Private practice "rankings"

[deleted941485]

Exactly.

This forum has been eye-opening in regards as to what the silver spoon coastal elite regard as rural.
I literally got an email today about a practice in TX offering "over 600k + bonus."
I have a feeling it wasn't Austin.

It was probably Laredo or Lubbock

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[deleted941485]

The Chilicothe, OH, (which is about an hours drive from Columbus, OH) job filled like 5 years ago with someone who is still there I believe. There is not as many of these very high paying and quality rural jobs out there these days as there were in the recent past. I can't say that I even recall seeing the Minot ND job posted in quite sometime either. Some of the these same high paying rural jobs do seem to pop up every 2 or 3 years and I'm guessing that is because its not all $500K+ working 40 hours a week with a good infrastructure that advertisements make them seem to be.

Only an hour from a major metro.

 

[TDDro]

It was probably Laredo or Lubbock

The Laredo one has been offering a retainer during residency. IIRC one of the partners is looking to retire and it would be walking into a 900k/y job. Who knows what underlying work needs to be done though (physics, dosimetrists, machines).

Edit: the Lubbock one has offered the retainer

 

[medgator]

The Laredo one has been offering a retainer during residency. IIRC one of the partners is looking to retire and it would be walking into a 900k/y job. Who knows what underlying work needs to be done though (physics, dosimetrists, machines).

No income tax in tx. That's a new car every year

 

[deleted941485]

No income tax in tx. That's a new car every year

Maybe run into El Chapo.

 

[Radz08]

The Laredo one has been offering a retainer during residency. IIRC one of the partners is looking to retire and it would be walking into a 900k/y job. Who knows what underlying work needs to be done though (physics, dosimetrists, machines).

Edit: the Lubbock one has offered the retainer

So what’s the problem with the TX job? That’s an insane salary for no takers. Especially in the current job market

 

[TDDro]

So what’s the problem with the TX job? That’s an insane salary for no takers. Especially in the current job market

Well...it's Lubbock. It's literally in the middle of nowhere. About 400 miles from El Paso, 400 miles from Dallas, 500 miles from Austin. I think it's the largest town in that swath as well, with ~200k population and Texas Tech. So unless you grew up in West Texas (family), it's probably not enticing as a cultural fit. Not gonna find any 5-star restaurants. Would be good for someone with a family who all just want a simple, quiet life.

 

[deleted941485]

So what’s the problem with the TX job? That’s an insane salary for no takers. Especially in the current job market

Fails to compensate for the lack of really the loss of everything else. Most people aren't from Lubbock or know it. Its not exactly a shining city on a hill so no real cultural amenities. The people that work there are also probably just passing through as well. If you’re youngish and still single it’s also a double edge sword. Stack bank but nobody around to connect with. I see hear about these postings all the time and laugh.

 

[KHE88]

It was probably Laredo or Lubbock

I inquired about the Laredo job last year. Not surprised if it's still available. It sounded like a complete disaster ready to implode at any given second. All with the perks of being in a border town.

I'd much, much rather be in Lubbock, by a million miles.

What's interesting is the probably 10 different email I got yesterday from that job near Modesto, CA offer 550k + bonus starting. RVUs were like high 60s IIRC.

 

[deleted941485]

I inquired about the Laredo job last year. Not surprised if it's still available. It sounded like a complete disaster ready to implode at any given second. All with the perks of being in a border town.

I'd much, much rather be in Lubbock, by a million miles.

What's interesting is the probably 10 different email I got yesterday from that job near Modesto, CA offer 550k + bonus starting. RVUs were like high 60s IIRC.

I saw the Modesto one. It’s like living in central PA but with better weather I guess. You’re not really near the parts of CA that make it well CA. I guess better than kaiser perhaps...not really sure anymore

 

[psy3]

I saw the Modesto one. It’s like living in central PA but with better weather I guess. You’re not really near the parts of CA that make it well CA. I guess better than kaiser perhaps...not really sure anymore

It's 60 mile from far end of the east bay, Pleasanton, last stop for BART?? So, technically you can commute to work for 1hr ish depending on traffic and get to SF for the weekend. Certainly better gig at 550k than Stanford instructor gig if you need to be in SF area.

