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This offer is for a position in a small single physician surgical dermatology private practice office in a highly affluent community outside of Los Angeles, CA. The physician is an experienced Moh's surgeon who deals almost exclusively in skin cancer, reconstruction, and cosmetics (no medical derm). She is offering a "training year" and I am seeking a "foot in the door" with dermatology. 

Let me preface this post by saying I know it's a pretty rough offer, but my hope is once developing a skill set within surgical dermatology. I'd hope to become an asset to the practice in order to negotiate a better deal or become more marketable to another derm practice that may give me a better offer. 

  • Salaried at $4800/month for the first 3 months, $5600/month for the next 3 months, and $6400/month for the next 6 months ($69,600 pretaxed). 
  • "On Call" weekends and holidays to field the occasional  phone call. 
  • Hours are essentially "open to close" at the office usually between 10-12 hours a day mon-fri until i'm trained well enough to know when its ok to cut out early. Exempt employee status with no set breaks, lunch, or overtime compensation.
  • Profit sharing 401k pension plan where the employer gives 7.5% of annual salary toward retirement with a vesting schedule that becomes completely matured after 6 years. So after 1 year, 0% vested, 2 years 20%, 3 years 40% vested, 4 years 60% vested, 5 years 80%, and 6 years 100%. 
  • CME money is limited to any actual amount. It’s approved on case by case basis and seems like ill rarely have much say in how it’s used. 
  • Malpractice is clams made without tail
  • Health insurance is covered 50% after the first 3 months for the first year. Then 100% covered starting after the first year. 
  • PTO is 7 holidays where the office is closed anyways. 10 additional days will accrue over the first year, 11 the next year, 12 after that, and so on. 

 

I appreciate any and all feedback. Thanks!

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Guest HanSolo

Would you really receive world class training? By comparison, the Medical College of Wisconsin offers a dermatology fellowship in which you know you would. Plus, the salary is 55k there with full benefits, and you would legit be more marketable after. 

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I actually like your perspective of going in to learn and show what you're worth and negotiating from there. I did that, and it worked out very well for me. A few things to think about trying to get incorporated: 

  • See if you can get a review/renegotiation at 6 months. You may find you don't need a whole year of training. I was basically on my own at 3 months, and I would have to look some things up or ask questions, but I felt pretty good about everything. If all you're doing is skin cancer, reconstruction and cosmetics, I don't see why you would need that long. Maybe for medical derm too, but those things are pretty straight forward if you aren't seeing crazy rashes. 
  • Vacation days? How many? Any limitations to when you can take them? 
  • If having to take call, will they provide you with a call phone or expect you to use your personal cell phone. If personal, consider asking for payment or credit for your phone bill 
  • Not sure what you mean by CME money not "coming into play"? Since it's required for licensing, you want to make sure that's built in because it can be expensive. Unless you mean they'll just pay for whatever, and then I say go for it. 
  • Need tail coverage. 
  • Are commissions/bonuses an option in the future? Make sure that's something you discuss up front. And will you have access to your collections? 
  • Are you guaranteed a job after this first year or would this solely be a training year? If just a training year, I would pass completely and keep looking. If you're not getting general derm training, this would not be that helpful to you as any derm that hires you will likely want to train you in their methods, and will likely be willing to pay a full salary. 
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Run as fast as you can and don't look back!!

new grad Derm PA here (my 1 year anniversary with the practice will be in a few months) my package isn't the BEST but it was a reasonable starting point 

-102,500 (straight salary, no productive bonus but I plan to negotiate that at my 1 year mark)

-830-430 M-Th 8-12 on Fri

-2500 cme With 5 paid days off to attend conferences, courses etc)

- 15 Days PTO

- 5 sick days

- All major holidays off (plus half days off the days before thanksgiving/Christmas/New Years eve and an additional day off after said holiday)

-no call/nights/weekends

- no health insurance, medical or dental (but I'm married and spouse covers this in full)

-no 401k/profit sharing (also requesting at anniversary mark)

 

20-30 patients a day 

mainly gen Derm for now

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