Jump to content

Recommended Posts

Was hoping to get some opinions on an offer before I accept, this is my first contract as a new grad!

Position is a fellowship located in New York, level III trauma center seeing 70K patients a year. First 12 months a physician will always also see your patients, with review to determine if you can begin seeing level 4/5 independently for the last 6 months. Not the greatest area but that means a very diverse patient population. There is NO residency program, so the PA fellows have first dibs at procedures and other opportunities if they want to learn them. Lead PA has been there 10+ years which tells me something, and says PAs get a very high level of autonomy in this ED with great physician support. 

18 month contract (can sever with 120 days' notice)

Full time hourly at $40.95/hr (+$5/hr night differential). 36 hours/week at 12-hour shifts rotating between observation, fast track and main ED. 5 hours/week didactic education. Opportunities to pick up additional shifts at 1.5x base. (Based on scheduling preferences/OT, anywhere between 88-100K/year)

Full medical/dental/vision/disability benefits (Was told you don't get benefits summary until after you sign, is this standard? I find this strange and need to clarify)

401K match (need to obtain details)

Malpractice + tail

Full reimbursement for license/DEA

$1,500 CME allowance/year

NO PTO except as required by state law (was told they work with your requests and are able to schedule you early one week/late next to gain 7-8 days off for vacation though)

5K completion bonus at end of term, additional 5K retention bonus if you accept a position there at the end of the fellowship

ACLS, ATLS, PALS, emergency ultrasound and emergency airway training provided

Seems like a great opportunity as a fellowship to get my foot in the door of EM (have spent 5 months applying for EM positions in various states across the country with no bites, and I've been an EMT 8 years). Thanks in advance! 

  • Upvote 1
Link to comment
Share on other sites

1 minute ago, TeddyRucpin said:

Not to powerbomb your thread, however, did they say what your pay would be if offered (and you accept) a job there after fellowship?

After I was given an offer I did ask this and was told she "did not know what the current offer is." To be fair, I have been working directly with a recruiter and not the physician group's HR directly. Hoping to contact them on Tuesday to get at least a ballpark, but I do know it is salaried and only the fellows are hourly. 

Link to comment
Share on other sites

Are there any off shift rotations like ICU, anesthesia, U/S, ortho?  What is actually done in the 5 hours/wk didactic periods?

It may be a great place to learn, but it really sounds like what they're calling a fellowship is in fact an 18 month relatively low paying training job in a high cost of living area.  For comparison, I started out at a Level III trauma center 8 years ago with about the same volume for $50/hour.  We rotated through all areas, saw pretty much everything except level 1 pt's and grew at our own pace.  We didn't have dedicated didactic periods.

  • Upvote 1
Link to comment
Share on other sites

  • Moderator
4 hours ago, ohiovolffemtp said:

Are there any off shift rotations like ICU, anesthesia, U/S, ortho?  What is actually done in the 5 hours/wk didactic periods?

It may be a great place to learn, but it really sounds like what they're calling a fellowship is in fact an 18 month relatively low paying training job in a high cost of living area.  For comparison, I started out at a Level III trauma center 8 years ago with about the same volume for $50/hour.  We rotated through all areas, saw pretty much everything except level 1 pt's and grew at our own pace.  We didn't have dedicated didactic periods.

No off service rotations means not a legit residency in my opinion. It’s structured on boarding. Not saying there is no value in it, but there are much better training programs. You could spend a whole year in a level one ED and only do a handful of lines and intubations. The average ED physician intubated about 12 times per year in one study. Not nearly enough to become an expert without an anesthesia rotation. Maybe a couple chest tubes? You’ll be knocking those out in a trauma surgery rotation. Slamming out bronchs in the MICU. But more important than procedures is knowing how to manage patients like a specialist and not being a consult machine.

