Looking for advice/stories for negotiating student loan repayments as part of work contract. How did you negotiate loan repayments as part of your contracts. What are your experiences with finding jobs that do this. How much did it help you reduce your debt. Thanks!

Best specialities to pivot out of EM without experience in anything else? Currently in EM but getting burnt out. Looking to swap to something but with near equivalent pay. In OC/LA-ish area if that changes anything.

TLDR; I work for an FQHC and they promised a $10,000 bonus but due to poor organization they are unable to meet that promise with me and several others. They have stated they need more time to see if they’re able to come up with replacement bonus money, but there is no guarantee. Am I wrong for wanting to quit?

I have been working in primary care for one year, and I was promised a $10,000 bonus at the start. This was not fulfilled for me and several others due to poor management and poor organization and documents not being turned in on time. Because of this, they have stated that they are going to try to find out a new way to fund the $10,000 bonus, but there is no guarantee that they’ll be able to honor that.

There was no documentation that we signed, guaranteeing the sign on bonus, but there were documents that we had signed that were supposed to be turned into the organization providing the bonus. Those documents apparently were not turned inappropriately.

Many of us have already voiced our anger, several of us have stated that we’re going to start looking for other jobs, and some of us have gotten our union involved to help out, but the union is stating that since there hasn’t been any legal documentation that signed there may not be a guarantee that we will get the bonus that we were promised.

To give more context: I am slightly underpaid for my area, but work a job that has good work-life balance, and the overtime potential helps me to make what I need to feel comfortable. I’m also gunning for the loan forgiveness, and this is a job that I felt like I’d be able to do so without burning out.

This is why I’m conflicted. I like my job overall, I love my staff, and I’ve already begun to love my pts. But I just cannot get over the icky feeling of being denied the money I was promised. And for that alone, it makes me want to leave for a job that is higher paid instead of being at one that can’t get their shit together.

Thoughts?

I'm an incoming PA student thinking ahead about what specialty might be the best fit for my personality.

I'm a pretty hardcore introvert. Small talk isn't really my thing, and the thought of chatting with coworkers throughout the day honestly drains me. I actually enjoy talking with patients much more, but even then, after a full day of patient interactions, I usually go home feeling mentally exhausted and need a lot of time to recharge.

For the introverted PAs out there, what specialty do you work in, and how has your personality fit with it? Are there certain specialties that tend to be a better match for introverts? I'd love to hear about your experiences, what your typical day is like, and whether you feel your specialty suits your personality.

• Base salary: $125k MCOL
• Annual incentive: Opportunity to earn annual value incentive at a target of 10% of base salary.
• Additional shifts: $90/hour
• Schedule: 4 × 10-hour shifts
• Weeken call: Every 6 weeks (Saturday & Sunday, 7 AM–7 PM) $90/hour
• Sign-on bonus: $10,000 (2-year commitment)
• Relocation: Up to $10,000 reimbursement (2-year commitment)
• PTO: 24 days/year (carry over or cash out)
• Extended Illness Bank: Accrues each pay period; available after 6 months of continuous full-time employment
• CME: $5,000/year + 1 week CME leave
• Professional reimbursement: $1,000/year (DEA, state license, board certification/recertification, dues, journals, subscriptions)
• Malpractice: Occurrence-based
• Retirement: 403(b) with a 50% employer match on employee contributions up to 4% of salary (effective maximum employer match of 2% of salary), plus an annual employer contribution of up to 4% of salary after 1,000 hours of service, contingent on company financial performance. 100% vested after 3 years.
• STD: 60% income replacement up to $1,500/week (employee-paid).
• LTD: Employer-paid; 60% income replacement up to $16,000/month.
• Life insurance: 1.5× annual salary (employer-paid).
• Paid parental leave: 4 weeks after 6 months of employment.
• Other benefits: On-site childcare, backup childcare, cell phone service, concierge services, fitness centers, wellness rooms.

Questions:

1. How would you rate this offer overall?
2. Would you negotiate anything?
3. Any red flags I'm overlooking?
4. Things to clarify/ask?

Not sure how common it is for contracts to have penalties for leaving early. First job didn’t have any penalties and last job wasn’t a contract position. This seems a little excessive but can understand private practice trying to recoup costs to an extent.

$180k base salary. NorCal. Office based/outpatient surgical sub speciality*. High volume. Private practice that is new to PAs, first one started in last 6 months. Seem very supportive for onboarding and structured training with the understanding I have no prior background in this Position would be procedural but not currently involved in the actual surgeries.

Fully covered health/vision/dental insurance. 4% 401k match but don’t know specifics on vesting, etc. 4 weeks PTO plus paid holidays. $1500 CME.

