Your Physician Job Offer Survival Guide: 40+ Questions to Secure the Right Deal
Whether you’re fresh out of training, looking for a new start, or or advancing into the next chapter of your career, it’s essential to know what you’re signing up for before committing to a new job.
Back in the early 1990’s, the managing partner of my first practice seemed taken aback when I asked to review the contract before signing. He muttered something about the good old days, when business was done with a handshake. I doubt that was ever a good idea. But even when you have a contract in hand, it’s important to have a clear understanding of the implications of your decision. After all, it’s likely that you’re not just taking a job— you’re planning to build a life there.
To help you get started, I’ve compiled a comprehensive list of questions that you should consider before accepting a new position. These cover everything from compensation and call schedules to long-term growth opportunities and organizational culture. There is no one-size-fits-all solution. It’s important to understand that every contract and compensation structure is unique. Take some time to clarify what your own needs are, what you’re willing to bend on, and what is non-negotiable.
Even if everything sounds perfect, it’s a good idea to get multiple perspectives from current and past physician group members whenever possible. By asking the right questions, you can make an informed decision that supports both your career and your well-being. Before signing on the dotted line, always consult with a qualified healthcare contract attorney or advisor to review your offer and ensure your interests are protected.
1. Role and Responsibilities: Know What You're Signing Up For
What are the specific expectations for this role?
What is the call schedule like? How often will I be on call?
What’s the breakdown of clinical vs. non-clinical duties?
What does a typical day or week look like?
How is research time and support structured?
Are there opportunities to shape or evolve the role over time?
2. Compensation and Benefits: Understand the Full Package
What is the compensation structure (salary, RVUs, bonuses)?
Is the salary guaranteed or productivity-based? Are there annual increases?
Are there sign-on bonuses, relocation assistance, or student loan repayment options?
What are the retirement plan options (e.g., 401(k), 403(b), employer match)?
Is malpractice insurance provided? What type (claims-made or occurrence)? Is a tail provided if I leave or retire?
What health, dental, vision, life, or disability benefits are included?
How is paid time off (PTO) structured? Is it separate from sick leave?
Is there a maternity/paternity leave policy?
What are the CME benefits (time off and stipend)?
Are there additional income opportunities (moonlighting, teaching, consulting)?
What expenses are reimbursed (licensing, board fees, memberships)?
3. Career Development: Beyond the First Year
Are there opportunities for leadership roles or academic involvement?
What is the pathway for promotion or advancement?
Are mentorship or onboarding programs available for new physicians?
Does the organization support continuing education or conference attendance?
4. Practice Environment: Assess the Day-to-Day Reality
What is the patient population like? What are the common conditions treated?
How are new patients assigned? Can I build my own panel?
How many patients am I expected to see per day or week?
What is the support team structure (RNs, PAs, MAs, scribes)?
What EMR system is used? Are physicians involved in EMR decision-making?
What quality metrics are tracked? How are they measured and used?
5. Organizational Culture: Find Out What It’s Like to Work There
How would you describe the culture of the organization or department?
How is physician well-being supported?
What is the leadership style? How accessible are department and executive leaders?
How are conflicts or concerns typically handled?
How many physicians have left in the past 5 years? Is it possible to contact them?
6. Long-Term Prospects: Look Ahead
Is there a path to partnership, ownership, or becoming a shareholder?
If I can’t become a partner, will I still have the opportunity to serve on committees or vote on important changes?
What are the organization's strategic goals or planned changes over the next 3–5 years?
Is there flexibility for role changes down the road (e.g., reduced hours, academic time, admin focus)?
7. Community and Logistics: Make Sure It Fits Your Life
What is the surrounding community like in terms of cost of living, schools, and lifestyle?
What support is offered for relocating (e.g., temporary housing, realtor support, moving expenses)?
Are there opportunities for physicians to connect socially or professionally outside of work?
If you have a spouse or significant other, will the community suit their needs and interests?
If your spouse or partner needs to find a job, will the organization provide assistance with this?
8. Exit Clauses and Contract Flexibility: Read the Fine Print
Does the contract include a non-compete clause? What are its terms?
What happens to bonuses or relocation benefits if I leave early?
Is there flexibility to renegotiate compensation or scope after the first year?
Are there limitations on outside paid non-clinical work like medical writing, speaking, legal consultations, or industry collaboration?
What is the termination process—by either party?
Final Thoughts
Job offers are about more than just numbers. They're about your well-being, your career trajectory, and the life you want to build outside the hospital, clinic, or lab. Leaving a job that’s a poor fit is incredibly stressful, not to mention a financial hit, so take the time and effort to ensure the opportunity aligns with your values and goals.
If you're navigating a career decision and want support thinking through the details, coaching can help. I work with physicians at all stages of their careers to clarify what matters most and move forward with purpose.
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