ETA: not that anyone who hasn’t done a residency is a consult machine. No offense intended

  • Like 1
Link to comment
Share on other sites

9 hours ago, LT_Oneal_PAC said:

No off service rotations means not a legit residency in my opinion. It’s structured on boarding. Not saying there is no value in it, but there are much better training programs. You could spend a whole year in a level one ED and only do a handful of lines and intubations. The average ED physician intubated about 12 times per year in one study. Not nearly enough to become an expert without an anesthesia rotation. Maybe a couple chest tubes? You’ll be knocking those out in a trauma surgery rotation. Slamming out bronchs in the MICU. But more important than procedures is knowing how to manage patients like a specialist and not being a consult machine.

ETA: not that anyone who hasn’t done a residency is a consult machine. No offense intended

There are no outside rotations other than the ED, no. And the didactic sessions are lectures and hands on trainings with the residency program (the other hospitals have ED residents just not this one). 
 

I know it’s a relatively low offer for the area, but I’m from the area and would be fortunate enough to live at home with no rent. I do agree this sounds more like a lowball lengthy onboarding, but emergency medicine has been the end goal since high school. I’ve always know this is where I wanted to be. I’ve spent ~5 months applying all over the country and gotten zero interest in placement of a new grad without experience, other than a single recruiter who said she WILL place me, but it could take upwards of a year due to covid and hospitals currently wanting experience. I’ve also applied to half a dozen other residencies and been denied. While this isn’t perfect, the providers were willing to answer questions and discuss patients and plans and you’re always paired with a PA or physician. Are there better opportunities out there, absolutely. But for the pay and ability to live at home rent free it seemed like a busy place to get my bearings and the experience I need to be considered in other ERs. 
 

I planed to use CME allowance to do an EM course before starting as well to be better prepared. 

Link to comment
Share on other sites

10 hours ago, tally17 said:

There are no outside rotations other than the ED, no. And the didactic sessions are lectures and hands on trainings with the residency program (the other hospitals have ED residents just not this one). 
 

I know it’s a relatively low offer for the area, but I’m from the area and would be fortunate enough to live at home with no rent. I do agree this sounds more like a lowball lengthy onboarding, but emergency medicine has been the end goal since high school. I’ve always know this is where I wanted to be. I’ve spent ~5 months applying all over the country and gotten zero interest in placement of a new grad without experience, other than a single recruiter who said she WILL place me, but it could take upwards of a year due to covid and hospitals currently wanting experience. I’ve also applied to half a dozen other residencies and been denied. While this isn’t perfect, the providers were willing to answer questions and discuss patients and plans and you’re always paired with a PA or physician. Are there better opportunities out there, absolutely. But for the pay and ability to live at home rent free it seemed like a busy place to get my bearings and the experience I need to be considered in other ERs. 
 

I planed to use CME allowance to do an EM course before starting as well to be better prepared. 

I understand the circumstances. If you really have passion for EM and not having luck for EM/ EM residency position, you just have to do whatever you have to do. I would have done the same thing knowing that at least I will be able to work in EM after this opportunity.  

Link to comment
Share on other sites

12 hours ago, CXPAC said:

I understand the circumstances. If you really have passion for EM and not having luck for EM/ EM residency position, you just have to do whatever you have to do. I would have done the same thing knowing that at least I will be able to work in EM after this opportunity.  

Thank you so much for this. It's really nice to hear someone else understands my hesitation but also desire to just take it. I KNOW the offer isn't the best considering the lack of formal rotations, which sucks. But at the end of the day, EM is where I want to be. I thought I'd find another niche but the passion for the ED hit me immediately on my rotations. Have I considered other specialties, sure, but nothing makes me want to get up and go like EM did. And like you said, at the end of the day, if I stick it out 18 months or even a year, at least I KNOW I'll have a leg to stand on to be considered for EM positions elsewhere whereas right now, EM + new grad just seems minuscule with covid. Which I get, you want some experience to hit the ground running and help out, it's hard to find the time to train a new grad among delta.  

