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Derm offer--Advice needed

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Hi everyone, 

I have been offered a job running a clinic and want to get some feedback on the offer. I have one year experience in a busy ER. I would be running the clinic by myself, and there would be a 2-4 month "mini fellowship" where I would be traveling to their different clinics for one-on-one training and examinations, etc. 

Here is the offer:

Mon-Fri 8-5

Training Pay $75000 (pro-rated for the 2-4 month training)

Base pay which starts immediately after training- $140k

Bonus Structure paid quarterly: 20% of collections greater than $35k per quarter. (I wouldn't likely start hitting this bonus in the first year because this is a new clinic which needs to be built up)

15 days PTO plus holidays

5 days CME with no allowance

100% health coverage for me. I pay to add my family members. 

Potential for partnership down the road.

I'd love some feedback, please! I am a little nervous to leave a stable position, but I know derm positions are hard to come by without experience. 

Thanks in advance


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The Ultimate Guide to Getting Into Physician Assistant School, Fourth Edition

Seems like a great offer but just curious, how much experience do you have in derm? Would you be comfortable running the clinic by yourself?

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Do you have the details about the clinic? Mainly cosmetic? If so, that brings in beaucoup money. I'll echo the above, how much exp do you have in derm? 

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Thanks for the feedback everyone. Not much experience, other than a dermatology rotation in school, and the derm I see in the er. I've voiced my concerns about running a clinic solo with my limited experience, and they've assured me that I wouldn't be cleared u til I'm found to be competent. They also have a system for consultations where every provider in the company has access and can respond with insights and advice. 

This would be a mix of medical and cosmetic derm. I would be doing excisions, biopsies, along with a variety of cosmetic procedures. 


Edited by brooks23

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That offer sounds uh-may-zing! High base salary with great bonus structure. I currently work in hospital based dermatology in California where we see a ton of awesome and rare textbook cases most places will never see! We have our fair share of procedures and tons of excisions on a daily basis. That salary range sounds fairly spot on as well. You are going to love dermatology! Best of luck!

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So.....2-4 months of training and you would essentially be on your own? Nope nope nope. That’s the kind of crap that gives derm PA’s a bad name on the MD boards, and with good reason.  Sure, you’ll be able to biopsy lesions and treat acne but do you think you’ll be able to manage blistering disorders or complicated skin cancer patients on your own without direct and easy access to a board certified dermatologist? And don’t think it doesn’t happen...I know a colleague who saw Sweet’s syndrome her first week in practice. Dermatology is a wonderful field but you can’t learn it in 8 weeks. I’ve been in derm for over 15 years and recently left a job because I was tired of being the only provider at my clinic (my in office SP retired and the company did not replace him). Sure, i could easily take care of 98% of the patients....it’s the 2% that kept me up nights. Find a job where you are appropriately trained and supported. Best of luck come to you. 

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