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Sounds like radiology.
What to do after residency if no job offers?
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I've been reading this thread with interest, despite the fact that I'm only in the middle of my intern year.
An article linked to earlier in this discussion (http://dx.doi.org/10.1016/S0360-3016(98)00476-3) outlines job outcomes for 1995 residency training program graduates. I'm interested in gathering and reporting more recent data. Assuming I get IRB approval, how could I go about reaching out to radiation oncologists who have graduated in the past 1-3 years? Does ASTRO keep that kind of information?
Newer, updated information could be useful for current residents, medical students considering applying to the specialty, and (hopefully) The Powers That Be (training programs, professional societies) as we all evaluate the direction Radiation Oncology is heading in the coming years.
EDIT: looks like the older study used ARRO data. I'll do some more reading and see if I can find someone to get in touch with through that organization.
An article linked to earlier in this discussion (http://dx.doi.org/10.1016/S0360-3016(98)00476-3) outlines job outcomes for 1995 residency training program graduates. I'm interested in gathering and reporting more recent data. Assuming I get IRB approval, how could I go about reaching out to radiation oncologists who have graduated in the past 1-3 years? Does ASTRO keep that kind of information?
Newer, updated information could be useful for current residents, medical students considering applying to the specialty, and (hopefully) The Powers That Be (training programs, professional societies) as we all evaluate the direction Radiation Oncology is heading in the coming years.
EDIT: looks like the older study used ARRO data. I'll do some more reading and see if I can find someone to get in touch with through that organization.
Last edited:
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Get in while the getting is still relatively good.
Med schools pumping out more MDs + more IMGs + Rad Onc programs pumping out more grads + MDs pushing back retirement + reducing compensation across the board = no reason to be overly optimistic.
Rad Oncs will still do well financially and professionally but not all will learn to adapt to the new age to maximize return on investment.
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GFunk is just being very very political, he would have addressed Wombat's points if he wasn't a PD that he probably met at ASTRO. Fair enough. I think GFunk has his own biases as someone in PP.
I work in private practice. Gfunk's post captures the gist of it. Lots of old-timers sticking around. Many of these guys don't even knowhow to do IMRT. I know several attendings working in prime areas in their 70s-80s still doing 2D treatments. It's crazy. They are looking for young guys to do locums work. They'll talk about a "full time position" as numbers go up, but the reality is in big cities, the market is saturated and numbers aren't going up. The other thing: you are very unlikely to find a job in prime area unless you have connections to that area. If you want to work in Southern California, you had better do your residency in the area. Of couse there are exceptions, but for the most part, jobs are filled internally by people who know people. I'm going through the hiring process myself, and I really won't consider anyone unless someone I know knows them. I have too much to lose to risk things on an unknown commodity.
I have been checking this forum on and off for many years but never felt I had anything meaningful enough to post, especially since the "regulars" are usually spot on. However, I am sure that this thread is generating a lot of interest and anxiety so I finally decided I would post to provide some facts and opinions.
I'm about 5 years out of residency and at the main site of an academic center. I'm not the program director, but I am very good friends with most of the residents since we are close in age and not that far in our careers. Overall, I truly believe that we have an excellent residency program and our residents are very well trained.
However, I can objectively verify the common themes that others have posted. In the past 4-5 years:
1. Our residency program has expanded, in fact it has nearly doubled. We had 4 residents for at least 20-25 years and now we have 7. In other words, every 4 years we graduate 3 more residents than we used to, and worse yet each of these residents plans to work for 30+ years . . . you do the math but clearly the equilibrium has shifted and will continue to do so for many, many years to come.
2. The vast majority of our attendings value resident education over resident work. I see patients, especially routine non-educational follow-ups alone all the time so the resident can do more meaningful things AND we hired mid-level providers out of our clinical practice fund, i.e. no bonus, to enhance resident education. Despite this, there are more than one or two attendings who act like it is a violation of the US constitution for an attending to see a patient without a resident or be interrupted from one of their 10-15+ research meetings, conference calls, etc per week, and there is at least 1 attending in his early 70's who makes a full salary and has no plans to retire but literally could not see patients without a resident (I'll leave it at that). These individuals would love to increase the residency spots even further because of their own selfishness and they couldn't care less what happened to those residents after graduation, let alone 10-15 years from now.
3. All of the private practices in the community have shut down or been acquired. Within a 75-125 mile radius (depending on which direction) there is now only one other hospital system, so you have to work for the university, the other system, or move very far away.
