How Early is Too Early?

[FindMeOnTheLinks]

At the risk of inciting another job market flame war....

How early is too early in your residency to start reaching out to establish relationships and get your foot in the door towards first attending job?

Leaning heavily towards rural private practice in midwest or south FWIW. Am only an intern currently so obviously don't even have a good understanding of this field nor what makes for a good job, but with the current climate just want to get an idea of when to start that process. I understand for academics, usual timeline PGY4 and many interviews are done at ASTRO during PGY-5, but was curious if its much different for private practice. Would rather be proactive than reactive. Anybody had success establishing PP connections as a PGY-2/3?

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[thecarbonionangle]

At the risk of inciting another job market flame war....

How early is too early in your residency to start reaching out to establish relationships and get your foot in the door towards first attending job?

Leaning heavily towards rural private practice FWIW. Am only an intern currently so obviously don't even have a good understanding of this field nor what makes for a good job, but with the current climate just want to get an idea of when to start that process. I understand for academics, usual timeline PGY4 and many interviews are done at ASTRO during PGY-5, but was curious if its much different for private practice. Would rather be proactive than reactive. Anybody had success establishing PP connections as a PGY-2/3?

If you reach out to Carlsbad,NM now they may even sign you on spot and pay you a stipend all of residency Theres also always Quincy, IL

 

[Krukenberg]

At the risk of inciting another job market flame war....

How early is too early in your residency to start reaching out to establish relationships and get your foot in the door towards first attending job?

Leaning heavily towards rural private practice in midwest or south FWIW. Am only an intern currently so obviously don't even have a good understanding of this field nor what makes for a good job, but with the current climate just want to get an idea of when to start that process. I understand for academics, usual timeline PGY4 and many interviews are done at ASTRO during PGY-5, but was curious if its much different for private practice. Would rather be proactive than reactive. Anybody had success establishing PP connections as a PGY-2/3?

Reach out preferably by faculty connections, but if not cold email mid to late pgy 3, and set up casual meetings for pgy4 Astro. Keep in mind though that even with casual meets you’ll be sized up

 

[xrthopeful]

If you have a particular location in mind and have ties, it does not hurt to reach out. I probably would not bother until you were a PGY3 though. Definitely not as an intern, and even PGY2 seems too early.

 

[Chartreuse Wombat]

At the risk of inciting another job market flame war....

How early is too early in your residency to start reaching out to establish relationships and get your foot in the door towards first attending job?

Leaning heavily towards rural private practice in midwest or south FWIW. Am only an intern currently so obviously don't even have a good understanding of this field nor what makes for a good job, but with the current climate just want to get an idea of when to start that process. I understand for academics, usual timeline PGY4 and many interviews are done at ASTRO during PGY-5, but was curious if its much different for private practice. Would rather be proactive than reactive. Anybody had success establishing PP connections as a PGY-2/3?

Never too early to network. AT each opportunity introduce yourself to soon to be colleagues. Even if it is years before you are looking for a job it is good idea to get to know radiation oncologists that you run across. I have two in particular that I keep in touch with 25 years after meeting them as an intern.

The narrower "finding a job" can wait until PGY-4. Approach everyone as if they know something you don't (because they do).

Good luck

 

[metallica81788]

Make a list of everywhere you think you'd like to apply/work and the doctors that are there. Start casually reaching out to them via email first then phone maybe PGY3/4 transition, although it's never too early to network. Things are different if your residency is in a different region then you are trying to get to. Keep an open mind.

Not sure where you're doing residency, but don't hold any hope for your faculty to help you. I'm sure there are places where they can and will help establish connections and meetings, but treat the process as if you are the only one looking out for your future.

 

[GapCalc]

Not sure where you're doing residency, but don't hold any hope for your faculty to help you. I'm sure there are places where they can and will help establish connections and meetings, but treat the process as if you are the only one looking out for your future.

Sadly, this was my experience as well. I'm happy to have found a position I am happy with, but it had approximately 0% to do with outreach from those who were responsible for my training.

 

[Reaganite]

Never too early. Offer to do locums PGY3 if you can. (per my carrier this is the earliest they will provide coverage, although other carriers may differ). And agree with others--if youbarent gonna be staffing their satellite, your attendings likely wont give 2 ****s about you. I literally left residency without being asked one time where I was going to be working.

