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    Physician job offer comparison

    Compare 2–3 offers side by side at 1, 3 and 5 years. Counts what matters after you sign: bonus repayment schedules, tail coverage liability, wRVU cuts, loan forgiveness, and your state's non-compete statute. Your numbers stay in your browser.

    Runs in your browserNot legal or financial advice

    Time horizon

    Evaluates cumulative compensation, clawbacks if leaving, tail exposure, and loan forgiveness progress at:

    Student loans: $250k federal balance, 3 yrs residency PSLF creditEdit loan assumptions
    Scenario Presets:
    Private · auto-saved in browser
    Offer 1Internal Medicine (Outpatient)Nonprofit / PSLF

    Nonprofit Academic Medical Center

    State: TXBase: $285,000
    Net Realized Value (Year 3)
    $879,028
    Includes salary, wRVU pay, bonus kept, minus tail and loan payments
    What differs from the state rule and published norms

    No state-cap or benchmark deviation found in the terms entered.

    Cumulative CompensationBase $855,000 + wRVU $69,600
    $924,600
    2026 wRVU Efficiency CutRate restated: absorbs CMS -2.5% cut
    Restated
    Signing Bonus Retained100% kept (36 mo commitment)
    $40,000
    Tail Coverage Exit LiabilityEmployer pays 100% of tail coverage upon departure.
    $0
    Student Loans (PSLF)72/120 payments towards tax-free cancellation
    −$85,572
    Non-Compete Law (TX)5 mi, 12 mo · Texas limits physician non-competes (e.g. max 5 mi, 12 mo). Stated terms fit within numeric caps, but subject to statutory conditions.
    Subject to state limits
    Offer 2Orthopedic SurgeryFor-profit / no PSLF

    For-Profit Surgical Group

    State: TXBase: $385,000
    Net Realized Value (Year 3)
    $1,215,448
    Includes salary, wRVU pay, bonus kept, minus tail and loan payments
    What differs from the state rule and published norms
    • Non-compete distance: 15 miles exceeds statutory cap of 5 miles
    • Non-compete duration: 24 months exceeds statutory cap of 12 months
    • Signing-bonus clawback: Clawback is not prorated by time worked; MGMA norm is prorated repayment.
    Cumulative CompensationBase $1,155,000 + wRVU $219,960
    $1,374,960
    2026 wRVU Efficiency CutUnadjusted: loses ~$11,180/yr (88% procedural)
    −2.5% Cut
    Signing Bonus Retained100% kept (24 mo commitment)
    $60,000
    Tail Coverage Exit LiabilityPhysician pays tail out-of-pocket (~$110,000).
    −$110,000
    Student Loans (PSLF)Standard repayment (no PSLF)
    −$109,512
    Non-Compete Law (TX)15 mi, 24 mo (all sites) · Texas statute restricts physician non-competes. The contract's terms exceed state limits: 15 miles exceeds statutory cap of 5 miles; 24 months exceeds statutory cap of 12 months. Warning: Measured from all employer-owned or affiliated locations, compounding the geographic footprint into an overlapping metro exclusion zone.Before spending a negotiating request on this term, you can ask the employer to confirm in writing how the agreement complies with the statute, or take the comparison to an attorney.
    Exceeds state cap
    Offer 3Hospitalist (Internal Medicine)Nonprofit / PSLF

    Regional Health System

    State: PABase: $305,000
    Net Realized Value (Year 3)
    $954,656
    Includes salary, wRVU pay, bonus kept, minus tail and loan payments
    What differs from the state rule and published norms

    No state-cap or benchmark deviation found in the terms entered.

    Cumulative CompensationBase $915,000 + wRVU $82,500
    $997,500
    2026 wRVU Efficiency CutRate restated: absorbs CMS -2.5% cut
    Restated
    Signing Bonus Retained100% kept (36 mo commitment)
    $50,000
    Tail Coverage Exit LiabilityTail is 100% vested (employer pays).
    $0
    Student Loans (PSLF)72/120 payments towards tax-free cancellation
    −$92,844
    Non-Compete Law (PA)8 mi, 12 mo · Pennsylvania limits physician non-competes (e.g. max N/A mi, 12 mo). Stated terms fit within numeric caps, but subject to statutory conditions.
    Subject to state limits

    Edit offer

    Auto-populates typical tail costs and procedural wRVU shares.

    What this comparison shows that salary benchmarks cannot

    Salary reports and job boards (like Doximity and Marit) tell you whether an employer's initial salary number is in line with national or regional percentiles. But at the moment of signing, the headline salary is often not what decides whether an offer protects your wealth or impairs it.

    1. The Loan Forgiveness (PSLF) Wedge

    Public Service Loan Forgiveness (PSLF) cancels remaining federal direct loans tax-free after 120 qualifying payments at a 501(c)(3) nonprofit or government hospital. For a physician graduating with $250,000+ in federal debt who already accumulated 3–4 years of credit in residency, staying at a nonprofit employer can yield six figures of tax-free forgiveness. A private-equity group offering $40,000 more in base salary often yields less total wealth after accounting for private loan debt service.

    2. Bonus Repayment: Proration vs. Cliff Clawbacks

    AMN recruiting data shows signing bonuses average over $49,000, and MGMA data finds 80% of employers tie them to a 1–3 year commitment. A contract requiring 100% repayment in full (a cliff) exposes you to severe financial friction if you depart in month 22 of a 24-month contract. A prorated repayment clause releases your liability month by month.

    3. The 2026 CMS Efficiency wRVU Cut

    The 2026 Medicare Physician Fee Schedule cut work RVUs by 2.5% on approximately 7,700 non-time-based (procedural) codes. If an employer uses a standard 2025 per-wRVU conversion rate without restating or adjusting for the 2026 CMS efficiency cut, a physician performs the exact same procedural volume for 2.5% less production pay.

    4. State Non-Compete Law Changes (2025–26)

    Statutes in 30 jurisdictions void or strictly bound physician non-competes. For example, Texas law (effective September 1, 2025) caps physician non-competes at 1 year and 5 miles, requires a buyout capped at annual salary, and voids the non-compete entirely if terminated without good cause. Pennsylvania Act 74 (effective 2025) caps non-competes at 1 year and renders them unenforceable if the physician is dismissed. Knowing your state's statutory limits prevents you from signing an overbroad covenant or wasting negotiating leverage on terms the statute already eliminates.

    Notice: This tool performs mathematical modeling and statutory cross-referencing based on published state statutes and federal loan rules. It does not provide legal or financial advice. Contract enforceability depends on specific contractual language, local court jurisdiction, and individual circumstances. Consult a licensed health care attorney in your state before executing an employment contract.