Chances of matching in rad/onc

[birb56]

I'm doing a transitional year next year and I've floated the idea applying to radiation oncology since I really enjoyed shadowing my local's hospital's rad/onc attendings. The problem for me is I might be a lackluster candidate to apply and I feel like the current NRMP Match data doesn't paint an accurate picture since the unmatched rate is so low and I can't say I really know what these candidates are like.

I will be honest. For rad/onc, I may not be a competitive applicant. If not, I accept that but I wanted to check. My steps 1/2 are 215/240 (I know this could be a disqualifier) and I only have one publication, as well as another I'm currently working on. Do I have a shot at matching anywhere? (I don't have a preference for program or career location)

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[dieABRdie]

Peruse this forum for just a bit... you will get your answer.

 

[medgator]

I'm doing a transitional year next year and I've floated the idea applying to radiation oncology since I really enjoyed shadowing my local's hospital's rad/onc attendings. The problem for me is I might be a lackluster candidate to apply and I feel like the current NRMP Match data doesn't paint an accurate picture since the unmatched rate is so low and I can't say I really know what these candidates are like.

I will be honest. For rad/onc, I may not be a competitive applicant. If not, I accept that but I wanted to check. My steps 1/2 are 215/240 (I know this could be a disqualifier) and I only have one publication, as well as another I'm currently working on. Do I have a shot at matching anywhere? (I don't have a preference for program or career location)

Highest match rate for US seniors out of any specialty in the country and you're worried about matching? Should be more concerned about finding that good job that isn't in Timbuktu when you graduate from a specialty where the job market is going nowhere fast

 

[thecarbonionangle]

Bro, you could easily walk into a top mid tier place. This is the epoch of buying arse low to the ground. You are a superstar compared to some people who matched at these hellpits.

Do you have a pulse?
Is your temperature lukewarm (at least 32C)?
Do you have at least an arm?

If so you are in brotha!

 

[goodkerma]

Multiple people matched this year at well-regarded programs who have failed step exams on first attempt and/or haven’t even done a formal radonc rotation. Only chase the publications if it brings you happiness- it is no longer a requirement even at “top” programs. Do one formal radonc rotation and get a letter of recommendation and you’re golden. Be prepared for the pain when it comes time to graduate, though.

 

[RTOGsaveRadonc]

Bro, you could easily walk into a top mid tier place. This is the epoch of buying arse low to the ground. You are a superstar compared to some people who matched at these hellpits.

Do you have a pulse?
Is your temperature lukewarm (at least 32C)?
Do you have at least an arm?

If so you are in brotha!

I didn’t hear him say he had a criminal record so should be good.


Take your talents elsewhere, you seem like a smart dude. In a way, our speciality is a Ponzi scheme to fatten gluttonous chaors

 

[heartisinradonc]

This is pretty sad. I am in a similar Anglophone country and there are similarly no jobs whatsoever in the profession, hypofractionation/SABR making everyone extinct, medical oncologists running rampant with no evidence treating anyone and everyone their can get their hands on. However out here there's only a handful of training positions and the training college is becoming more ruthless every year.

 

[RickyScott]

You can walk in to a top place, but you won’t leave with a job

 

[birb56]

Multiple people matched this year at well-regarded programs who have failed step exams on first attempt and/or haven’t even done a formal radonc rotation. Only chase the publications if it brings you happiness- it is no longer a requirement even at “top” programs. Do one formal radonc rotation and get a letter of recommendation and you’re golden. Be prepared for the pain when it comes time to graduate, though.

Yeah, I'm struggling to get the full picture. I've talked to people optimistic and negative views on rad/onc's future. Obviously, it will never die since ppl will always need radiotherapy but as far as the job market goes, shouldn't I be good if I don't have any geographic preference? I'm not looking to graduate and work in a big metro city. I'd say I'd like to aim for a mid-size city in the South.