 

[deleted941485]

It's 60 mile from far end of the east bay, Pleasanton, last stop for BART?? So, technically you can commute to work for 1hr ish depending on traffic and get to SF for the weekend. Certainly better gig at 550k than Stanford instructor gig if you need to be in SF area.

Because we set the bar high here. Stanford “jobs” or Uber for Rad oncs shouldn’t even be considered an employment opportunity.

 

[KHE88]

It's 60 mile from far end of the east bay, Pleasanton, last stop for BART?? So, technically you can commute to work for 1hr ish depending on traffic and get to SF for the weekend. Certainly better gig at 550k than Stanford instructor gig if you need to be in SF area.

Sorry, it's not in Modesto. It's in Sonora, 50 miles NE of modesto. And salary is 500k, 550k is after bonus. My bad.

 

[deleted941485]

Sorry, it's not in Modesto. It's in Sonora, 50 miles NE of modesto. And salary is 500k, 550k is after bonus. My bad.

I checked my inbox. It’s actually 495K to be exact.

 

[thecarbonionangle]

Fails to compensate for the lack of really the loss of everything else. Most people aren't from Lubbock or know it. Its not exactly a shining city on a hill so no real cultural amenities. The people that work there are also probably just passing through as well. If you’re youngish and still single it’s also a double edge sword. Stack bank but nobody around to connect with. I see hear about these postings all the time and laugh.

Is this job really 900k? Thats crazy! I suppose for the right candidate it could be amazing. Single, willing to date a mature college student, may not be a bad gig for the right person! Food is fantastic im sure. Do they have a cracker barrel? Walmart?

 

[deleted941485]

Is this job really 900k? Thats crazy! I suppose for the right candidate it could be amazing. Single, willing to date a mature college student, may not be a bad gig for the right person! Food is fantastic im sure. Do they have a cracker barrel? Walmart?

Something about it always didnt seem right. The posting has been around for a while I think. what kind of contract do they make you sign. 2 yr commitment? The non compete is probably irrelevant. Probably expected to have 60 patients in treat or something cray. literally just signing the plans as they come in

 

[medgator]

Something about it always didnt seem right. The posting has been around for a while I think. what kind of contract do they make you sign. 2 yr commitment? The non compete is probably irrelevant. Probably expected to have 60 patients in treat or something cray. literally just signing the plans as they come in

Yup. Good luck getting coverage. Or sleep. 60 otvs in one day. Wowzas

 

[thecarbonionangle]

Something about it always didnt seem right. The posting has been around for a while I think. what kind of contract do they make you sign. 2 yr commitment? The non compete is probably irrelevant. Probably expected to have 60 patients in treat or something cray. literally just signing the plans as they come in

Just saying if true (is it?), that is a silly silly amount of money. If you got to have 60 on treat, you’d be very well paid, with weekends still.

 

[Neuronix]

I checked my inbox. It’s actually 495K to be exact.

Where do you guys get these emails from? Once or twice a month I get emails from recruiters trying to find open jobs or locums positions to place their people in. I probably get one or two emails a year about open opportunities and they never include details.

 

[thecarbonionangle]

Yup. Good luck getting coverage. Or sleep. 60 otvs in one day. Wowzas

Why can’t you spread 60 over a few days. These are generally pretty easy, with some exceptions. Why wouldnt your partners cover?

 

[thecarbonionangle]

Where do you guys get these emails from? Once or twice a month I get emails from recruiters trying to find open jobs or locums positions to place their people in. I probably get one or two emails a year about open opportunities and they never include details.

I was thinking same. Please share details of how to receive such emails

 

[medgator]

Why can’t you spread 60 over a few days. These are generally pretty easy, with some exceptions. Why wouldnt your partners cover?

I figured it was a single linac single doc practice with that setup and pay. Who knows

 

[TDDro]

Well consider that the referral basin is probably 200 miles in any direction, maybe encompassing a total pop of 1M? With no competition around they keep 95% of technical fees and 100% professional lol. I've never seen formal correspondence with the 900k number, just hearsay. I do know they've had difficulty even getting physics out there. Probably nothing wrong with the practice (who knows how old the machines are, but again....no competition). The guys are in their 60s/70s from what I understand and one is looking to retire.

