M4 thinking strongly about applying to Rad Onc: Why is there so much dissonance between opinions real life and the internet?

[scarbrtj]

If anyone entered this field expecting millions a year like Reaganite and Scarb earn(ed), then yeah that sucks. I can see how you feel scammed.

This statement is a scam. I never said I earned millions. Every rad onc I know has made more than me. But “private plane money” era of rad onc over, and I only heard stories, never experienced it. Camel’s back could only take so much straw.

---

Members don't see this ad.

 

[Krukenberg]

One thing I will say to all of this is that as an organization, Astro is dominated by academics but not because they do not solicit community membership for their committees. Increased pp participation in the organization may benefit the field as a whole.

I think this can’t be emphasized enough. PP can’t just complain about ASTRO then not participate in it and expect anything to change.

Look at the Board of the American College of Cardiology: Officers and Trustees - American College of Cardiology

I count at least 5 board members who look like they’re in community practice.

 

[Neuronix]

1. The best analogy to account for the disconnect between "real life" [PGY5s report they are getting decent jobs] and "the internet" [established ROs like me spreading doom and gloom] is a person standing on train tracks with a train chugging towards her miles away. The train will eventually hit and it won't be pretty, but there is time before it hits.

I love ya G, but this is where I disagree. There is no train. Maybe those of you who got out into good PP positions see something coming that will destroy the high salaries of the entrenched groups. But for new or recent grads who will never become technical partners or hang out in academic satellites, how could we get hit by a train? Drop the starting salaries to 200k instead of 300k? Fellowship requirement for a sizeable percentage of new grads? I guess it could happen. Is that a trainwreck?

The disconnect between what you hear in person and what you hear online has two causes in my opinion.

First, as others have posted, academics are under a lot of pressure to stay positive and promote (self promote, promote their department, etc). Residents need to butter up their attendings to get jobs--nobody wants to be the negative one. Remember, it's the 3 "As" in that order! Affable is the first "A"! We've even had PDs on here who post that the most important traits in residents are #1. Personality, #2. Personality, #3. Personality. So... RAH RAH RAH Rad onc is great! Our program is awesome! (Psst: If I keep this up can I has job plz?!) The resident who actually fights back or even says anything not optimistic is labelled as non-affable, and what kind of rad onc has a bad personality? A bad rad onc--duh (3 "As" most important!).

Second, this is a slow downward trajectory. There will not be a year where all of a sudden nobody gets jobs. For the past several years, we have seen gradually increasing difficulties. Every year it gets a bit worse. Every year is a new normal. A few more people have to do fellowship. A few more people work locums or part-time. A few more people end up in rural nowhere for under $300k/year with no way out.

This is metaphor of the frog who boils in the kettle that is being slowly warmed. You put a frog in hot water and it jumps out. You slowly turn up the heat, and the frog boils to death with time because it doesn't realize that the heat is slowly increasing.

That's our specialty. Every year it gets worse. There are good new jobs every year. How many? I don't know. Nobody knows. I think we can all agree that there aren't 200. Let's say for funsies that there are 140 new jobs per year. That's 60 rad oncs who will come on here and post or just change their minds into accepting whatever cards they got dealt in life and move on. Still, there will be some posters like xrthopeful who will come on here and say everything's fine and if only you had just chosen the right residency program, or applied to every open job in the country instead of having any kind of preference, or whatever else, you would have fared as well as them and their buddies who got one of the 140 good jobs.

As long as we keep graduating 200, we will keep producing a percentage of unhappy rad oncs who are undercompensated, part-time employed, stuck in a location they find difficult to tolerate, or are otherwise dissatisfied. And what's undercompensated? I'm sick of these comparisons to "if I had gone into business". Compare yourself to other medical specialties like med onc and radiology where new grads are making 50-100% more and have basically their choice of location.

Just stopping expansion won't fix the supply-demand mismatch. Even if there was some will to fix this problem, it would take a long time to unwind the damage. The specialty needs to contract or the indications need to significantly expand to create demand. There is simply no evidence that radiation utilization will increase. Even oligometastatic disease (which Evilcore constantly denies me for anyway) is a small percentage of possible growth. Cardiac ablations? Also a niche area. Only growth area I've seen lately is in working for insurance companies denying rad onc care--though of course that salary (like locums) is a race to the bottom as rad oncs become further oversupplied.