 

[birb56]

You can walk in to a top place, but you won’t leave with a job

This is a point I commonly hear. I understand that job openings are tight in highly desirable areas but if I'm not looking for any top metro area and would be satisfied in any mid-sized city in the South, shouldn't I be fine?

 

[heartisinradonc]

Yeah, I'm struggling to get the full picture. I've talked to people optimistic and negative views on rad/onc's future. Obviously, it will never die since ppl will always need radiotherapy but as far as the job market goes, shouldn't I be good if I don't have any geographic preference? I'm not looking to graduate and work in a big metro city. I'd say I'd like to aim for a mid-size city in the South.

Hypofractionation/SABR + more rad oncs than are needed is all you need to know. RT will be increasingly utilised in earlier stage cancers (primary lung/renal/liver) but will only be treated by a handful of chosen rad oncs in a short number of fractions. Med oncs will continue to overtreat with protracted regimens with little to no benefit to patients.

 

[metallica81788]

This is a point I commonly hear. I understand that job openings are tight in highly desirable areas but if I'm not looking for any top metro area and would be satisfied in any mid-sized city in the South, shouldn't I be fine?

I just wanted a mid-sized city in the South and found nothing when I finished. Ultimately I ended up in one out of residency but the path was not linear and I got lucky. I had similar thinking of not wanting anywhere "desirable" by usual metrics but it was still difficult. Timing and connections are everything and those are getting more difficult to pull off each year.

 

[thecarbonionangle]

If you are ok with a midsized city anywhere and i mean anywhere and are also willing to compromise to it being close to a midsized city with a generous definition of “close” i think you will be ok. The problem is nobody can predict where a job will pop up. the so called “undesirable” southern states are saturated as well. Its not like you see tons of jobs posted and unfilled in these places. People actually want to live there too. For example nobody can guarantee you will get a job in a midsized alabama/mississippi (or surrounding states) city right off the bat

 

[fiji128]

Do a little work and scroll through the job postings thread. It is felt that the job posted on the ASTRO board represent about 50% of all available positions (for both new and experienced docs) at any given point time. In the long run, meaning >5 years every metric points to available opportunities decreasing. Not sure why some one would want to bet their professional future on that but some still do.

 

[OTN]

This is a point I commonly hear. I understand that job openings are tight in highly desirable areas but if I'm not looking for any top metro area and would be satisfied in any mid-sized city in the South, shouldn't I be fine?

No

 

[thesauce]

Job market is seeing a very temporary improvement. The bottom will fall out again very soon. This is a bad move.

 

[IRattending2021]

I wonder if he couldn’t match radiology.

On my year one of my classmate was hell bent on radonc but last minute panicked because he didnt think he had the score for it.

So he applied to radiology and matched at Brighams instead.

 

[deleted1116990]

shouldn't I be good if I don't have any geographic preference?

No.

Seriously, put this idea to rest now. Apply to radiology, dermatology, large animal veterinary school, literally anything else. Many of us are extremely envious of your situation and the options you have right now.

 

[jondunn]

No.

Seriously, put this idea to rest now. Apply to radiology, dermatology, large animal veterinary school, literally anything else. Many of us are extremely envious of your situation and the options you have right now.

you're envious?

dude, I'm sorry.

 

[RSAOaky]

I have a great job but if I were a senior med student applying right now I would apply for radiology, period. You've spent the best decade of your life going into debt and working your ass off to become a doctor, why roll the dice on a field you may not even get a job in?

 

[RSAOaky]

Have you ever heard of Pascal's wager? The gist of it is that you should believe in God regardless of whether God truly exists, because if God does exist and you don't believe, you're going to Hell. On the contrary, if God does exist and you believe you go to heaven, and if God doesn't exist then it didn't matter anyways. I have proposed RSAOaky's corollary below and it makes the choice quite clear.

