Not negotiating your first contract could mean more than 1.5 million dollars left on the table, over the course of a career.

Physicians as a whole under-negotiate, or do not negotiate at all. Women in medicine, even more so. As a fellow finishing training in pursuit of a new position, I felt grossly underprepared to negotiate my first attending contract.

Fortunately, through the interview process and with the help of mentors and a lawyer, I was able to bridge most of this gap. But it was certainly a steep learning curve.

Always negotiate, do not cheat yourself!

This is by no means exhaustive, but these were a few tips given to me:

1. Clearly define duties (including hours worked, call schedule, vacation time).

   
   

2. Discuss and minimize restrictive covenants/non compete clauses (consult a physician contract lawyer who is based in your state of future employment—they will likely be able to assist with this).

   
   

3. Clarify all benefits (health, dental, malpractice insurance (type and length of coverage), 401K/pension, life/disability insurance, spouse/dependent coverage, CME time/money, relocation assistance).

   
   

4. Negotiate base compensation, any incentive based algorithms, overtime/call pay, moonlighting opportunities/restrictions, and potential loan repayment. Go into the process knowing your market value.

   
   

5. Address other ancillary support that may make your day-to-day easier (secretarial staff, a PA/NP to assist, personal office space, protected research/academic/administrative time, etc).