 

[medgator]

Never too early. Offer to do locums PGY3 if you can.

Key! Good way to develop those connections and see if there is a good fit on both ends.

Don't expect much out of your residency esp if you are looking for a job outside of where you trained. I came back to near where I grew up and actually had family connections in the area help me get my eventual job (that never made it to ASTRO career center) after my first mulligan out of training (which I did see on ASTRO!)

 

[Irradi8or]

Agree that even in casual meetups you'll get sized up. Some of my partners have done these casual meetups and they really can lead to a negative impression. Best to prepare and be on good behavior.

 

[deleted774703]

At the risk of inciting another job market flame war....

How early is too early in your residency to start reaching out to establish relationships and get your foot in the door towards first attending job?

Leaning heavily towards rural private practice in midwest or south FWIW. Am only an intern currently so obviously don't even have a good understanding of this field nor what makes for a good job, but with the current climate just want to get an idea of when to start that process. I understand for academics, usual timeline PGY4 and many interviews are done at ASTRO during PGY-5, but was curious if its much different for private practice. Would rather be proactive than reactive. Anybody had success establishing PP connections as a PGY-2/3?

First person I’ve ever heard say they want a PP job in rural MW = probably don’t have to do anything at all and you have a shot to be signed immediately

 

[medgator]

First person I’ve ever heard say they want a PP job in rural MW = probably don’t have to do anything at all and you have a shot to be signed immediately

Yup. Maybe with some loan repayment or a resident stipend too while the getting is still good

 

[Mandelin Rain]

If you're a FIRE kind of person, you want to come out making the best money you can (say 500-600k), in the lowest cost of living area, and continue to do so for 5-8 years and you can be done,

Average 600k over 8 years minus 60k for 401k/HSA minus 40% taxes is 325 take home. Could spend 75k (roughly twice as much as a resident take home) AND pay off 250k in student loans in year 1. Years 2-8 you dump that same 250k into taxable account and you'll have >2 million plus >500k in 401k.

By the 4% rule, you can now retire and withdraw >80k per year, in addition to any locums type assignments you may do.

It surprises me that there aren't more people that do this (I didn't do this, but many times wish I did). Note: these numbers are not available in SF or NYC.

 

[medgator]

If you're a FIRE kind of person, you want to come out making the best money you can (say 500-600k), in the lowest cost of living area, and continue to do so for 5-8 years and you can be done,

Average 600k over 8 years minus 60k for 401k/HSA minus 40% taxes is 325 take home. Could spend 75k (roughly twice as much as a resident take home) AND pay off 250k in student loans in year 1. Years 2-8 you dump that same 250k into taxable account and you'll have >2 million plus >500k in 401k.

By the 4% rule, you can now retire and withdraw >80k per year, in addition to any locums type assignments you may do.

It surprises me that there aren't more people that do this (I didn't do this, but many times wish I did). Note: these numbers are not available in SF or NYC.

I think the effective tax rate would actually be lower than that, esp if you can go to rural tenn, tx or ak etc where the tax rates are low/zero on income

 

[Mandelin Rain]

Just going for round-ish numbers.

But that's a pretty straightforward path to FIRE if you're looking at jobs where the OP is. Finish up your primary career before 40 and live a reasonably nice lifestyle on your own terms thereafter. Romantic.

 

[deleted1002574]

Most of those guys - PoF, WCI, etc - started investing in 2008. Any one would be a genius if their career started in late 2007, early 2007 and started investing right after the crash.

You could be dead in 5 years after starting your job. And after all that work, limiting your spending to less than a quarter of what you have post tax... doesn’t sound like a life. I mean the one guy was taking 1 week of vacation a year, taking his family on the most tightly wound trip ever. Good lord. There is too much good food to eat, concerts to attend, places to see, charity to give to, celebrations to be head... And then done at 40-45 working and still only being able to spend $80k a year. That doesn’t sound like living... we already gave up our 20s and early 30s.

Alternatively, you can save like a normal person at 20-25% of your post tax, and you know, go to a restaurant or two, Europe and few domestic trips a year, and retire at 60 rather than have your husband/wife and kids rolling their eyes when you have stopped buying salsa, because you can just raid the Taco Bell sauce rack every week, drive home in your beat up ‘98 Bonneville with no AC or heat and eat pre packaged ramen in your $150,000 2 bed / 2 bath condo in the worst part of town that you lived in as a resident.

