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ER "Letter of Intent" Offer (new grad)

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I should start off by saying that I have read every post titled "new grad ER offer" but nothing sounds similar to my offer. I was extended this offer on Saturday, and I have already tried renegotiating. He did not budge.

The job is 3 hours away to my house now. The cost of living in this new area is much more costly than where I am living now.


Here is the offer:

Hourly rate $50/hour with raise expected in 2 months to $55/hour

o Sign on bonus of $5,000 for 3 year commitment($2500 with return of LOI and $2500 upon first shift)- prorated pay back if early departure - in the job ad, it listed sign on bonus and relocation allowance separately. When I asked him about this, he said that this sign on bonus included my relocation allowance? I am a friends with the PA that worked here just this past year (she worked here for 6 years) and she got both. She loved this job, but told me to not accept unless he offered both to me.

o Independent Contractor status- must create a corporation and be paid via direct deposit (this will require me paying for someone (attorney) to create for me, $500-$1000

o Paid malpractice including tail

o 2 months of intensive ED training (paid), during which you will be expected to attend the ____ resident lectures every Thursday (not paid).-since the drive to these lectures would be 120 miles away (there and back), I requested gas compensation. He said no, and that he thought I would be happy to go to these lectures unpaid, because I would be hanging out with "doctors and residents."

o Required: self-study in Emergency Medicine with monthly evaluations to assess progress. Will also complete the EM boot camp curriculum prior to start in ED (material provided).

o Minimum of 14 shifts per month (between 10-12 hours each depending on season) for first 2 months and then a minimum of 12 shifts thereafter

o 3 year contract with perpetual renewal, one hundred and twenty day notice for change in status.- On the phone interview, he said 2-3 years, at the in-person interview, he said a minimum of 2 years. When I asked for this be be changed to two years, he said no. That he would be investing $15k into training me, and it would only be worth to him to have me on 3 years.

o Shared bonus compensation quarterly that is based on our Patient Satisfaction, Left Without Medical Screening, Core Measure bonuses- when obtained from the hospital - have no idea what "core measure bonus" is?

o Will begin work as soon as credentialing is complete – expected January 2016.


He said once I sign, he would send over the contract, so not really sure what this letter of intent really means then anyway? Let me know your thoughts. I have until this Saturday to give him a definitive answer.


Other possible red/odd flags I noticed:

- during the phone interview, he asked if I had children and if was married. He quickly said, I know it's illegal to ask, but... Being that I'm married and without children, I answered him anyway. He seemed

pleased because the area this job is in, is mainly for the elderly and the wealthy (aka: no fun dating life for singles here). He also requested that I bring my husband to the in person interview. I thought that was odd? Anyone ever heard of that?

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I forgot to mention that his wife does something within this company. Every post on here says to never work with spouses. The only thing different here, is that I knew the PA that worked here for 6 years. She recently left (her own words to me) was because she was a single mom, and wanted to date (this city is for retirees with money). I met her coincidently during my ER rotation at another ER before i even interviewed here. She had nothing negative to say about her 6 years here. Except that I should not accept unless he gave me what his job ad advertised- which was a sign on bonus and a relocation allowance (cost of living is high there!) so my question is, is it still a bad sign that his wife and him work together?

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lol, he thought you'd be happy to attend resident lectures unpaid...uh, no.  Asking you to bring your husband to the interview is very strange and the fact that he flat out asked you illegal questions while mentioning that he knows they're illegal should tell you that there will be no respect for work-life balance.  $55/hr as 1099 is crappy and there are too many red flags.  I would pass on the offer.

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The 3 year contract and the contractor status are the killers here.  Your tax burden as a contractor is going to make your pay seem much lower than it is...especially in an area that you say is expensive.


I know your pain, you want to get the specialty that you want...but this might not be the way to get it.

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Thanks so much for all your help. Today is the day I am to let him know my decision (which was going to be no), but before I sent it, he emailed me. He changed the long drive to the unpaid lectures every Thursday and he changed the contract from 3 years to 2.5 years. The only thing I am still holding out for is the relocation allowance, as promised in the job ad.


I have taken all your comments into consideration, and I really was going to turn it down! If he doesn't add on the relocation allowance, i think it will be a "no-go," though


His email this morning:

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  • Moderator

New grad friend of mine is currently pulling $78/hr as a 1099 in an ED. 


You'll really be selling yourself and the profession short here if you take that kind of pay.

THAT'S AWESOME!. my per deim jobs pay 65, 70, and 80/hr....with 29 yrs of experience, 20 of it as an em pa.

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Thanks for everyone's input! I don't think I will be taking this job, after reading all of your comments. I was extended another offer from an urgent care just this week.

-$65/hour, 12 shifts per month 13.5 hour shifts (guaranteed $126,360 annually)- interviewer (owner) and recruiter both told me that I would only have to do 10 shifts. Is this a big deal?

-health and dental insurance 50% covered

-no sign on bonus, no reimbursement for DEA etc, no CME

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