Quantifying Job Market Difficulties and predicting ahead

[RadOncMegatron]

As the article mentions, it was Ed Halperin who talked about *his* experience being a bottom-feeding catfish. One of the biggest names in our field, traveling hat in hand from academic center to academic center, saying "can i haz dean?" and all the centers saying "nah bruh you rad onc you weak."

Oh my I LOL’d so hard. We had a small small small sliver of a chance to be a respected specialty with the caliber of students we attracted. Now all hope is gone since the caliber of applicants are going down. We don’t have any power in medicine, can’t admit patients, can’t take care of sepsis, can’t fix anything in the OR, ask med Onc to take care of all inpatient med needs, ask surgeons to take care of many of OUR toxicities, and send many of our best to satellite clinics. Sorry for the rant, but these academics with their dishonesty or dangerous ignorance at best fooling gullible med students with only clinical considerations and not real life ones need to be laughed at in “anonymous corners of the internet.”

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[radiation]

1)Sure, but then astra zeneca should hire the doc as an employee. Can’t see them doing this with a medical oncologist out of training- they would pay them an actual salary?

Don't have to be out of training, can do as a resident.

Med onc has a bunch of these

Careers at Genentech

The little things we do every day add up to big breakthroughs. Making a difference in the lives of millions starts when you make a change in yours.

www.gene.com

sometimes I think we get more pleasure complaining about stuff rather than saying, gee that actually could be good

 

[Old rad onc]

When I graduated from residency, I applied all over the country and all practice settings. I got two offers, both "academic", both similar pay, and in two wildly different parts of the country. I took the one on the beach because... Why not?

I could have negotiated into probably 2-3 more offers inside and outside academics, but the pay was pretty similar both at hire and full production, and this was in several parts of the country including upper midwest.

Several years into attendinghood and I would say that nothing has changed. I get the occasional discussion even 3-5 years in that sounds exactly like what I was discussing when I graduated (the $300k discussions are particularly insulting now). I stopped looking though, it's a huge distraction from moving forward and was just getting me nowhere.

N=1 I know, but this is the reality on the ground.

I graduated in mid 1990s. Had 2 offers, both pp and partnership after 3 years. One was in Las Vegas and offered 250k but working 12 hours a day and 5 days a week. 2nd offer was in SoCal north of LA. 125k and 4-4.5 days a week, 9 hours a day. So I took less money to stay in California. 6 years later no partnership.

I was mad, and madness makes you do crazy things. So I bought my own medallion and started a practice across the street. Borrowed against a house, had an old linac, and 9 mos in was treating 10 pts. The hospital and doc tried to kick me off the medical staff. Was barely making it but did not give up. Won enough battles to hang in and build a new center, risking everything I had again 5 years later.

15 years later, treating 30 a day, realizing how lucky I have been and love the work. Compared to the rest of the world, 300k a year would be a great living, but once you make 2-3 x that, accepting less for the same work is hard.

My one regret was in around 1998 or so Apple was selling at $6 per share. I was going to buy 10,000 shares but my bro in law talked me out of it. Mind you this was pre I-pod, pre I phone etc. Taking into account a 7x split and a later 4x split if I held all the way through ( which I doubt I would have the balls to do) I would now have 280,000 shares x 135 = 28.8 million.

So stop worrying too much about the future of rad Onc and just find the next Apple. You guys are all AOA so if you stick to good work , there will always be a way! This stupid virus has reminded me that life is short. Control what you can, then let go and be grateful you have work! The whiners at ASTRO are looking out for themselves and hard to blame them as silly as they blame us for students avoiding their trap. Rad Onc is still the greatest field in medicine and being an intimate part of a patients team while they fight cancer is certainly a privilege.

One reason I still see my patients in person for the consult. Only now my waiting room is used for consults. The patients come in one at a time through texts via the back door. No patients or staff have had COVID from the practice. Despite all the problems in our field I’m still an optimist. If patients are being cured with pancreas cancer, there is still hope for our field!

 

[deleted941485]

I graduated in mid 1990s. Had 2 offers, both pp and partnership after 3 years. One was in Las Vegas and offered 250k but working 12 hours a day and 5 days a week. 2nd offer was in SoCal north of LA. 125k and 4-4.5 days a week, 9 hours a day. So I took less money to stay in California. 6 years later no partnership.

I was mad, and madness makes you do crazy things. So I bought my own medallion and started a practice across the street. Borrowed against a house, had an old linac, and 9 mos in was treating 10 pts. The hospital and doc tried to kick me off the medical staff. Was barely making it but did not give up. Won enough battles to hang in and build a new center, risking everything I had again 5 years later.

