ERAS Stats- RadOnc Uptrending

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As always, I also want to point out the awful wage stagnation in RadOnc. I have it buried in my bookmarks folder and need to dig it back out, but there was the data published in 2020 or so showing we were dead last (#17 of 17).

I remember 10 or so years ago the starting salary for an East Coast academic position was $260k.

Today, I personally know multiple people who had starting salaries in East Coast academic spots for $280k-$290k...or less.

I think the ARRO survey is spot on with "average starting salary". Most of the hospital employed positions seem to be offering $500-600k. Most academic positions seem to be offering $250-$290k. The average salary reported this year was approximately $360k.

I looked back at the old ARRO salary data over the years and there hasn't been a lot of movement. As I recall (haven't looked in awhile), it was around $300k for quite some time, then it's been at this $350k-ish mark for a few years now. Yadda yadda inflation.

This Reddit post about $514k and how they "can't believe it" perfectly captures the average attitude. In one sense, it's "a lot" of money compared to the American average, the negative salary of medical school, the $50-60k in residency, and the salary increase happens almost overnight. I get it.

In another sense, it's an abysmal salary compared to just 20-30 years ago, not just when you adjust for inflation and spending power but also in absolute terms. When you consider your upfront investment of time/money/effort (med school debt + training time debt) and the revenue you generate not only through your own practice but through your total activities within a hospital (labs, imaging, referrals, etc) it's an INSANELY low percentage.

The RadOnc pitch on Shark Tank:

"I will pay you a $500k salary. The investment I'm looking for is 13 years of post-high school training, $300k in debt, limited geographic mobility, total assumption of liability, generating $3-$5 million dollars per year in collections (not charges) for the hospital with a total ROI for labs/imaging etc generating another $1-2 million per year."

"Where do I sign?"
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1668956418144.png
The youngsters on here won't know this reference, but ya'll do.

If you want to make 750k a year, you're going to have to work somewhere you don't want to live full time. and your family won't go. Unless you are already in on the dealio (think 2 years with Texas Oncology or equivalent) or somehow are magically transported in time back about 15 years ago when you could still be a real partner in a multispeciality practice and get paid.

Those days are gone. Forever. For those of us who are mid to late mid career... you're stuck. Unless you drink red bull..
 
sirspamalot said:
View attachment 362278 The youngsters on here won't know this reference, but ya'll do.

If you want to make 750k a year, you're going to have to work somewhere you don't want to live full time. and your family won't go. Unless you are already in on the dealio (think 2 years with Texas Oncology or equivalent) or somehow are magically transported in time back about 15 years ago when you could still be a real partner in a multispeciality practice and get paid.

Those days are gone. Forever. For those of us who are mid to late mid career... you're stuck. Unless you drink red bull..
Click to expand...
This isn't strictly true. Don't ask me how I know...
 
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elementaryschooleconomics said:
As always, I also want to point out the awful wage stagnation in RadOnc. I have it buried in my bookmarks folder and need to dig it back out, but there was the data published in 2020 or so showing we were dead last (#17 of 17).

I remember 10 or so years ago the starting salary for an East Coast academic position was $260k.

Today, I personally know multiple people who had starting salaries in East Coast academic spots for $280k-$290k...or less.

I think the ARRO survey is spot on with "average starting salary". Most of the hospital employed positions seem to be offering $500-600k. Most academic positions seem to be offering $250-$290k. The average salary reported this year was approximately $360k.

I looked back at the old ARRO salary data over the years and there hasn't been a lot of movement. As I recall (haven't looked in awhile), it was around $300k for quite some time, then it's been at this $350k-ish mark for a few years now. Yadda yadda inflation.

This Reddit post about $514k and how they "can't believe it" perfectly captures the average attitude. In one sense, it's "a lot" of money compared to the American average, the negative salary of medical school, the $50-60k in residency, and the salary increase happens almost overnight. I get it.