Prob not a lot of neurosurgeons there, so probably bank off that GK too.

 

[thecarbonionangle]

I figured it was a single linac single doc practice with that setup and pay. Who knows

Didnt they say that one of the partners was retiring which makes me think it was a bigger group

 

[KHE88]

Where do you guys get these emails from? Once or twice a month I get emails from recruiters trying to find open jobs or locums positions to place their people in. I probably get one or two emails a year about open opportunities and they never include details.

I honestly have no idea. Probably has something to do with me casting such a wide next during my initial job search a year ago. I took every cold call from every recruiter no matter what and gave them my info.

I got probably 10 emails about jobs in the past month alone. All rural. Probably half offering salary, and all of those that disclosed numbers were 500k+
And then I'd typically get spammed the same job from multiple different places at once. I got the Sonora job from at least 3 different places, maybe 4.

 

[KHE88]

Just got a new one for Evansville, IN. Advertised a salary. 500k second year.

I really don't understand the people who say that can't find any rural opportunities paying 500k+.

I get these rural job searches all the time. Never anything non-rural. But still. If you're willing to live in Evansville, IN (not even truly rural, actually a small city), I feel like you'll still be fine.

 

[deleted18755]

Just got a new one for Evansville, IN. Advertised a salary. 500k second year.

I really don't understand the people who say that can't find any rural opportunities paying 500k+.

I get these rural job searches all the time. Never anything non-rural. But still. If you're willing to live in Evansville, IN (not even truly rural, actually a small city), I feel like you'll still be fine.

As I've stated before, those with sick parents, children with whom they share custody, or partners with careers that require specific regions or cities are one thing, but the fact that a recent graduate in his or her early 30's wouldn't take a job in a small city or even town with an internet connection for the kinds of salaries that are being thrown around, even if just for 3-5 years blows my mind (or makes me think these jobs don't actually pay as much as they say or are otherwise deathtraps).

If you're single just focus on helping a community in need (heck I know plenty of young people who went to every corner of the third world for more than a few years living in tents to provide medical and or humanitarian care while being paid almost nothing) and saving a ton of money, if you have a spouse even better since you can keep one another company (or planning your next VIP vacation, which you should be able to afford easily and I assume take every 2-4 months) and maybe he or she can work from home or whatever doing something meaningful, or if you are married to another physician I assume he or she would likewise make a fortune in the same place pulling in seven digits among the two of you living in a town where a household income of $50,000 is upper middle class. Leave by the time you'er 35-37 with a war chest or hang out another few years and quite possibly literally retire at 40 while your neurosurgery and many other friends from medical school are hardly a few years into their career!

The fact that nobody on this forum has done this or even mentioned knowing somebody who has leads me to believe "kids these days" are nuts or the jobs don't pay as much as they claim or are otherwise awful.

 

[KHE88]

The fact that nobody on this forum has done this or even mentioned knowing somebody who has leads me to believe "kids these days" are nuts or the jobs don't pay as much as they claim or are otherwise awful.

N=1 here. That's exactly what I did, so you're preaching to the choir. Given the instability in the field, this was a no brainer for me. Becoming financially independent as soon as possible.

The salaries are real and income potential is significantly higher than 500k. I had multiple offers, not just promise letters or verbal discussions, but real contracts waiting for my signature.

What it comes down to at the end of the day, is nobody is willing to live in a town where the only place to buy groceries is Wal-mart, the best restaurant is Longhorn steakhouse, and there is not a major airport within 5 hours driving distance.

 

[xrthopeful]

plenty of people are doing that. clearly many people have rad onc jobs in every corner of this country. plenty of non-rad oncs do that too. It takes multiple med oncs, breast surgeons, urologists etc to support one rad onc so clearly they're all out there making bank too.


and for the record, you can do quite well in rad onc making good money (500-600k as partner) in many legit cities as well. I don't know why people are acting like you can't? Many people here ARE or know people that are, so it's just BS to say otherwise.