I have a call with the attorney in a bit and assuming my clarifications are not red-flags, I will be signing the contract. Thank you everyone for the help! 

  • Like 1
Link to comment
Share on other sites

3 hours ago, tally17 said:

Thank you so much for this. It's really nice to hear someone else understands my hesitation but also desire to just take it. I KNOW the offer isn't the best considering the lack of formal rotations, which sucks.

Dude (or Dudette), you asked for opinions on the position and you got them.  The point folks are trying to get across here is that this wouldn't be considered a fellowship.  You've got many people on this board who have done fellowships, are part of a fellowship training program or are even directors of said programs.  They (we) have a tendency to take these terms pretty seriously as there are multiple programs out there who use exploit new grads as cheap labor.  Once they leave that program and tell the next hiring position "I'm fellowship trained" and then blow it their first week it casts a negative light on all fellowship programs.

Is this a fantastic sounding job for someone who wants to break into EM while they have the ability to live at home, in the location they want? Hell yeah. Would I call it a fellowship or a residency? No. If I'd chosen EM right off the bat it's an offer I likely would've taken as well.  The 120 days notice is a little brutal though, unless that goes both directions. Best of luck in the position and maybe I'll take a patient off your hands someday.

 

  • Like 1
Link to comment
Share on other sites

2 hours ago, MediMike said:

Dude (or Dudette), you asked for opinions on the position and you got them.  The point folks are trying to get across here is that this wouldn't be considered a fellowship.  You've got many people on this board who have done fellowships, are part of a fellowship training program or are even directors of said programs.  They (we) have a tendency to take these terms pretty seriously as there are multiple programs out there who use exploit new grads as cheap labor.  Once they leave that program and tell the next hiring position "I'm fellowship trained" and then blow it their first week it casts a negative light on all fellowship programs.

Is this a fantastic sounding job for someone who wants to break into EM while they have the ability to live at home, in the location they want? Hell yeah. Would I call it a fellowship or a residency? No. If I'd chosen EM right off the bat it's an offer I likely would've taken as well.  The 120 days notice is a little brutal though, unless that goes both directions. Best of luck in the position and maybe I'll take a patient off your hands someday.

 

No disrespect intended in any of my responses, I apologize if it ever came across as such, it was never my intention. I throughly appreciate everyones insight. Everyone confirmed what I was thinking myself: that this doesn't seem very fellowship/residency to me. But, it's a foot in the door to EM which it isn't always the most new-grad friendly field. Perhaps the training will surprise me (I hope.) 120 days does go both ways after the initial 6 months (thankfully). Thank you, and perhaps someday! 

  • Like 1
Link to comment
Share on other sites

  • 2 weeks later...
  • Moderator

is this an approved residency?  Like one that is listed on https://appap.org/programs/postgraduate-pa-np-programs-listings/

 

 

It sounds like they have figured out a way to hire new grads cheaper

 

by the end of the 18 months you should be seeing any patient coming in the department independently with back up.

 

 

--------------

also I would NEVER sign a 120 day notice, no way.  Think of it this way - you are living with your Sig Other and you decide to break up.  Would you want to live together for the next 4 months???  That is what you are signing.  60 - 90 days is more then enough time.  8 weeks is okay for both parties.

