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New graduate, Internal Medicine offer Chicago

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Hello everyone!

I was hoping to get some input from whoever is willing to shed some insight on an offer I received today. It's an outpatient IM position in the southwest suburbs of Chicago. Mainly consists of clinic time, plus 3 half days at two nursing homes. I would also be on staff at the local hospital, but normally don't have patients there. It's M-F, 8 hour days. I would be on call for the nursing homes daily, plus two Saturdays/month. In addition, I'd also work two Saturdays per month.


4-5 year contract

Base salary: 84,000

401k 3-7% after 1 year.

25% of collections over 200,000 after 1 year.

2 weeks vacation, doesn't increase over time. 5 sick days.

5 days for CMEs, $1000 for them.

No health insurance coverage.

State license/DEA covered

Malpractice covered.


I'd appreciate any kind of advice on the matter, I know it is not a very good offer, but I was hoping to get some advice on how to counter-offer or if it's worth counter-offering. This is a practice with 4 physicians and 1 PA. It provides for a good learning environment which is important to me, however pay and benefits are also important.

Thank you in advance!



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Don't sign a 4-5 yr contract.  1 yr max.

Not sure about the market but $84k seems low for any area.  Do you get paid for call (you should), do you get paid extra for Saturdays (you probably should)?

Are you eligible for the 401k immediately?  You should be.  Ideally the match would start immediately as well but I have heard of matching not starting right away.  Know the vesting schedule.

I can't comment on collections but I would say make sure you have access to billing information so you know if you're being compensated fairly.  Also find out from the other PA if possible how much this typically amounts to.  It sounds good but if you don't hit 200k, no bonus.

Is 2 weeks of vacation 10 days?  Nope.  That's low and even worse that it doesn't increase over time.  3-4 weeks at LEAST.

CME money is a little low but the least of your problems.

Why no health insurance?  If they don't offer a group plan, do they offer reimbursement for you to buy it?  Or your salary should be much higher.

If this offer had just ONE of these things I'd say yea, bad offer but possibly negotiable.  Considering there are so many problems, I consider this a red flag.  I wouldn't bother negotiating because there's likely no way you'll talk yourself up to reasonable compensation and benefits on all fronts.

Edited by MT2PA
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lots of "red flags' mentioned above. I've seen much higher offers in chicago-land. Nursing home patients can be complicated and draining....being on call daily would be a drain. Very low salary compounded by the fact that no health insurance is offered. 4-5 year contract is unheard of. I would look elsewhere

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A sincere thank you to all who replied! It was a shock to me that after such a successful interview, the offer was as terrible as this. It almost hurt! But like you all said, if there were a few points to negotiate on, perhaps it would be okay. But there are too many flaws, and it makes me think they don't truly know the value of a PA (not just financially speaking). Thanks again! And if I get a reply fro them worth sharing, I'll be sure to post it here.

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4 minutes ago, anewconvert said:

For what it’s worth, they know exactly what the value of a PA is, they are just hoping you don’t, and if not you then some other new grad. 

yup, that is a terrible offer in all regards

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I actually interviewed for this position in Chicago and received a very similar offer. Honestly, I did not even try to negotiate because there were so many red flags. Think about it, you would have 2 days off a month; you would not make the productivity that first year; the nursing home deal was horrible - seeing so many patients in a month, basically taking call every single day with no compensation... I laughed while on my car ride home because it was such a terrible offer. There are other great positions in Chicago and I just accepted an offer making 25% more than that with half the work. Just keep pursuing and please don't take that offer with that practice; they are hunting for a new grad to take that low offer because they know how much they can make off of you. PM if you need

unfortunately, some poor new grad will take that offer and set a terrible precedent and leave very shortly after

Edited by Buckybrain
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