New Grad ER Position

[JMZPAC]

Hey guys, I will be graduating in about two weeks and could not be more excited to start my PA career!

I was wondering if I could get your guys' input on an ED offer I just received:

-30 min outside a major Midwestern city.

-Starting base salary of $54/hour, with $5/hr increase after 1 year. Important to note I'll be starting half salary ($27/hr) for first 4 weeks of "training/shadowing"

-Yearly bonus (Unspecified amount)

-Minimum 14 10-hour shifts per month (Comes out to $90,720 min.), with opportunity to pick up extra shifts

-No OT or PTO, but scheduling is flexible with the ability to stack shifts

-3% retirement

-Malpractice/health/dental included

-$1500 CME yearly

-When I visited for on-site interview, learning atmosphere seemed amazing. All docs and staff very supportive. New renovated ED. Level II trauma center where they give PAs the option to see whatever they are most comfortable with, even to the point of running trauma codes. 

 

I have found out very hard to find hospital systems that will take in new grads, and rightfully so. As someone who can't see himself in any other field besides EM, I put a lot of weight into working at a place that will let me flourish and reach my full potential. What do you think?

 

[PACJD]

Not bad an offer, but sucks there's no PTO or OT. If it's a good learning environment, definitely go for it. After one year you'll be making $59 an hour which is solid. I would work a couple extra shifts to break 100k a yr though 

[EMEDPA]

no PTO sucks and 1500 cme is low.

[PAtoB]

no PTO and training wage screams run from offer in my strong opinion.

[wookie]

Seems decent if you consider this is your best offer so far in emergency medicine.

Do you know whether it will actually be a good learning environment from someone who works there or was that just your impression? I'd gladly take less pay for a good learning environment.

Regarding PTO, I've read a ton of threads that said no PTO is a deal breaker. In my recent (new grad) job search, I got the impression that PTO is not as common as this forum led me to believe.

I'm not fond of the training pay though. I'd really try to negotiate that down to 0 or 1 weeks.

[SoCal_PA]

Maybe it has to do with location but sounds like a subpar offer. 

As a new grad in emergency med this was my offer:

Employee status at $64/hr

13-15 x10 hr shifts/month

4 weeks PTO

3% bonus end of year

7% 401k match

Health, vision, dental covered

[PACJD]

1 hour ago, SoCal_PA said:

Maybe it has to do with location but sounds like a subpar offer. 

As a new grad in emergency med this was my offer:

Employee status at $64/hr

13-15 x10 hr shifts/month

4 weeks PTO

3% bonus end of year

7% 401k match

Health, vision, dental covered

Now this is a good offer!

[PAtoB]

6 hours ago, wookie said:

Seems decent if you consider this is your best offer so far in emergency medicine.

Do you know whether it will actually be a good learning environment from someone who works there or was that just your impression? I'd gladly take less pay for a good learning environment.

Regarding PTO, I've read a ton of threads that said no PTO is a deal breaker. In my recent (new grad) job search, I got the impression that PTO is not as common as this forum led me to believe.

I'm not fond of the training pay though. I'd really try to negotiate that down to 0 or 1 weeks.

pto is common. we are professionals.

[wookie]

1 hour ago, PAtoB said:

pto is common. we are professionals.

What does being professionals have to do with anything? Maybe CMGs and hospitals offering PTO is standard in your region and maybe it's not where he is. Where I'm from, it's standard for surgical positions (your specialty) to offer plenty of PTO, but it's not common in emergency med (OP's and my specialty).

For all we know, if he declines this offer, there is another new grad hungry for that position. He expressed that he lives in an area that is tough on new grads for emergency med. It's irresponsible to plant a blanket statement in someone's mine that "pto is common" when you don't share the same background.

I'm all for furthering the profession by negotiating as much as we can as I did when I was going through the process.

Aren't you a new grad, as well? It's probably too early as a new grad (you, me, and OP) to feel so entitled from the get-go. I'd take good learning environments above all else.

[dphy83]

I think that this seems like a decent offer. With typical Midwest cost of living you should be quite comfortable. The CME is on the lower end but I have seen lower. Ask if they provide ACLS, PALS, and ATLS (they should if it's a level II). If so then 1500 CME isnt so bad and can get you (most of) one good conference per year which is really all you need. Agreed the 1/2 salary for a full month is stinky (which actually lowers your above anticipated salary by about 3 grand). I think 2 weeks of that salary is fair-ish. Maybe meet them somewhat in the middle and offer to work 9 or so shifts at that rate for 2 weeks? Or just let it go and suck it up for a month. Either way I think it's a decent offer. Nice work.