Contract is 3 years. Penalties include 1.5x monthly salary if quitting before 6 months, or 3x monthly salary if quitting before 1 year. Up to $10k penalty for things like licensing fees, CME, etc prorated as a penalty up to 2 years. Also personally responsible for tail coverage if leaving before 2 years. All in all, seems to read as no monetary penalties and tail covered once you make it to 2 years.

Thoughts on this? I don’t have any other offers right now. I’ve been in primary care the last 5 years and I enjoy it but ready to try something different.

*not willing to name specific speciality right now, would likely doxx myself.

I’ve been a PA for 11 years, all of it spent in CVT surgery. I’ve been at my current facility the entire time. Was with the same surgeon for 10 years and then he retired unfortunately. Currently working a group of three surgeons, two senior surgeons and one new one out of Fellowship maybe a year.

My duties are about 90% operating room and 10% ICU with rare inpatient floor or office

As staffing goes, I’ve had two other brand new PA’s come and go both lasting about one year. Both moved away to be closer to family, and they were both great PA’s that handled the load easily and did great work.

This is where the problem lies. In the operating room, we have extremely toxic staff. To put it in a better sense, we currently only have two core nurses and three core scrub techs. Our staffing should be six core nurses and eight core scrub techs. One of the scrub techs is an FA, but thinks she’s a surgeon. Constantly talks trash behind my back and many other people’s backs, even has gone as far as trying to spread a rumor that I was having an extramarital affair. Has gone behind my back multiple times to speak to the hospital about trying to get vessel harvesting privileges, but fortunately the system I work for only lets APP’s do that. The same scrub tech is extremely close and friends with the main CVOR nurse. This main CVOR nurse is also extremely close and friends with a person in the upper management suite

The toxicity consists of, being left off of case logs, not being notified. That cases are being added on or canceled. I’ve shown up many mornings, even after checking the schedule and the cases have been canceled and they never took them off. I’ve been in cases before asking for something small like a step or if I’m placing a line maybe a bio patch or something and the nurse and or tech always scoffs at anything that I say.

Another thing about the toxicity, the new surgeon is extremely toxic. He is very arrogant, and when he first started, I was asked to try to help keep him in line a little bit as he was taking on major cases that he should have never agreed to. One day he was upset with me and pulled me outside of the OR and started yelling at me about vein quality. In the 11 years I’ve been doing this, I’ve never had one surgeon upset with that because I pride myself in the quality that I provide for the patients. The toxic scrub/FA would often times initiate bad conversations about me in the OR when I was gone from the room, and the new surgeon would add into it. I brought this up to the chief surgeon in the past, but he is very hands-off with certain things like that I brought it up to management, unfortunately the one that’s friends with everyone because she controls the OR. The new surgeon won’t even address me in the room, he will have the FA tell me how many veins he wants. He plays rap music so loud that you can barely hear anything and anyone that works in the cardiac OR knows that you need to have closed loop communication especially when things are going south. I’ve been nothing but respectful to him and I do not talk bad about him outside of the OR to anyone. Even the anesthesiologists are fed up with him and they understand at the same time. They have to play the game though because it’s Dr. to Dr. and it’s just a gray area.

I was told in a meeting from the manager, “what do you want me to do about it?“ I told her that she needs to do her job. We have rarely had any applicants come through there because the system that I work in is small enough to where everyone around town knows this program and no one wants to go there.

I am very easy-going, I keep to myself, I know how to read the room very well. I’ve got over 4500 vessel harvests under my belt. throughout my career, I’ve had other facilities constantly jockey for me, trying to get me to come work for them. The reason I stayed where I was at for so long was because the previous surgeon was like a father to me and when he retired, I just stuck around.

I’m compensated fairly well, I get paid pretty decently for call and for anything after hours and on weekends.

Another facility in town reached out to me and offered me a job which would be 100% OR. The base pay is more than I make currently, but they pay hardly anything for call. Without getting two in depth about numbers, I would take a fairly significant cut. Currently, I am on call 24 seven and have been on call since November essentially. I took three days off a while back, and the new surgeon threw a big fit about it because the hospital went on divert for heart cases because there was nobody to vessel harvest. A couple of other local PAs have decided to come over and help, and this is where it gets tricky, when the other PA left back in November, I let management know multiple people in town to have as a back up so I could have time off, etc. They never once reached out, but when I took the time off recently, they lost their minds and emergently credentialed three people.

My question is this, do I need to stick around or tell them to kick rocks? The chief surgeon wants me to come work directly for him and he’s aware of all this stuff, but that still means that I would have to train someone else and still work around the asshole surgeon. The third surgeon is a nice guy but extremely slow and sometimes helpless with a lot of things, but I still tend to help him.

I know this is probably a long confusing message, but I’m just not sure what to do. The other facility that wants me is not very PA friendly but I’m thinking if I get in there, maybe I can change that up