What Recruiting Really Costs: A Guide for MedTech Hiring Managers
The fee or the job ad is the smallest part of what a hire costs. How to count the whole thing, including the costs that never show up on an invoice.
FloodGate Medical · October 20, 2026 · 3 min read
Ask what a hire costs and most people name the recruiter's fee or the price of a job posting. Those are real, but they're the smallest part of the bill. The larger costs sit elsewhere: in the weeks a seat sits empty, in the months a new hire takes to reach full productivity, and, when a hire doesn't work out, in doing it all again.
In MedTech the stakes are higher than average. Many roles carry revenue or regulatory responsibility directly, the talent pools are small, and a vacancy in the wrong seat can delay a launch or a submission.
The direct costs
These are the costs that appear on an invoice or a budget line:
- Sourcing: job postings, job board subscriptions, recruitment marketing and referral bonuses.
- Search fees: contingency or retained fees when you use an outside firm.
- Assessment and verification: background checks, credential and license verification, and any assessments you use.
- Interview logistics: candidate travel, ride-alongs and on-site visits.
- Relocation and sign-on: relocation packages and signing bonuses.
- Your recruiting team: the salaries, tools and applicant tracking system behind in-house recruiting.
Cost per hire
The standard way to measure the direct cost is cost per hire: total external and internal recruiting costs over a period, divided by the number of hires in that period. The method was set out in a joint ANSI and SHRM standard, which makes it comparable from year to year and between companies.
Cost per hire is useful for budgeting and for spotting waste. It has one important limit: it only counts what you spent to recruit. It doesn't count what the open seat cost you while you recruited.
The costs that don't show up on an invoice
Vacancy cost
Every day a revenue-carrying seat sits empty, that revenue is at risk. An open sales territory doesn't just stop growing; existing accounts get less attention, and competitors notice. For non-revenue roles the cost shows up as delayed projects, overtime and work done by people who should be doing something else.
A simple way to estimate it:
Daily vacancy cost = the contribution the role makes per day + the cost of covering the work + the cost of anything delayed
FloodGate's Vacant Territory Calculator does this for sales territories using your own numbers.
Hiring manager and interviewer time
Every interview, debrief and reference call takes time from people who are paid to do something else. For a senior hire with several rounds and a panel, the hours add up quickly.
Ramp time
A new hire is rarely fully productive on day one. In medical device sales, a new representative typically needs time to learn the products, earn case coverage, build trust with physicians and get through hospital credentialing before they're carrying a full quota. A hire who arrives with relationships and product knowledge ramps faster, which is part of why experienced MedTech candidates command higher pay.
The cost of a mis-hire
When a hire doesn't work out, you pay for the original search, the salary and severance, the lost productivity, the disruption to the team, and then another search. In a commercial role, you may also lose accounts. The cost of getting the hire wrong is almost always larger than the cost of getting it right.
How the sourcing method changes the math
| Method | How it's paid | Where it fits |
|---|---|---|
| In-house recruiting | Recruiter salaries, tools and advertising | High-volume roles, a strong employer brand and enough recruiting capacity |
| Contingency recruiting | A fee only when a hire is made, as a share of first-year base salary | Roles with a broad pool of active candidates |
| Retained search | Staged payments as the search progresses, commonly a third of first-year cash compensation | Senior, scarce and business-critical roles |
The cheapest method on paper isn't always the cheapest in total. A lower fee that produces a slower hire, or a hire who leaves within a year, can cost far more than the difference in fees. For more on the retained model, read executive search fees.
Building a realistic recruiting budget
- Start with what the vacancy costs. Estimate the daily vacancy cost first. It tells you how much speed is worth.
- Count the full direct cost. Include assessment, travel, relocation and internal time, not just fees and ads.
- Match the method to the role. Save the most rigorous, most expensive process for the roles where a mis-hire would cost the most.
- Plan for ramp time. Build the time to full productivity into the plan, especially for quota-carrying roles.
- Measure quality, not just cost. Track how long hires stay and how they perform, not only what they cost to recruit.
FloodGate Medical is a retained search firm specializing exclusively in MedTech, helping companies fill commercial, clinical, regulatory, quality and operations roles. See how a search works.
Frequently asked questions
How is cost per hire calculated?
Total external and internal recruiting costs over a period, divided by the number of hires in that period. The method was set out in a joint ANSI and SHRM standard, which makes it comparable between years and companies.
What does a vacancy cost?
A simple estimate: the contribution the role makes per day, plus the cost of covering the work, plus the cost of anything delayed. For sales territories, FloodGate's Vacant Territory Calculator works it out from your own numbers.
What does a bad hire cost?
The original search, the salary and severance, lost productivity, disruption to the team and another search. In a commercial role you may also lose accounts, so getting the hire wrong almost always costs more than getting it right.
Is in-house, contingency or retained recruiting cheapest?
It depends on the role. In-house suits high-volume roles, contingency suits roles with a broad pool of active candidates, and retained search suits senior, scarce and business-critical roles. A lower fee that produces a slower hire, or one who leaves within a year, can cost far more.
Traditional search is built to reward transactions, not outcomes.
Put a number on your open seat.
Tell us about the role, or run the numbers first with the Vacant Territory Calculator.