[JMPAC]

I think it sounds like a pretty good offer and worth it to be able to work in EM as a new grad. I also started out in EM for my first job and didn't get PTO but I've loved my job and the experience has been priceless. When I was first applying, a lot of places wouldn't even consider interviewing a new grad for emergency med and just replied to my application with "sorry, we don't hire new grads". Even if it's not the most perfect offer, it would be worth it to get your experience in. You can always negotiate things in a year or move on to better offers once you have a few years of experience. I also get $1500 for CME and that's a number I've heard from a few of my friends in different specialties, as well. I get all of my licensing and hospital credentialing covered outside of that, so it's been more than enough for me. The hourly is quite a bit less than what I get, but I'm not sure what's standard for the area you're in or what the cost of living is. I say, go get your EM experience, learn as much as you can and reassess in a couple years. 

[cg02186]

I'm in Ortho and have 4 weeks PTO but I had two ER offers coming out and spoke with preceptors at my ER rotation.  None of those three ED positions had PTO.  Maybe it's regional but I've never seen an ER position with PTO.  I mean your required to work twelve 12 hour shifts at a lot of places and that leaves you  18 days a month off.  If you work the minimum 12 shifts a month that's 144 a year, meaning your off 221 days a year...you literally are off more than you are on so I don't think no PTO for ER is necessarily a deal breaker if everything else is good.

[tunafish]

On July 30, 2017 at 0:40 PM, cg02186 said:

I'm in Ortho and have 4 weeks PTO but I had two ER offers coming out and spoke with preceptors at my ER rotation.  None of those three ED positions had PTO.  Maybe it's regional but I've never seen an ER position with PTO.  I mean your required to work twelve 12 hour shifts at a lot of places and that leaves you  18 days a month off.  If you work the minimum 12 shifts a month that's 144 a year, meaning your off 221 days a year...you literally are off more than you are on so I don't think no PTO for ER is necessarily a deal breaker if everything else is good.

yes and no. you are working less shifts but you are working 12s... this is a day and and a half of regular work, plus nights. there are plenty of places with no pto but no pro should be compensated by higher hourly rate

[anewconvert]

On 7/30/2017 at 0:40 PM, cg02186 said:

I'm in Ortho and have 4 weeks PTO but I had two ER offers coming out and spoke with preceptors at my ER rotation.  None of those three ED positions had PTO.  Maybe it's regional but I've never seen an ER position with PTO.  I mean your required to work twelve 12 hour shifts at a lot of places and that leaves you  18 days a month off.  If you work the minimum 12 shifts a month that's 144 a year, meaning your off 221 days a year...you literally are off more than you are on so I don't think no PTO for ER is necessarily a deal breaker if everything else is good.

My hospitalist job is 3 12's/ week (14 shifts/month) and I get 35 days/yr PTO plus 5 for CME. 

 

You shouldnt have to kill yourself on the front and back of the month to take a vacation in the middle. 

[beattie228]

15 minutes ago, anewconvert said:

My hospitalist job is 3 12's/ week (14 shifts/month) and I get 35 days/yr PTO plus 5 for CME. 

 

You shouldnt have to kill yourself on the front and back of the month to take a vacation in the middle. 

Agree with this completely. Not offering PTO simply because you work fewer days a week (for longer shifts) isn't an offer I would take.

 

I work 3 12's/week (12-16/month depending on if I pick up extra shifts for 1.5X pay) and I get 5 weeks PTO (not including sick time) plus 5 days for CME. To each their own, I suppose, but I enjoy my vacations that much more knowing I'm getting paid to sip a fruity drink on a beach somewhere to recharge my batteries.

[PAtoB]

On 7/27/2017 at 2:11 AM, wookie said:

What does being professionals have to do with anything? Maybe CMGs and hospitals offering PTO is standard in your region and maybe it's not where he is. Where I'm from, it's standard for surgical positions (your specialty) to offer plenty of PTO, but it's not common in emergency med (OP's and my specialty).

For all we know, if he declines this offer, there is another new grad hungry for that position. He expressed that he lives in an area that is tough on new grads for emergency med. It's irresponsible to plant a blanket statement in someone's mine that "pto is common" when you don't share the same background.

I'm all for furthering the profession by negotiating as much as we can as I did when I was going through the process.

Aren't you a new grad, as well? It's probably too early as a new grad (you, me, and OP) to feel so entitled from the get-go. I'd take good learning environments above all else.

As someone with 28 years of work experience before my first PA job, I stand by my PTO comment AND my training wage comment within the PA industry.

