Quantifying Job Market Difficulties and predicting ahead

[hal9k]

you seem new to the game. welcome.

i assume you're new if you think 240 is a real salary. it is something listed on a government official posting. perhaps it is the university salary and there is also a UIowa Physicians Group salary. we have seen this time and time again

be smarter.

i was thinking the same thing. Real salary is probably 240 x2

---

Members don't see this ad.

 

[Baws]

you seem new to the game. welcome.

i assume you're new if you think 240 is a real salary. it is something listed on a government official posting. perhaps it is the university salary and there is also a UIowa Physicians Group salary. we have seen this time and time again

be smarter.

Unsure the reason behind your hostility. No, I am not new to this game. I was in the job hunt very recently in the midwest region

This salary is fairly common for a low volume satellite; i had similair offers and took a 280K job (low volume and excellent QOL, but it was the best I could get)

 

[Baws]

i was thinking the same thing. Real salary is probably 240 x2

I can't comment on this job specifically, but academic satellites do not pay well

I work at one

 

[fiji128]

you seem new to the game. welcome.

i assume you're new if you think 240 is a real salary. it is something listed on a government official posting. perhaps it is the university salary and there is also a UIowa Physicians Group salary. we have seen this time and time again

be smarter.

I can only go by what they are publicly posting. Not in a position to make what if assumptions about inside info they may not be posting at some random community clinic. I do know, from my own personal experience, that anything I’ve been offered from an “academic” institution has been exceedingly low balled compared to the revenue that I would be expected to bring in, so this fits with that. If this was a legit private practice set up I’m sure the salary would be in the $500K range. Doubt they are anywhere near that.

 

[TheWallnerus]

be smarter.

Thought you were going to say “avoid rad onc” but no.

Everyone always talking about the rad onc hidden salary. The rad onc hidden jobs. The rad onc hidden perks. Rad onc is turning into Scientology. Only go to residencies that help you go clear.

 

[medgator]

you seem new to the game. welcome.

i assume you're new if you think 240 is a real salary. it is something listed on a government official posting. perhaps it is the university salary and there is also a UIowa Physicians Group salary. we have seen this time and time again

be smarter.

Do you know the real salary? Feel free to post it here or the private subforum. Certainly would be more helpful than trolling

 

[TheWallnerus]

Do you know the real salary? Feel free to post it here or the private subforum. Certainly would be more helpful than trolling

He’s not trolling. Just being coy and thirst trappy

 

[deleted1111261]

you seem new to the game. welcome.

i assume you're new if you think 240 is a real salary. it is something listed on a government official posting. perhaps it is the university salary and there is also a UIowa Physicians Group salary. we have seen this time and time again

be smarter.

maybe the person that is posting the job should “be smarter” and post the actual salary? You think when I’m going to hire, I’m going to post a salary that’s lower than what we are going to pay? What an interesting strategy …

My guess all in, salary around 300ish

 

[elementaryschooleconomics]

maybe the person that is posting the job should “be smarter” and post the actual salary? You think when I’m going to hire, I’m going to post a salary that’s lower than what we are going to pay? What an interesting strategy …

My guess all in, salary around 300ish

That would be my guess as well. Or something like 240 base, but a guaranteed total of 350-500 in the first two years, switching to production based in year 3.

Lurkers reading these threads: please beware of the shiny "sticker price" on some of these jobs. I know there are rural gigs offering very high salaries that sound enticing. It would be great to go to rural Oklahoma and make 500k a year with 10 on beam. However, if that 500k is only guaranteed for the first two years, there's NO WAY you're making that with not a lot of patients on beam after your salary switches to production.

It's a trap!

 

[medgator]

maybe the person that is posting the job should “be smarter” and post the actual salary? You think when I’m going to hire, I’m going to post a salary that’s lower than what we are going to pay? What an interesting strategy …

My guess all in, salary around 300ish

Given the location in rural iowa, i would expect more, but if that is truly the case, it will show you how ****ty the job market has gotten

 

[Baws]

That would be my guess as well. Or something like 240 base, but a guaranteed total of 350-500 in the first two years, switching to production based in year 3.

Lurkers reading these threads: please beware of the shiny "sticker price" on some of these jobs. I know there are rural gigs offering very high salaries that sound enticing. It would be great to go to rural Oklahoma and make 500k a year with 10 on beam. However, if that 500k is only guaranteed for the first two years, there's NO WAY you're making that with not a lot of patients on beam after your salary switches to production.

