Bloodbath in Red Journal

[bluebubbles]

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[medgator]

"Employment After Radiation Oncology Residency: A Survey of the Class of 2014"

This will be coming out in next month's red journal. Only 60% response rate, but of those, nearly 71% felt the job market was worse than what they expected, going into residency. 1/3 couldn't get their geographic preference and 16% couldn't land an academic gig. At the end of the day though, >90% of respondents had a job. Salina, KS and Rhinelander, WI will always make room for you.

FWIW....

 

[seper]

http://www.redjournal.org/article/S0360-3016(15)00337-5/fulltext

8/167 are in fellowship, more than I would have gussed

 

[medgator]

http://www.redjournal.org/article/S0360-3016(15)00337-5/fulltext

8/167 are in fellowship, more than I would have gussed

It could be the start of a trend....

I know of at least 1-2 people in the last couple of years that have done fellowships after not finding A job in a specific geographic locale to give it a year to see if conditions changed.

 

[BobbyHeenan]

http://www.redjournal.org/article/S0360-3016(15)00337-5/fulltext

8/167 are in fellowship, more than I would have gussed

It does mention that 5 out of 7 that did not secure employment subsequently entered fellowships. I'm not sure of the exact individual situations, but I'm willing to bet the reason for at least some of them is due to constricting job market (ie can't find a job you like, so might as well do a fellowship). This phenomena has been seen in radiology and you're going to see it happen in rad onc too I think.

In the figure in the paper it basically says 7 out of 97 people looking for employment did not find a job. 7% seems alarmingly high to me, though I'm sure there may be some selection bias going on (?only those disgruntled answered the questionnaire maybe?). It's hardly apples to apples, but with this data a newspaper could run the headline: "US Radiation Oncologists have higher unemployment rate (7.2%) than the national average (5.4%)."

I hope there is more discussion on this in the Red Journal and from the powers that be. It's not just about unemployment though, it's about under-employment and sticking new grads into bad situations (revolving door never-make-partner gigs, employed at hospital with a terrible contract, or Rhinelander, WI) just to have A job.

 

[Surf123]

Very sobering to read these posts as an MS3 interested in radonc. I go to a top 5 med school, but would you all discourage future students from entering the field if they have very specific geographic interests (CA)? My constraints are due to SO's job and family. It seems like the job market is on the path to getting worse in the next 5-10 years?

Also it seems like residency spots were contracted in 1995 due to the poor job market. Has the job market not gotten sufficiently bad enough yet for that to happen again?

So interesting that rad onc decreased spots in response to poor market back then. In radiology, we have had a bad market for 7 years or so and spots have expanded! Of course we did not fill 150 positions last match. I hope your field does not go the way of radiology. The oversupply not only hurts those looking for work, but also those working with downward pressure on salaries, decreasing stability, increased workload, etc. There are few career and geographic options and you tend to go where the work is. Not sure if greedy opportunists abound in rad onc, but radiology has a good number of bad groups, predatory corporations and telerad. Companies who have no trouble exploting radiologists.

 

[BobbyHeenan]

So interesting that rad onc decreased spots in response to poor market back then. In radiology, we have had a bad market for 7 years or so and spots have expanded! Of course we did not fill 150 positions last match. I hope your field does not go the way of radiology. The oversupply not only hurts those looking for work, but also those working with downward pressure on salaries, decreasing stability, increased workload, etc. There are few career and geographic options and you tend to go where the work is. Not sure if greedy opportunists abound in rad onc, but radiology has a good number of bad groups, predatory corporations and telerad. Companies who have no trouble exploting radiologists.

Oh, the opportunists are out there.

Each year at our annual meeting Terry Wall (a rad onc with a legal background as well, as I recall) does an amazing job of helping senior residents evaluate practices and contracts. He warns about a lot of big warning signs that the job really could be not a good situation (revolving door of prior employees that never make partner, buying into a practice that does not own machines, hospital or employment contracts that really aren't favorable for you, poor support staff coverage, poor dosimetry/physics ratios, etc).

This published report in the Red Journal does a good job of getting the field a baseline for unemployment numbers. What it doesn't do (and I'm not sure if it could be possible), is touch on how much compromising is going on out there, where people take jobs that have warning signs everywhere, but they just need A job. I know this goes on now, and my perception is it's at a higher rate than previous years, but I just don't know.