Those type of offers exist because there is a history of 'green' PAs accepting them. Two classmates didn't even know what PTO meant when they heard others talking about it in the classroom.

The ED where I spent 3 months as a student starts NEW employees there at 4.8 weeks of PTO, with 12-13 scheduled work shifts per month; my classmates in other surrounding EDs get anywhere from 3-4.5 weeks PTO.

I mean, if you're being offered $101,100 salary to work 13 monthly shifts but there's no PTO and you want to take 7 full days off for a vaycay, or even bridge for 10 straight days off, you're salary is not $101,100 if you decide not to front or backload your schedule into an insane 5-7 straight 12-hour-shifts work stint - it's more like nearly $2K less salary. And another $1,900ish less than that for each additional week you take off. Just saying, to each their own.

[EMEDPA]

agree with above. unless you get a ridiculous hourly rate like 90-100/hr you need a benefits package and pto.

if someone wants to pay me 100/hr I will subsidize my own benefits/licenses , etc

[wookie]

On 8/6/2017 at 3:16 PM, PAtoB said:

The ED where I spent 3 months as a student starts NEW employees there at 4.8 weeks of PTO, with 12-13 scheduled work shifts per month; my classmates in other surrounding EDs get anywhere from 3-4.5 weeks PTO.

I mean, if you're being offered $101,100 salary to work 13 monthly shifts but there's no PTO and you want to take 7 full days off for a vaycay, or even bridge for 10 straight days off, you're salary is not $101,100 if you decide not to front or backload your schedule into an insane 5-7 straight 12-hour-shifts work stint - it's more like nearly $2K less salary. And another $1,900ish less than that for each additional week you take off. Just saying, to each their own.

I completely agree with your logic of what a salary is actually worth with and without PTO. My point was simply that different areas of the country have certain trends of what is typically offered. Your example of EDs providing PTO is specific to your location, thus anecdotal and not applicable to everywhere in the country. Although OP's job doesn't offer PTO, I wouldn't necessarily advise that he "run from offer". Unless ED PA's throughout the country agree to strike over lack of PTO, this is not likely to change anytime soon. Some people still need jobs, income, experience, etc. If he works there 1 year and moves on, that's the company's loss. 

[EMEDPA]

I am looking at my first full time 1099 offer in my career. no benefits except malpractice, but the money is the best I have ever seen and full time is six 24 hr shifts/month.

[PACJD]

2 hours ago, EMEDPA said:

I am looking at my first full time 1099 offer in my career. no benefits except malpractice, but the money is the best I have ever seen and full time is six 24 hr shifts/month.

How much? If you don't mind sharing that is lol. 

[EMEDPA]

Potentially > 200K/YR with a few side gigs that I do for fun a few days/mo and won't quit. 

[PACJD]

Crazy. Good for you!

[JMPAC]

7 hours ago, wookie said:

I completely agree with your logic of what a salary is actually worth with and without PTO. My point was simply that different areas of the country have certain trends of what is typically offered. Your example of EDs providing PTO is specific to your location, thus anecdotal and not applicable to everywhere in the country. Although OP's job doesn't offer PTO, I wouldn't necessarily advise that he "run from offer". Unless ED PA's throughout the country agree to strike over lack of PTO, this is not likely to change anytime soon. Some people still need jobs, income, experience, etc. If he works there 1 year and moves on, that's the company's loss. 

I have been working in the ED for two years without PTO. None of us get it, including the docs. We just move our shifts around. I work 12-14 shifts a month and have never been denied time off, so I've been pretty happy with the whole set up. In my first career, your time off was actually limited by available PTO so it was sometimes a drawback. I was salaried and not even able to choose to take unpaid time off.

Apparently, one of our PAs recently figured out that PTO is state law for us and we are going to be getting it pretty soon. Fine by me, but I wasn't really upset about it. I have seen ER offers that have vacation, sick time and CME hourly pay which does sound pretty amazing.

Anyway, my point is to back you up and say lack of PTO shouldn't be a deal breaker. :)

[PAtoB]

12 hours ago, EMEDPA said:

I am looking at my first full time 1099 offer in my career. no benefits except malpractice, but the money is the best I have ever seen and full time is six 24 hr shifts/month.

That's the only type of no-benefits job I'll ever consider, regardless of where I live in the U.S. If there's no PTO, no health insurance offered, it'd better be made up in the form of salary since I know how much of a discount an employer is getting with a PA.  ;)

[MyNameWasUsed]

How is it possible that PAs, being a medical provider/practitioner, does not get PTO. When I worked as a rad tech AIDE getting paid $11/hr, I still got PTO. The receptionist that works at the same ED probably gets PTO. How insulting.