 

[xrthopeful]

This is their second time posting, they must not be getting many hits. I encourage people in the market to apply. Partnership track position with bonuses

'radiation OR oncologist OR STATECODE:"KY"' Jobs | ASTRO Radiation Oncology Career Center

1,355 'radiation OR oncologist OR STATECODE:

careers.astro.org

 

[deleted956486]

Partnership? Where does it say that? Partnership with the university? Lol

 

[xrthopeful]

Ctrl-F is your friend.

I suspect it's a private group that has an affiliation and staffs some of their clinics. But looks like still a private group. Some 'academic' places still have that setup.

 

[medgator]

This is their second time posting, they must not be getting many hits. I encourage people in the market to apply. Partnership track position with bonuses

'radiation OR oncologist OR STATECODE:"KY"' Jobs | ASTRO Radiation Oncology Career Center

1,355 'radiation OR oncologist OR STATECODE:

careers.astro.org

Lexington is a cool college town, great college bball. I can think of less desirable places than Lexington.

 

[medgator]

Partnership? Where does it say that? Partnership with the university? Lol

It's Partnership with Lexington clinic, a large multi specialty group, which isn't the same as being employed by UK.

 

[RickyScott]

If anyone entered this field expecting millions a year like Reaganite and Scarb earn(ed), then yeah that sucks. I can see how you feel scammed.

I dont think any recent grads entered the field with those expectations. I do think most top medical students who entered the field have expectations of a job of minimum around 300k in their geographic region of preference . Otherwise, they could have chosen another interesting specialty that can easily provide this. The expectations of earning millions is somehow distasteful, but equally absurd/distasteful is this notion that radonc is the only enjoyable field in medicine: you found nothing else interesting in medical school? It is a total illusion of self (and yes, our sense of self is an illusion that you should seek to overcome), to think that you would be less happy practicing another specialty with better employment terms, geography, pay etc.

 

[evilbooyaa]

Lexington is a cool college town, great college bball. I can think of less desirable places than Lexington.

This referenced job is in Richmond, KY, approximately 1 hour outside of Lexington, KY.

Better than some other posted jobs in terms of location? Sure. But Richmond is a small town.

This idea of "don't have any preferences whatsoever and you'll get a job, see the field is doing just fine" is disingenuous IMO. The horror stories of residents posted over the weekend should not be minimized or explained away with how the resident is at fault.

I agree that there are not 150 good rad onc jobs available yearly. Good is a subjective term obviously, but I personally imagine that number is somewhere closer to 100-125. However, the folks that are of the position of "this is fine, everything is fine" will point to their own personal anecdotes/sample size.

I know people in good positions, I know of people in bad positions. I'm happy for those in good positions. I would like to minimize the number of people in bad positions.

Supply and Demand applies to us like it does for any employed position. As oversupply (the most recent job market papers suggest an oversupply, not an undersupply, but there's crickets in response to that) continues, salaries will continue to decrease, while administrators make more money. Now that last part is not unique to rad onc, but I agree that the comparison of Rad onc salaries should be done to med-onc and radiology. I'm not intimately familiar with radiology salaries, but I know most med-oncs are starting out at at least 1.5x what rad oncs are, with a much more available job market.

The previous mantra of Rad Onc was "you may not get the geographical city/state or even region that you want, but you'll have decent salary and/or lifestyle".

Now the mantra seems to be "apply to every job in the country and immediately sign be happy with the first offer that doesn't completely lowball you if you want to guarantee that you have a job".

 

[evilbooyaa]

Here are some no non-sense things I think we as a field can do to at least kick this can down the road (if not reverse the trend). Remember that drastic changes will likely be unpalatable to the field.

1) If you had to SOAP as a residency program within the last 5 years, you are not allowed to even apply to expand your residency program for 5 years from when you SOAPed. Hard stop, no appeals.