	The RadOnc Job Market Sucks	The RadOnc Job Market is Awesome
#LiterallyAnythingElse	Eternal Happiness	Eternal Happiness
#RadOncRocks	Eternal Damnation	Eternal Happiness

 

[elementaryschooleconomics]

So I somewhat fell victim to this train of logic as a student:

1) Even the optimistic people acknowledge geographic limitations
2) Usually, they say "it will be tough to get a job in NYC or LA, sure, but other locations are more open"
3) This morphs into "it is tough to get a job in a desirable location", which for highly-education professionals, often means a metro/city area

IF the message from the optimistic crowd is "RadOnc is OK but it can be hard to get a job in good cities",
THEN the assumption becomes "it is easier to get a job in less metropolitan/more rural areas"

However, we're tied to the expensive and government-regulated linear accelerator, a machine which requires a decent-sized population for it to be financially viable (if the government approves it at all).

So then the small-to-mid-sized cities and suburban/rural areas are also difficult because no jobs exist if no linear accelerator exists.

Do not make the assumption that it is "easy" to get a job in "less desirable" locations because you have heard it's hard to get jobs in Top 10 cities. Being tied to the linear accelerator means geographic preferences are challenging no matter what.

 

[TheWallnerus]

If you are ok with a midsized city anywhere and i mean anywhere and are also willing to compromise to it being close to a midsized city with a generous definition of “close” i think you will be ok. The problem is nobody can predict where a job will pop up. the so called “undesirable” southern states are saturated as well. Its not like you see tons of jobs posted and unfilled in these places. People actually want to live there too. For example nobody can guarantee you will get a job in a midsized alabama/mississippi (or surrounding states) city right off the bat

There are three or two rad onc job openings in one coastal southern state similar to what you mention I am looking at right this second. Given the size of the state (and given really the size of the whole country), I have suddenly had the epiphany that there is about one rad onc job in US every 15 to 20 thousand square miles. Insane.

 

[deleted1116990]

So I somewhat fell victim to this train of logic as a student:

1) Even the optimistic people acknowledge geographic limitations
2) Usually, they say "it will be tough to get a job in NYC or LA, sure, but other locations are more open"
3) This morphs into "it is tough to get a job in a desirable location", which for highly-education professionals, often means a metro/city area

IF the message from the optimistic crowd is "RadOnc is OK but it can be hard to get a job in good cities",
THEN the assumption becomes "it is easier to get a job in less metropolitan/more rural areas"

However, we're tied to the expensive and government-regulated linear accelerator, a machine which requires a decent-sized population for it to be financially viable (if the government approves it at all).

So then the small-to-mid-sized cities and suburban/rural areas are also difficult because no jobs exist if no linear accelerator exists.

Do not make the assumption that it is "easy" to get a job in "less desirable" locations because you have heard it's hard to get jobs in Top 10 cities. Being tied to the linear accelerator means geographic preferences are challenging no matter what.

There are so many variables in play for a 27-28 year old to make a decision, the ramifications of which don't fully materialize until over 10 years later. Will you have married your girlfriend by then? Will she want the same things? Will she be totally fine with living in any mid sized southern city?

He is probably thinking. I visited Nashville, TN once. That was an alright place. I could live there. Or a place like that. There's probably other places like Nashville that need rad oncs. I'm sure of it.

There is a non-zero chance this is how this plays out. You go into rad onc and train at one of the hellpits along the Mississippi thinking you will get a job in Nashville. You fail to get a job in Nashville (because there's only about 50 other people who would like to do the exact same thing). You eventually find a 450k salaried job at a rural hospital that advertises itself as "conveniently located" near the major metros of Memphis and Nashville with triple digit mile driving distances. Your wife divorces you and takes half of your paycheck. The hospital cuts the other half. You get a gift certificate to Applebees for Doctor's Day. That's it. End of story.

Or he could just go into radiology and leave the doors open to subspecialize in whatever he wants and work wherever he wants. How is this even a choice?

