Should a new OB/GYN join a partnership track practice?

Yes, when the track is a written path with priced terms, and no, when the track is a verbal promise attached to years of associate pay. A track you cannot read is not a track. A real partnership track states how long the associate period runs, what the buy in costs and how it is paid, how distributions work once you are a partner, and who carries the premium and the tail at every stage. A vague track asks you to fund the difference between associate pay and partner pay for years, in exchange for an outcome the practice can reprice when you arrive.

Part of the OB/GYN hub.

What a real track puts in writing

Start with the associate period itself. The contract should state its length, your salary or production terms during it, and the exact conditions for the partnership decision at the end: a vote, a production threshold, or an automatic step on a date. An automatic step on a stated date is a term you can plan around. A vote with no stated criteria is a second hiring process scheduled years from now, and the years before it are spent at associate economics.

Then the buy in. Ask for the formula before you ask for the number, because a formula tells you how the price will move between now and your buy in date, while a number quoted today can be replaced by a larger number then. Ask how the buy in is paid: in cash, from withheld distributions across a stated period, or in installments, and ask what the buy in buys: a share of accounts receivable, equipment, goodwill, the entity itself, or some stated mix.

Then the partner economics you are buying into. Distributions follow the group documents, not the recruiting conversation, so read how collections, overhead, and the premium are allocated. The premium is the line to find first, because the AMA reports it at $49,804 a year in Los Angeles and Orange County, $135,974 in Philadelphia, and $243,988 in Miami Dade for a $1M/$3M OB/GYN policy. Your share of that figure comes out of the same collections that fund distributions, and groups allocate it differently: equally per partner, by production, or by claims experience. Ask also how the buy sell formula values your share at exit, because the exit formula is the second half of the price of joining.

The malpractice terms that decide the track

Partnership in OB/GYN is partly a malpractice arrangement, so the track documents should name the coverage terms at each stage. As an associate, who pays your premium, and is the policy occurrence or claims made? At partnership, does your premium share change, and does the group fund tails centrally or assign each departure its own bill? A tail commonly runs 150 to 200 percent of the mature annual premium, due as one lump sum when a claims made policy terminates. On the Philadelphia premium, $135,974 times 1.5 is $203,961 and $135,974 times 2 is $271,948. On the Florida premium, the band reaches $365,982 to $487,976. A track that brings you to partnership and then assigns you a personal tail at your first exit has moved one of the largest checks in the specialty onto your side of the table, and that term belongs in the decision from the start.

Ask what happened to the last two partners who left. Their treatment is the track terms in action: whether the group paid the tail or the departing partner did, and whether the buy sell formula paid what the document promised. Ask also what happens to your own tail if you leave during the associate period, because an associate who departs in year two can face the same claims made mechanics as a partner, at the moment her household reserves are thinnest. Heidi, the new attending in the Heidi and Spencer case, chose the employed route instead, with her employer carrying her tail, about $280,000 of loans on a Public Service Loan Forgiveness count, and an attorney reviewing her contract before she signed. A track has to offer ownership value large enough to justify giving up that carried coverage and that running loan count.

Finally, read the track against the restrictive covenant. A partnership path that ends with a covenant barring you from local practice if the partnership vote goes against you is asking for years of associate pay and your local career as the price of a no. The covenant terms on an associate exit should be read before the track is accepted, not after it ends.

Follow up questions

The track is two years and the partners will not state the buy in. Should I sign?

Not on the strength of the promise alone. A practice that cannot state its buy in formula has not priced its own partnership, and the price that appears in two years will be set by the people receiving it. Ask for the formula and the last associate buy in that actually closed. If the answers stay verbal, value the job as a two year associate position with no partnership attached, and compare it on that basis against employed offers.

Does partnership help or hurt a Public Service Loan Forgiveness count?

It usually ends it. Forgiveness requires full time work for a qualifying employer, and a private partnership is rarely one, so your count stops where the partnership begins. If your remaining forgiveness value across your 120 payments is large, finishing the count as an employee before joining a track can be worth more than an earlier buy in. The AAMC median education debt is $200,000 for the class of 2025, so for many new attendings this is a six figure ordering decision.

What if I reach the partnership decision and decline?

Then you are leaving, and the associate exit terms govern: your tail treatment, your covenant, and any repayment duties on bonuses or buy in advances. Read those terms now as the price of a no, because they are. A track with a personal tail and a wide covenant makes declining nearly as expensive as accepting on bad terms.

Related questions

• Should I take a hospital employed OB/GYN job or join a private group?
• Large group for malpractice coverage or small practice for ownership?
• What does buying into an OB/GYN practice with a malpractice history cost?

Sources

American Medical Association, Policy Research Perspectives, medical liability premiums (reported $1M/$3M OB/GYN premiums of $49,804 in Los Angeles and Orange County, $135,974 in Philadelphia, and $243,988 in Miami Dade, accessed October 2026)

Physician Side Gigs, malpractice tail insurance coverage (tail coverage commonly costs 150 to 200 percent of the mature annual premium as a one time lump sum, accessed October 2026)

Federal Student Aid, Public Service Loan Forgiveness (forgiveness after 120 qualifying monthly payments while working full time for a qualifying employer, accessed October 2026)

Association of American Medical Colleges (median education debt of $200,000 for the class of 2025, accessed October 2026)

Takeaways

• Join a track only when the associate period, the partnership decision, the buy in formula, and the exit terms are in writing before you sign.
• Price the premium share first: your allocation method decides what partnership pays, at market premiums from $49,804 to $243,988 a year.
• The tail at partnership and at exit runs 150 to 200 percent of the premium, reaching $365,982 to $487,976 on the Florida figure. Know who pays it at each stage.
• Partnership usually ends a Public Service Loan Forgiveness count, so sequence the count and the track by their dollar values.