Seven Job-Search Mistakes of New Physicians

Leigh Page


April 07, 2015

In This Article

Now It's Up to You

7. Failing to Be a Tough Negotiator

The central focus of contract negotiations is your compensation. Your salary for your first position after training is crucial because it will become a benchmark for subsequent salary levels that you'll receive.

"There's always room to negotiate salary," Reinstein says. Employer representatives may refuse to budge, asserting that they can't pay more than "fair market value." The Stark Law, the Medicare Anti-Kickback Statute, and IRS guidelines prohibit hospitals in particular from paying more than the going rate for the area, based on surveys of physician income by location and specialty. However, salaries for new physicians are often lower than average—at the 25th percentile of the average salary, for example, according to a report[7] by The New England Journal of Medicine Career Center. Therefore, it's unlikely that a payment boost would violate the law.

Reinstein says that candidates should be careful not to give the impression that they're satisfied with a certain level of compensation too early in the process. You first need to have an understanding of all aspects of the work, such as inclusion of overnight call. If you indicate agreement with a salary level early on, "the employer views it as a commitment, and it's very hard to negotiate that figure any further," he says.

Just as important as the base salary are extra perks that employers throw in to sweeten the offer, which can amount to tens of thousands of dollars in extra pay. Common ones include paid malpractice and disability insurance, matching contributions to retirement plans, paid CME classes, and, in rare cases, even a housing allowance. Reinstein adds that employers who won't budge on base salary are often willing to increase these extra payments.

For example, employers usually provide a signing bonus, ostensibly meant to cover a new physician's extra expenses, such as payments on student loans. According to Merritt Hawkins, 70% of its job searches involved a signing bonus. The average amount was $21,773, with a high of $150,000.

The money doesn't come without a catch or two, however. You must report it as taxable income, and if your employment ends before the contract expires, you're often required to return at least part of the payment—plus you won't get back the taxes you paid on this income, Reinstein says.

Before you sign anything, "think of other benefits you want in the contract," Reinstein says. "If research is important to you, ask for a research budget. If time off is important, ask for additional days off."


Your first job will be something you'll always remember, so it's important to make sure it's the right one for you. Though it can be hard for a busy trainee like yourself to find the time to do a thorough job search, as you can see from what our experts shared in this article, the benefits are well worth it—and may pay handsomely for many years to come.


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