15 years later, treating 30 a day, realizing how lucky I have been and love the work. Compared to the rest of the world, 300k a year would be a great living, but once you make 2-3 x that, accepting less for the same work is hard.

My one regret was in around 1998 or so Apple was selling at $6 per share. I was going to buy 10,000 shares but my bro in law talked me out of it. Mind you this was pre I-pod, pre I phone etc. Taking into account a 7x split and a later 4x split if I held all the way through ( which I doubt I would have the balls to do) I would now have 280,000 shares x 135 = 28.8 million.

So stop worrying too much about the future of rad Onc and just find the next Apple. You guys are all AOA so if you stick to good work , there will always be a way! This stupid virus has reminded me that life is short. Control what you can, then let go and be grateful you have work! The whiners at ASTRO are looking out for themselves and hard to blame them as silly as they blame us for students avoiding their trap. Rad Onc is still the greatest field in medicine and being an intimate part of a patients team while they fight cancer is certainly a privilege.

One reason I still see my patients in person for the consult. Only now my waiting room is used for consults. The patients come in one at a time through texts via the back door. No patients or staff have had COVID from the practice. Despite all the problems in our field I’m still an optimist. If patients are being cured with pancreas cancer, there is still hope for our field!

So you made your money already...awesome.

the rest of us should get the Robin Hood app.

 

[beamotherapy]

I'm all in on Gamestop stock right now.

 

[elementaryschooleconomics]

 

[deleted941485]

More self destructive behavior from one of our own! Seriously we should be taking the belts away from ROs they may try to hang themselves

 

[radonc17]

More self destructive behavior from one of our own! Seriously we should be taking the belts away from ROs they may try to hang themselves

encourage all to speak out against this trial

In addition to common sense, the data is on our side to not run this trial

 

[drewdog1973]

I KNEW IT! That's why this board was so quiet Tue - Wed, everyone was getting rich on Robin Hood / GME / AMC. You guys should have told me!

 

[RickyScott]

encourage all to speak out against this trial

In addition to common sense, the data is on our side to not run this trial

Honestly, I don’t have a problem with the science. It is the preoccupation with eliminating xrt, while expanding residencies, trying to recruit minorities, and spouting garbage about radonc taking a leadership role (while decreasing our treatment role).

 

[deleted941485]

encourage all to speak out against this trial

In addition to common sense, the data is on our side to not run this trial

Absolutely not necessary trial. They really have nothing better to run?

 

[BobbyHeenan]

encourage all to speak out against this trial

In addition to common sense, the data is on our side to not run this trial

Is there a trial for 30/5 APBI versus AI versus 30/5 plus AI?

Please NRG run that one.

If I know Debra, she doesn't want to take her AI for 5 years, she wants the healing rays instead.

 

[radonc17]

Honestly, I don’t have a problem with the science. It is the preoccupation with eliminating xrt, while expanding residencies, trying to recruit minorities, and spouting garbage about radonc taking a leadership role (while decreasing our treatment role).

I agree with preoccupation of eliminating RT and expanding residencies

I have a big problem with the science b/c trial after trial shows RT omission is inferior with LR (primary endpoint) and is never powered to say no diff in OS or DFS etc

RE leadership roles - I think we should def pursue that, but RO is clearly divided into multiple factions. Ones that are looking to run trials for promotion, while others trying to promote the field, etc

Is there a trial for 30/5 APBI versus AI versus 30/5 plus AI?

Please NRG run that one.

If I know Debra, doesn't want to take her AI for 5 years, she wants the healing rays instead.

@BobbyHeenan closest trial is EUROPA trial -> BCS -> RT vs AI

Absolutely not necessary trial. They really have nothing better to run?

Yup....

 

[deleted941485]

Med Onc and Pharma continue to laugh at us.

 

[radonc17]

Med Onc and Pharma continue to laugh at us.

As they should. They don't undercut their entire field solely for promotions...

 

[deleted941485]

As they should. They don't undercut their entire field solely for promotions...

No they don’t. They miraculously found a way to promote themselves without also putting themselves out of bussiness like it’s a badge of honor

 

[thecarbonionangle]

More self destructive behavior from one of our own! Seriously we should be taking the belts away from ROs they may try to hang themselves

I dont treat breast but this seriously pisses me off. Our field is filled with people who want to write off our own single modality. Why do we always do this? so frustrating. It is time to actively fight this. I will not enroll in a single de-escalatiom write off XRT trial. Neither should you!

 

[drewdog1973]

The field is in tremendously bad shape when you see even what the younger generation are tweeting.
It is like being in a carnival fun house. I'd feel bad, but they are tying their own rope.