It's a trap!

While I could see a bonus making this a 290-310K job, there is absolutely no way it goes beyond 350 ever

main campus academic jobs start in the high 200s to low 300s in the Chicago/Kansas area (and the main campus pays better because your bonus is often higher due to the research and volume components: around 40K): personal experience and offers I know of

Just because an academic place is rural, does not mean it pays better! UCSD and MDACC have some of the highest salaries in academics. (Note for private practices and hospital employees, rural usually means more money)

 

[medgator]

While I could see a bonus making this a 290-310K job, there is absolutely no way it goes beyond 350 ever

main campus academic jobs start in the high 200s to low 300s in the Chicago/Kansas area (and the main campus pays better because your bonus is often higher due to the research and volume components: around 40K): personal experience and offers I know of

Just because an academic place is rural, does not mean it pays better! UCSD and MDACC have some of the highest salaries in academics. (Note for private practices and hospital employees, rural usually means more money)

Getting screwed on both fronts. Lovely

 

[hal9k]

While I could see a bonus making this a 290-310K job, there is absolutely no way it goes beyond 350 ever

main campus academic jobs start in the high 200s to low 300s in the Chicago/Kansas area (and the main campus pays better because your bonus is often higher due to the research and volume components: around 40K): personal experience and offers I know of

Just because an academic place is rural, does not mean it pays better! UCSD and MDACC have some of the highest salaries in academics. (Note for private practices and hospital employees, rural usually means more money)

MDACC salary is public info.. Their pay is probably better than most private practice at this point

 

[RickyScott]

you seem new to the game. welcome.

i assume you're new if you think 240 is a real salary. it is something listed on a government official posting. perhaps it is the university salary and there is also a UIowa Physicians Group salary. we have seen this time and time again

be smarter.

Salary aside, seems to be a job for someone with a stay at home wife?

 

[seper]

This 1 mil —> 450K transition in rural salaries is an accomplished fact, unfortunately

It's really shocking once you run the numbers and understand what the professional charges and collections would be for an average amount on beam (20). If you're treating 40, it's wild. Nobody teaches you this in residency because the junior faculty don't know and it's not in the chair's interest for residents to fully understand the business.

There is now a generation of young rad oncs who have been gaslit into believing what fair compensation is. The older rad oncs know better, and many of them have an interest in keeping this a secret. It's not like the discount on your compensation is being passed on to the patients. If you have your own practice, you can decide to do charity care if you want. Good luck even getting a patient through a door at these "non-profit" hospitals without ability to pay guaranteed up front.

Some of these rural centers can break even with 8-10 patients on treatment. And that's despite a 700k rad onc salary "expense." Food for thought.
I'm beating a dead horse here, but if you are going to take a hospital employed job, do it in a decent sized city. An extra 100k or even 200k isn't worth it (you'll lose half to taxes at that point as a W2 employee). The only thing that makes those locations acceptable is independent practice.

And if you're an older rad onc with a service contract at a hospital, please for the love of God and the sake of the field, please do not make a deal with the hospital to become an employee before you retire. Pay it forward and find a new grad to take over your practice, teach him/her the business and how to continue independent practice with the hospital. Once hospitals get a taste of employing rad oncs, they will never go back.

 

[RickyScott]

This 1 mil —> 450K transition in rural salaries is an accomplished fact, unfortunately

Re job in rural Iowa advertised for 240k- how much does a family doc, neurologist, psych make in same location?even dosimetry can make 150 k.

 

[Gfunk6]

Re job in rural Iowa advertised for 240k- how much does a family doc, neurologist, psych make in same location?even dosimetry can make 150 k.

LOL, you can be a psychiatrist in San Quentin making >$300k. Plus you get to meet interesting people

 

[Gfunk6]

Just got some junk mail asking me if I wanted to "supplement [my] clinical income."

www.seak.com

 

[Neuronix]

Hey did you guys get this one? I almost fell out of my chair laughing.

 

[elementaryschooleconomics]

Hey did you guys get this one? I almost fell out of my chair laughing.

View attachment 343654

Yup, that just graced my inbox as well.

Pretty much sums it up, I think.

 

[medgator]

Hey did you guys get this one? I almost fell out of my chair laughing.

