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Residents & Fellows Corner | Jul/Aug '15

The Fundamentals of Negotiating Your First Employment Contract

Negotiate wisely. Don't do it the hard way!

If you have been offered a position, congratulations! You are almost there. Now, it is time to start negotiating your employment contract. You are likely wondering where to begin, so here are some of the most fundamental dos and don’ts.

Think about what is of greatest importance to you when you receive your first proposal, and make a list. If there are certain aspects such as working weekends or in varied locations that are unimportant to you, note them, and focus on the items that you really value.

Ask for what you think is fair, and know what you are asking for. Consult industry professionals, friends, and colleagues if you are not sure what might be fair. Issues could include anything from the term of the contract to salary/incentive expectations to restrictive covenants and call schedules. Recruiters and consultants often have a better idea of the averages because they work on a national scale.

Absolutely ask for what you think you are worth, but don’t try to play hardball or leverage the situation. If you are asked about other jobs you are considering, by all means be honest but without trying to force anyone’s hand. If you feel reasonably comfortable with all of the major points, don’t nitpick minor details that might cause unnecessary second-guessing. It is okay to counter-propose; the employer is expecting it.Don’t request changes to the agreement just for the sake of doing so. Be prepared to be finished, if and when your counteroffer is accepted. Be respectful of everyone’s time and effort.

Remember that this is your career and that some details that others might find unsatisfactory may be fine for you. Just because it is not the “norm,” don’t let it stop you from agreeing to terms that seem attractive to you.

Consult an attorney. Sure, the expense might be a couple of hundred dollars, but your future is well worth the minor cost. Remember to verify that you will meet the necessary conditions for employment: licensing, insurance, credentialing, hospital, and surgery center privileges, etc.

Keep from being overwhelmed. The negotiating process can be demanding, but you will greatly benefit from keeping the lines of communication open with your potential employer. Fluid and prompt correspondence will help maintain momentum and reduce avoidable complications.


The absolute goal of negotiating a contract is a fair compromise for both parties. This contract is essentially the outline of your futures, and a win is what everyone wants. DO be ready to accept!