 

[radonc17]

The field is in tremendously bad shape when you see even what the younger generation are tweeting.
It is like being in a carnival fun house. I'd feel bad, but they are tying their own rope.

i feel bad for the current PGY3-5s

wheels really spinning off and nobody truly warned us in 2016ish outside of Blood Bath thread

Even that thread really took off later on

either way, this is why I’m thankful for SDN

Current students have been appropriately forewarned at this point. It’s up to them now to decide what’s best for them

 

[evilbooyaa]

The field is in tremendously bad shape when you see even what the younger generation are tweeting.
It is like being in a carnival fun house. I'd feel bad, but they are tying their own rope.

Care to expound as to what the issues with what the younger generation are tweeting? And how are they 'tying their own rope'?

 

[drewdog1973]

Care to expound as to what the issues with what the younger generation are tweeting? And how are they 'tying their own rope'?

Usual suspects. #radoncrocks crew. People supportive of *everything*. I think it's almost pictures of women and linac time, soon, isn't it? No need for names, they know who they are. If you say everything is great, if you don't speak forcefully against expansion, if you just feed people crap, you are tying your own rope.

 

[OTN]

This trial does not have equipoise between the two arms based on currently-available data, and I would consider it unethical to enroll patients on the trial. I also consider it unethical the trial was opened to begin with.

 

[RickyScott]

I think

Usual suspects. #radoncrocks crew. People supportive of *everything*. I think it's almost pictures of women and linac time, soon, isn't it? No need for names, they know who they are. If you say everything is great, if you don't speak forcefully against expansion, if you just feed people crap, you are tying your own rope.

cutesy, BFF stuff, stuffed animals and mentoring crap?

 

[evilbooyaa]

Usual suspects. #radoncrocks crew. People supportive of *everything*. I think it's almost pictures of women and linac time, soon, isn't it? No need for names, they know who they are. If you say everything is great, if you don't speak forcefully against expansion, if you just feed people crap, you are tying your own rope.

Ah, OK. Haven't seen a ton of that recently, FWIW.

 

[deleted941485]

Just remember those Medallion taxi drivers...remember them well.

The Board Cert from the ABR is your taxi medallion. Feature it proudly but just know it’s worthless and no one will be coming to bail you out.

 

[RO5231]

This trial does not have equipoise between the two arms based on currently-available data, and I would consider it unethical to enroll patients on the trial. I also consider it unethical the trial was opened to begin with.

Effects of Radiotherapy in Early-Stage, Low-Recurrence Risk, Hormone-Sensitive Breast Cancer

Radiotherapy after breast conservation has become the standard of care. Prior meta-analyses on effects of radiotherapy predated availability of gene expression profiling (GEP) to assess recurrence risk and/or did not include all relevant outcomes. This ...

www.ncbi.nlm.nih.gov

Looks like it was partially based on this analysis combining prior trials in a similar cohort of patients. Wouldn’t consider a 9% absolute increased risk of recurrence at 10 years without RT negligible. Not sure what this study adds or how it greatly benefits patients with shorter courses of RT available nowadays.

 

[Radonc90]

I have an M3 right now, amazing Step 1 score (98 percentile), interested in radonc.
She shadowed me for the last 3 years.
I can set her up with top 20 programs in the US, but she just said no to radonc, knowing what is going on in the field.
Smart girl, she may go into surgonc or hemonc but not radonc.

PS: The so-called "radonc leadership" is completely disconnected from the millennial gen.
A little too late, yrs of wandering, wrong focus, infighting, then BAM the pandemic hit, the PERFECT storm!

 

[scarbrtj]

I have an M3 right now, amazing Step 1 score (98 percentile), interested in radonc.
She shadowed me for the last 3 years.
I can set her up with top 20 programs in the US, but she just said no to radonc, knowing what is going on in the field.
Smart girl, she may go into surgonc or hemonc but not radonc.

PS: The so-called "radonc leadership" is completely disconnected from the millennial gen.
A little too late, yrs of wandering, wrong focus, infighting, then BAM the pandemic hit, the PERFECT storm!

For students like that, and with opportunities like this out there................

 

[elementaryschooleconomics]

For students like that, and with opportunities like this out there................

700k with 26 weeks vacation??? WHAT

 

[Neuronix]

Probably a night shift job. They're one week on, one week off around here. Some places pay a premium for it because it's hard to find people who will work just nights.

 

[medgator]

Probably a night shift job. They're one week on, one week off around here. Some places pay a premium for it because it's hard to find people who will work just nights.

can't blame them....