 

[deleted18755]

N=1 here. That's exactly what I did, so you're preaching to the choir. Given the instability in the field, this was a no brainer for me. Becoming financially independent as soon as possible.

The salaries are real and income potential is significantly higher than 500k. I had multiple offers, not just promise letters or verbal discussions, but real contracts waiting for my signature.

What it comes down to at the end of the day, is nobody is willing to live in a town where the only place to buy groceries is Wal-mart, the best restaurant is Longhorn steakhouse, and there is not a major airport within 5 hours driving distance.

I probably shouldn’t have said nobody (especially since I’m far removed now from residents or really even any recent graduates) but just curious: are there many residents or new graduates who never planned on working in rural America who are now thinking “f it ... the job market is uncertain at best, I’ve got a lot of student loans, and/or I want to be financially independent ASAP so I’m taking the highest paid job I can regardless of where or if I have to work 80 hours/week as long as I can practice ethically for 3-5 or years or a little longer then seeing where life takes me!”

Maybe people like that just don’t post on this forum and quality jobs do indeed fill so it’s just the crappy ones that keep getting reposted. I have no idea.

 

[evilbooyaa]

It was probably Laredo or Lubbock

Laredo is hiring per recent recruiter e-mails. I haven't heard anything about Lubbock.

 

[KHE88]

I probably shouldn’t have said nobody (especially since I’m far removed now from residents or really even any recent graduates) but just curious: are there many residents or new graduates who never planned on working in rural America who are now thinking “f it ... the job market is uncertain at best, I’ve got a lot of student loans, and/or I want to be financially independent ASAP so I’m taking the highest paid job I can regardless of where or if I have to work 80 hours/week as long as I can practice ethically for 3-5 or years or a little longer then seeing where life takes me!”

Maybe people like that just don’t post on this forum and quality jobs do indeed fill so it’s just the crappy ones that keep getting reposted. I have no idea.

I don't know anybody else doing it. I think the problem is that residents are either:
Married and their spouse won't go to the middle of nowhere because they either don't want to be there or won't be able to get a job in their field.
Single and they don't want to go to the middle of nowhere and have no dating prospects.

Takes a certain inidividual. Such as someone returning to his/her rural hometown, someone who is single who doesn't mind putting off serious dating for at least a few years, or a married couple where the non-rad onc stays at home.
I'd wager all three of these categories combined account for <10% of trainees.

 

[KHE88]

Today's rural job email:

New Mexico: 550k+

60k signing bonus.

Nobody wants these jobs. They are there!

 

[Ray D. Ayshun]

Today's rural job email:

New Mexico: 550k+

60k signing bonus.

Nobody wants these jobs. They are there!

Where are they listed? It's not on ASTRO.

 

[medgator]

Where are they listed? It's not on ASTRO.

You have to hunt around... Practice match, practice link, physician career, comphealth, medical recruiters online etc are all sites that have these kind of jobs. Sometimes, the jobs are directly posted on the hospitals website itself

 

[deleted941485]

You have to hunt around... Practice match, practice link, physician career, comphealth, medical recruiters online etc are all sites that have these kind of jobs. Sometimes, the jobs are directly posted on the hospitals website itself

Funny most of these guys will come to me with some dog**** job in academia covering satellites expecting me to produce meaningful academic work on 1 day/week and this is in the midwest the supposed "promised land" haha.

When hunting for a job, take any major city draw a circle 2 hours around it and then quite literally put an electric fence around it surrounded by a moat of fire and that is whats available to the new grads.

 

[Neuronix]

Keep it professional not personal. The last two posts were over the line and I deleted them.

 

[medgator]

Funny most of these guys will come to me with some dog**** job in academia covering satellites expecting me to produce meaningful academic work on 1 day/week and this is in the midwest the supposed "promised land" haha.

When hunting for a job, take any major city draw a circle 2 hours around it and then quite literally put an electric fence around it surrounded by a moat of fire and that is whats available to the new grads.

Sure, if you stick to what's posted at Astro, avoid word of mouth jobs etc

 

[xrthopeful]

When hunting for a job, take any major city draw a circle 2 hours around it and then quite literally put an electric fence around it surrounded by a moat of fire and that is whats available to the new grads.