4. JOBS UPON GRADUATION
Two positions have been filled since I have been here, both by internal graduates. As somebody else mentioned, they would never hire an applicant unless somebody they knew knew them. What's a million times better than that . . . a resident who graduated at the top of their medical school class then performed brilliantly under my direct supervision day after day for four years and is well liked by the staff, familiar with the area, referring physicians, etc. We have two such individuals every single year (see #1 above) so even if a position were to open anytime soon, they would get first priority.
The other residents have all found jobs in hospital based private practice or academic satellites (although two were MD/PhD none were "die hard" academics). I stayed in contact during the interview process and still talk to several of them. Long story short, I can confirm what most others have said: there are plenty of jobs out there, many that pay very well from day 1 (don't kid yourself, you can make more in one day, or maybe even one half of one day, than most of your patients make working M-F) with a lot of vacation (6-8 weeks . . . there are also plenty of 4 day week jobs out there too), benefits (retirement, life/disability insurance, even crazy things like any doctor gets "all you can eat, all day, every day, from the cafeteria), etc but you are going to have to live in a small to medium sized city, which among other things makes it very difficult for your spouse, who is probably a professional, to find a job and of course to stay near family. On the flip side, cost of living is very low AND you make way more because of supply/demand.
I can think of many residents who graduated recently whom I have talked to in the past few months, all but one of whom are very happy and satisfied with there personal and professional lives, and one current PGY-5. They are living/working in: here, Alabama (not Birmingham), Arizona (not Phoenix), Georgia (not Atlanta), Northeast Ohio, rural Virginia, and someplace in Missouri (not sure if it is near St. Louis).
In summary, there are plenty of jobs that pay very, very well, with incredible benefits and wonderful staff/colleagues/patients, etc. but God help you if you are determined to live in San Diego, Boston, NYC, or for that matter in any given location in any given year. Clearly, things are going to get more difficult every year for the foreseeable future.
I'm about 5 years out of residency and at the main site of an academic center. I'm not the program director, but I am very good friends with most of the residents since we are close in age and not that far in our careers. Overall, I truly believe that we have an excellent residency program and our residents are very well trained.
However, I can objectively verify the common themes that others have posted. In the past 4-5 years:
1. Our residency program has expanded, in fact it has nearly doubled. We had 4 residents for at least 20-25 years and now we have 7. In other words, every 4 years we graduate 3 more residents than we used to, and worse yet each of these residents plans to work for 30+ years . . . you do the math but clearly the equilibrium has shifted and will continue to do so for many, many years to come.
2. The vast majority of our attendings value resident education over resident work. I see patients, especially routine non-educational follow-ups alone all the time so the resident can do more meaningful things AND we hired mid-level providers out of our clinical practice fund, i.e. no bonus, to enhance resident education. Despite this, there are more than one or two attendings who act like it is a violation of the US constitution for an attending to see a patient without a resident or be interrupted from one of their 10-15+ research meetings, conference calls, etc per week, and there is at least 1 attending in his early 70's who makes a full salary and has no plans to retire but literally could not see patients without a resident (I'll leave it at that). These individuals would love to increase the residency spots even further because of their own selfishness and they couldn't care less what happened to those residents after graduation, let alone 10-15 years from now.
3. All of the private practices in the community have shut down or been acquired. Within a 75-125 mile radius (depending on which direction) there is now only one other hospital system, so you have to work for the university, the other system, or move very far away.
4. JOBS UPON GRADUATION
Two positions have been filled since I have been here, both by internal graduates. As somebody else mentioned, they would never hire an applicant unless somebody they knew knew them. What's a million times better than that . . . a resident who graduated at the top of their medical school class then performed brilliantly under my direct supervision day after day for four years and is well liked by the staff, familiar with the area, referring physicians, etc. We have two such individuals every single year (see #1 above) so even if a position were to open anytime soon, they would get first priority.
The other residents have all found jobs in hospital based private practice or academic satellites (although two were MD/PhD none were "die hard" academics). I stayed in contact during the interview process and still talk to several of them. Long story short, I can confirm what most others have said: there are plenty of jobs out there, many that pay very well from day 1 (don't kid yourself, you can make more in one day, or maybe even one half of one day, than most of your patients make working M-F) with a lot of vacation (6-8 weeks . . . there are also plenty of 4 day week jobs out there too), benefits (retirement, life/disability insurance, even crazy things like any doctor gets "all you can eat, all day, every day, from the cafeteria), etc but you are going to have to live in a small to medium sized city, which among other things makes it very difficult for your spouse, who is probably a professional, to find a job and of course to stay near family. On the flip side, cost of living is very low AND you make way more because of supply/demand.
