If not rad onc, where else would you suggest med students look?

[Mandelin Rain]

In case it wasn't clear. At no point did I imply that we drop to our knees 5 times daily to face Kansas City.

I do think it's a reasonable city, with reasonable amenities, and an airport to get you where you'd rather be if that applies. I think roughly 95% of people could find happiness there if they gave it a chance. Especially if they found a good job with a really good private practice group, which coincidentally, Kansas City has.

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[evilbooyaa]

I agree with I think both sides of the argument. I think people have their own preferences on where to live - I don't think there is anything 'wrong' with people who believe either way in regards to tolerability of living outside the top 5 populated cities. I think at the end of the day, if you are not willing to even consider living in a city as small as Cleveland or Kansas City, Rad Onc is not the right field for you.

If you would PREFER to be in SF, LA, Chicago, NYC, or Atlanta but are willing to consider smaller cities then this field could be for you.

 

[von Matterhorn]

Yeesh, that KC/Cleveland comment really stirred up some controversy. I don't think people should be so quick to judge those who have geographical preferences. Clearly some of you in this thread prioritize career, earning potential, etc. above other factors related to location. Other people prefer being near family, friends, the ocean, whatever. Why either side would judge the other is beyond me. Do what makes you happy in life.

Interesting side note - I met up with the PI I did previous research with. He has been in rad onc for 20+ years. According to him, he still gets recruitment emails/calls as often as he felt like he did at the start of his career. The only thing that has changed, in his mind, is that he no longer gets many ~500-600k base guarantees in smaller towns like he once did, and he said you generally have to work harder for your pay than you did 20 years ago. He was pretty insistent on there being a healthy job market otherwise. Kind of frustrating to see such radically opposing opinions on this, even on SDN. I don't actually believe the job market is that robust given some of the studies and data I have seen online, but there certainly seems to be a subset of rad oncs out there that, for one reason or another, are pretty convinced the job market is pretty good.

 

[deleted947887]

Yeesh, that KC/Cleveland comment really stirred up some controversy. I don't think people should be so quick to judge those who have geographical preferences. Clearly some of you in this thread prioritize career, earning potential, etc. above other factors related to location. Other people prefer being near family, friends, the ocean, whatever. Why either side would judge the other is beyond me. Do what makes you happy in life.

Interesting side note - I met up with the PI I did previous research with. He has been in rad onc for 20+ years. According to him, he still gets recruitment emails/calls as often as he felt like he did at the start of his career. The only thing that has changed, in his mind, is that he no longer gets many ~500-600k base guarantees in smaller towns like he once did, and he said you generally have to work harder for your pay than you did 20 years ago. He was pretty insistent on there being a healthy job market otherwise. Kind of frustrating to see such radically opposing opinions on this, even on SDN. I don't actually believe the job market is that robust given some of the studies and data I have seen online, but there certainly seems to be a subset of rad oncs out there that, for one reason or another, are pretty convinced the job market is pretty good.

Academic rad oncs are doing their best to attract canaries. The same thing happened in pathology.

 

[medgator]

. I don't actually believe the job market is that robust given some of the studies and data I have seen online, but there certainly seems to be a subset of rad oncs out there that, for one reason or another, are pretty convinced the job market is pretty good.

Probably the ones who aren't looking.

The farther out you are from training and/or looking for a job, the less credibility you probably have.

The data supports a deteriorating job market, supported by many anecdotes here and elsewhere.

Doubling spots in a decade was bound to do that eventually in the era of more observation, hypofx and sbrt

 

[Mandelin Rain]

I don't think people should be so quick to judge those who have geographical preferences. Clearly some of you in this thread prioritize career, earning potential, etc. above other factors related to location. Other people prefer being near family, friends, the ocean, whatever. Why either side would judge the other is beyond me. Do what makes you happy in life.

Literally every single person has a geographical preference. If you prioritize that above all else. Cool. That's awesome. This is probably not the career for you.


You also are a DO who wants a competetive, life style specialty who "fell into" rad onc research but is now spooked that you will not be able to practice where ever you want. You seem to be unwilling to round. You are apparently unwilling to do more research in the other lifestyle specialties to make yourself more competetive. You came here asking us to solve this problem for you.

At some point, you may need to do more than what makes you happy.

 

[winstonfoot5]

given some of the studies and data I have seen online

what studies are these?

 

[medgator]

what studies are these?

Search the forums. This is one example from a few years ago when the market was arguably better:

https://www.redjournal.org/article/S0360-3016(15)00337-5/abstract

"Seventy-one percent felt the job market was worse than what they anticipated when entering residency. Thirty-three percent found no job openings in their geographic area of preference. "

 

[deleted941485]

Probably the ones who aren't looking.