2) Increase minimums significantly across the board for all sites. Going from 5 to 7 interstitials is not enough. Going to at least 5 or 10 tandem insertions is literally 2 patients at most programs (that do 5 fraction cervical HDR), and is not sufficient. If a program is barely scraping by on brachy or pediatric experience with 8 (for example) residents, they will be forced to contract to allow residents to meet their numbers. No additional time to be given for 'revamping'. Either you can meet the numbers based on your current experience or you lose the residents. For example, a program that has 8 residents that log the minimum of 5 interstitials over the course of their residency: increase the minimums to 10, and the residency is only allowed to take 1 per year until they prove that their total case number exceeds 50, (if they want a 5th), 60 (if they want a 6th), etc.

3) Mandate that all attendings in academics have to go at bare minimum 2 months every academic year without resident coverage. While this may force even more satellite rotations, that will be a marker to medical students of how over-stocked a program is with residents. Do medical students really want to go to a place that will force coverage at 5 different hospitals during residency?

 

[medgator]

This referenced job is in Richmond, KY, approximately 1 hour outside of Lexington, KY.

Good catch, it was hidden in the first paragraph, although to be fair it's 25 miles from Lexington center per Google, about a 38 min commute.

Fwiw, that's my daily mileage/minute commute to one of my main practices.

Theoretically you could live on the outskirts of lex to commute there I imagine if you wanted it shorter.

Completely agree with everything else you've written

 

[evilbooyaa]

Good catch, it was hidden in the first paragraph, although to be fair it's 25 miles from Lexington center per Google, about a 38 min commute.

Fwiw, that's my daily mileage/minute commute to one of my main practices.

Theoretically you could live on the outskirts of lex to commute there I imagine if you wanted it shorter.

Completely agree with everything else you've written

Agreed. I'll re-phrase to 30-45 minutes drive and ability to work the reverse commute. My post was not meant to poo-poo the job - it sounds like a decent community satellite position.

 

[xrthopeful]

I see it as more than a community satellite, it’s a legit PP job with partnership.

Outside of like 1-2 that I know of, the majority of these types of great group practices (SERO, Chicago group, ROA in New England, Indianapolis group, Jacksonville one) involve staffing sites in potentially small centers (aka rural) with lots of drive time in between.

 

[scarbrtj]

I see it as more than a community satellite, it’s a legit PP job with partnership.

Outside of like 1-2 that I know of, the majority of these types of great group practices (SERO, Chicago group, ROA in New England, Indianapolis group, Jacksonville one) involve staffing sites in potentially small centers (aka rural) with lots of drive time in between.

Good catch, it was hidden in the first paragraph, although to be fair it's 25 miles from Lexington center per Google, about a 38 min commute.

Fwiw, that's my daily mileage/minute commute to one of my main practices.

Theoretically you could live on the outskirts of lex to commute there I imagine if you wanted it shorter.

Completely agree with everything else you've written

Theme song of the modern rad onc

 

[xrthopeful]

Second time in last month I’ve seen this Phoenix job posted too. Seems like people would want to apply.

Jobs on PracticeLink

www.practicelink.com

 

[thecarbonionangle]

I was a resident that just graduated this July, and I would like to share my experience with the job search. I started out wanting to apply for a job in a mid to large size city, but I did not get any interview offers. So I started to apply for small towns and rural places like the ones advertised by recruiters. That's how I got my first interview and offer, but I still wanted to live in a mid to large town within drivable distance (3-4 hours) to my or my wife's home state so I played the delay game with that rural offer. Guess what, that rural offer was filled in about 2 weeks. I then could not get any additional interviews until spring and close to graduation. I had to do some serious calling to recruiters and beg for interviews. Eventually I got one offer in a small town two plane rides from either my home state or my wife's, and the salary is in the mid 200s (about 100K lower than my first job offer). My job search was horrible and I lost weight stressing about not having employment after graduation. My advice for residents looking for jobs is to accept the first decent offer you get. Employers will low ball you once they know you are desperate as it gets close to graduation. I don't know how people are still getting good jobs because the other residents that I know have similar experiences as I. The miserable likes to co-miserate I guess. Just an FYI, my IM friend got offered 280K in a similar sized town/state as I. Our med onc fellows got offered 425K in a large metro popular with tourists. Med students wanting to go into rad onc at this moment must be crazy.

keep applying. important learning case up there. Pay attention applicants this year. The game is different now.

