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Hello! I am a new grad graduation 6/2022, super interested in working EM.  I have an offer that seems reasonable, but would love input. 

- $57/hr for 6 months orientation, 130-150 hours/month, FT benefits start at 108 hrs/month.  

- $65/hr starting month 7; RVUs additional per hour and bonuses additional.  
-medical, dental, life insurance, malpractice with tail coverage

-10% employer 401k contribution starting after 3 months. 

-$4500 business expense/cme budget year 1, $2500 following years.  I believe licensing is responsibility of employee.   

- Aim for providers to average 2.2 patients/hour after orientation.  APPs and docs evenly see fast track and higher acuity.  No solo coverage, always doc on site and see level 1 acuity together or docs see level 1.  They sound very supportive, but want PAs to function to top of license with procedures, see acuity etc. I would like feedback about how reasonable this pace is.  

-** $10,000 fee if leave before 2 year anniversary for any reason.  Exact wording if if employee ceases FT employment before 2 year anniversary.  I assume this means is terminated or chooses to leave.  


This is an EM physician owned hiring group.  The culture seems good. They have a structured orientation and continued training for APPs.  Love the supportive culture from experienced APPs and docs with emphasis on functioning to top of license with support.  Training for intubation, LP, running codes etc. but no solo coverage for APPs.  This is midwestern small city.  Pay is significantly higher than other opportunities I have seen.  This area can also be difficult to find new grad EM job.  

-I honestly plan to accept.  Just want to make sure the $10,000 fee for leaving prior to 2 years isn’t completely ridiculous and seeing 2.2 pt/hr is reasonably attainable.   

Thank you! 

Edited by Lk56123
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Sounds like the benefits package from one of the big 3 EM staffing companies.  Financially, it's not a bad deal.

Your concern about seeing 2.2 patients/hour is well founded.  Unless you have a patient mix that includes a fair number very low acuity complaints that require little to no testing, e.g. see in the room, chart, and discharge, it will be hard to attain.  It's not just the acuity, as a PA you'll likely be doing many of the lac repairs, I&D's, and FB removals.  Some of those, especially suturing larger wounds, will be a time sink.  Talk to the PA's who currently work there and ask them how many patients they see per hour.

For comparison, when I was working in a busy level III trauma center, I tried to hit patients+procedures+30 min segments of critical care time of 2/hour.  We had almost no level 5's and not that many level 4's.

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I won't say which, but this offer is from a CMG; 2.2 pph is the general goal after + 1 year of practice with the group, and your pph average is gradually increased during the first year to 2.2 to account for growing pains, etc. Your patient population will have the largest effect on how well you transition to 2.2 pph. I don't know how enforceable the $10k penalty is for not completing your initial contract. No PTO/sick time is standard in EM.

Do your training modules early and shadow your colleagues in the department before your start date. Plan out your CME budget in Year 1 so that you use all of the allotted funds.

EDIT: Your state license and DEA license are reimbursed separately from the CME allowance.

Edited by Apollo1
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