Originally Posted by mdeast (Post 10930475)

I was also curious to what exact a fast-track route to Hem/Onc (or other specialties) is? (i.e. 5 years of residency and fellowship instead of 6). I'm thinking about doing internal medicine (2 years) and then hem/onc fellowship (3 years), with the intention to do some sort of clinical research in addition to my normal practice.

Originally Posted by Pewl (Post 10995663)

I noticed that in the above graphs, there was no mention of radiation oncologists in the groupings, only "oncologists." This makes me wonder if they are lumping rad onc and med onc into one category. Based on the numbers I've seen, rad onc salaries tend to raise the aggregate "oncology" salaries in these groupings. I won't lie, median private practice rad onc salaries are kinda ridiculous. But, either way I think you'll be able to earn a reasonable income. :)

Originally Posted by texashemonc (Post 10899295)

Compensation is steadily declining each year in private practice for hem/oncs. But it is a complicated formula and varies by the market you practice in. The technical side (chemo drugs) has definitely hit everyone hard as erythropoietin use is practically non-existent now except for CKD patients. With many medicare pts going into medicare HMO plans, many oncologists are not taking these patients as these tend to be lower income patients with much more chronic problems and difficult for them to come up with their copays. So even there may be more cancers being diagnosed, many patients do not have either adequate insurance, no insurance, or are medicare/medicaid (which we lose or break even at best).

Am definitely working harder than 10 years ago even though income declining. Often am always one of the last doctors to leave in the medical office building parking lot each evening so that can be depressing at times.

Most solo practices have consolidated and joined larger groups or got bought out by hospital chains. For a solo doctor to survive, either have to have a great referral base, or work in small rural town with no other competition. But the trade off is less time off. Hard to go on vacation worrying about your coverage as only you know your patients the best. I dread coming back from a week off vacation as that following week will always be a torture as you end up double booking patients routinely.

Starting salary at academic centers usually run between 150-200K,although somewhat slightly more for "community" academic docs, who do strictly clinic/office/hospital work 5 days/week with no free research time. Problem for that sort of job is that the administrators can pile as many patients on to your schedule beyond your control even though you are strictly salary based with very little if any productivity bonus.

Private practice starting will usually run 200-275K depending on geography. If partnership is made, then can certainly make 400-800K although income strictly proportional to how many patients you see in the office and hospital. Biggest problem I see are new doctors who enter a congested market (any mid to large metro city) and stay for not more than 1-2 years before leaving.

Originally Posted by DrVanNostran (Post 11026268)

Thanks for the response, I was wondering if you could expand on this? Are new docs leaving the larger markets because they can't get enough patients? Difficult to make partner?

Also, does anyone know how the chicago market is? I would like to end up in burbs of Chicago eventually :) Thanks.

Originally Posted by asprin81 (Post 10996028)

Rad Onc is always lumped with radoilogy, not with oncology

Originally Posted by KarmaDoc (Post 11244622)

I have a feeling that the "wide variation in oncology salaries" are due to the fact that rad oncs are indeed being lumped with med oncs in those graphs.

Originally Posted by gojonn (Post 11285316)

KarmaDoc, after reading multiple comments by GutOnc, one of our best resources, I have to disagree with you. I highly doubt rad onc get's lumped in with med oncs causing a broad range in salaries. The large discrepencies is purely related to practice types, locations, and preferences (as in I prefer to see a lot of patients and make a lot more money).

Originally Posted by DocIM (Post 13791092)

Getting a job in Hem/Onc has become increasingly difficult right now. I know 2 people from 2nd tier hem/Onc programs having trouble finding suitable positions, they already gave up looking in mid-big size cities.

Apparently, hospitals are cutting down on hiring hem/Onc docs due to uncertainty resulting from the impending implementation of obamacare. So the next few years could be rough for hem/Onc grads.

Originally Posted by DocIM (Post 13795603)

Did you graduate from a top tier program? They have a lot of research background and went to mid-tier med schools. They do have offers, not great, but from not so desirable places in the middle of nowhere. Apparently, that is what many hospitals have told them. It is due to uncertainty of how implementation will occur and funding for obamacare that GOP will try to cut-off. So although it is law, implementation of obamacare depends on some federal funding. Yes, it will add many new patients but no one is sure about the implementation. Businesses don't like uncertainty and act accordingly when it comes to business decisions.