View attachment 343654

Was just about to post this.... $1600 daily rate in a job with terrible geography posted to ASTRO. Sums things up in our field quite well

 

[Gfunk6]

Was just about to post this.... $1600 daily rate in a job with terrible geography posted to ASTRO. Sums things up in our field quite well

Mathematically it corresponds to ~ $400k annually, Also < 3 hours to drive to Omaha and < 5 hours to Kansas City.

 

[medgator]

Mathematically it corresponds to ~ $400k annually, Also < 3 hours to drive to Omaha and < 5 hours to Kansas City.

You're selling it pretty good there, gfunk... Might become a perm position for a special someone!

 

[metallica81788]

That's a 7 figure job and location if I've ever seen it. Oh wait those don't exist anymore...

 

[dieABRdie]

Hey did you guys get this one? I almost fell out of my chair laughing.

View attachment 343654

I did see that. Very exciting opportunities.

The side by side comparison to GYN and Med/Heme Onc is priceless.

Somebody PLEASE tweet #RadOncRocks. I nominate you.know.who.....

 

[jondunn]

but at least some of you get your super lax supervision rules!

hope you're happy.

 

[CodeRedDew]

I can't comment on this job specifically, but academic satellites do not pay well

I work at one

Can you list some pros/cons to working at an academic satellite? Everyone's default answer seems to be "say no to academic satellites" but is there something I'm missing with a gigs like this:

Academic satellite where main institution has PSA with local hospital (town of 20k population but 35-40 minutes away from large metro area), base salary $375k x3 years (with slight % increase per year), ~10-12 pts avg on treatment per physician (two physician practice). Obviously LCOL area so you could grab a decently sized home for a reasonable price.

Sure, it's not a tenure track and no true "academic" research opportunities but not really interested in either. Spouse and I also come from smaller cities, so we're not averse to these areas.

I value my QOL and time outside of medicine, so a lower workload with the backing/support of a major academic institution seem like a decent gig to me, esp. as a PGY5 in this current RO market. So what exactly am I missing here given the 'no to academic satellite' sentiment that is prevalent among these forums. Are there stories of ppl in these low-clinical workload positions who ultimately get bent over and ****ed by the chair/admin??

 

[jondunn]

Can you list some pros/cons to working at an academic satellite? Everyone's default answer seems to be "say no to academic satellites" but is there something I'm missing with a gigs like this:

Academic satellite where main institution has PSA with local hospital (town of 20k population but 35-40 minutes away from large metro area), base salary $375k x3 years (with slight % increase per year), ~10-12 pts avg on treatment per physician (two physician practice). Obviously LCOL area so you could grab a decently sized home for a reasonable price.

Sure, it's not a tenure track and no true "academic" research opportunities but not really interested in either. Spouse and I also come from smaller cities, so we're not averse to these areas.

I value my QOL and time outside of medicine, so a lower workload with the backing/support of a major academic institution seem like a decent gig to me, esp. as a PGY5 in this current RO market. So what exactly am I missing here given the 'no to academic satellite' sentiment that is prevalent among these forums. Are there stories of ppl in these low-clinical workload positions who ultimately get bent over and ****ed by the chair/admin??

It sounds like the perfect job for you, and for others who have the same goals as you. Many on SDN want ‘grind and make tons’ jobs. So yeah academic satellite jobs aren’t that.

But in many cases I’ve seen including great friends of mine, they are 8-230 jobs where you don’t have to worry about much.

 

[dieABRdie]

Can you list some pros/cons to working at an academic satellite? Everyone's default answer seems to be "say no to academic satellites" but is there something I'm missing with a gigs like this:

Academic satellite where main institution has PSA with local hospital (town of 20k population but 35-40 minutes away from large metro area), base salary $375k x3 years (with slight % increase per year), ~10-12 pts avg on treatment per physician (two physician practice). Obviously LCOL area so you could grab a decently sized home for a reasonable price.

Sure, it's not a tenure track and no true "academic" research opportunities but not really interested in either. Spouse and I also come from smaller cities, so we're not averse to these areas.

I value my QOL and time outside of medicine, so a lower workload with the backing/support of a major academic institution seem like a decent gig to me, esp. as a PGY5 in this current RO market. So what exactly am I missing here given the 'no to academic satellite' sentiment that is prevalent among these forums. Are there stories of ppl in these low-clinical workload positions who ultimately get bent over and ****ed by the chair/admin??

