New Grad Ortho Offer

[PA-SGuy]

Hello, ortho job with 50% clinic/OR split. Dedicated training with one surgeon for 6months-1 year depending on how things go until I can see clinic patients on my own. Met with surgeon and he is very nice. I graduate in mid July. 

Location: upper midwest

Base: 85,000. 

Call/rounding: on average another 6k-10k per year depending on how many days I do. One weekend every 2 months, 1:14 call.

1 week/2,500 CME. 21 days PTO/year.

Bonus eligible after 1 year. Bonus paid quarterly, was told high volume PAs made 30-50k/year in production. 401k elibile after 1 year. No sign-on bonus, relocation stipend or loan reimbursement mentioned. Ability to pick up shifts in ortho injury clinic at $75/hr.

50% percentile salary for new grads according to salary report is 91,500.

Thoughts? Would like to counter with some relocation money at least, does the 401k start seem unusual? Anything else i should mention? this is an offer sheet i received last week and not actual contract yet.

I believe they mentioned they pay for license, malpractice. 

Any tips/advice appreciated

[Anachronist]

Sorry if I'm a little out of my league on this one as a matriculating student, but from what I've seen here, that has potential. Especially if you like the surgeon, that is golden; sooo many complaints about people being run over and abused at their first jobs here. It looks like you basically get a shake down year, as a new grad that's fair. If they like you and you like them, you can run the numbers on your productivity and renegotiate after a year or two. 

I have played the relocation/travel and 401k game before, it isn't worth it in the short term, what is 5 or 10k to move really in the grand scheme? And unless you're planning on pounding your 401k then a missed year is no biggie. If nothing else you can put it in an index fund.

[MT2PA]

It's low for ortho surg but I don't know enough about surg to offer a realistic counter.  You should aim for minimum 50th percentile at least.  Definitely counter the salary.  I don't know anything about bonus structure to offer insight on that.

401k eligibility should be almost immediate (with first paycheck).  Compounding interest always matters.  Start investing early.  Depending on the type of practice (large hospital vs private/small group) this isn't always easy to negotiate but you should ask.

You should absolutely ask for relo/bonus.  Loan reimbursement you could ask for but I wouldn't be surprised if thats a non-starter.  Don't undersell yourself.  Especially if you are actually moving from somewhere - ask.

You didn't mention health insurance - but that should also be eligible almost immediately (or at least within the first 3 months).

Get everything in writing (i.e reimbursement for license fees, etc).  Know your worth.  New grad or not, somethings are inherent to any/all jobs (401k, health insurance) and you should not just take what they are offering bc you are a new grad.

[PA-SGuy]

2 hours ago, MT2PA said:

It's low for ortho surg but I don't know enough about surg to offer a realistic counter.  You should aim for minimum 50th percentile at least.  Definitely counter the salary.  I don't know anything about bonus structure to offer insight on that.

401k eligibility should be almost immediate (with first paycheck).  Compounding interest always matters.  Start investing early.  Depending on the type of practice (large hospital vs private/small group) this isn't always easy to negotiate but you should ask.

You should absolutely ask for relo/bonus.  Loan reimbursement you could ask for but I wouldn't be surprised if thats a non-starter.  Don't undersell yourself.  Especially if you are actually moving from somewhere - ask.

You didn't mention health insurance - but that should also be eligible almost immediately (or at least within the first 3 months).

Get everything in writing (i.e reimbursement for license fees, etc).  Know your worth.  New grad or not, somethings are inherent to any/all jobs (401k, health insurance) and you should not just take what they are offering bc you are a new grad.

Yes, health insurance, vision, dental included. Thinking of asking for 88k, 1500 relocation and still not sure about 401k. Guess it doesn't hurt to ask.

[AbeTheBabe]

Waiting for a year on the 401K is not a huge deal, what's more important is what is the math and vesting schedule?

Also, you need more info about the bonus. What is the bonus? I'm in ortho and we get a percentage of our total collections (10-12%). 

Also, you need to figure out realistically how many hours you'll be working in an average week to counter. If you're working 40 hours per week then I could deal with the slightly low salary for the good benefits and good surgeon relationship. Working 50-60 hours? No thanks.

[PA-SGuy]

Just now, AbeTheBabe said:

Waiting for a year on the 401K is not a huge deal, what's more important is what is the math and vesting schedule?

Also, you need more info about the bonus. What is the bonus? I'm in ortho and we get a percentage of our total collections (10-12%). 

Also, you need to figure out realistically how many hours you'll be working in an average week to counter. If you're working 40 hours per week then I could deal with the slightly low salary for the good benefits and good surgeon relationship. Working 50-60 hours? No thanks.

Thank you for the reply. I will be asking for details about bonus structure. Surgeon said he is always out by 5pm. Surgeries are in the morning with clinic after. So he said 40 hours/week. Also spoke to another PA there and he was very happy and left a different ortho group to join. I will ask about 401k details.

