Finishing residency or fellowship brings your career to a pivotal position. Your first attending contract may look straightforward, but the details can shape your income, schedule,and mobility for years. Most contracts follow a similar structure, but the language inside each section matters. While you should closely review your entire employmentagreementbefore you sign, here are some areas to specifically focus on.
1.Base salary structure
A bigger paycheck is exciting, butdon’tlet the number distract youfromhow that salary is built.
Guaranteed vs ramp-up compensation
Guaranteed pay is fixed income not tied to productivity.It usually lasts for only the first year or two asan attending.Ramp-up compensation assumes your productivity will grow and may require you to pay money back if youdon’tmeet targets.
Watch for:
Guarantees shorter than one year
Productivity expectations thatdon’tmatch your specialty
High turnoveramongattending physicians
Knowyour worth
Salary benchmarks exist for every specialty and region. Employers use them, but the data may not be the most recent. You can use this informationas well to understand what a competitive salary should look likeand confirm the offer aligns with your specialty, location, and expectedworkload.It’salso okay to ask a potential employer about thebenchmarksthey used to calculate your offer.
2.Productivityexpectations
Your job contract willlikely referenceproductivity, usually measured throughwRVUs. Every visit, procedure, and service has awRVUvalue based on time, skill, effort, and risk.
Understanding howwRVUswork can help you evaluate whether productivity targets in your job agreement are realistic and whether bonuses tied toperformanceare achievable.
It’sokay to aska potential employer how manycurrentattendings meet theirwRVUtarget.If the number is low,or the answer is vague,that’sa warning sign.
3.Bonus structure
Not all bonuses are equal. Knowwhat’soffered, howit’searned, whenit’spaid, and whether conditions exist whereyou’dhavetorepay it.
Common bonus types include:
Sign-on bonus: review repayment rules, whether repayment is prorated, and whether the bonus is paid upfront or over time.
Retention bonus: usually paid after 1-3 years. Confirm the exact payout date and whether you must be actively employed to receive it.
Quality bonus: tied to metrics like patient satisfaction, compliance, or preventive care. Vague or unrealisticbenchmarks make these hard to earn.
Productivity bonus: based onwRVUs. Make sure targets align with your actual responsibilities.
4.Benefits package
Do not overlookwhat’sincluded in your benefits package.It can add tens of thousands of dollars to your compensation.
Retirement plans
Look for:
Employer match of at least 4-6%
Immediateor shortvesting
Access to a 401(k), 403(b), or 457(b)
Ifyour potential employerdoesn’tcontribute at all,oroffersvery littlein matching,it’sa big red flag.
CMEand professional expenses
Continuing medical education is a cornerstone of being a successful physician, and your employer should support you by providing a CME allowance.A competitive package includes $3,000-$5,000 annually plus 5-7 days of CME PTOthat can coverlicensing, DEA, board fees, credentialing, and society dues.
Malpractice insurance
Malpractice insurancecoverageis a must-have on your employment agreement, otherwise you could beouttens of thousands of dollars.You should have either occurrence-based coverage or claims-made coverage with employer-paid tail.
Health, dental, and vision
Ifyou’rea W2 employee your job agreement should ideally include:
Low-premium or employer-paid insurance
Reasonabledeductibles
HSA or FSA options
1099 employees willmost likely haveto find insurance on their ownas theywon’tbe eligible for group coverage from their employer.
Disability insurance
Employer-paid, long-term disability with own-occupation language is ideal when it comes to a group policy, butit’salsoa good ideato supplement with a personal policy that can follow you through your whole career. Both W2 and 1099 employees are eligible for personal disability insurance coverage.Ifyou’dlike to explore your options,reach out to ustoday.
Otherkey benefits
Dive deeper into your job contract and make sure the benefits package includes:
Employer-paid basic life insurance
20-30 daysof PTO
Paid holidaysand separate sick leave
Paid parental leave
Relocationsupport($10,000 - $20,000)
Student loan repaymentassistance
Onboardingand credentialing support
5. Non-competeclauses
Yournon-competedetermineswhere you can work if you leave your employer. It should be specific and reasonable.
Look for
Clear mileage limits(about15 milesurban and50rural)
Durationnolonger than24 months
Restrictionslimitedto your specialty
Exactlocations therestrictionapplies to(especially ifyou’reworking in a hospital system)
Exceptions forsituationslike employer termination without cause
A non-competeshould protect the employer’s business interests, not trap you in a job or force you to move to keep working.
6. Contract length, renewal,andtermination
After breaking down the minutiae of your job contract,don’tforget to take some time to look athow it functions overall.
Term Length
Most fixed-term contracts last 1-3 years. Confirm that length is clearlystatedwhether they renew automatically,and how negotiation works. Evergreen contracts renew yearly unless notice is given, so you should be proactive about requesting updates to compensation.
Termination
Your employment contract should outline thevarious typesof termination, including:
Without cause termination with 60-120 days’ notice for both parties
For cause termination with clearly defined reasons and an opportunity toremedy issues
Automatic termination for specific events like loss of board certification
Make sure repaymentobligationsandtail coverageresponsibilitiesare clear if the contract ends early.
7. Professional opportunities
How non-clinicalroles are supported is one other areathat should be outlined inyour employment agreement.
Stipends
If you take on extraresponsibilities, the job contract should specify:
Stipend amount
Payment schedule
Defined duties and time expectations
Available support and resources
Protected Time
Ifyou’regivenprotectedtime, it should be clearly defined and shielded from clinic overflow. This time supports teaching, research, leadership, and special projects.
Don’treview your contractalone
Physician employment agreements can be dense and unfamiliar. Getting professional help can clarify thefinancial impactof each clause and ensure the job contract supports your goals. The team at Physician Financial Group can help you evaluate your contract before yousign onthe dotted line.Reach out todaytolearn more.
Guardian, its subsidiaries, agents, and employees do not provide tax, legal, or accounting advice. Consult your tax, legal, or accounting professional regarding your individual situation. This material is intended for general use. By providing this content, Park Avenue Securities LLC and your financial representative are not undertaking to provide investment advice or make a recommendation for any specific individual or situation, or to otherwise act in a fiduciary capacity. Please contact a financial representative for guidance and information that is specific to your individual situation.8994564.1 (Exp. 7/28)