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

  • Similar Content

    • By VAPAPA
      I'm a new grad PA on the job hunt. I've been applying to everything but I really want to work in the ED, inpatient hospitalist, or in an urgent care. I've applied to countless job postings (over 120) with only a couple phone interviews, but nothing has really panned out. I'm also willing to relocate and have passed my boards. It seems like those specialties aren't hiring new grads right now which is frustrating. 
      I just recently received an offer from an addiction medicine clinic I interviewed at. They're offering 85k until I'm credentialed then 105k. They have an RVU bonus up to 35k per year. Malpractice and medical insurance are covered with 401K matching and 3 weeks PTO for the first year then 5 weeks after. The clinic is great, the providers truly care about their patients. It's not just a methadone clinic, they have group therapy, psychologists, social workers, and coaches for their patients. In addition, everybody there seems to truly care about what they do. 
      My only apprehension with accepting this offer is that I'll get stuck in addiction medicine/behavioral health. It's easy to get pigeon-holed and lose a lot of your general clinic knowledge working in behavioral health. I'm worried I won't be able to transition to working in the ED which is what I truly desire. So my question is, does anyone have insight or transition from addiction medicine/behavioral health to another specialty, such as family med, hospital med, GI, etc...? Should I reject the offer and wait it out until I get a position in a medical specialty?
    • By hipsnap21
      Hi everyone, I received my first offer today after applying for what feels like a million jobs. The position is in emergency medicine. It's a hospital I worked in prior to PA school. They are offering me the following: 
      $60/hour with a guarantee of 120 hours per month (equals out to $86,400 annually) 120 hours PTO annually and 40 hours long term sick annually. Malpractice and tail insurance as well as CME credits through the company's online learning institute.  Benefits: medical, eye, dental and 401K with up to 3% match after a year of employment No reimbursement for licensing, DEA, or CME allowance as they provide CME credits through their online learning institute. I'm satisfied with the hourly rate, it's pretty on par with what I see in the AAPA salary report for NY new grads, but my question is - is this a good offer? The annual salary is quite low compared to the salary report for EM positions, but I believe that's due to the low number of monthly hours. I've asked for a signon bonus and I've asked to be guaranteed 140 hours per month as that raises my salary considerably, but I'm looking for opinions as I'm new at this and want to make sure I don't take the first offer I get just out of excitement to be offered a job.
       
      Thanks in advance!!
    • By pahopeful46
      Hello!
      I was just offered a job as a new grad in psych at a private practice outpatient clinic in the Houston, Tx area. My hours would be 9-6 or (10-6 with no lunch break) Tuesday - Friday and a possible Saturday shift from 9-1 which I am clarifying now as to if this is set in stone or not since it was unclear. They told me I would be shadowing the first two weeks and then after that I will slowly see my own patients while consulting with the doc after each patient. They currently have one NP who they hired as a new grad and trained.
      Salary: I told them I was looking for 100k since that is the average for a new grad in Texas and they offered me this breakdown: 92k for years 1-2, 102k for years 3-4, and 113k for years 5-6. Then, a bonus set up like this: starting at 6 months, a quarterly bonus at 65% patient occupancy is a 1k bonus quarterly, at 75% patient occupancy a 1750 bonus quarterly and at 90% occupancy and greater a 3k bonus quarterly. The bonus seems okay but I have no idea how to gauge this since idk if I will even be hitting these numbers as a new grad. They told me the NP currently sees follow ups in 15 min slots or 4 an hour with a break after to chart and that new pt visits are 1 hour. They told me my follow ups would be set for 30 minutes instead of 15 since I am new.
      CME: 1500
      PTO: 7 days first year (this seems very low to me and was also not broken down into CME or sick days so now I have no idea if I even get CME days so that will be in my email back with questions)
      Malpractice coverage and 401k with 5% match effective after first year. It was also unclear if the 401k is not effective at ALL until the first year or if just the matching so I will be asking this as well. Need to ask if this includes tail coverage?
      Overall, I am happy to have a job offer but wondering if this is a good one. I would like to counter with a base salary of 96-97 possibly since a 1k bonus for three quarters in my first year would put me at the average new grad salary in Texas of 100k. Does this seem unreasonable? I also really don't like how the salary is already structured for the next 6 years and how I do not get a yearly raise to match inflation even. Is this common? What do you all think I should include in my counter? Overall, is this a good offer and would you take it as a new grad? Is it a bad idea for me to counter? Please help!! Thank you!
      Edit to add: they do not offer health insurance if this makes a difference. Thank you!
×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More