 

[deleted1111261]

There are so many variables in play for a 27-28 year old to make a decision, the ramifications of which don't fully materialize until over 10 years later. Will you have married your girlfriend by then? Will she want the same things? Will she be totally fine with living in any mid sized southern city?

He is probably thinking. I visited Nashville, TN once. That was an alright place. I could live there. Or a place like that. There's probably other places like Nashville that need rad oncs. I'm sure of it.

There is a non-zero chance this is how this plays out. You go into rad onc and train at one of the hellpits along the Mississippi thinking you will get a job in Nashville. You fail to get a job in Nashville (because there's only about 50 other people who would like to do the exact same thing). You eventually find a 450k salaried job at a rural hospital that advertises itself as "conveniently located" near the major metros of Memphis and Nashville with triple digit mile driving distances. Your wife divorces you and takes half of your paycheck. The hospital cuts the other half. You get a gift certificate to Applebees for Doctor's Day. That's it. End of story.

Or he could just go into radiology and leave the doors open to subspecialize in whatever he wants and work wherever he wants. How is this even a choice?

The bit about Applebee's is particularly harrowing.

 

[Ray D. Ayshun]

Lived in Nashville for a while. Was awesome around 2010. Now. Hellpit.

 

[thecarbonionangle]

Lived in Nashville for a while. Was awesome around 2010. Now. Hellpit.

Hipsters, bums, hippies, wokesters ruined it like they ruined austin and similar places which are now “popular”

 

[TheWallnerus]

The bit about Applebee's is particularly harrowing.

The quality over time at Applebees and in rad onc applicants are probably superimposable curves

 

[RSAOaky]

The quality over time at Applebees and in rad onc applicants are probably superimposable curves

Wow I didn't realize Applebee's had gotten so bad!

 

[deleted1111261]

Hipsters, bums, hippies, wokesters ruined it like they ruined austin and similar places which are now “popular”

Seriously. This is true about pretty much all the places the cool kids want to live.

Gotta go where the puck is going, not where it's at. Once #radonc is talking about it, it's too late.
I would suggest "Magic City" in North Dakota or Bullhead City, AZ - these are the next Asheville/Boulder/etc.

 

[CurbYourExpectations]

You get a gift certificate to Applebees for Doctor's Day. That's it. End of story.

So you're telling me there's a chance I live within the range of an Applebees? ......

 

[medgator]

Hipsters, bums, hippies, wokesters ruined it like they ruined austin and similar places which are now “popular”

Go check out Boise

 

[medgator]

Seriously. This is true about pretty much all the places the cool kids want to live.

Gotta go where the puck is going, not where it's at. Once #radonc is talking about it, it's too late.
I would suggest "Magic City" in North Dakota or Bullhead City, AZ - these are the next Asheville/Boulder/etc.

I think that brinks truck job in Minot is long gone though

 

[deleted1116990]

So you're telling me there's a chance I live within the range of an Applebees? ......

50/50. But there will definitely be a dairy queen that sells meth out the back.

 

[jondunn]

I hear Tacoma is where it's at!

the next 'boomtown'

 

[RickyScott]

I hear Tacoma is where it's at!

the next 'boomtown'

Duluth?

 

[medgator]

I hear Tacoma is where it's at!

the next 'boomtown'

MultiCare hiring, so i heard

 

[deleted1111261]

MultiCare hiring, so i heard

😊

 

[zapzapzap]

Or he could just go into radiology and leave the doors open to subspecialize in whatever he wants and work wherever he wants. How is this even a choice?

Radiology popularity/competitiveness has shot way up in the last couple of cycles. Tougher out there than I've ever seen it, even vs. the early 2000s. In a neutral world obviously agree, but atm not sure rads is realistic w/ 215 step 1 (USMD?).

 

[jondunn]

there are people going into radiology now that would have been going into rad onc 5 years ago. radiology is gonna be increasingly more competitive

 

[RaptorA]

This is pretty sad. I am in a similar Anglophone country and there are similarly no jobs whatsoever in the profession, hypofractionation/SABR making everyone extinct, medical oncologists running rampant with no evidence treating anyone and everyone their can get their hands on. However out here there's only a handful of training positions and the training college is becoming more ruthless every year.