In another sense, it's an abysmal salary compared to just 20-30 years ago, not just when you adjust for inflation and spending power but also in absolute terms. When you consider your upfront investment of time/money/effort (med school debt + training time debt) and the revenue you generate not only through your own practice but through your total activities within a hospital (labs, imaging, referrals, etc) it's an INSANELY low percentage.

The RadOnc pitch on Shark Tank:

"I will pay you a $500k salary. The investment I'm looking for is 13 years of post-high school training, $300k in debt, limited geographic mobility, total assumption of liability, generating $3-$5 million dollars per year in collections (not charges) for the hospital with a total ROI for labs/imaging etc generating another $1-2 million per year."

"Where do I sign?"
Click to expand...

Those academic salaries are criminal considering how much more academic centers have metastasized and cornered the market
 
elementaryschooleconomics said:
This Reddit post about $514k and how they "can't believe it" perfectly captures the average attitude. In one sense, it's "a lot" of money compared to the American average, the negative salary of medical school, the $50-60k in residency, and the salary increase happens almost overnight. I get it.
Click to expand...

Yep, I interviewed at one rural place about 2 hours from a very desirable metro area. There was a 30 year old new grad staffing the place by himself who the hospital had obviously majorly screwed over and he was just sitting their taking it. The comment was made that "well, I can easily drive into X on the weekends, and do I really need more than 500k anyway?" He should have been making 800k easy based on the volume of work they were throwing at him (totally inappropriate for a brand new grad anyway, esp in a solo position), and admin was calling all the shots, directing everything in the clinic, and he was just taking it. Zero autonomy. It was nuts. You bring a new grad in to a 2 person practice at a 500k salary, lose the other partner immediately, dump the other 50% of the work on the new guy without any increase in pay or hire a locums while they recruit, and they expect you to say, sure no problem, all because you are in the enviable position of being a TWO HOUR DRIVE from a desirable area? Only in rad onc...
 
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Moonbeams said:
Yep, I interviewed at one rural place about 2 hours from a very desirable metro area. There was a 30 year old new grad staffing the place by himself who the hospital had obviously majorly screwed over and he was just sitting their taking it. The comment was made that "well, I can easily drive into X on the weekends, and do I really need more than 500k anyway?" He should have been making 800k easy based on the volume of work they were throwing at him (totally inappropriate for a brand new grad anyway, esp in a solo position), and admin was calling all the shots, directing everything in the clinic, and he was just taking it. Zero autonomy. It was nuts. You bring a new grad in to a 2 person practice at a 500k salary, lose the other partner immediately, dump the other 50% of the work on the new guy without any increase in pay or hire a locums while they recruit, and they expect you to say, sure no problem, all because you are in the enviable position of being a TWO HOUR DRIVE from a desirable area? Only in rad onc...
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Trust me, rad onc's 2 hour drive from a very desirable metro for a position offering X with such a such set up is everyone else's 45 min drive offering the equivalent.
 
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Noticed this gem popped up on my Google.
4008011C-E917-4147-B1DE-1D3945B20655.jpeg
 
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Fpg1245 said:
Those academic salaries are criminal considering how much more academic centers have metastasized and cornered the market
Click to expand...

Reminder that ASTRO subsidizes the academic chairs' effort of compiling salary data and then it is kept secret from applicants. I should do this reminder every fall as the job search ramps up.

If you work at or used to work at an academic center you can help a lot by giving applicants detailed info on prior comp packages and explaining areas where you think negotiation might be successful for that applicant.
 
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NotMattSpraker said:
Reminder that ASTRO subsidizes the academic chairs' effort of compiling salary data and then it is kept secret from applicants. I should do this reminder every fall as the job search ramps up.

If you work at or used to work at an academic center you can help a lot by giving applicants detailed info on prior comp packages and explaining areas where you think negotiation might be successful for that applicant.
Click to expand...
How do most radoncs not see that ASTRO works against their interests?
 