I definitely know satellite docs that are being screwed... but none of them are "low-clinical workload." If you can find a satellite with 10-12 patients per doc on average and "support" from a major academic institution that actually pays $375 then by all means pounce on that ****. My experience with the satellites was more like 20-24 on beam, and if you have 10-12 on beam at one place you will be driving to another one for sure. I put "support" in quotations because academic institutions aren't particularly known for their clinical efficiency. Clinics can take four times longer than they would in a well oiled private practice. Its usually the same workload as private practice with more effort required and at least 50% less compensation... all the while not being able to achieve those things that your academic promotion will be based on.

I'm sure there are good gigs out there but the above description is NOT an exaggeration for many of them. So look closely at the actual logistics of their workflow and whether or not you are provided what you need for the work you have to do. Find a place that offers different tracks for promotion such as "clinical educator" or "community practice," rather than simply one traditional pathway. If you can find it.... then yeah its not such a bad gig.

 

[dieABRdie]

But in many cases I’ve seen including great friends of mine, they are 8-230 jobs where you don’t have to worry about much.

Were these actual academic satellites?

OP... if you don't mind small towns there are quite a few 8-2:30 jobs in community practice out there that pay well. If you aren't really set on academics then keep those on your radar.

 

[jondunn]

Were these actual academic satellites?

Yes. Multiple in different states.

 

[yesmaster]

It sounds like a VA job.

A rose by any other name…

 

[OTN]

It sounds like a VA job.

A rose by any other name…

I really enjoyed taking care of VA patients when I was in training. Sure, it can be agonizing to get things done on the floor, but the radonc department was fairly well-run when I was there.

My main concern about this job would be the 10-12 patients on treatment. Tough to say if future reimbursement trends will make that level of volume feasible.

 

[jondunn]

It sounds like a VA job.

A rose by any other name…

Totally different than the VA. A lot of these community hospitals are gorgeous and have good money invested in the cancer center. They also allow a nice level of autonomy for your sphere, away from the rest of the dept.

At the VA you make no rules and have no voice.

 

[yesmaster]

Autonomy and facility quality, yes that’s true. However, I’d argue you trade off location since rad onc VA’s tend to be in desirable urban areas. The main similarity is patient volume and lack of career progression.

 

[medgator]

Autonomy and facility quality, yes that’s true. However, I’d argue you trade off location since rad onc VA’s tend to be in desirable urban areas. The main similarity is patient volume and lack of career progression.

VA hours tend be much more rigid/fixed, plus all those extra quasi holidays off like presidents or Columbus day

 

[RickyScott]

Academic satellite jobs in major cities are highly competitive today. An 8-4 job in kentucky for 300 k w/ 350 ceiling where the main center tells you how to treat every case? No thanks. Virtually any other specialty would pay better in this location and come without the geographic restrictions. Remember geography is the biggest factor for most residents.

 

[deleted941485]

Academic satellite jobs in major cities are highly competitive today. An 8-4 job in kentucky for 300 k w/ 350 ceiling where the main center tells you how to treat every case? No thanks. Virtually any other specialty would pay better in this location and come without the geographic restrictions. Remember geography is the biggest factor for most residents.

People think I am crazy for wanting to retrain. "Oh the opportunity costs" but seriously consider the fields trajectory, your chances of getting a second job, and loss of clinical autonomy, loss of geographic flexibility (Via pathways etc). If you have no attachments, it may not be as crazy as it once was.

 

[medgator]

People think I am crazy for wanting to retrain. "Oh the opportunity costs" but seriously consider the fields trajectory, your chances of getting a second job, and loss of clinical autonomy, loss of geographic flexibility (Via pathways etc). If you have no attachments, it may not be as crazy as it once was.

I'd probably try to just go to BFE at this point and FIRE out in 10-12 years. No good reason for any decent US MD/DO student to go into this field though

 

[deleted941485]

I'd probably try to just go to BFE at this point and FIRE out in 10-12 years. No good reason for any decent US MD/DO student to go into this field though

Ive only been out a few years. Good if you already have some scratch saved. I dont think FIRE may even be a thing for us. Look at EM- No one even talking about FIRE anymore.

 

[medgator]

Ive only been out a few years. Good if you already have some scratch saved. I dont think FIRE may even be a thing for us. Look at EM- No one even talking about FIRE anymore.

If you're out a couple years with BC, there are still jobs to be had now paying over half a mill starting.

Definitely would not want to be in training now or finishing soon, esp post APM starting next year

 

[elementaryschooleconomics]

If you're out a couple years with BC, there are still jobs to be had now paying over half a mill starting.