The farther out you are from training and/or looking for a job, the less credibility you probably have.

The data supports a deteriorating job market, supported by many anecdotes here and elsewhere.

Doubling spots in a decade was bound to do that eventually in the era of more observation, hypofx and sbrt

Also, as market gets tighter the geographic areas that have openings will be even smaller than it is now by the time these people graduate.

These idiot Med students keep telling me they are geographically flexible like a parrot that’s learned a few words. My next question is how flexible? I love asking them that because the mental gymnastics they perform to show just how flexible they are is a real riot.

 

[deleted18755]

Yeesh, that KC/Cleveland comment really stirred up some controversy. I don't think people should be so quick to judge those who have geographical preferences. Clearly some of you in this thread prioritize career, earning potential, etc. above other factors related to location. Other people prefer being near family, friends, the ocean, whatever. Why either side would judge the other is beyond me. Do what makes you happy in life.

Interesting side note - I met up with the PI I did previous research with. He has been in rad onc for 20+ years. According to him, he still gets recruitment emails/calls as often as he felt like he did at the start of his career. The only thing that has changed, in his mind, is that he no longer gets many ~500-600k base guarantees in smaller towns like he once did, and he said you generally have to work harder for your pay than you did 20 years ago. He was pretty insistent on there being a healthy job market otherwise. Kind of frustrating to see such radically opposing opinions on this, even on SDN. I don't actually believe the job market is that robust given some of the studies and data I have seen online, but there certainly seems to be a subset of rad oncs out there that, for one reason or another, are pretty convinced the job market is pretty good.

Big difference between getting a random call or email offering $500-600,000 and a written contract so I definitely wouldn't judge the market on that, especially now that there are more reliable data.

I can definitely verify that I work harder for my pay now than I did 20 years ago and I'm sure this trend will continue, but I assume that is the same for everybody in medicine and wonder if it's the case for 99% of American workers.

 

[KHE88]

These idiot Med students keep telling me they are geographically flexible like a parrot that’s learned a few words. My next question is how flexible? I love asking them that because the mental gymnastics they perform to show just how flexible they are is a real riot.

Flexibile like they'd be willing to go to a "rural" area like Kansas City?

Oh wait, here we've learned that even a large city like Kansas City is still totally unacceptable.

This field and the trainee attitude from the last 10 years is absurd.

We have a serious problem with rad onc providers in truly rural areas, yet the focus is on how we don't have enough women in this field as if there is some ghost in the machine keeping them out. Newsflash: women have had equal opportunity to go into radiation oncology for quite a while now. If there is a program out there discriminating against admitting women, please by all means show me. Or some systematic oppression occuring in medical school discouraging them from applying to this "boys club" specialty? Show that to me. Burden of proof is on you. I think the reality is that they are actually being elevated in the rank list based on commentary I have heard first and second hand. Perhaps there is some other reason it's not a perfect 50:50 ratio (such as self-selection based on inherent differences in the sexes) and that's not really a problem?

We could focus on real problems, like the maldistrubution in Trump fly-over deplorable country. But nobody cares about that.

 

[winstonfoot5]

Search the forums. This is one example from a few years ago when the market was arguably better:

https://www.redjournal.org/article/S0360-3016(15)00337-5/abstract

"Seventy-one percent felt the job market was worse than what they anticipated when entering residency. Thirty-three percent found no job openings in their geographic area of preference. "

Thanks for sharing. Interesting. I guess it depends on the perspective but this doesn't sound so bad. (glass half empty or half full?) This is from five years ago. "Combining respondents and nonrespondents, the unemployment rate for all 2014 graduates was at least 4.4% (7 unemployed out of 158 who sought employment) but no more than 7.9% (13 unemployed out of 164 who sought employment)." And that is counting fellowship as "unemployed". Does this mean 67% did find job openings in their geographic region of preference?

 

[RadOncDoc21]

Big difference between getting a random call or email offering $500-600,000 and a written contract so I definitely wouldn't judge the market on that, especially now that there are more reliable data.

I can definitely verify that I work harder for my pay now than I did 20 years ago and I'm sure this trend will continue, but I assume that is the same for everybody in medicine and wonder if it's the case for 99% of American workers.

I would speculate that there are more people involved who are in the middle (administration) that are getting paid for the increased amount of work we are doing.

 

[scarbrtj]

The "salary landscape" has definitely worsened over time. No one can convince me otherwise. The trend is a worry.
Albert Koong makes $600K; old-timers that were non-chairmen seem to make 'bout as much. In the 2003 timeframe, some rad onc chairmen were making 700-900K and they didn't have to be at MDACC to do so. All the residents I knew in that era wouldn't crawl outta bed for a new job less than 500K starting. Those were the days lol. Some chairmen nowadays seem to make a lot less than $500K; but this (I hope) prob doesn't factor in patient care.