I'm going to keep it nice and clean and board-friendly so this doesn't get deleted.

This quite simply is not true or even close to true.

 

[evilbooyaa]

Funny most of these guys will come to me with some dog**** job in academia covering satellites expecting me to produce meaningful academic work on 1 day/week and this is in the midwest the supposed "promised land" haha.

When hunting for a job, take any major city draw a circle 2 hours around it and then quite literally put an electric fence around it surrounded by a moat of fire and that is whats available to the new grads.

I think this is extremely hyperbolic. If by major city you mean NYC, SF, LA, Chicago, Atlanta (let me know what else you consider a major city) I know of approximately 4-5 jobs that have been posted in those cities. At least 2 of them are for truly academic positions. I feel like it's an issue, but let's not become completely hyperbolic in our statements about the job market. The only way to be taken seriously is not to become the hysterical exaggerator that the twitter crowd says we are.

 

[Reaganite]

I think this is extremely hyperbolic. If by major city you mean NYC, SF, LA, Chicago, Atlanta (let me know what else you consider a major city) I know of approximately 4-5 jobs that have been posted in those cities. At least 2 of them are for truly academic positions. I feel like it's an issue, but let's not become completely hyperbolic in our statements about the job market. The only way to be taken seriously is not to become the hysterical exaggerator that the twitter crowd says we are.

Exactly. The hysteria is out of control and detracts from the real problems this board has done a great job addressing. I know of about 5 new grads in 1 of those cities alone with new jobs last probably 2 years, albeit all academic or hospital employed.

 

[Krukenberg]

Exactly. The hysteria is out of control and detracts from the real problems this board has done a great job addressing. I know of about 5 new grads in 1 of those cities alone with new jobs last probably 2 years, albeit all academic or hospital employed.

Can’t +1 this enough. If you’re just going off jobs posted on Astro then yea they tend to not be great, but way more jobs exist than what’s posted online. Do some purposeful networking over the course of residency and be in a position to get a word of mouth job. Small industries and specialties will always have a big emphasis on who you know.

 

[thecarbonionangle]

Can’t +1 this enough. If you’re just going off jobs posted on Astro then yea they tend to not be great, but way more jobs exist than what’s posted online. Do some purposeful networking over the course of residency and be in a position to get a word of mouth job. Small industries and specialties will always have a big emphasis on who you know.

Again with this narrative of if you just network enough, there is this fountain of amazing jobs out there that you might be allowed into. IDK if true or not. It works out for some people of course, but it isn't necessarily a better "extreme" or the "truth". People will never agree until we hit rock bottom, if we do. Some will say "I know so and so, and they are fine". For me it is basic math, I don't see things getting "better" unless we address oversupply long run, while we will have somewhat a reduced need for XRT. Objective data tells us that we are not addressing this. So I'm in the middle, I see the negative trends, some positive things with new indications (which I don't think will be enough, in my limited experience) and find myself very worried about the future. Maybe I worry too much, maybe not. We will see....

We have a multi-faceted emperor's new clothes situation in our field, where people see different things and even if they do see it, it may or may not be a problem in their eyes.

 

[deleted947887]

Again with this narrative of if you just network enough, there is this fountain of amazing jobs out there that you might be allowed into. IDK if true or not. It works out for some people of course, but it isn't necessarily a better "extreme" or the "truth". People will never agree until we hit rock bottom, if we do. Some will say "I know so and so, and they are fine". For me it is basic math, I don't see things getting "better" unless we address oversupply long run, while we will have somewhat a reduced need for XRT. Objective data tells us that we are not addressing this. So I'm in the middle, I see the negative trends, some positive things with new indications (which I don't think will be enough, in my limited experience) and find myself very worried about the future. Maybe I worry too much, maybe not. We will see....

We have a multi-faceted emperor's new clothes situation in our field, where people see different things and even if they do see it, it may or may not be a problem in their eyes.

I don't think anyone is really seeing anything. I think that those with 10-15 years left in their career figure, "Why rock the boat? This is not my problem." Especially those in academics going for chair type positions.