Definitely would not want to be in training now or finishing soon, esp post APM starting next year

Optimistic view: burnout from additional COVID waves, significant reimbursement cuts from all angles, dealing with APM, and significant increase in documentation burden causes people to retire or leave clinical medicine entirely, opening potential jobs for new grads

Pessimistic view: those new grads endured multiple COVID waves in residency training, will have to navigate significant reimbursement cuts from all angles, deal with APM, and the documentation burden will continue to increase, meaning significantly more manhours are required for stagnate-to-decreased salaries and increasing limitations on autonomy

Because I did my intern year in a traditional Internal Medicine residency program, I still get texts and emails for Hospitalist or other IM positions, with salaries better than the ARRO survey-endorsed median starting salary for new RadOnc grads...and we haven't even entered the APM timeline yet.

But, just like there have always been people willing to go practice rural Family Medicine in the Appalachian hills, there will always be medical students interested in Radiation Oncology. I imagine a future where Memorial Sloan Kettering's Radiation Oncology Department hosts a yearly talk entitled "Minnesota Rural Physician Loan Forgiveness Guidelines".

 

[deleted941485]

Optimistic view: burnout from additional COVID waves, significant reimbursement cuts from all angles, dealing with APM, and significant increase in documentation burden causes people to retire or leave clinical medicine entirely, opening potential jobs for new grads

Pessimistic view: those new grads endured multiple COVID waves in residency training, will have to navigate significant reimbursement cuts from all angles, deal with APM, and the documentation burden will continue to increase, meaning significantly more manhours are required for stagnate-to-decreased salaries and increasing limitations on autonomy

Because I did my intern year in a traditional Internal Medicine residency program, I still get texts and emails for Hospitalist or other IM positions, with salaries better than the ARRO survey-endorsed median starting salary for new RadOnc grads...and we haven't even entered the APM timeline yet.

But, just like there have always been people willing to go practice rural Family Medicine in the Appalachian hills, there will always be medical students interested in Radiation Oncology. I imagine a future where Memorial Sloan Kettering's Radiation Oncology Department hosts a yearly talk entitled "Minnesota Rural Physician Loan Forgiveness Guidelines".

You are basically getting all the bad misfits in medicine right now...that no one else wants. You can't reason with them either. Its a 4 year residency where you could conceivably bide your time to find something else to do.

 

[elementaryschooleconomics]

Just in time for those worried about the job market: it's back!

 

[medgator]

Just in time for those worried about the job market: it's back!

View attachment 346224

"But it's ok because it is mainly targeted at FMGs/IMGs". Kid you not, that's the response some people give when trash like that is posted on the Astro job site

 

[seper]

Moffitt is just so ridiculous now. Sadly, they used to do good RadOnc research / field advancement.

 

[jondunn]

"But it's ok because it is mainly targeted at FMGs/IMGs". Kid you not, that's the response some people give when trash like that is posted on the Astro job site

of course can be criticized, but when FMGs are the predominant takers of all of these fellowships, discussion of the ethics of fellowships that are non-accredited should be divorced from the job market discussion to a certain extent. not a popular opinion, but seems to be clear to me.

 

[medgator]

of course can be criticized, but when FMGs are the predominant takers of all of these fellowships, discussion of the ethics of fellowships that are non-accredited should be divorced from the job market discussion to a certain extent. not a popular opinion, but seems to be clear to me.

So it's ok to take advantage of/exploit certain populations of people for cheap labor? Not going to agree. It's quite blatant in some of the positions, advertising a "proton" fellowship at a glorified PP while one of the points mentions "doc of the day" coverage.

20 years ago, some of those "fmgs/imgs" became well known attendings at many academic places without the need for bogus "advanced/proton" fellowships

 

[deleted941485]

So it's ok to take advantage of/exploit certain populations of people for cheap labor? Not going to agree. It's quite blatant in some of the positions, advertising a "proton" fellowship at a glorified PP while one of the points mentions "doc of the day" coverage

Certain populations are exploited while the others have rights…yes I’m quite certain that I’ve read about this somewhere in my HS history class. This is the story of America.

 

[medgator]

Certain populations are exploited while the others have rights…yes I’m quite certain that I’ve read about this somewhere in my HS history class. This is the story of America.

Yup.... And some people speak out about while others remain silent (some of them even like/benefit from it!)