Think Twice: The Risks of Accepting Counter-Offers in Healthcare

8 Minutes

In the complex world of healthcare, making decisions about your career can feel overwhelming, especially if your current employer presents you with a counter-offer. Maybe your employer has discovered you’re looking for new positions before you’ve secured a new offer or maybe you’ve already handed your notice in.. whatever the situation, I’m hopeful this blog will be of use to you!

As someone who has helped hundreds of doctors (across Anaesthesia, ICU, Surgery and Pathology) find jobs in the NHS, I've seen the consequences of hastily accepting counter-offers, and so I want to share some important points for you to consider before making a decision.

Firstly, lets address the allure! When your employer finds out you’re planning a career move and decides to make you a new offer of employment, it can make you feel valued and newly recognised. Whilst it’s flattering to be appreciated for your work, promises made during a counter-offer process can often fall short in reality. Once you’re back in work, there’s a chance you’ll be left feeling disappointed and unsatisfied.  

Accepting a counter-offer can also affect your relationships at work and your future opportunities. Your colleagues might feel like you're not committed to your job, and your employer might not trust you as much.

But the biggest reason to think twice about accepting a counter-offer is that the comfort it brings you might not last. Staying in a familiar environment may provide initial relief, but eventually, you might find yourself dealing with the same problems you had before. Although every situation is unique, the most common reasons that I come across when I see doctors looking for new opportunities are:

  1. Lack of clinical exposure or too much exposure in one particular area
  2. Lack of career progression
  3. No promise of contract extension
  4. Lack of CESR support
  5. Unfavourable work schedule or hours
  6. Personal reasons meaning a change in location is necessary

Unless you fall into the bracket of number 5 (moving for personal reasons) – when a counteroffer is issued by a current employer, usually it will attempt to provide what it is that you feel you’re ‘missing’ or currently lacking. And, although I’m a big advocate for doctors being recognised for their full value and receiving the support that they deserve, my strongest belief when considering counter offers is that…

If your current department genuinely has your best interests at heart, then why would they not have already offered what they are promising now? And, why has it taken you to express your desire to leave and move on for your current employer to see your value?

Which leads me onto the things that you should consider when you’ve received a counter offer.

  1. Will anything change (other than salary or contract length)?
  2. Is it actually possible for the Trust to provide what it is you’re looking for? *This is super important for doctors considering a move due to the need for CESR support or differing clinical exposure. An offer that promises "full CESR support" is understandably attractive to someone who's working towards specialist registration, but it's so important to consider what the Trust are actually promising with this. Do they have dedicated CESR mentors? Do they have the clinic time to offer up for new clinical exposures? Do they have clinicians that have already completed a CESR application with them? Will you have designated SPA time for CESR paperwork? Do they have all the necessary subspecialties at the Trust for you to complete a portfolio? And, if they do, are they able to offer rotations or secondments?
  3. Will you feel more valued in you stay?
  4. Will the counter offer provide the growth, career progression and challenges that you were initially seeking?
  5. Consider the cultural aspects that made you unhappy in your current role. Will accepting a counter offer truly address those concerns?
  6. Is the contract length more important than the clinical duty? *In some cases, it genuinely is more important to the individual and so a promise of a permanent contract or annual extension may be the best thing. Either way, before you make a decision, it's important to weigh up the tenure against the professional development opportunities.

Before you decide to accept a counter-offer, think about why you started looking for a new job in the first place. Think about what you really want for your career in the long run.

I've seen many doctors regret accepting counter-offers (even after a few months of making the decision to stay), only to find out that the opportunities they once had are gone.

In conclusion, even though a counter-offer might seem like a good idea at first, it's important to be careful. Trust your instincts, think about your options carefully, and be open to new challenges and opportunities for real satisfaction in your career.

For full disclosure, I genuinely do believe there are some situations where staying at your current employer is the right move. It really is down to each individual situation and the motivations behind the initial job search. For me and my judgement, it really comes down to what it is you want from your long term career within the NHS.

On a more personal level, I truly am a firm believer that honesty is always the best policy. If you're unhappy in your current position within the NHS, my best advice is to BE HONEST! If your current department can do something to make you happier then they will and then you can happily avoid the stress of a counter-offer. If your employer can't make the changes you need, then it's probably time to explore new opportunities that can.

If you're an Oncologist and you find yourself facing a counter offer and would like some advice,  please feel free to drop me a line - I'm always happy to offer some objective advice! You can reach me using