Now for the fun part: sorting through all of those job offers and negotiating your first contract. As you review these, consider how each might affect your short- and long-term career goals. When weighing the pros and cons, here are a few elements to consider:  

  1. Salary: This is usually the first consideration. Remember, salary will most likely be adjusted based on where you plan to work. For example, you can expect to earn more in areas with a high cost of living (think New York City or San Francisco.) Be sure to keep this in mind when researching fair market value for your role and region. 
  2. Bonuses: Many practices will offer a sign-on bonus or a loan repayment package. Note that this typically means you commit to work a certain length of time with that practice. In addition, there are performance bonuses which can increase your overall income and are based on merit. All of these bonuses can be incentives to join, provided they align with your career goals. 
  3. Benefits: Do you know the details on the benefits package? This may include medical, dental, and vision insurance, as well as matching 401k retirement contributions. Find out your monthly premium and matching amounts to accurately weigh the total value of the offer. 
  4. Coverage: Do you know if malpractice and tail insurance coverage are paid for, or would you be responsible for this? If covered, this can significantly add to your overall take-home pay. 

Beyond the hard numbers, weigh the following: 

  1. Professional development: As your first job out of residency, what resources does the practice offer for your continued growth? This can include mentorship, networking, and opportunities to specialize. 
  2. Specialization: You can join a practice that already specializes in an area you are passionate about. Or you can join a general practice and build a specialty from the ground up. Consider the opportunities for how to step forward into the specialization you desire at each practice. 
  3. Culture: Are you aligned with the culture of the practice? Is it a relaxed and calming environment? High interaction and activity? As this will be your “home away from home,” make sure you choose an environment that will support you.   
  4. Flexibility: Do you have flexibility with your schedule? Can you work remotely a few days a week? Will you have good work-life balance? 

And read the fine print: 

  1. Non-compete clauses: Does the contract restrict your services after you leave the practice? Will you be able to treat similar types of patients within the region once you leave? If not, how long would this restriction last? Make sure you are clear on how these non-compete clauses will affect you and your long-term goals. Ask your program director or program alumni for recommendations on healthcare attorneys that can review these contracts.  

Considering these nine elements will allow you to clearly assess offers while being mindful of your short- and long-term goals. This will help you establish a stronger negotiating position and get what you want. 

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