Your First Job Offer Is Here… Now What? 5 Questions to Ask Before You Sign

For residents and fellows, few moments feel more exciting than receiving that first physician job offer. After years of training, the idea of starting your career and finally earning a real salary is thrilling. But before you rush to sign, it’s important to pause. A job offer isn’t just about pay — it sets the tone for your career, lifestyle, and financial future.

Here are five key questions to ask before signing your first physician contract.

1. How Is My Compensation Structured?

A salary number is just the beginning. Is the contract based on a guaranteed salary, salary plus bonus, RVUs, or collections? Each model has pros and cons. Understanding how you’ll actually earn money is essential to avoid surprises.

2. What Are the Call Coverage Expectations?

Call duties can dramatically affect work-life balance. Ask how often you’ll be on call, whether holidays and weekends are included, and if call responsibilities are equally shared among physicians.

3. Who Pays for Malpractice Insurance and Tail Coverage?

Malpractice insurance is a major financial factor in any contract. If tail coverage isn’t included, you could be responsible for tens of thousands of dollars if you leave the position. Clarify who pays and how coverage is structured.

4. Are There Restrictive Covenants Like Non-Competes?

Non-compete clauses can limit your ability to work in the same area if you leave the job. Check the geographic radius and duration. Overly broad restrictions can hurt your future opportunities.

5. What Does the Termination Clause Say?

Can either party terminate without cause? How much notice is required? These details matter if you decide to leave or if the employer ends the agreement.

Taking the Next Step

Asking these questions ensures you go into your first job with clarity and confidence. The goal isn’t to avoid signing — it’s to make sure the contract supports your career goals, financial health, and personal life.

Use our Physician Contract Checklist to evaluate your offer in detail, and consider a professional review with ContractGuard MD to highlight potential risks before you commit.

Frequently Asked Questions

How soon should I respond to a job offer?

Employers often expect a response within a few weeks, but you should always review the contract thoroughly before signing.

Can I negotiate my first job offer?

Yes. Even early-career physicians can negotiate aspects like salary, bonuses, call schedules, or relocation assistance.

What if I already signed but have concerns?

If possible, request clarification or amendments before starting. In some cases, you may need professional guidance on your options.

Do all contracts include a non-compete?

No. Not every employer includes a non-compete, and some states limit or ban them. Always check your contract and know your state laws.