Beyond the Offer: What Every Neurosurgeon Needs to Know About Contracts, Negotiations, and Recruiters
The American Society of Black Neurosurgeons (ASBN) kicked off its Life After Residency Seminar Series with an insightful session titled “Beyond the Offer.” This virtual seminar was designed to help neurosurgery residents transition successfully into their careers, focusing on the real-life considerations that residency doesn’t often cover: contract negotiation, legal protections, and the power of strategic recruitment.
Whether you’re approaching the end of your training or considering your next career move, here’s what you need to know.
Key Takeaways from the Seminar: Everything is Negotiable
Yes, You Need a Lawyer for Contract Review
Ericka Adler, a healthcare attorney with over 25 years of experience, stressed the importance of having an attorney review your employment contract—not just to negotiate better terms, but to ensure you fully understand what you're signing.
Pro tip: If it’s not in writing, it doesn’t count. Verbal promises mean nothing if they’re not included in your contract.
Top Contract Considerations:
Call schedule: Specify call frequency in the contract.
Work location: Clarify if you’re assigned to multiple locations.
Duties: Ensure your role is well-defined.
Compensation: Know the terms of bonuses, guarantees, and future raises.
Non-compete clauses: They're real, enforceable in most states, and often difficult to change.
Malpractice insurance: Understand the difference between claims-made and occurrence policies and who pays for “tail” coverage if you leave.
Negotiation is Expected—Don’t Be Afraid to Ask
"Everything is negotiable—until it isn’t," Adler explained. But you won’t know what’s on the table unless you ask.
How to negotiate effectively:
Focus on what's most important to you (e.g., call schedule, signing bonus, non-compete radius).
Prioritize your requests.
Frame your asks as questions, not demands.
Keep the conversation professional, collaborative, and cordial.
Example:
"Would it be possible to include a signing bonus?"
"I noticed the call schedule isn't specified—can we clarify that?"
Missed the seminar? Check out the “Everything is Negotiable” segment below!
Key Takeaways from the Seminar: Show Me the Money
Understanding the Role of Recruiters
Tessa Rolleston from Rossman Search provided insight into how recruiters can support neurosurgeons during the job search process.
What a recruiter can do for you:
Identify opportunities that match your personal and professional goals.
Provide insider knowledge on hospital systems, compensation standards, and practice cultures.
Serve as a liaison between you and the employer to keep communication smooth.
Help you organize and prioritize offers so you're making the best long-term decision.
Timing tip: Start your job search at least 18 months before finishing your training to allow time for interviews, site visits, and contract negotiations.
Red Flags to Watch For:
Employers unwilling to include key details in your contract.
Contracts with unlimited call requirements or no cap on duties.
Large portions of compensation labeled “discretionary.”
Contracts that “lock you in” for multiple years without an out.
Non-competes that cover wide geographic areas.
Surprise repayment clauses for bonuses if you leave early.
The transition from residency to practice is one of the most important periods in your career. Beyond just accepting an offer, you should:
Advocate for yourself.
Get the right support (lawyer + recruiter).
Know your worth.
Protect your future with a clear, fair, and transparent contract.
After years of training, your career deserves thoughtful planning—not just to survive, but to thrive.
Want more support?
Be sure to join the next session of the ASBN Life After Residency Seminar Series: Beyond the Paycheck Financial and Career Moves that Matter, and connect with trusted professionals Mr. Kyle Wort (Larson Financial) and Dr. Edie E. Zusman, FAANS , who are committed to ensuring your success both in and out of the operating room.