2019 Terry Wall Data Discussion

[Neuronix]

EDIT: This thread was split out of another thread at the request of a user to specifically discuss this topic. The data itself is in the private forum. I'm not sure if it's meant to be public. If you would like access, please PM me.

Or Terry Wall's data.

Thanks for reminding me of that. That's one of the pieces of data I didn't have in the private forum. I asked for it there, and one of our users sent me a copy of Terry Wall's presentation for 2019. Thanks for that.

I was struck by a few slides:

2019 ARRO Private Practice Entry Survey
“How would you have changed your job evaluation process?” (handwritten questions)
• “Picked a different speciality or avoided medicine altogether. It was a brutal process because the job market is so absymal. People say to network early—I tried that and nothing came of it. It comes down to luck, otherwise your good job options are out in the middle of nowhere. These are high paying jobs with nice people, but you sacrifice a lot giving up location.”

2019 ARRO Private Practice Entry Survey
“How would you have changed your job evaluation process?” (handwritten questions)
• “Not entered rad onc.”
• “I would have asked for more assistance from my chairman and program director, who did essentially no outreach on my behalf. I had wrongly assumed they would be interested in helping me find a job, but that just was not true.”
• “had minimal support from the training program (very passive)”
• “put less faith in my home institution.”
• “the job market is terrible.”

2019 ARRO Private Practice Entry Survey
What do you like most about private practice? (handwritten comments)
• “It was my only job offer.”

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[Krukenberg]

Thanks for reminding me of that. That's one of the pieces of data I didn't have in the private forum. I asked for it there, and one of our users sent me a copy of Terry Wall's presentation for 2019. Thanks for that.

I was struck by a few slides:

If I recall correctly some of those slides were quotes from the 90s that he revealed to make a point. Someone else please confirm though

 

[Neuronix]

If I recall correctly some of those slides were quotes from the 90s that he revealed to make a point. Someone else please confirm though

Everything I posted was specifically from the 2019 responses. There are older responses, most of which are more about how to evaluate practices or complaints about their practices rather than comments about how to find positions or about the job market being bad. The only thing from the past that seems directly connected to the theme of the bad job market is this 2016 quote.

2016 ARRO Private Practice Entry Survey
“How would you have changed your job evaluation process?” (handwritten questions)
• “Married someone different and not be restricted by location.”

 

[scarbrtj]

Thanks for reminding me of that. That's one of the pieces of data I didn't have in the private forum. I asked for it there, and one of our users sent me a copy of Terry Wall's presentation for 2019. Thanks for that.

I was struck by a few slides:
“Picked a different speciality or avoided medicine altogether. It was a brutal process because the job market is so absymal."
“the job market is terrible.”

2019 ARRO Private Practice Entry Survey
What do you like most about private practice? (handwritten comments)
• “It was my only job offer.”

Yeesh. I've made some calculations, and predictions using calculations, which can be snoozy. But when the predictions come true, that's not snoozy. That's bad. And it seems to be happening, so not a prediction per se anymore. Next year will be worse. Can you imagine that?

 

[scarbrtj]

Thanks for reminding me of that. That's one of the pieces of data I didn't have in the private forum. I asked for it there, and one of our users sent me a copy of Terry Wall's presentation for 2019. Thanks for that.

I was struck by a few slides:

I think what happens is that you have a ton of academics slaving away for somewhere between $200-400k and everyone else making 500k+.

Welp got finished looking at the 2019 Wall survey.
Think SDN is depressing sometimes? Read the Wall survey. If potential rad onc applicants read that, I reckon we'd have zero actual applicants. I mean it's that bad. Hide the wife and kids stuff. Also I see that on avg the starting salaries are now likely higher in academics than PP? Further sign of a bubble-about-to-burst IMHO.

 

[Pointless]

Welp got finished looking at the 2019 Wall survey.
Think SDN is depressing sometimes? Read the Wall survey. If potential rad onc applicants read that, I reckon we'd have zero actual applicants. I mean it's that bad. Hide the wife and kids stuff. Also I see that on avg the starting salaries are now likely higher in academics than PP? Further sign of a bubble-about-to-burst IMHO.

