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New Grad Job Offers Advice

Has 3 years experience.

Which offer would you consider?

  1. 1. Which offer would you consider?

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13 members have participated

I need some help with potential offers from recent interviews. I have had a lot of terrible offers including awful schedules, independent contracting that does not adequately compensate for taxes, no benefits with shady dealings, etc. Below are the most promising of what is left. I am a new graduate FNP.

Pain Management/Addiction - Help expand a private business that currently has one MD who is triple boarded and looking to redefine pain management (not cash for pills). About a 30 minute commute with no traffic and a really nice facility. Includes malpractice and health insurance (not sure how much of the premium would be covered). Other benefits pending formal offer (should be soon). Great potential for learning concepts and skills related to pain management. Really great doc who is excited to teach.

Cardiology - Part of a team of faculty and fellows at a teaching institution. Extensive orientation process with the possibility of running a low risk cardiology clinic after training (based on comfort levels, areas of interest, etc.). An hour commute with no traffic or would relocate. Full benefits including full coverage of health insurance and great retirement benefits. Looking for someone long term based on depth of training. Great group of doctors and would be in clinic with the head of the department at least once a week. No formal offer and others still interviewing. Would likely have to turn down the first offer to see if this one pans out.

Pay would be about the same for both. I worry about the former because of the current stigma of pain management and the latter based on desire for long term as it is my first job in a new role. Both would be great learning opportunities and have potential for extensive networking.

Any comments or advice?

TakeTwoAspirin, MSN, RN, APRN

Specializes in Peri-op/Sub-Acute ANP.

Just my opinion, but I would not accept an offer in pain management as a first position. I think the cardiac job will give you a much better skill base, and frankly is probably more highly regarded and good looking on your resume. The people I know who have worked pain management tend to burn out. The money can be good if you can handle it, but you will earn it.

BCgradnurse, MSN, RN, NP

Has 11 years experience. Specializes in allergy and asthma, urgent care.

I agree with the above poster. I think the cardiology job would best utilize your skills and give you a more broad based experience. Pain management can suck the life out of you if a clinic is not well run, and I have yet to see many that are. Please go back and read mountainaireNP's posts about her experience in pain management. They may help make your decision an easy one.

Good luck!

I agree with take two aspirin. In my area, pain management has to pay more to NPs because nobody wants it. No matter what the MD said, no matter how many certifications he has, you will be seeing 25 patients plus per day and doling out medications all day. My friends in this field just hate it, they all want to leave, they get very tired of dealing with many of the patients who are very manipulative and will do anything to get medication. Even if you are sympathetic to them at the start, you seem to get frustrated with them after just a few months. it is very limited, you will be doing very little diagnostic and prescribing beyond pain meds, and the frustrations do not seem to be worth it.

the cardiology position sounds so awesome! it looks like you are going to learn A LOT. if i were in your shoes, i think i would express interest in joining but meanwhile continue to interview just in case an offer does not pan out. i'm sorry to hear about your new grad interviewing experiences...i'm a new grad and share your pain!

I personally have no love of cardiology. That being said, I think pain management has a huge stigma and therefore patients are severely undertreated. I would love to learn more about alternative ways to treat pain. For what it's worth.


Has 3 years experience.

Update: Still interviewing and deciding. Will be shadowing in the pain management practice to check it out further.

I also have upcoming interviews for a family practice clinic with a big hospital system that I already work for which sounds promising. M-F 8-5 and rotating half day Saturdays. Pay would be a little less than the other two options, but the experience would be more general. Same 30 minute commute mentioned before.


Has 9 years experience. Specializes in Adult Internal Medicine.

Take the cardiology job :)

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Designer NP, MSN, NP

Has 18 years experience. Specializes in Occ med/Urgent care.

Take the cardiology job :)

Sent from my iPhone.

I second this statement!

I would shadow them all to see what would be a better fit for you. The Family Practice and Cardiology sounds great! I agree with everyone about the Pain Management Position. I work in a facility where people seek Antibiotics, and I swear it can be a uphill battle, so I can't imagine working in a Pain Clinic. That would drive me insane!When people hurt, cough, or just feel bad, they want a quick fix. Finding a job as a new NP is very challenging...Good Luck!!!!

I would shadow and talk to other providers there to get a real sense of how they like it. Another consideration is how much you'd be bringing home, espeically if you're driving 2 hours/day- that can really cut into your charting time if you have stuff to bring home. Otherwise, if all else is equal, I would take Cardio b/c there's more room for growth, better pay long term, better looking on resume, less burn-out, and better skill set. Good luck!


Has 3 years experience.

Another update: I had another offer in the mean time and ended up going with a FQHC about 10 minutes from my house with excellent benefits. Thanks for all of your advice!

Congratulations! 10 mins from your house?...nice! Keep us posted and Good Luck!:up:


Has 19 years experience. Specializes in Hospital medicine; NP precepting; staff education.

I do not see how to answer the poll, but I agree with the majority and think that cardiology would be the most beneficial as it would appear to be less "trendy" than pain management (a fine field, but niche, to be sure). I think there is staying power and so much opportunity for growth.


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