Why Changing Jobs Is More Than Just a Title Update

Changing jobs is about more than updating your LinkedIn profile or putting on a new white coat. For physicians, in particular, each move can affect not only your paycheck but also your benefits, family finances, legal risks, and even where your kids go to school.

Every job change means you need to take a hard look at:

• What you’re leaving behind (employer contributions, contract restrictions, benefits)
• What you’re getting next (new contract, pay, insurance, schedule, unique perks)
• How your transition will impact your wallet and peace of mind (insurance gaps, taxes, moving costs)

Even if you’re not a physician, many of these concepts carry over into other high-earning fields. Missing one important detail now can cause big headaches later.

Employment Contracts: Your Most Important Job Document

Why Reviewing Your Contract is Essential

A job contract isn’t just a formality. For physicians and high-income earners, contracts have hundreds of little details that can shape your short- and long-term plans. Both your current employer and your future employer will have their own set of terms, and understanding them up front will help you avoid unpleasant surprises.

A knowledgeable attorney can save you serious trouble. They can explain unfamiliar language, spot red flags, and help you negotiate changes. It’s worth every penny, whether you’re staying put, leaving, or choosing between multiple offers.

Key Contract Items You Should Review

Set aside some time with your contract(s) and pay close attention to these hot spots:

• Non-compete Clauses: Many physician contracts limit where you can work after leaving. These clauses can tie your hands for years, affecting your options within certain zip codes or specialties.
• Compensation Details: Know your base pay, bonus structure, relative value units (RVUs), relocation assistance, and student loan repayment bonuses.
• Schedule and Call Duties: Some roles require frequent overnight calls or weekend shifts. Clarity saves frustration later.
• Termination Clauses: Understand what can get you fired and what severance, if any, you’ll receive. Also, check what notice you must give if you want to leave.
• Restrictive Covenants: Along with non-compete, look for non-solicitation clauses that might prevent you from poaching staff or patients.
• Malpractice Insurance: Check whether coverage continues after you leave (tail coverage). For certain specialties (like OB/GYN or neurosurgery), tail coverage can be shockingly expensive.
• Benefits Package Overview: Look for details on retirement accounts (401k or 403b), disability and life insurance, paid leave (vacation, parental, sick), continuing medical education (CME) allowances, and any unique bonuses.

Here’s a basic checklist:

Contract Element	Review Points
Non-compete/Restrictive Covenants	Limits on future work (location, duration, scope)
Compensation	Salary, bonus, RVUs, loan repayment, relocation, extra perks
Termination and Notice	What ends the contract, required notice, severance, and causes for dismissal
Call/Schedule	Detailed breakdown of duties, hours, and expected call rotations
Malpractice Insurance	Who pays, tail coverage details, timing, and cost
Benefits	Retirement, health, life, disability, education, CME, leave policies

Tip: Contracts can sometimes be changed even after they’re first offered. If you don’t understand something, ask for clarification or see if it can be negotiated. Don’t sign until you know exactly what you’re agreeing to.

Maximizing Current Employer Benefits and Avoiding Mistakes

Vesting of Employer Retirement Contributions

Vesting refers to the point at which the money your employer contributes to your retirement accounts actually becomes yours. Your own contributions are always 100 percent vested, but matching funds may require you to stay a certain length of time.

Here’s a quick look at how vesting can work:

Years Worked	“Cliff” Vesting (All at Once)	“Graded” Vesting (Gradual)
1	0%	20%
2	0%	40%
3	100%	60%
4	100%	80%
5	100%	100%

If you’re close to being fully vested—maybe only a month or two away—waiting could mean thousands more in your pocket. Double-check these details before leaving your current job.

Stock Options and RSUs

If you or your spouse has stock options or restricted stock units (RSUs), check the vesting schedule there as well. Missing a big vesting milestone could mean leaving real money behind. “Cliff” vesting (all at once after a waiting period) is common with RSUs and stock options, especially in the tech and biotech industries.

Building Your Emergency and Transition Fund

Switching jobs isn’t always seamless. Even the best-planned moves can bring weeks or months without full income. That’s where your emergency or transition fund steps in.

What should your fund cover?

• Living expenses during gaps between jobs
• Moving costs (trucks, flights, deposits, new furniture)
• Unexpected emergencies (health issues, home repairs)

A good rule is to have 3-6 months of fixed expenses set aside. Families with kids or more complicated lives may want a bigger cushion.

Handling Health Insurance During the Switch

If you lose employer health coverage before your new plan kicks in, know your options:

• COBRA: Lets you extend your old coverage, but you pay the full premium (often much higher than you’re used to).
• Spouse’s Plan: If you’re married and eligible for your spouse’s employer insurance, this can be a good bridge.
• Marketplace or Private Insurance: Plans are available, but shopping takes time and may cost more out of pocket.

Plan for these extra costs, and don’t assume your new job’s benefits begin on Day 1.

Making Sense of Your New Employer’s Contract and Benefits

Reviewing Every New Offer with Expert Help

If you have multiple offers, have each contract reviewed by a qualified attorney. Your financial planner can compare salary and benefits, but legal advice comes from attorneys.

Line up your offers side by side and look at the complete package.