Hasn't there always been relative parity for starting salaries between academics and PP? It's nice to look at what you make right out of residency but I think it more informative to know what you'll be making for the rest of your career. I think that is maybe part of the confusion on this board... people are conflating starting salaries with actual pay 2+ years out of residency.

Sure, you can expect 200-400 as a new academic attending and probably the same on a partnership track. If that remains the case for the PP person after 3 years, then we got trouble.

 

[deleted1002574]

Eh .. reports of academic satellites docs at UPMC making $450-500+ fresh out of residency and not too far off for other larger satellites. I don't know what the Mayos pay or CCF, but I presume close to stay competitive?

 

[seper]

I'm familiar with what large networks / satellites pay in Ohio and surrounding states, and the actual numbers are more like c. 325K after individual bonus.

[

Eh .. reports of academic satellites docs at UPMC making $450-500+ fresh out of residency and not too far off for other larger satellites. I don't know what the Mayos pay or CCF, but I presume close to stay competitive?

 

[nkmiami]

Eh .. reports of academic satellites docs at UPMC making $450-500+ fresh out of residency and not too far off for other larger satellites. I don't know what the Mayos pay or CCF, but I presume close to stay competitive?

Never heard of that kind of starting salary at an academic facility, but who knows.

 

[evilbooyaa]

Never heard of that kind of starting salary at an academic facility, but who knows.

These are numbers for rural (think 1-2 hours away from biryani) satellites with affiliations to academic facilities.

 

[RadOncMegatron]

EDIT: This thread was split out of another thread at the request of a user to specifically discuss this topic. The data itself is in the private forum. I'm not sure if it's meant to be public. If you would like access, please PM me.



Thanks for reminding me of that. That's one of the pieces of data I didn't have in the private forum. I asked for it there, and one of our users sent me a copy of Terry Wall's presentation for 2019. Thanks for that.

I was struck by a few slides:

Again, no surprise. At the risk of

Risk + Opportunity Cost = 4 years undergrad + 4 years Med School + 5 Years Residency + Opportunity Costs (other career not just M.D., other specialty, student debt burden, lost financial gain from other career, geographic restriction, strain on family/personal life) + chance of finding a bad job (~30% per survey)

How much of this can be alleviated by restricting residency expansion? How much can be alleviated by doing med onc? I know med oncs switching jobs relatively easy in town and I know only a few (close to zero) that are able to do so.

Let's say "only" 1/6 people can't find a good job that is TERRIBLE for someone who put in so much time. I also picked 1/6 b/c that's risk in Russian roulette. NO GOOD!

What is bad is that much of this is a self inflicted wound via academics who opened the flood gates of residency and are buying up satellites (well, I do blame admin mostly on this).

 

[deleted941485]

I had a chance to skim the starting salaries. Pretty much flat over the last 4 years which really means inflation has been eroding it in real terms.

For rad onc, the PP world is essentially irrelevant as it continues to shrink and the academic world is pretty much taking over everything.

People complain about academia moving to a productivity based system which makes sense as their reimbursement per case declined and will continue to do so.

I can foresee a day when productivity bonuses become nonexistent. It doesn’t matter how hard you work you are paid the same but really declining in real terms.

 

[RickyScott]

Let's say "only" 1/6 people can't find a good job that is TERRIBLE for someone who put in so much time. I also picked 1/6 b/c that's risk in Russian roulette. NO GOOD!.

exactly- again these guys are AOA etc

 

[elementaryschooleconomics]

Again, no surprise. At the risk of

Risk + Opportunity Cost = 4 years undergrad + 4 years Med School + 5 Years Residency + Opportunity Costs (other career not just M.D., other specialty, student debt burden, lost financial gain from other career, geographic restriction, strain on family/personal life) + chance of finding a bad job (~30% per survey)

How much of this can be alleviated by restricting residency expansion? How much can be alleviated by doing med onc? I know med oncs switching jobs relatively easy in town and I know only a few (close to zero) that are able to do so.

Let's say "only" 1/6 people can't find a good job that is TERRIBLE for someone who put in so much time. I also picked 1/6 b/c that's risk in Russian roulette. NO GOOD!

What is bad is that much of this is a self inflicted wound via academics who opened the flood gates of residency and are buying up satellites (well, I do blame admin mostly on this).

