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frenchcrazy

New Grad ER Offer - Any red flags?

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Long-time lurker, I was just offered a job (my first) in emergency medicine and I'm very excited to get my feet into this field. I researched salaries in the AAPA salary report and would like to solicit some additional thoughts on this.

BASIC INFO:

  • Base salary $55/hour - translates to $92,400 base salary with 1680 hours expected annually (aka 140/hours a month)
  • $1.50 per RVU bonus, paid out bi-yearly
  • $3,000 CME
  • Malpractice with tail coverage in perpetuity 
  • Health / Dental / Vision provided at a very low cost
  • Long-term disability insurance provided
  • 401K
  • Low-volume, small ER, semi-rural area. Low cost-of-living. I've been told I'll see about 10 patients per shift. Twelve hour shifts by default.

ADVANTAGES:

  • It's the field I've desired since staring PA school
  • Only day shifts, there is no overnight PA coverage
  • Access to every level of acuity. There is no fast track. So I'll really get to practice to the fullest extent.
  • Low patient volume means I can spend more time with patients and not feel super rushed while I'm learning or getting used to EMED
  • Supervision: I'll always be working with at least one physician who is willing to help and bounce questions off of me. I spoke with this person and they have a great attitude and outlook about emergency medicine. The group also states that they've trained up many new grads.
  • I'll have the ability to travel to different locations and/or pick up extra shifts 
  • They will work with me to make sure all of my credentials get processed quickly 

CONS:

  • There is no PTO throughout the group. I've seen this before for EMED, but I also know that some people receive several weeks of vacation. I personally love my vacation time, so I was torn about it. I was told that people would take 2-4 vacations a year, but this involves moving shifts around or working less in a particular month. 
  • The 401k is available, but there's no information on an employer match (because I don't think there is one)
  • Not sure how many RVUs I would generate with such a low volume of patients
  • I do not believe DEA fees will be covered. I also already paid for my state licensure fees out-of-pocket. 

The offer seems very fair, especially for my location. But I'm obviously inexperienced and the doctor alluded that he expects me to negotiate and come up with a counter-offer. So I don't think I'm jeopardizing the job by coming back with something. I have all of my certifications and prior EMS experience if that means anything. 

I also wanted to say that I see the RVU bonus as just that... a bonus. I don't really expect it to sway my decision by much. Does the value of $1.50 seem fair? 

Thank you for your time.

Edited by frenchcrazy
grammar

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I am a new grad as well and I’d take this. Obviously it isn’t perfect but from my experience aggressively trying to obtain an ER job over the past six months, this sounds like a great gig! I may have missed this in the post, but are you expected to fly solo with access to the physician or will they be there onsite with you? 

 

As far as negotiating, I’d personally try to bump it up a couple bucks and ask for 60 or something like that because why not. I’d also ask for DEA reimbursement. That thing is expensive. 

 

Edit: is it possible they provide DEA reimbursement out of the CME? 3k is on the higher side of what I’ve seen and I did speak with one ER group who lumped all of their licensing reimbursements under “CME”.

 

 

Edited by Hopeful2015

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Yes, one physician would always be on site! I was also thinking about asking for $60 and expecting some sort of counter, but as you alluded to - it's hard to find a new grad EM job and I'm pretty risk averse. I don't want to let this opportunity pass me by. 

Thank you for the response 🙂

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3 hours ago, frenchcrazy said:

Yes, one physician would always be on site! I was also thinking about asking for $60 and expecting some sort of counter, but as you alluded to - it's hard to find a new grad EM job and I'm pretty risk averse. I don't want to let this opportunity pass me by. 

Thank you for the response 🙂

No problem. Obviously my experience is limited, but I’d absolutely submit a counter. They’ve already invested a lot of time and energy into interviewing and selecting you and I promise they don’t want to go through that again, even if they do have lots of apps to choose from. Also, your EMS experience is a big deal and is becoming rarer and rarer among new grads. 

 

Either way, nice job nailing this one! 

Edited by Hopeful2015
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You can also ask them what the other PAs in the group made in RVU compensation for the last year (i.e. a range) to get a sense of what you can expect from RVU compensation.

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just treat the bonus like a bonus. don't depend on x thousand/yr. I know many who have and they got into financial trouble over it by buying cars, boats, etc they could not afford.

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