 

[deleted956486]

keep applying. important learning case up there. Pay attention applicants this year. The game is different now.

Falit also owns part of that practice (technical). Cant speak for him, but if that was me, I'd love a market that creates cheap labor.

 

[medgator]

Falit also owns part of that practice (technical). Cant speak for him, but if that was me, I'd love a market that creates cheap labor.

Same reason why academic chairs want it

 

[medgator]

Things will change only when they have to scramble for residents the same way their residents must scramble for jobs.

That's pretty much what they did in the 70s-90s

 

[thecarbonionangle]

The only thing that any of these selfish chairs will respond to is a dramatic drop off in the number/quality of residency applicants, which will ding their precious “prestige.” I know of several who were nervous about the match and concerned about drop in quality.

Still most stuck their heads in the sand and attributed it to a one-time fluctuation (ha!!) or boards fiasco, but if same or worse decline this year we may see substantive discussion and at least honest acknowledgement that residency expansion and declining job market is the real underlying reason.

Things will change only when they have to scramble for residents the same way their residents must scramble for jobs.

The recent match showed that chairs just care about a warm body. The guy who posted about “misanthropes” is a shameful panderer but there are many more. The best things about RUHUB is some already exposed themselves as being unable to be part of the solution. I look forward to this panel, the UCLA chair sure has our backs!

 

[Lamount]

There has been so much posted on this thread, that I wanted to absorb it for a couple of weeks before posting. I don't think I have any unique insight to offer but I am happy to summarize from my perspective:

When I was first applying for residency many years ago, Gfunk was a helpful voice of wisdom and encouragement... and since then, I have always appreciated his perspective. I agree the concerns that have been raised regarding residency expansion and its impact on the job market. However, I have always thought that this only represented half of the "problem". There is undoubtedly an issue of supply outpacing demand. The 'oversupply' component is discussed at length on these forums... however the 'under-demand' component is equally as important and is not addressed on these nearly enough.

Speaking as a neophyte who is just beginning his career, I think that we, as a specialty, do a very poor job of explaining our value to every-day people. Many patients I encounter have never heard of radiation oncology until they were diagnosed with cancer, despite its widespread use in cancer therapy... yet EVERYONE has heard of medical oncologists, radiologists, ENTs, Derms, Urologists, GIs, Neurosurgeons, Ophthalmologists... and all of the other specialists to whom we compare our compensation. How can we reasonably advocate for ourselves in congress when congressmen answer to voters who don't know we exist?

If 15 years from now, we have nothing better to offer than what we are offering today, we can't reasonably expect to be compensated any better... and can't be surprised if we are paid worse. In addition to devoting forums to hand wringing about negative trends largely beyond our control... we should devote some discussion to ways that we can actually improve things for ourselves.

 

[Lamount]

The only thing that any of these selfish chairs will respond to is a dramatic drop off in the number/quality of residency applicants, which will ding their precious “prestige.” I know of several who were nervous about the match and concerned about drop in quality.

Do you actually perceive these chairs as "selfish"? Do you think they are pocketing the money they make from forgoing an NP because they got another resident? They are responding to pressure to cut costs from above and demands to improve working conditions from below. One can reasonably accuse them of sacrificing the interests of the job market for the interests of their department, but "selfish" is a needlessly personal attack.

 

[Neuronix]

The ONLY reason to have residents is to educate them for their future careers, and academic departments are paid by society (Medicare) to do so.

Residents are valuable. Haven't you heard? The positions can be bought and sold now--going rate seems to be about $100,000 each.

The $55 million bid that won Hahnemann residency slots was ‘a big surprise’

The winning bid far surpassed the baseline bid of $7.5 million by Tower Health, which has an academic partnership with Drexel University.

www.inquirer.com

 

[medgator]

Residents are valuable. Haven't you heard? The positions can be bought and sold now--going rate seems to be about $100,000 each.