 

[medgator]

FIRE seems really excessive but if my physician spouse could also swing a lucrative job in BFE, it's something I'd strongly consider. Easier for kids to change schools etc before late elementary school

 

[Mandelin Rain]

Most of those guys - PoF, WCI, etc - started investing in 2008. Any one would be a genius if their career started in late 2007, early 2007 and started investing right after the crash.

You could be dead in 5 years after starting your job. And after all that work, limiting your spending to less than a quarter of what you have post tax... doesn’t sound like a life. I mean the one guy was taking 1 week of vacation a year, taking his family on the most tightly wound trip ever. Good lord. There is too much good food to eat, concerts to attend, places to see, charity to give to, celebrations to be head... And then done at 40-45 working and still only being able to spend $80k a year. That doesn’t sound like living... we already gave up our 20s and early 30s.

Alternatively, you can save like a normal person at 20-25% of your post tax, and you know, go to a restaurant or two, Europe and few domestic trips a year, and retire at 60 rather than have your husband/wife and kids rolling their eyes when you have stopped buying salsa, because you can just raid the Taco Bell sauce rack every week, drive home in your beat up ‘98 Bonneville with no AC or heat and eat pre packaged ramen in your $150,000 2 bed / 2 bath condo in the worst part of town that you lived in as a resident.

You could also be dead the day you graduate residency. Man, would you look stupid then. I wouldn't make life plans around the possibility of a tragic, untimely death.

"Only" spending $80k per year seems out of touch with reality. If you're spending 80k, you have more than probably 75-80% of Americans. Americans who DO eat at nice restaurants and DO take vacations. At 80k of spending, you're not stealing food or living in a flea bag apartment. You're living a comfortable middle class life, with as much time as you want to spend with your family or supplement that lifestyle with occasional work. Maybe you need Diddy yachts, magnums of Ace of Spades at the club, and Manhattan high rises... but that's not everyone (exaggeration cuts both ways).

And the 4% rule doesn't assume the returns we've seen over the past 10 years (abnormally high). Rather, it considers the entire history of the market in America.

 

[medgator]

Easiest advice is to live the same lifestyle you had as a chief resident for a few more years and bank the rest

 

[Mandelin Rain]

Easiest advice is to live the same lifestyle you had as a chief resident for a few more years and bank the rest

I didn't get this advice at the time, but wish I had.

 

[Mandelin Rain]

To the OP, I don't think it's ever "too" early to start reaching out. No one is going to wait 4 years for you, but at least expressing some interest might keep you on a radar or two. I wouldn't reach out more than annually initially, though.

 

[deleted1002574]

I didn't get this advice at the time, but wish I had.

Orrrr .... you can save 20-25% of gross and retire at a normal age. Why do people want to do everything in extremes? Marathons. 20 hours of fasting. Remove X from your diet. Climb Everest. Weird.

$500,000 income at a hospital - $18k to 401k, $18k to 403b. $64k into a taxable account. $50k to your student loans. Once it's paid, off, transition that into savings. And, voila, you have about $150k to spend a year, and don't have to LLAR, opening those little ketchups packets and refilling your empty off-brand HEINTZ bottle and driving home in your '89 Coup De Ville that still has a cassette player.

 

[Mandelin Rain]

Extremes like saying someone spending 75k can't afford ketchup? I wonder who would be THAT extreme?



Thought experiment: I have to work ten hours a day to buy my name brand ketchup vs I buy off brand catsup and spend all my time doing whatever the hell I want.

I wonder why people would prefer the latter?

 

[FindMeOnTheLinks]

First person I’ve ever heard say they want a PP job in rural MW = probably don’t have to do anything at all and you have a shot to be signed immediately

Have rural roots and tired of the rat race of the big city and academics. The improved financial dynamics don't hurt either

Thanks to all for your input.

 

[deleted774703]

Have rural roots and tired of the rat race of the big city and academics. The improved financial dynamics don't hurt either

Thanks to all for your input.

Nothing wrong with that at all! Good luck with your job search!

 

[Mandelin Rain]

Have rural roots and tired of the rat race of the big city and academics. The improved financial dynamics don't hurt either

Thanks to all for your input.

You may find that being a big fish in a smaller pond suits you very well. Becoming a known entity and fixture of/in a community is pretty cool.