To be clear, no job is perfect. But make no mistake, if administrators or "opportunists" sense or know the market is tightening, that does not do us any favors. I personally know one high level academic administrator that has his finger on the pulse of the job market (he's fair but a very shrewd business man) and he told may straight out that he knows the market is tightening, he's seen more applications than ever before (this was in late 2014), and he was able to be more selective and compromise less on his end because he knows it's getting tougher to find those good jobs.

 

[medgator]

. What it doesn't do (and I'm not sure if it could be possible), is touch on how much compromising is going on out there, where people take jobs that have warning signs everywhere, but they just need A job.

I thought the 1/3 chance of someone not getting any job in their preferred geographic locale and >2/3 subjectively feeling it to be worse a job market than when they started was pretty sobering, personally.

 

[seper]

True, I see adverse effects of MD oversupply for those in "mid-career" also.

So interesting that rad onc decreased spots in response to poor market back then. In radiology, we have had a bad market for 7 years or so and spots have expanded! Of course we did not fill 150 positions last match. I hope your field does not go the way of radiology. The oversupply not only hurts those looking for work, but also those working with downward pressure on salaries, decreasing stability, increased workload, etc. There are few career and geographic options and you tend to go where the work is. Not sure if greedy opportunists abound in rad onc, but radiology has a good number of bad groups, predatory corporations and telerad. Companies who have no trouble exploting radiologists.

 

[Surf123]

Sorry to hear about bad situations in your field. Seems like us MDs without control of patients have little bargaining power or leverage other than our numbers. When we are in surplus, we are sitting ducks from the vantage point of employers and administrators. I know this first hand being employed in radiology in a competitive area which is saturated. Work conditions have fallen and productivity demands have risen. Contract renewal time is extremely tense. Finding new worthwhile opportunities is tough without uprooting family in mid life. Hope your leaders keep your numbers low so that your working careers are better and you have more career flexibility.

 

[bluebubbles]

I wonder if senior leadership has any incentive to control residency positions. As BobbyHeenan mentioned, chairmen benefit from an oversupply of radiation oncologists, since they get a better deal on new faculty.

 

[thecarbonionangle]

The problem is rampant in academic medicine as a whole. Essentially hospitals should be hiring more attendings but instead they just hire more residents or have residents cover more patients; residents are cheap labor without the ability to unionize or negotiate their contracts. Residents are not students (supreme court case actually about that decided it) so we are taxed without any exceptions unless you are married/kids. Academic attendings also want to be covered by residents so they just have to write a five line attending note that reads "I agree with the findings as documented by the resident....blah blah".

Heres a recent article on the crisis in American Medicine: http://www.nybooks.com/articles/archives/2015/jun/04/training-young-doctors-current-crisis/

 

[medgator]

The problem is rampant in academic medicine as a whole. Essentially hospitals should be hiring more attendings but instead they just hire more residents or have residents cover more patients; residents are cheap labor without the ability to unionize or negotiate their contracts. Residents are not students (supreme court case actually about that decided it) so we are taxed without any exceptions unless you are married/kids. Academic attendings also want to be covered by residents so they just have to write a five line attending note that reads "I agree with the findings as documented by the resident....blah blah".

Heres a recent article on the crisis in American Medicine: http://www.nybooks.com/articles/archives/2015/jun/04/training-young-doctors-current-crisis/

Yet if you talk to people at the medical school level, they swear it's a travesty that medicare GME/DME funding has been frozen for 20 years because it has hampered growth of residency slots as a whole while med schools have sprouted up left and right (both DO and MD).

 

[canadianoutlaw]

Residents are not students (supreme court case actually about that decided it) so we are taxed without any exceptions unless you are married/kids

Does anyone have a citation for this? I hear about this all the time but would like to read the primary source

 

[Neuronix]

Does anyone have a citation for this? I hear about this all the time but would like to read the primary source

http://www.aaos.org/news/aaosnow/apr11/advocacy1.asp

 

[OTN]

I thought the 1/3 chance of someone not getting any job in their preferred geographic locale and >2/3 subjectively feeling it to be worse a job market than when they started was pretty sobering, personally.

Radonc is tiny, tiny tiny. 1/3 chance of not getting a job in a preferred geographic locale is actually much better than I would have assumed. I always tell people if you're interested in one area only of the country, radonc might not be for you.