The $55 million bid that won Hahnemann residency slots was ‘a big surprise’

The winning bid far surpassed the baseline bid of $7.5 million by Tower Health, which has an academic partnership with Drexel University.

www.inquirer.com

https://www.bizjournals.com/philadelphia/news/2019/08/06/hahnemanns-proposed-residency-sale-opposed-by-feds.html

 

[deleted941485]

https://www.bizjournals.com/philadelphia/news/2019/08/06/hahnemanns-proposed-residency-sale-opposed-by-feds.html

Residents are valuable. Attendings...eh not so much.

 

[seper]

Unsavory Philly business practices. Good thing, CMS opposes this "human sale".

Residents are valuable. Haven't you heard? The positions can be bought and sold now--going rate seems to be about $100,000 each.

The $55 million bid that won Hahnemann residency slots was ‘a big surprise’

The winning bid far surpassed the baseline bid of $7.5 million by Tower Health, which has an academic partnership with Drexel University.

www.inquirer.com

 

[RickyScott]

In addition to devoting forums to hand wringing about negative trends largely beyond our control... we should devote some discussion to ways that we can actually improve things for ourselves.

The first step would be recognition by our professional society that there are "negative trends," and a position statement put forward like what happened in Emergency Medicine. They had no problem calling out residency expansion and requesting that stakeholders....

 

[medgator]

The first step would be recognition by our professional society that there are "negative trends," and a position statement put forward like what happened in Emergency Medicine. They had no problem calling out residency expansion and requesting that stakeholders....

The non response so far from ASTRO speaks volumes....

The Residency Training Landscape - ASTRO Blog- American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

A look at the overall training and oversight system that trains medical students to provide specialized care as a licensed physician.

www.astro.org

Honestly the comments are more insightful...

 

[thecarbonionangle]

Surprised that comments have not been deleted.

 

[scarbrtj]

.

Surprised that comments have not been deleted.

Am I reading astro.org or studentdoctor.net?! But now, technically and officially, the (nefarious, ill-favored) "internet message boards" include both astro.org and here.
Watch out!

 

[Lamount]

Are you kidding? Residents are not a means to “cut costs” for departments, nor are they a means to “improve working conditions” for faculty.

The ONLY reason to have residents is to educate them for their future careers, and academic departments are paid by society (Medicare) to do so.

And med students should choose a speciality based upon where they can do the most good rather than how much they will be compensated, but alas even moral people can occasionally act with impure motives.

Expansion of a residency program driven by the reasons you listed is by definition selfish. It may not enrich leadership personally, but if it makes their other INDEPENDENT responsibilities (cutting costs and improving conditions) easier, then it is selfish nonetheless. ESPECIALLY if it is done in the face of evidence that we are training too many residents.

We’re truly in a sad place if we no longer expect our leaders to lead by doing what’s best for their trainees, even if it means standing up to their bean counter bosses.

Example: Some chair somewhere chose to add another resident to help make a few overloaded clinics run more smoothly and didn't have enough funds to hire an NP. They prioritized employee satisfaction and decreasing patient wait times over concerns about our job market. Was this the right choice? Who knows. Was there a better way... could a more effective chair have found a work around? Quite possibly. In this example, was the chair being 'selfish'? Not by my standards.

More importantly, when has being rude and insulting ever been an effective means of persuasion? Will a chair read your post and have an epiphany?

Speaking broadly (not directed specifically to rad0nccc):

Many of the posts on these forums are self-defeating.
-Leveling personal attacks against 'academics' and then act surprised when they don't wish to engage on sdn. If you would like to have a respectful debate, then be professional.
-Imploring med students not to apply and then being upset when we have a terrible year at the match. Isn't this exactly what you wanted? Either SDN is having an effect on the residency pool, and its impact is not entirely positive... or it has having absolutely no impact at all and your posts are falling on deaf ears.
-Lamenting that our starting salaries are down to 300k from 500k a few years ago. Really?

Clearly, things are not so great right now. Contrary to what many may believe, these forums aren't helping.

Perhaps a moderator can start a sticky that discusses innovative research, community outreach... or other ways in which we can utilize the impact of the SDN community to help ourselves out of this slump.

 

[medgator]

And med students should choose a speciality based upon where they can do the most good rather than how much they will be compensated, but alas even moral people can occasionally act with impure motives.