I'm still relatively neophytic 'round here but this has been discussed *a long time* (and not just @SDN) and seems to be going from bad to real bad. Sad.

 

[medgator]

Thanks for sharing. Interesting. I guess it depends on the perspective but this doesn't sound so bad. (glass half empty or half full?) This is from five years ago. "Combining respondents and nonrespondents, the unemployment rate for all 2014 graduates was at least 4.4% (7 unemployed out of 158 who sought employment) but no more than 7.9% (13 unemployed out of 164 who sought employment)." And that is counting fellowship as "unemployed". Does this mean 67% did find job openings in their geographic region of preference?

the glass is 1/3 full, 2/3 empty. And this was based on the 2014 class. Can't imagine what the stats look like for 2018, with 800 new grads hitting the market since then

 

[radiaterMike]

FWIW - the reported salaries do not necessarily include bonuses (Jim Harbaugh makes more than what is reported for example)

 

[thecarbonionangle]

The "salary landscape" has definitely worsened over time. No one can convince me otherwise. The trend is a worry.
Albert Koong makes $600K; old-timers that were non-chairmen seem to make 'bout as much. In the 2003 timeframe, some rad onc chairmen were making 700-900K and they didn't have to be at MDACC to do so. All the residents I knew in that era wouldn't crawl outta bed for a new job less than 500K starting. Those were the days lol. Some chairmen nowadays seem to make a lot less than $500K; but this (I hope) prob doesn't factor in patient care.

I'm still relatively neophytic 'round here but this has been discussed *a long time* (and not just @SDN) and seems to be going from bad to real bad. Sad.

As Trump says, “we will see...” but not looking good folks!. SAD.

 

[SneakyBooger]

In 2025, this fellow treats breast cancer with a one week course; number of patients on tx =4.
What a difference decisions re: fraction number make! This guy lowered his professional salary from ~$1 million to less than $200K over a 20 year period.
Of course this is "only" a gedankenexperiment

$200K is still too much.
I hope ASTRO will see to it that rad oncs make far less.

 

[SneakyBooger]

I would go derm.

 

[seper]

Great find, thanks for sharing. About $270K starting at a large department, in a good city. Very consistent with what I hear personally.

Some chairmen nowadays seem to make a lot less than $500K; but this (I hope) prob doesn't factor in patient care.

I'm still relatively neophytic 'round here but this has been discussed *a long time* (and not just @SDN) and seems to be going from bad to real bad. Sad.

 

[Manatee3]

Here's what I know: I've worked in private practice in a large city, pulling in a lot of money but working myself to death- and for The Man- who was making way more money off the practice's combined efforts- and now in a small town, making less, but with a good QOL-this time making lots of $ for the Hospital.
Rad Onc is a "fun" specialty. I absolutely would not have picked this field way back 20+ years ago if I knew then what I know now. We are skilled at 1 thing, and to do this 1 thing, we require a bazillion dollar machine which someone else owns. If you are in a big city, your labor will be in competition with everyone else who wants your spot. You may be subject to a non-compete if and when you leave, which will probably make you have to move. In a small town, you will have to uproot and move completely also to find a different position. The good old days are gone.
I would look at interventional radiology- interventional oncology is a new branch of IR which looks fun. I wish we could train in that.
Even sports medicine or psych: where you can hang a cash-only shingle and have a low-tech practice sounds good to me.

 

[scarbrtj]

Here's what I know: I've worked in private practice in a large city, pulling in a lot of money but working myself to death- and for The Man- who was making way more money off the practice's combined efforts- and now in a small town, making less, but with a good QOL-this time making lots of $ for the Hospital.
Rad Onc is a "fun" specialty. I absolutely would not have picked this field way back 20+ years ago if I knew then what I know now. We are skilled at 1 thing, and to do this 1 thing, we require a bazillion dollar machine which someone else owns. If you are in a big city, your labor will be in competition with everyone else who wants your spot. You may be subject to a non-compete if and when you leave, which will probably make you have to move. In a small town, you will have to uproot and move completely also to find a different position. The good old days are gone.
I would look at interventional radiology- interventional oncology is a new branch of IR which looks fun. I wish we could train in that.
Even sports medicine or psych: where you can hang a cash-only shingle and have a low-tech practice sounds good to me.

Be careful. If telling the truth is a crime they gonna put you under the jail. This thing about “the man”. The kids that are getting out making 300-400k. They do realize that about 3 to 4 million is getting collected under their name from their care? This is a 10% commission sales job. I think the mattress salesman at Haverty’s does better. And rad onc has way less overhead percent.