Before someone picks this strawman battle - OBVIOUSLY MedOnc and other specialties are faced with their own issues. I view this as: if you ABSOLUTELY MUST BE A CANCER DOCTOR, MedOnc is a safer bet than RadOnc.

It's by no means bulletproof, or the best job ever, etc etc - we know.

 

[RadOncMegatron]

Before someone picks this strawman battle - OBVIOUSLY MedOnc and other specialties are faced with their own issues. I view this as: if you ABSOLUTELY MUST BE A CANCER DOCTOR, MedOnc is a safer bet than RadOnc.

It's by no means bulletproof, or the best job ever, etc etc - we know.

Why is it so hard for everyone to be honest about this? It's beyond me... If you are honest than at the minimum you can deflect blame. Here I'll help you:

"Radiation oncology is the best field in medicine, satisfying intellectually, with incredible patient interaction, focus on research, and is the most technologically advanced field in medicine. The job market is not the best right now with only 70% of graduates who are happy with their career, but trends towards hypofractionation, APM, and the increase in residency expansions may make things much more difficult in the future for our specialty with limited job options (esp. with PP dying out) and geographical inflexibility. This is not unique to rad onc, but it is important for you to know nonetheless. Many are interested in academics, but most positions are unfortunately taken on the main campus, but we may have some satellite positions available. If that is a risk you are willing to take come join us in this great field, we will train you well, but do not complain that you were not warned after completing residency."

 

[elementaryschooleconomics]

Why is it so hard for everyone to be honest about this? It's beyond me... If you are honest than at the minimum you can deflect blame. Here I'll help you:

"Radiation oncology is the best field in medicine, satisfying intellectually, with incredible patient interaction, focus on research, and is the most technologically advanced field in medicine. The job market is not the best right now with only 70% of graduates who are happy with their career, but trends towards hypofractionation, APM, and the increase in residency expansions may make things much more difficult in the future for our specialty with limited job options (esp. with PP dying out) and geographical inflexibility. This is not unique to rad onc, but it is important for you to know nonetheless. Many are interested in academics, but most positions are unfortunately taken on the main campus, but we may have some satellite positions available. If that is a risk you are willing to take come join us in this great field, we will train you well, but do not complain that you were not warned after completing residency."

This should be the Terms of Service which you must click "Accept" on to continue applying to RadOnc through ERAS.

 

[PhotonBomb]

Why is it so hard for everyone to be honest about this? It's beyond me... If you are honest than at the minimum you can deflect blame. Here I'll help you:

"Radiation oncology is the best field in medicine, satisfying intellectually, with incredible patient interaction, focus on research, and is the most technologically advanced field in medicine. The job market is not the best right now with only 70% of graduates who are happy with their career, but trends towards hypofractionation, APM, and the increase in residency expansions may make things much more difficult in the future for our specialty with limited job options (esp. with PP dying out) and geographical inflexibility. This is not unique to rad onc, but it is important for you to know nonetheless. Many are interested in academics, but most positions are unfortunately taken on the main campus, but we may have some satellite positions available. If that is a risk you are willing to take come join us in this great field, we will train you well, but do not complain that you were not warned after completing residency."

This is a lot more reasonable than what is often said here. No one would disagree with this. Should be the auto pop up when you login to the sub forum

 

[Pointless]

Why is it so hard for everyone to be honest about this? It's beyond me... If you are honest than at the minimum you can deflect blame. Here I'll help you:

"Radiation oncology is the best field in medicine, satisfying intellectually, with incredible patient interaction, focus on research, and is the most technologically advanced field in medicine. The job market is not the best right now with only 70% of graduates who are happy with their career, but trends towards hypofractionation, APM, and the increase in residency expansions may make things much more difficult in the future for our specialty with limited job options (esp. with PP dying out) and geographical inflexibility. This is not unique to rad onc, but it is important for you to know nonetheless. Many are interested in academics, but most positions are unfortunately taken on the main campus, but we may have some satellite positions available. If that is a risk you are willing to take come join us in this great field, we will train you well, but do not complain that you were not warned after completing residency."

For the love of God, yes! Sticky this!