Compensation has never been the overriding issue when folks are looking for jobs. Geography has, and to a lesser degree, qol. Scarbrtj has even posted data regarding this. Why the ongoing red herring arguments re: compensation?

Contrary to what many may believe, these forums aren't helping.

These "forums" shed a light on a problem ASTRO was happy to ignore for years while the shameless expansion of residency positions occurred during the era of hypofx/sbrt.

I guess you prefer information assymetry. Many of us do not.

 

[xrthopeful]

I think compensation has come up a TON, medgator. There were pages and pages about business salaries versus radonc lol. That’s not a red herring

 

[radOresident]

Example: Some chair somewhere chose to add another resident to help make a few overloaded clinics run more smoothly and didn't have enough funds to hire an NP. They prioritized employee satisfaction and decreasing patient wait times over concerns about our job market. Was this the right choice? Who knows. Was there a better way... could a more effective chair have found a work around? Quite possibly. In this example, was the chair being 'selfish'? Not by my standards.

or they could have had the attending run their clinic more efficiently. But no, let's continue to handicap these dinosaur academics who can't do their own job by adding residents to do it for them.

-Lamenting that our starting salaries are down to 300k from 500k a few years ago. Really?

Where I come from a 40% decrease in salary is a big deal. I'm glad to hear that you're perfectly fine losing $200k/year. If you're eager enough to lose more money, I'll gladly take it off your hands.

Clearly, things are not so great right now. Contrary to what many may believe, these forums aren't helping.

If it gets the message out to medical students not to go into this field, then it's helping. Unfortunately academic chairs will continue to be selfish (or, whatever you choose to label them) and take IMG/FMGs as warm bodies to get the work done until the system comes crashing down.

 

[Lamount]

Compensation has never been the overriding issue when folks are looking for jobs. Geography has, and to a lesser degree, qol. Scarbrtj has even posted data regarding this. Why the ongoing red herring arguments re: compensation?


These "forums" shed a light on a problem ASTRO was happy to ignore for years while the shameless expansion of residency positions occurred during the era of hypofx/sbrt.

I guess you prefer information assymetry. Many of us do not.

Compensation is discussed quite a bit on these forums... are these posts reflective of real concerns, or do they represent an over-exaggeration of a minor issue?

Shedding light is the first step. What next? Are we all only capable of "shedding light"?

 

[medgator]

Compensation is discussed quite a bit on these forums... are these posts reflective of real concerns, or do they represent an over-exaggeration of a minor issue?

Shedding light is the first step. What next? Are we all only capable of "shedding light"?

I have seen geography posted as a much bigger issue, subjectively, on SDN, borne out by the data posted previously in the forum.

Many of us have proposed solutions as well. It's incumbent on the specialty organizations like ASTRO to acknowledge the problem and do the same.

 

[Neuronix]

I think compensation has come up a TON, medgator. There were pages and pages about business salaries versus radonc lol. That’s not a red herring

We agreed with the several reported posts that these discussions were not productive and removed many posts on this topic.

Lamount, if you would like to start a new thread with suggestions about how to fix the issues discussed on SDN, you are welcome to do so.

 

[OTN]

And med students should choose a speciality based upon where they can do the most good rather than how much they will be compensated, but alas even moral people can occasionally act with impure motives.

Wanting to be compensated as much as possible for one's work doesn't imply "impure motives" it implies "human nature". This whole "physicians/radoncs need to be perfectly altruistic as human beings" is not realistic or fair, and administrators take advantage of it to our detriment: Opinion | The Business of Health Care Depends on Exploiting Doctors and Nurses

 

[fiji128]

This is their second time posting, they must not be getting many hits. I encourage people in the market to apply. Partnership track position with bonuses

'radiation OR oncologist OR STATECODE:"KY"' Jobs | ASTRO Radiation Oncology Career Center

1,355 'radiation OR oncologist OR STATECODE:

careers.astro.org

The local acedmic center bought the radiation services from this large multi subspeciality private practice group. The job is for a satellite about 30-40 mins from the main site. This particular site has had staffing trouble staffing for years. Now that its affiliated with the local university pay is probably around the 250K neighborhood now. I know a few years back they pay at this particular site was much higher. Welcome to the future of Rad Onc! Such a privilage to be apart of this.