 

[Haybrant]

Actually I would agree, there is almost no way into those big cities or very very limited way in. Many of us have that experience so others can diminish it all they want but For prospectives in rad onc go look at our job board or look on indeed. Then go look at the radiology/GI/derm job listings. Which situation would you rather be in? The idea of finding jobs through other means is total BS, might work but why risk it when they’ll come knocking on your door in other fields. Still boggles my mind why anyone would put themselves at this risk

 

[Krukenberg]

Again with this narrative of if you just network enough, there is this fountain of amazing jobs out there that you might be allowed into. IDK if true or not. It works out for some people of course, but it isn't necessarily a better "extreme" or the "truth". People will never agree until we hit rock bottom, if we do. Some will say "I know so and so, and they are fine". For me it is basic math, I don't see things getting "better" unless we address oversupply long run, while we will have somewhat a reduced need for XRT. Objective data tells us that we are not addressing this. So I'm in the middle, I see the negative trends, some positive things with new indications (which I don't think will be enough, in my limited experience) and find myself very worried about the future. Maybe I worry too much, maybe not. We will see....

We have a multi-faceted emperor's new clothes situation in our field, where people see different things and even if they do see it, it may or may not be a problem in their eyes.

I agree with all of that, but I think it’s misleading when people say things like what WFA said but deleted: draw a 2 hour circle around any major city and new grads can’t get any jobs within that perimeter. That’s factually not true at the moment. Sure things could get worse but hyperbole like that discredits the legitimate concerns we all have among the people with power to actually make changes.

 

[fiji128]

Can’t +1 this enough. If you’re just going off jobs posted on Astro then yea they tend to not be great, but way more jobs exist than what’s posted online. Do some purposeful networking over the course of residency and be in a position to get a word of mouth job. Small industries and specialties will always have a big emphasis on who you know.

A job market that functions off of opaque things like "word of mouth" and "better networking" ect is a sign of a dysfunctional job market where sellers significantly out number the buyers. Its a sign/symptoms of a maldistribution. There is no reason for the rad onc job market to function like that except for that reason.

As far as these rural location jobs that are out there post your CV to one of those recruiter websites and it will get passed around you'll start getting those emails as well. Today's email from a recruiter states they have jobs in Grand Forks ND, Sandusky OH (been posted for years), Midland MI, Martinsville VA, Laredo TX (been posted for years), Carlsbad NM (been posted for years), Vincennes IN, Watertown NY.

 

[evilbooyaa]

Actually I would agree, there is almost no way into those big cities or very very limited way in. Many of us have that experience so others can diminish it all they want but For prospectives in rad onc go look at our job board or look on indeed. Then go look at the radiology/GI/derm job listings. Which situation would you rather be in? The idea of finding jobs through other means is total BS, might work but why risk it when they’ll come knocking on your door in other fields. Still boggles my mind why anyone would put themselves at this risk

It's one thing to say "there are not as plentiful of jobs in major cities like there are in other specialties". That is not a hyperbolic statement. It's still an issue that needs to be addressed. I was simply talking about jobs that were posted online. Maybe not all on the ASTRO board but across a few websites. Rush is/was hiring. Atlanta has an opening. I saw at least 2 NYC positions. Will those be hard to get? Sure, but to say it's impossible is irresponsible. It absolutely is a seller's market and is a dysfunctional job market - don't want to sound like an apologist in that regard.

I do agree that 'networking' for jobs is crappy, but AFAIK the best jobs have always been word of mouth, even when the job market was better. As somebody hiring, why post your job online if you can get more than enough candidates from your previous contacts who you trust?

 

[medgator]

I do agree that 'networking' for jobs is crappy, but AFAIK the best jobs have always been word of mouth, even when the job market was better. As somebody hiring, why post your job online if you can get more than enough candidates from your previous contacts who you trust?

Nailed it. Quality PP jobs want someone with ties to the region and the 3 A's. Why pay money to ASTRO to post a quality job when you can get a great candidate through word of mouth and connections that will be what you are looking for?

 

[thecarbonionangle]

Besides practicematch and practicelink, what other websites (besides ASTRO) are recommended to check out?