Key items to compare:

• Salary and bonuses
• Retirement plans (type of account, employer match, vesting)
• Insurance (health, dental, vision, life, disability)
• Paid leave and CME/training stipends
• Student loan repayment options
• Unique perks (such as tuition help, learning funds, relocation, or housing benefits)

Retirement Plans: Differences That Matter

Not every employer uses the same retirement plan. For example, hospitals affiliated with universities may use 403b or 457b plans instead of 401k plans. Eligibility and employer match vary widely.

Here’s how two offers might stack up:

Benefit	Employer A (401k)	Employer B (403b/457b)
Immediate Access	Yes	After 1 year
Employer Match	6% of pay, vests in 3 years	8% of pay, vests gradually
Plan Type	401k	403b and 457b (can use both)

If there’s a gap between jobs or a delay in plan eligibility, consider “back-loading” contributions to your current plan before you leave.

Tax Surprises: What to Watch For

Changing jobs can throw your tax situation into chaos if you don’t plan ahead:

• Sign-on and moving bonuses may push your taxable income higher for the year.
• Tax deductions for moving expenses are no longer available.
• When you land at your new employer, update your W-4 (the form that tells your employer how much to withhold from your paycheck).
• Many high earners find better results marking their W-4 as “single, zero” even if married, to avoid underpaying withholding.
• If you pay too much FICA (Social Security/Medicare) taxes because you hit the annual cap with multiple employers, you can claim a credit on your tax return, but your accountant needs to know about your job change to catch it.

Tax Tips for Job Changers

• Update your W-4 with each new job.
• Track cumulative FICA taxes for possible credits.
• Review any sign-on or moving bonuses for tax impact.
• Schedule a meeting with your CPA to review withholding and avoid underpayment or overpayment.

Location: The Impact of Cost of Living, Taxes, and Schools

Moving to a new city? The numbers might surprise you. State and city tax rules can significantly reduce your take-home pay. For instance, living in Tampa means no state income tax, but in Philadelphia, you’ll pay both state and hefty local taxes.

Schools also matter. Urban locations with well-rated public schools can save you big on private tuition. In some regions, private K-12 yearly costs might match in-state college tuition.

Don’t forget to consider daily living factors, such as traffic, public transportation, nearby restaurants, sports, cultural events, and how family-friendly a new area feels. Your quality of life matters as much as your paycheck.

Checklist When Comparing New Areas

• State and local taxes
• Public and private school quality and costs
• Real estate market and home prices
• Commute and transportation options
• Local amenities and recreational opportunities

Unique Academic Perks: Are They Worth More Than Extra Pay?

Academic hospital jobs often pay less on paper, but the extras can stack up, especially when it comes to education benefits. Tuition waivers for your children, full or partial tuition reimbursement at affiliated colleges, or generous retirement contributions can add up to six figures over time.

Public Service Loan Forgiveness (PSLF) eligibility is another big factor. If you’re on track for loan forgiveness, switching to private practice could cost you that benefit.

Always factor in these perks when comparing total compensation. Sometimes, what looks like a lower base salary can win out when you crunch the long-term numbers.

Real Estate and Capital Gains: Selling, Renting, or Holding

Planning to sell your home as part of a move? Don’t overlook the capital gains exclusion:

• Married filing jointly: Up to $500,000 of profit excluded from federal tax (if you’ve lived in the home for two of the last five years)
• Single: Up to $250,000 excluded

If you’re weighing renting your place instead of selling, consider the possible loss of this exclusion. Market booms have pushed many homes into this territory, turning what was once a minor detail into a key planning point.

Always check with a tax advisor before making final real estate decisions. Tax rules change, and local advice is priceless.

Your Job Change Action Checklist

Changing jobs isn’t just about signing one contract and starting another. Here’s a summary checklist to keep your plans on track and minimize costly mistakes:

Job Change Checklist:

•  Review current and future contracts with a qualified attorney
•  Compare non-compete, compensation, benefits, and work duties
•  Check vesting schedules for retirement account employer contributions
•  Review equity vesting dates (stock grants, RSUs, etc.)
•  Build an emergency and transition fund (3-6 months of expenses)
•  Plan for health insurance gaps (COBRA, spouse, private coverage)
•  Prepare for tax changes (W-4 updates, bonuses, FICA, moving costs)
•  Compare the cost of living, school quality, and taxes if relocating
•  Factor in educational and academic perks for yourself or your family
•  Review potential real estate impacts and capital gains exclusions
•  Involve your CPA or financial planner for detailed projections

You can find more planning tools, worksheets, and guides in the WealthKeel Weekly newsletter and resource library.

If you want deeper information on topics like the difference between 401k, 403b, and 457b plans, or to connect with expert planners or brokers, visit the Physician Cents resources page.

Final Thoughts

Changing jobs is an exciting opportunity, but it’s also a moment where missing details can pile up fast. Whether you’re a physician, a spouse in tech, a pharma exec, or another high earner, treat your transition like a business deal. Protect yourself by reading every contract, knowing your finances inside and out, and lining up your family’s needs before you make a move.

Build your team—attorney, financial planner, accountant—and use them. Invest your energy up front, and you’ll enjoy a much smoother landing in your new role.

Good luck with your transition, and remember, your next chapter deserves a strong start!