 

[deleted956486]

The local acedmic center bought the radiation services from this large multi subspeciality private practice group. The job is for a satellite about 30-40 mins from the main site. This particular site has had staffing trouble staffing for years. Now that its affiliated with the local university pay is probably around the 250K neighborhood now. I know a few years back they pay at this particular site was much higher. Welcome to the future of Rad Onc! Such a privilage to be apart of this.

Partnership track guaranteed by xrt (hopefully?)

 

[xrthopeful]

It said in the posting it was for a partnership track. I posted it here, you know, to actually help people.

'probably around the 250k neighborhood' - lol I'm sorry this has been your experience but this is not realistic for this job, dude. Don't spread bad info.

 

[medgator]

The local acedmic center bought the radiation services from this large multi subspeciality private practice group. The job is for a satellite about 30-40 mins from the main site. This particular site has had staffing trouble staffing for years. Now that its affiliated with the local university pay is probably around the 250K neighborhood now. I know a few years back they pay at this particular site was much higher. Welcome to the future of Rad Onc! Such a privilage to be apart of this.

To be fair, the posting clearly states it involves the Lexington clinic and its partnership track. Makes me believe it is legit.

Hopefully this info is helpful to someone who can actually vet it out and report back here

 

[deleted956486]

Wanting to be compensated as much as possible for one's work doesn't imply "impure motives" it implies "human nature". This whole "physicians/radoncs need to be perfectly altruistic as human beings" is not realistic or fair, and administrators take advantage of it to our detriment: Opinion | The Business of Health Care Depends on Exploiting Doctors and Nurses

I completely disagree. Anyone coming into radonc should be willing to give up 5 years of their life, time with family, monetary gains, and, if need be, family altogether. You dont like it? Apply to IM.

 

[scarbrtj]

Speaking broadly (not directed specifically to rad0nccc):

Many of the posts on these forums are self-defeating.
-Leveling personal attacks against 'academics' and then act surprised when they don't wish to engage on sdn. If you would like to have a respectful debate, then be professional.
-Imploring med students not to apply and then being upset when we have a terrible year at the match. Isn't this exactly what you wanted? Either SDN is having an effect on the residency pool, and its impact is not entirely positive... or it has having absolutely no impact at all and your posts are falling on deaf ears.
-Lamenting that our starting salaries are down to 300k from 500k a few years ago. Really?

Clearly, things are not so great right now. Contrary to what many may believe, these forums aren't helping.

Perhaps a moderator can start a sticky that discusses innovative research, community outreach... or other ways in which we can utilize the impact of the SDN community to help ourselves out of this slump.

I like your optimism but you are being too naive and also too SDN penurious. SDN *is not* the problem. Just like seeing the Wizard behind the curtain was not the problem; Dorothy et al. woulda been short-shrifted either way had she and her crew not had overt evidence at the last second that they were in the midst of a scam. Med students and especially a potential rad onc resident are not so cavalierly swayed by an "internet message board" alone. As I have said before: SDN is one data point among many, and it is not easily dismissed as untruthful or incorrect. So SDN is neither helping nor hurting. "Exactly what [we] wanted" is anything but this and the present state of affairs.

 

[evilbooyaa]

And med students should choose a speciality based upon where they can do the most good rather than how much they will be compensated, but alas even moral people can occasionally act with impure motives.

Correct, and when they do so, it is not unreasonable for people to state that the behavior is reprehensible or unacceptable.

Example: Some chair somewhere chose to add another resident to help make a few overloaded clinics run more smoothly and didn't have enough funds to hire an NP. They prioritized employee satisfaction and decreasing patient wait times over concerns about our job market. Was this the right choice? Who knows. Was there a better way... could a more effective chair have found a work around? Quite possibly. In this example, was the chair being 'selfish'? Not by my standards.

