use this as a lesson learned...

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  • 3 weeks later...

So I ended up taking the position. They increased my offer to 85K and said we could renegotiate the salary and bonus structure after 6 months. They also said the first month would be a lot of shadowing and they would "start me out slow with patients."

I really only wanted to do family medicine/internal medicine for 1 - 2 years any way and then go into something else. One thing though - this offer does not have a contract. And in the offer letter it states they will cover malpractice. Does that mean I can leave whenever and not have to worry about paying tail?

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