I can think of many residents who graduated recently whom I have talked to in the past few months, all but one of whom are very happy and satisfied with there personal and professional lives, and one current PGY-5. They are living/working in: here, Alabama (not Birmingham), Arizona (not Phoenix), Georgia (not Atlanta), Northeast Ohio, rural Virginia, and someplace in Missouri (not sure if it is near St. Louis).
In summary, there are plenty of jobs that pay very, very well, with incredible benefits and wonderful staff/colleagues/patients, etc. but God help you if you are determined to live in San Diego, Boston, NYC, or for that matter in any given location in any given year. Clearly, things are going to get more difficult every year for the foreseeable future.
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Thanks for that information, great stuff. It's interesting to hear from the perspective of the Harvard or MDACC experience (most likely MDACC)
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Figured he meant 7/year
Just to clarify, definitely not at MDACC or Harvard (and I wouldn't want to be!). I guess I would call my institution a "solid mid-tier" program in a medium sized city . . . probably very similar to at least 15-20 other programs in most regards.
Yes, the increase is from 4 to 7 total, which is why I tried to clarify by saying every 4 years we turn out 3 more residents. I also wanted to point out that while this might not seem like much (less than one more resident every year), it actually really is since that extra 0.75 resident every year plans to work for 30+ years so one could argue that the impact of these seemingly small increases is exponential in a way but in any event clearly they will have an impact for decades and decades to come. Also, I might not be exaggerating when I say that literally every single program I know of has either increased its resident spots in the past 3-5 years, plans to do so in the next 1-2 years, or both. Nobody in academics seems to care, in fact maybe even the opposite . . . programs brag about how much they have or are expanding and program directors are awarded/promoted for doing so.
Yes, the increase is from 4 to 7 total, which is why I tried to clarify by saying every 4 years we turn out 3 more residents. I also wanted to point out that while this might not seem like much (less than one more resident every year), it actually really is since that extra 0.75 resident every year plans to work for 30+ years so one could argue that the impact of these seemingly small increases is exponential in a way but in any event clearly they will have an impact for decades and decades to come. Also, I might not be exaggerating when I say that literally every single program I know of has either increased its resident spots in the past 3-5 years, plans to do so in the next 1-2 years, or both. Nobody in academics seems to care, in fact maybe even the opposite . . . programs brag about how much they have or are expanding and program directors are awarded/promoted for doing so.
This is just so scary... I've been interested in rad onc because I liked the treatment side of things and I liked interacting with the patients while shadowing and during my preceptorship, but I don't know if I want to continue pursuing something and solidifying my interest in a field that might turn into a radiology/pathology job market in 10 years when I'm finally a PGY-5 and on the job hunt. And if there are old timers that can't even use IMRT and use 2D treatments, then why aren't hospitals and private practices trying to push them out of the system? Is it just because they've been around so long that they have enough power to override them?
One of the questions that I have is that with an aging US population, will there be an expansion in radiation oncology centers or at linear expansions in positions within departments that'll help alleviate some of the workload?
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Time to polish those CVs, ladies and gentlemen: http://careers.astro.org/jobs/6667266/chair-department-of-radiation-oncology
Pretty sure they already know who they're hiring and its just a formality required by HR
Probably only 1/3 of them are attendings. Alot of physicists and radiobiologists are also faculty members.
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How's the Job search this year for the PGY-5s? I've been looking at the ASTRO postings and see that the West Virginia medical school is hiring another attending (http://careers.astro.org/jobs/7133480/radiation-oncologist), so it looks like they may be opening up the rumored residency program there eventually (perhaps soon?). A lot of the jobs I see are in smaller towns right now, with a few exceptions like UCSF looking for an MDPHD pediatrics attending, Mayo Arizona protons, and Kaiser HDR brachy in Santa Clara. There is certainly not enough job postings for all graduates. Curious to hear about this year for the current upcoming graduates.
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Everyone I know got jobs and not one of them was advertised. Two of them got academic jobs in fairly large mid tier centers. The other three got PP jobs in small-medium sized cities. The ASTRO job site will never give you a great sense of what's actually out there.
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Good jobs rarely are
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How do you find out about them? Do people email your chair/attendings and then they tell you? do you meet people at conferences and they offer it? For those of us who are not "well-connected" what should we be doing going into residency?
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Networking is important, especially if you know where you would like to eventually end up, geographically