We can play the semantics game all you want - a chair who adds residents for the above purpose is doing their department and the entire field a disservice. I thought chairmen and women were supposed to advance the field? Not weaken it for their own personal gain? Do you not realize that chair's bonus is directly tied in part to their ability to optimize stuff like that? That a chair is either 1) increasing his/her pocketbook or 2) taking the easy, wrong solution to their job of managing overloaded clinics? Are we really using the argument that "the path of least resistance" is what we want chairmen and chairwomen to pursue, and that's OK?

More importantly, when has being rude and insulting ever been an effective means of persuasion? Will a chair read your post and have an epiphany?

Those chairmen and women aren't ever going to have an epiphany on this. It's a matter of venting frustrations. They will have to retire and be replaced by people who actually care about the future of our field.

Speaking broadly (not directed specifically to rad0nccc):

Many of the posts on these forums are self-defeating.
-Leveling personal attacks against 'academics' and then act surprised when they don't wish to engage on sdn. If you would like to have a respectful debate, then be professional.
-Imploring med students not to apply and then being upset when we have a terrible year at the match. Isn't this exactly what you wanted? Either SDN is having an effect on the residency pool, and its impact is not entirely positive... or it has having absolutely no impact at all and your posts are falling on deaf ears.
-Lamenting that our starting salaries are down to 300k from 500k a few years ago. Really?

Clearly, things are not so great right now. Contrary to what many may believe, these forums aren't helping.\

Personal attacks against academics? Have you not read the posts about private practice docs are all money grubbers who overutilize IMRT just for the sake of their pocket books? There's negative comments across both sides of the aisle. There are both academicians and private practice docs active here. I likely wouldn't go somewhere people were calling me out for stuff, especially if I knew what I was doing was wrong or for the wrong reasons. This is why you don't have PP people routinely defending 40Gy in 20 fraction IMRT for a bone met on this forum, despite that being one of the insults to every private practice doc. Similarly, you have folks in academics not defending the chairmen/women who irresponsibly continue to expand residency. It's wrong, we know it's wrong.

Perhaps a moderator can start a sticky that discusses innovative research, community outreach... or other ways in which we can utilize the impact of the SDN community to help ourselves out of this slump.

We have had a number of posts on this forum regarding research and interesting case discussions, even in recent history. Again, we do not dictate what the topic of discussion is allowed to be on this forum.

 

[evilbooyaa]

It said in the posting it was for a partnership track. I posted it here, you know, to actually help people.

'probably around the 250k neighborhood' - lol I'm sorry this has been your experience but this is not realistic for this job, dude. Don't spread bad info.

Do you have personal knowledge of this job posting? @fiji128 appears to have inside knowledge about this job, like IRL. A recent PM from somebody who knows of this job personally says it's the red-headed stepchild of UKentucky.

The job posting can say whatever it wants - people are posting personal first or second-hand experiences. None of the stuff on the job posting is binding, it's the contract that is.

 

[xrthopeful]

Lol at chairmen/women working for a bonus like CEOs? Are you basing this on anything specific? Like have you heard of this happening before? What?


Also holy major intellectual dishonesty at acting like the rhetoric here is ‘equivalent’ in being anti-Pp and anti-academic. Even you don’t believe that

 

[thecarbonionangle]

It worries me when we cannot even agree on a simple thing that Chairs selfishly expanding is a clearly a bad thing. Some people are excellent pretzel twisters, good semantic gymnasts. It is how we get here to our present condition, however you want to describe it, people disingenuously equivocating that we don't have any trend yet and that we don't know anything about the future, now a clearly Selfish act if somehow not selfish to some. I don't get it and it leaves me without a full set of words of describe the situation, definitely a bad taste in my mouth. We will see what happens, as Trump likes to say!

 

[xrthopeful]

Do you have personal knowledge of this job posting? @fiji128 appears to have inside knowledge about this job, like IRL. A recent PM from somebody who knows of this job personally says it's the red-headed stepchild of UKentucky.

The job posting can say whatever it wants - people are posting personal first or second-hand experiences. None of the stuff on the job posting is binding, it's the contract that is.

I was replying to the NAM guy with the partnership part of the post/

And you’re a resident. Let me know when a PP job in an undesirable area offers 250k. The guy said ‘probably’ and not in a good faith way.