Yay!  You’ve gotten an offer…but it isn’t exactly what you wanted.  Is there wiggle room?  There might be.  Here are some things to consider as you approach negotiations.

Regarding non-clinical time (aka protected time)…It is ok to ask (within reason).

You can try to inquire about time and resources to pursue your interests using these strategies:

Avoid saying the words “protected time.”  It generally does not go over well.  Try “non-clinical time” or even “time and resources to do X, Y, Z.”

Remember, your time costs money.  Time not spent caring and billing for patients needs to be paid for by another means, either through the division or other parts of the hospital or grants.

Get a sense of how much non-clinical time other people in the division have and who is paying for that time.    This will help you gauge what is reasonable to ask for.  If nobody in the division currently has any, it is unlikely you will get 50% non-clinical time, no matter how amazing you are.

Remember, people want a return on their investments, so what skills did you gain in fellowship and how do you plan on making use of it with your time?  What will you show for your time at the end of year?  It is helpful to request time to do certain things and then include the deliverables that will come of that time.

For example: I request 20% research time to complete a pilot project in XXXX and apply for grant funding.   My goal  is to have an abstract and manuscript by 2 years and grant funding by 3 years.

How does your interests align with that of the needs of the institution?  Is there something they need that you can fill or bring and if so, would they be willing to support that with time and resources?

It takes time to get projects off the ground so if you planning on becoming grant-funded, it is not unreasonable to see if you can get support for the first few years as you prepare to submit for grants.

Be patient if you don’t get what you want.  Realize that you may have do your non-clinical projects on the side and demonstrate your worth for the first year or two.  If you can prove that you have something to contribute, you are more likely to get time to work on it in the future.

Regarding salary….

Know what you are worth.  It is important to have a sense of what the mean salary is for the region and nationally for pediatric hospitalists.  The average is about ~$140K but can vary, based on location and type of job.

You can find average pediatrician salaries by region on the US Department of Labor, Bureau of Labor Statistics website  or ask to see if someone in your division has access to the Medical Group Management Association report on salaries.

Remember, your salary may be standardized based on other people in the division so ask within reason.  Often times, the salary is set but there may be wiggle room in terms of sign-on bonus, relocation, CME, etc.

Also remember that non-salary benefits can be very attractive.  For example, some institutions may offer excellent health insurance for your family, pension or retirement plans, life insurance, home loan programs, day care for your children, productivity bonuses, etc.  All of this has value — sometimes quite a bit, so don’t just look at one number — your base salary.  Factor in benefits when comparing offers.

Regarding clinical responsibilities…

Again, get a sense of what members of the division currently have and what the criteria may be to getting those coveted teaching service times.  Lean back on your fellowship training as additional training in teaching skills and education that you can bring compared to other applicants.    Be willing to compromise and shuffle your time.  If you do less night shifts, you might have to do more day shifts or you may do less time on one less desirable service in exchange for more time on another less desirable service.

Remember your program director….

If you are struggling about what is reasonable to ask for, don’t forget to speak to your program director.  They are a great resource and may be a great advocate for helping you get what you want.

Above all, be polite and respectful when asking….

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