Which similar country are you referring to, if I may ask? I thought this problem was limited to the US owing to the reckless expansion of residency slots...

 

[heartisinradonc]

Which similar country are you referring to, if I may ask? I thought this problem was limited to the US owing to the reckless expansion of residency slots...

Australia. Absolute bloodbath here.

 

[medgator]

Australia. Absolute bloodbath here.

I've seen NZ advertising the last few years. Any jobs there for you guys?

 

[RaptorA]

I've seen NZ advertising the last few years. Any jobs there for you guys?

New Zealand has less than 20% of Australia's population so I assume it wouldn't take more than 5 Aussie radiation oncologists to saturate that market as well.

Australia. Absolute bloodbath here.

Oh no! Believe it or not, I was considering emigrating to Australia or Canada after residency if the situation in the US continues to deteriorate, but one of those option seems to be off the table already...

 

[CurbYourExpectations]

Oh no! Believe it or not, I was considering emigrating to Australia or Canada after residency if the situation in the US continues to deteriorate, but one of those option seems to be off the table already...

Canada is also getting over an oversupply.

 

[medgator]

New Zealand has less than 20% of Australia's population so I assume it wouldn't take more than 5 Aussie radiation oncologists to saturate that market as well.





Oh no! Believe it or not, I was considering emigrating to Australia or Canada after residency if the situation in the US continues to deteriorate, but one of those option seems to be off the table already...

Canada is also getting over an oversupply.

Canada has had an oversupply for years leading many of them to come down stateside to practice, supposedly their market is getting relativey better in Canada, but that may not be saying much

 

[heartisinradonc]

I've seen NZ advertising the last few years. Any jobs there for you guys?

Yeah NZ always is advertising. Great place to be if you want to be isolated from the rest of the world and make 25% of what you can make in Australia. Also the PM is basically a female version of Trudeau but even more obsessed with covid lockdowns and identity politics. Usually 1-2 positions a year on South Island.

 

[heartisinradonc]

New Zealand has less than 20% of Australia's population so I assume it wouldn't take more than 5 Aussie radiation oncologists to saturate that market as well.





Oh no! Believe it or not, I was considering emigrating to Australia or Canada after residency if the situation in the US continues to deteriorate, but one of those option seems to be off the table already...

Come to Australia if you want to be in the only livable country remaining on this planet but you may just have to locum in general medicine for a few years around the country.

 

[TheWallnerus]

Yeah NZ always is advertising. Great place to be if you want to be isolated from the rest of the world and make 25% of what you can make in Australia. Also the PM is basically a female version of Trudeau but even more obsessed with covid lockdowns and identity politics. Usually 1-2 positions a year on South Island.

I fielded a job offer in Christchurch for $220K USD in 2012. I like the NZ rad oncs. They seem to have a very nice chill QOL. To a NZ rad onc, they look at the U.S.'s rad onc "supervision" talk like Kamala Harris looks at a Proud Boy.

 

[heartisinradonc]

I fielded a job offer in Christchurch for $220K USD in 2012. I like the NZ rad oncs. They seem to have a very nice chill QOL. To a NZ rad onc, they look at the U.S.'s rad onc "supervision" talk like Kamala Harris looks at a Proud Boy.

Go for it. The starting salaries tend to be around 180-240k NZ dollar which is a lot less than 220k USD. Christchurch would probably be similar to a place like Birmingham, AL but much milder weather. Nothing wrong with NZ but it's not the most exciting place to be. You are right in that out here you can get literally any IMRT/SABR/IGRT funded by the government, no problem, but you will always be limited by the small population. I had thought about working in Dunedin for a while but I just couldn't get myself to make the move. Supposedly South Island is much nicer than the North but it was still too cold for me.