[AbeTheBabe]

I have one day a week where it's surgery in AM and clinic in PM and it's my longest day usually because surgery starts at 7am and I may or may not get lunch depending on how late surgery runs, so that's not an ideal setup. Today we had surgery only and I left at 3. If you work 6:45AM to 5PM with a 45min lunch that's a 9.5 hour day. You said you split 50/50 between OR and clinic so if you do that every day that's really 45-50 hours realistically.

[PA-SGuy]

On 4/18/2018 at 8:45 PM, AbeTheBabe said:

Waiting for a year on the 401K is not a huge deal, what's more important is what is the math and vesting schedule?

Also, you need more info about the bonus. What is the bonus? I'm in ortho and we get a percentage of our total collections (10-12%). 

Also, you need to figure out realistically how many hours you'll be working in an average week to counter. If you're working 40 hours per week then I could deal with the slightly low salary for the good benefits and good surgeon relationship. Working 50-60 hours? No thanks.

So i was able to negotiate to 88k with 15% collections - salary/overhead/benefits. bonus paid quarterly. on avg the PAs make 4k a quarter in bonus with ranges up to 10k a quarter

[PA-SGuy]

Question for you all- i guess the company does not require or have a contract to sign....is this common or should i be worried?

[SedRate]

On 4/26/2018 at 6:09 PM, PA-SGuy said:

Question for you all- i guess the company does not require or have a contract to sign....is this common or should i be worried?

I'm not sure about commonality, but it is worrisome. As the saying goes, "If it isn't written down, it didn't happen." I would request a written and signed agreement to finalize your employment. 

[SedRate]

On 4/23/2018 at 5:32 PM, PA-SGuy said:

So i was able to negotiate to 88k with 15% collections - salary/overhead/benefits. bonus paid quarterly. on avg the PAs make 4k a quarter in bonus with ranges up to 10k a quarter

I think this is a decent new grad salary setup for the Midwest as long as the hours are at 40 or less. That combined with the 21 days PTO, 401k (% match?), health insurance, and good surgeon sounds like a good first start. They definitely should cover malpractice insurance cost, so verify that. 

Has the surgeon had a PA before? If so, why did they leave? Is this surgeon newer/younger? Are you certain you want to go into ortho? Ortho can be very limiting and a lot of your newly obtained skills will go unused.

[PA-SGuy]

2 hours ago, Sed said:

I think this is a decent new grad salary setup for the Midwest as long as the hours are at 40 or less. That combined with the 21 days PTO, 401k (% match?), health insurance, and good surgeon sounds like a good first start. They definitely should cover malpractice insurance cost, so verify that. 

Has the surgeon had a PA before? If so, why did they leave? Is this surgeon newer/younger? Are you certain you want to go into ortho? Ortho can be very limiting and a lot of your newly obtained skills will go unused.

3% match after 1 year, malpractice covered. The practice has about 20 PAs and this particular surgeon has not had one but wants one and recognizes the learning curve. Most PAs they have were hired as new grads. I enjoyed my ortho rotation, particularly surgery, they do a lot of team coverage for the area which is also appealing. 

[SedRate]

3 minutes ago, PA-SGuy said:

3% match after 1 year, malpractice covered. The practice has about 20 PAs and this particular surgeon has not had one but wants one and recognizes the learning curve. Most PAs they have were hired as new grads. I enjoyed my ortho rotation, particularly surgery, they do a lot of team coverage for the area which is also appealing. 

Sounds good. Will you be accepting or continue to negotiate? I would suggest including a blurb about yearly reviews for consideration of raise in salary.

Your surgeon will also have a learning curve since they haven't had a dedicated PA before and may not know what to expect or ask of you. Some surgeons may have you do everything while others may limit your scope. Some may treat you like a resident while others a colleague. This will likely work its way out as you gain experience and confidence, but just keep that in mind and develop good communication with each other.

[PA-SGuy]

17 minutes ago, Sed said:

Sounds good. Will you be accepting or continue to negotiate? I would suggest including a blurb about yearly reviews for consideration of raise in salary.

Your surgeon will also have a learning curve since they haven't had a dedicated PA before and may not know what to expect or ask of you. Some surgeons may have you do everything while others may limit your scope. Some may treat you like a resident while others a colleague. This will likely work its way out as you gain experience and confidence, but just keep that in mind and develop good communication with each other.

I have accepted already. I was informed there is yearly review for salary raise, usually everyone gets 2-3%, sometimes up to 5%. He is very willing to let me do as much as i like including injections/arthrograms in the future

[SedRate]

9 minutes ago, PA-SGuy said:

I have accepted already. I was informed there is yearly review for salary raise, usually everyone gets 2-3%, sometimes up to 5%. He is very willing to let me do as much as i like including injections/arthrograms in the future

Congratulations! Good luck with your new job.