 

[medgator]

Radonc is tiny, tiny tiny. 1/3 chance of not getting a job in a preferred geographic locale is actually much better than I would have assumed. I always tell people if you're interested in one area only of the country, radonc might not be for you.

I guess it depends on how it is defined. I thought it would mean "region" not state or city. But if it meant actual city, then I agree, it's not that bad.

 

[TheWallnerus]

Pulling a Lazarus on this one.

From "blood bath" to Sitz bath

ASTRO Blog- American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

A series of blog entries covering a wide range on Oncology related topics by various contributors.

www.astro.org

 

[Palex80]

Nice picture.

 

[TheWallnerus]

Nice picture.

Just some college students waiting on the ASTRO workforce survey to determine the course of their entire life

 

[deleted941485]

Just some college students waiting on the ASTRO workforce survey to determine the course of their entire life

A sucker born every minute

 

[sueyom]

people, you very successfully freaked me out bringing back this thread title
i am going to need to read five radiobiology articles to calm myself

 

[elementaryschooleconomics]

people, you very successfully freaked me out bringing back this thread title
i am going to need to read five radiobiology articles to calm myself

It's 2022, and @TheWallnerus successfully trolls the Editor-in-Chief of the Red Journal, @sueyom, by necroposting in the almost 10-year old thread that was arguably the opening salvo in a series of events which catalyzed today's ASTRO announcement about a workforce study.

What a time to be alive.

 

[Palex80]

Just some college students waiting on the ASTRO workforce survey to determine the course of their entire life

Indeed. But the picture itself almost deserves a place in the „Dear you to reply thread“, so many things about it!

 

[Mandelin Rain]

Again, Hallahan's response is an obvious call for wage fixing and the only anti-competitive behavior surrounding this topic on record.

Insane he published it in the Red Journal.

 

[jondunn]

Chirag now the Astro workforce guy, how the tables have turned....

 

[Mandelin Rain]

Chirag now the Astro workforce guy, how the tables have turned....

I'm sure Red Journal apologies/mea culpas are forthcoming.

I'll mea culpa the tone of the OP. At the time, I was in a very similar position to Shah, and couldn't imagine writing that piece at that point in my career. Turns out, speaking your truth and being right eventually works out for you. Great job.

 

[BobbyHeenan]

I'm sure Red Journal apologies/mea culpas are forthcoming.

I'll mea culpa the tone of the OP. At the time, I was in a very similar position to Shah, and couldn't imagine writing that piece at that point in my career. Turns out, speaking your truth and being right eventually works out for you. Great job.

It wasn't HIS truth.

It was THE truth.

 

[TheWallnerus]

Again, Hallahan's response is an obvious call for wage fixing and the only anti-competitive behavior surrounding this topic on record.

Insane he published it in the Red Journal.

Dennis openly coupled increasing physician wage cost (to him) with a lack of physician supply and then laid bare his plans to drive down those costs by increasing physician supply. It sounds like a price fixing conspiracy not unlike what was shown in ‘The Informant!’.

We should report DH to the FBI (only half joking).

 

[deleted941485]

Dennis openly coupled increasing physician wage cost (to him) with a lack of physician supply and then laid bare his plans to drive down those costs by increasing physician supply. It sounds like a price fixing conspiracy not unlike what was shown in ‘The Informant!’.

We should report DH to the FBI (only half joking).

Yeah but honestly in this environment. Everyone hates doctors. So conspiracies to lower wages will be overlooked while “conspiracies” to increase wages will be prosecuted

 

[deleted1116990]

Everyone hates doctors.

Correct. Anybody questioning this should read the recent atrocity/hit piece on doctors in the Atlantic magazine. The physician salary argument for healthcare costs in America is about as intellectually lazy as it gets and always authored by ignorant journalists with obvious chips on their shoulders. The idea that if physician salaries are cut overnight by 50% that it will translate to 50% cost savings to patients is asinine.

 

[thecarbonionangle]

Dennis openly coupled increasing physician wage cost (to him) with a lack of physician supply and then laid bare his plans to drive down those costs by increasing physician supply. It sounds like a price fixing conspiracy not unlike what was shown in ‘The Informant!’.

We should report DH to the FBI (only half joking).

I agree LOCK HIM UP. He said the quiet part out loud.