INTRODUCTION: Plastic surgeons endure years of training yet remain poorly equipped to negotiate their first employment contracts. We evaluated elements in typical plastic surgeon employment contracts and assessed their comprehensiveness. METHODS: A 16 question anonymous survey was e-mailed to ASPS members. We sought information such as years in practice, geographic area, practice type, number of surgeons within the practice, and legal standing of partnerships. We asked whether respondents sought legal assistance in negotiating their first employment contract. Respondents were asked how malpractice and disability coverage were obtained. They were asked if options included: compensation incentives; compensation by formula; percentage-based compensation; moving/relocation expenses; student loan forgiveness; signing bonus; expense reimbursements. We asked how content they were with their contracts while allowing commentary. RESULTS: Our survey generated 404 responses. Regional distribution was as follows: West 9.75%; Midwest 27.8%; Northeast 24.3%; South 37.3%. 46.9% reported having been in practice for at least 20 years. 61.4% reported being in private practice; 26.1% reported having been in academia. Regarding practice size, 32.9% worked in a group practice (3 or more surgeons), 22.4% in partnership, and 23.4% in solo practice. For partnerships, 40.7% had made formal legal and 9.28% had made informal arrangements. 64.2% of respondents did not seek legal assistance. 42.9% reported claims-made malpractice coverage; 17.2% tail; 24.4% unspecified coverage; 0.75% had none. 33.4% of respondents reported employer purchased policies, whereas 65.6% purchased their own. 72.9% indicated having “own occupation” disability coverage. 7% of respondents reported inflation-adjusted salaries of $100,000-$150,000, 23% each for $151,000-$200,000 and $201,000-$250,000, 19% for $250,000-$300,000, 15% for $301,000-$400,000, and 12% in excess of $400,000. For options, 39.3% reported compensation incentives, 14.6% compensation by formula, 13.9% percentage-based compensation, 29.0% moving/relocation expenses, 1.26% student loan forgiveness, 8.31% signing bonus, and 46.1% expense reimbursements; 31.0% indicated that none applied. Using a five-point scale, 9.46% reported being “extremely dissatisfied” with their first contracts (score of 1); 24.1% were “perfectly happy” (score of 5). 311 respondents offered advice, with themes including seeking legal counsel, cautioning against non-compete clauses, seeking mentorship, and considering eventual solo practice. CONCLUSION: As healthcare evolves, new plastic surgeons will be employed by institutions. Our results reveal critical elements that should be negotiated to ensure smooth transition to practice. We advise seeking an attorney familiar with the profession to protect surgeons’ interests. REFERENCES: 1. Korman JM, Furnas HJ. The business of plastic surgery: navigating a successful career. Singapore: World Scientific; 2010. 2. Koltz PF, Frey JD, Sbitany H, et al. Employment Satisfaction in Plastic and Reconstructive Surgery and Its Influence on Graduating Residents in an Evolving Health Care Climate. Plast Reconstr Surg. 2015 Jul;136(1):96e-105e. 3. Chen JT, Girotto JA, Kitzmiller WJ, et al. Academic plastic surgery: faculty recruitment and retention. Plast Reconstr Surg. 2014 Mar;133(3):393e-404e. 4. Satiani B, Nair DG, Starr JE, Samson RH. Essentials of negotiating for employment in a changing environment. J Vasc Surg. 2014 Jul;60(1):253–9. 5. Graebner NK. Perils, pitfalls, and benefits of a surgeon as a health system employee: the contracting process. Am Surg. 2011 Jun;77(6):669–74.