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Q&A: Are some things negotiable when accepting a job offer? How do you negotiate without jeopardizing your job offer?

Written by: Curtis E. Haas, Pharm.D., FCCP
Published on: Jan 19, 2022

Are some things negotiable when accepting a job offer? How do you negotiate without jeopardizing your job offer?

Mia Lussier, Pharm.D.

Postdoctoral Fellow

Geisinger, Center for Pharmacy Innovation and Outcomes

Danville, Pennsylvania


Accepting your first post-training job is a big decision that can affect the trajectory of your career. Any reasonable employer recognizes the gravity of this decision for a young professional and should welcome and expect some reasonable degree of negotiation and discussion before finalizing acceptance of an offer. Lack of willingness to entertain negotiation and discussion should be a warning sign to the candidate. A “take it or leave it” attitude is likely to extend to many other aspects of the future employment relationship as well. However, it is also important to recognize that room for negotiation is quite limited in the financial environment of most health care systems, combined with the profession’s current supply-demand dynamics. Moreover, although salary is the usual area of interest, other items are also important to consider during the negotiation process.

Most reputable employers structure a salary offer on the basis of current regional market data, the candidate’s qualifications and experiences, and incumbent salaries. Contrary to common fears, most employers do not “low-ball” an offer in an attempt to save money because that would create internal inequities, distrust, and employee dissatisfaction. Although there may be some room for negotiation, it is generally a narrow range because the employer does not want to create equity and compression issues with incumbents. Ethical employers bring forward a fair and equitable offer. However, it is also important to consider the entire compensation package. Although benefits are rarely negotiable, they can add considerably to the package – especially retirement programs and paid vacation time. Benefit information is usually available through the employer’s HR department, which the candidate should thoroughly review before accepting an offer. Benefits can include health insurance (medical, dental, vision, prescriptions), retirement account(s), flexible spending or health savings accounts, life and disability insurance, and employee discount programs, to name some of the more common ones. Candidates should consider eligibility for themselves as well as their family (or future family) members, even if they are single without dependents at the time of the offer. Some employers provide short-term disability (STD) insurance to cover a portion of the employee’s income during illness, injury, pregnancy, and childbirth. STD insurance coverage is not something to overlook if the candidate is considering starting a family. The process for requesting vacation, holiday, and professional time off should also be well understood before accepting a position, giving the candidate an idea of the employer’s scheduling flexibility, a common employee satisfier.

Depending on the type of position and the candidate’s pursuits, there may also be negotiable funds to support educational advancement, professional travel, board certification, or research endeavors. The availability of departmental resources to support these interests should be discussed during negotiations. Employers often have criteria to qualify for this type of funding, but the candidate should understand these criteria upfront. For example, travel funds may be available only for those who are actively participating (e.g., presenting, doing committee work) at a professional meeting, instead of merely attending. If discussed ahead of time, expectations will be clear and will allow the new hire ample time to complete the necessary requirements.

Start dates are usually situation-specific and thus negotiable. Candidates should consider the need for time off after their residency, their fellowship, or a cross-country move. If candidates have the funds to postpone their start date for a few weeks to rejuvenate and get settled, they should negotiate a start date that provides for a short time off. Although there is usually a limit to what an employer will consider, a few weeks is generally acceptable.

It is not uncommon for new employees to have preplanned events or travel that will occur before they accrue adequate time off, depending on the candidate’s “introductory period” policies. The negotiation process is thus an opportunity for candidates to indicate whether time off will be needed for personal (e.g., family trips, weddings) or professional (e.g., meeting days) reasons before paid time off is available. Even if these requested days are granted, however, they may still be unpaid, depending on the employer’s policy. Candidates should ensure these approved requests are documented in writing before signing the official contract and/or offer letter. Moreover, candidates should ensure these dates are approved by their future department head or boss, rather than relying solely on the HR department to communicate the stipulations of the agreement.

Candidates may feel pressured to accept job offers without mentioning the factors noted above to avoid jeopardizing the offer, but such issues are not unexpected, and reasonable employers will not withdraw an offer over the common areas of negotiation. These conversations should normally take place after a formal offer, at which point employers have already made their decision on candidate selection. Neglecting to address the details of the offer before accepting it can lead to future unhappiness (and increased turnover) in the workplace, negatively affecting both parties. Candidates should prioritize the items of importance to them and make their priorities known. Employers should be candid and honest about which requests they can actually accommodate.


Curtis E. Haas, Pharm.D., FCCP

Chief Pharmacy Officer

University of Rochester Medical Center

Rochester, New York

Content from a previously published article by Dr. Deanna Horner was modified and updated by Dr. Curtis Haas to provide the current answer.