Negotiating For Your First Job - Some Thoughts For a Senior Resident About to Graduate

Yes, you can negotiate your first job.

Negotiating sounds scary. For some docs, the word conjures images of sitting across a table form someone, arguing loudly about why you deserve what you’re asking for. For others, it’s evokes the icky feeling of haggling at a car dealership.

Even if you think you’re comfortable negotiating, you might think you have no leverage to negotiate.

Negotiating for that first job is straightforward. It should not be a scary, intimidating or hyper-confrontational experience. If it is, then maybe you’re negotiating for the wrong job. The conversation should be a polite conversation between professionals. Initiate the conversation by respectfully asking for what you want.

What might you want?

Weekends off, certain days off, certain nights off, etc.

At this point, you’re probably thinking that’s impossible. If you’re only asking for what you want, yes, it will be difficulty.

Here’s the concept you have to use: To get something you have to give something. Think of your request as an offer for a trade.

But what do you have to trade as a graduating senior resident? You most likely are a well-trained, adaptable, energetic, emergency doc. However, you probably do not have a special skill, do not have a unique knowledge base, are not the best doc who ever graced an emergency dept, etc. What you have to trade is your time.

Here’s a couple examples to flesh out these concepts:

You need weekends free. Offer to work weekday nights.

You want ¾ time with full time pay. Offer to work that ¾ time as only nights.

You want 2/3 time with benefits. Offer to work a disproportionate number of unpopular shifts (nights/weekends).

Many more variations exist, based on what you need and what your prospective employer can offer.

Your employer will have limits on what they are able to do for you. They may also not badly need what you have to offer (i.e. another night/weekend person). However, many times they’ll be able to adjust “the standard package” somewhat if you offer something in return for what you ask. Only getting part of what you asked for is a lot better than getting none of what you asked for.

After you’ve come to an arrangement both sides agree with, make sure the language of your contract reflects the changes both sides agreed to. Make sure the language of your contract has no ambiguity.

There are certainly many more points to negotiating than the basic concepts in this post. However, as a senior resident, you have more ability to negotiate than you may think.

About me: I’m an emergency physician currently practicing in New York City. I did not negotiate for my first job, but have negotiated some aspect of every full or part time job I’ve had after that. I’m also the author of The Handbook of Medical Charting and A Guide to Clinical Decision Making.