Joe Li, DO, MPH
Resident Council Co-chair and Region 1 Representative
It’s March, and graduation is right around the corner. If you’re still figuring out your next steps, I recommend checking out this post on navigating your career options. The world is your oyster!
As you finish residency, understanding your physician contract is crucial. As a current PGY3 who is about to be fresh out of training, there are things that I’m afraid that I will miss and overlook. Spending time reviewing terms and understanding what to look for can make all the difference in shaping your career, work-life balance, and long-term financial stability. Here are some of the key things to consider.
Compensation
While base salary is important, you should also pay attention to different bonuses or incentives! Here are some things that many contracts include. Some may be things you can even request or add onto your contract.
Base salary: Self-explanatory. Make sure you check out what the average is in your area.
Sign-on bonus: Typically a lump sum that you receive when you sign or a set number of days after your start date. Remember to read the fine print and watch out for clawback terms, where you may have to pay back if you have to break the contract.
Retention bonus: Similar to above, but a lump sum that you receive after a set number of days or the first year of your anniversary. Pay attention to how it gets distributed.
Relocation bonus!
Loan Repayment: Self-explanatory. Remember to pay attention to the terms!
RVU-based bonuses: This is one of the key things to note on your contract. It is also commonly known as the “production bonus.” It’s important to know your how your RVU is structured via the RVU threshold and the per-RVU rate. Also, make sure to know what the national average is and what other physicians in the practice are able to achieve.
Quality bonus: These are bonuses you can get when you meet a certain metric within an institution.
Workload and Expectations
Transitioning from resident to attending is probably most likely going to improve your work-life balance, but it is important to ensure long-term success and to prevent burnout, especially in family medicine!
Clinical Hours vs. Precepting vs. Administrative Time: If you’re working in multiple capacities, it is important to understand how your time will be divided.
Scope of practice: Ensure that your contract reflects your actual role; how does your FTE (full-time equivalent) split up if you’re doing inpatient vs. OB vs. outpatient clinical work?
Ancillary staff: What support is available (medical assistant, nurses, office assistant, behavioral health, etc.)?
Call schedule: How often are you on the call schedule, and what does the call look like? Is it reasonable?
Other Important Things
Non-compete clauses or restrictive covenant: What is the radius of the geographic area? What specific institution? How long is the non-compete?
Contract duration and termination clauses: Make sure you pay attention to the duration of the contract and the criteria for termination in case you want some flexibility.
Benefits!!!!: Retirement contributions, health insurance, malpractice insurance (important to note if there’s tail coverage vs. occurrence based), amount of time off, and CME time (for you to attend conferences, like ACOFP!!).
Remember! This isn’t an exhaustive list. You can always negotiate for what you need!
If you’re reading this, congratulations--you’re almost at the finish line! I think the most important thing when choosing a job is making sure It aligns with your professional goals and meeting the quality of life that you want to have. Don’t rush into signing! Ask questions if you don’t understand something, negotiate where appropriate, and if needed, you can also consult a contract lawyer. This process can be stressful, but it’s an exciting milestone!