Working the Night Shift? It May Not be Good for Your Health

There’s even more evidence that working while the rest of the world is sleeping may increase your risk of cancer and heart disease

time.com

 

[scarbrtj]

700k with 26 weeks vacation??? WHAT

A statistical analysis of vacation time offered in online rad onc job postings versus online radiology job postings would be significant at P<0.0000000000001.

 

[medgator]

A statistical analysis of vacation time offered in online rad onc job postings versus online radiology job postings would be significant at P<0.0000000000001.

Rads jobs have always had better vacation offerings.... The upside of no continuity of care

 

[radonc17]

Probably a night shift job. They're one week on, one week off around here. Some places pay a premium for it because it's hard to find people who will work just nights.

can't blame them....

Working the Night Shift? It May Not be Good for Your Health

There’s even more evidence that working while the rest of the world is sleeping may increase your risk of cancer and heart disease

time.com

i don’t miss nights at all from intern year

good for those who are able to do it!

 

[radiation]

encourage all to speak out against this trial

In addition to common sense, the data is on our side to not run this trial

Agree with posters this trial is waste of time and resources. The real trial is to have a third arm with RT alone without endocrine therapy. If they were interested in QOL, short course partial breast vs 5/10/20 years of endocrine therapy would win every time

 

[BobbyHeenan]

Agree with posters this trial is waste of time and resources. The real trial is to have a third arm with RT alone without endocrine therapy. If they were interested in QOL, short course partial breast vs 5/10/20 years of endocrine therapy would win every time

How in the world can you treat breast, actually see patients....and do this trial and not include that arm? It’s in fathomable to me.

Nearly across the board all my 30/5 follow ups are NED, great cosmesis, but we spend our time talking about their AI misery chasing hot flashes and joint aches with other meds, dexa scans and bone meds, vagina dryness, libido, et al.

I’m getting pissed just typing this.

 

[radonc17]

How in the world can you treat breast, actually see patients....and do this trial and not include that arm? It’s in fathomable to me.

Nearly across the board all my 30/5 follow ups are NED, great cosmesis, but we spend our time talking about their AI misery chasing hot flashes and joint aches with other meds, dexa scans and bone meds, vagina dryness, libido, et al.

I’m getting pissed just typing this.

Agreed. Total lack of equipoise

I will not recommend this trial to any patient.

 

[hal9k]

I just looked at md Anderson rad onc alumni list..it’s amazing they continue to take 3-4 of the graduating residents every year. Their department is enormous

 

[RickyScott]

I thought it was 5? UPenn/mskcc have 4 or 5?

 

[hal9k]

I thought it was 5? UPenn/mskcc have 4 or 5?

It was 6 but then expanded to 7 spots in 2019. It’s listed on their website

 

[RickyScott]

It was 6 but then expanded to 7 spots in 2019. It’s listed on their website

never ceases to disgust me.

 

[hal9k]

never ceases to disgust me.

Wonder whether they can continue to take 3-4 of their own residents every year..

 

[RickyScott]

Wonder whether they can continue to take 3-4 of their own residents every year..

Math says no. Going to create so much competition within the class, because there will be so few opportunities outside the system. Going to put a lot of stress on the spouses, families...

 

[elementaryschooleconomics]

Wonder whether they can continue to take 3-4 of their own residents every year..

Definitely not this year, unless you count affiliate (outside of Texas) sites.

 

[radiaterMike]

Maybe they’ll hire a few and then rescind the offers ?

 

[thecarbonionangle]

“Theres a right way and then there is the _______ way!!!!”

 

[medgator]

“Theres a right way and then there is the _______ way!!!!”

I think it goes... there's the right way, the wrong way and the MD Anderson way.

 

[medgator]

I just looked at md Anderson rad onc alumni list..it’s amazing they continue to take 3-4 of the graduating residents every year. Their department is enormous

Financial toxicity can fund a lot....

 

[Baws]

'radiation OR oncology OR physician OR to OR join OR ascension OR STATECODE:"IN"' Jobs | ASTRO Radiation Oncology Career Center

3,322 'radiation OR oncology OR physician OR to OR join OR ascension OR STATECODE:

careers.astro.org

Evansville, Indiana is back!!

srsly...how bad is this job where it gets posted EVERY DAMN year???

 

[medgator]

'radiation OR oncology OR physician OR to OR join OR ascension OR STATECODE:"IN"' Jobs | ASTRO Radiation Oncology Career Center

3,322 'radiation OR oncology OR physician OR to OR join OR ascension OR STATECODE:

careers.astro.org

Evansville, Indiana is back!!

srsly...how bad is this job where it gets posted EVERY DAMN year???

That's a hospital job. Other one was with McKesson/US oncology i think.

Clearly no one a fan of the home state of Mike Pence though for some reason...