New grad PA torn between an accepted EM job and an unexpected Neuro ICU offer, MCOL Midwest
I’m a new grad PA and could really use some outside perspective.
About a month ago, I verbally accepted a position in a large academic ED that I was genuinely excited about. The only thing was it was lower compensation than I’d liked but it’s an academic hospital.
Since accepting, I’ve already been through about a month of credentialing/onboarding. I submitted my references, my references completed all the required forms, and the hospital has invested significant time into credentialing/privileging me.
Then this week I received the official formal offer from the ER position the same day I unexpectedly received an offer from a Neuro ICU at another major hospital system. The interview process at the ICU begun before I had an ER offer, but I continued through the process after the verbal offer just to see if they would offer me a job and what the compensation/ benefits would be.
ED offer:
$102K base + ~$5K value-based bonus, I don’t know if there is night shift shift diff
1,680 hours/year
Mix of 8- and 12-hour shifts
~2 weekends/month
1 week off each quarter + 5 vacation days
Start in December
Neuro ICU offer:
$130K days / $150K nights ($10/ hr shift diff)
1,612 hours/year
175 shifts/year
Split between two hospitals
about the same weekend commitment, but more flexible
I really like EM, but I’m also am okay with critical care and could see myself liking Neuro ICU, although neurocritical care wasn’t originally my main career goal. What I wanted to do with the ED is just work there for a couple years and figure out what I like then switch to a higher paying job.
I’m also struggling with the fact that I already committed to the ED job and they’ve invested a month of time into credentialing me and I submitted so many references for credentialing that already filled out the forms. I would hate to have to explain to my references and make them fill out more forms.
I’m also wondering if it would be reasonable to tell the ED about the Neuro ICU offer and ask whether there’s any flexibility in my starting salary, given that I already accepted about a month ago.
I guess I’m just asking how much weight should I put on accepting a verbal offer and working through credentialing. How bad would it look if I bailed and what would my references think? And would it look bad to negotiate pay after accepting a verbal offer a month ago (they never gave me much of a chance to negotiate to begin with)?