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NotMattSpraker said:
Reminder that ASTRO subsidizes the academic chairs' effort of compiling salary data and then it is kept secret from applicants. I should do this reminder every fall as the job search ramps up.

If you work at or used to work at an academic center you can help a lot by giving applicants detailed info on prior comp packages and explaining areas where you think negotiation might be successful for that applicant.
Click to expand...
It strikes me that this practice (subsidizing and then not disclosing) should be more of a concern for anti-trust activities by ASTRO.
 
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Link to it on reddit please?

Radonc is seriously not good to go into right now unless you are doing so at a top 10 institution, no cap (as my teenager says).
 
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NotMattSpraker said:
Reminder that ASTRO subsidizes the academic chairs' effort of compiling salary data and then it is kept secret from applicants. I should do this reminder every fall as the job search ramps up.

If you work at or used to work at an academic center you can help a lot by giving applicants detailed info on prior comp packages and explaining areas where you think negotiation might be successful for that applicant.
Click to expand...
I would also point out the following to applicants…

For some public academic centers, you can freely search anyone’s BASE salary (not including bonus, retirement etc…). Even if this isn’t the case where you are interviewing, it may be helpful to have a comparison.
 
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The academic centers extol the virtues of equity.
All doctors have the same contract and are paid the same.
Can I see these contracts to objectively verify your claim?
No, that's confidential and an inappropriate request. You need to trust us.

All rad oncs are equal, but some rad oncs are more equal than others?
 
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Celebrating 100 posts: Wishing all my photon bros a happy thanksgiving. Best smoked turkey you say? My vote: Greenberg

I haven't bought it, but I've happily eaten it at family gatherings for years.. can't wait for thursday....yum.
 
new grads had offers much higher than the ones quoted here at academic institutions in competitive locations.*

*Disclaimer for the SDN doom train: I am sure they will hate their job in 1 year and there will be a bait and switch and will join you with pitch forks
 
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sirspamalot said:
Celebrating 100 posts: Wishing all my photon bros a happy thanksgiving. Best smoked turkey you say? My vote: Greenberg

I haven't bought it, but I've happily eaten it at family gatherings for years.. can't wait for thursday....yum.
Click to expand...
Greenberg makes a great smoked turkey
Shows up ready to eat
They actually had a huge fire a couple years ago that shut down operations but now they are back
 
As someone in the job search, I can safely say that the average starting base for academic places is around 330k with the ability to make 80-100k in bonuses if you work hard. Satellites get a 30k bump. There are a few places that pay a lot worse with base sub 200k.
 
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metview said:
As someone in the job search, I can safely say that the average starting base for academic places is around 330k with the ability to make 80-100k in bonuses if you work hard. Satellites get a 30k bump. There are a few places that pay a lot worse with base sub 200k.
Click to expand...
#750orGTFO
 
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metview said:
As someone in the job search, I can safely say that the average starting base for academic places is around 330k with the ability to make 80-100k in bonuses if you work hard. Satellites get a 30k bump. There are a few places that pay a lot worse with base sub 200k.
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330 in Midwest is on par with most other specialties in these locations.
 
FWIW, based upon a few interview marathon sessions in the past few weeks, this year's crop of applicants seems fairly impressive to me -maybe not quite the same board scores as when we applied, but those are going away anyway. What are everyone else's impressions?
 
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Lamount said:
FWIW, based upon a few interview marathon sessions in the past few weeks, this year's crop of applicants seems fairly impressive to me -maybe not quite the same board scores as when we applied, but those are going away anyway. What are everyone else's impressions?
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Maybe ms4s are buying the dead cat bounce in the job market lately
 
medgator said:
Maybe ms4s are buying the dead cat bounce in the job market lately
Click to expand...
It seems like a lot of folks who just think the field is cool -less so the folks who are expecting champagne to pour from the heavens.

When I was in residency, I was one of the few folks who had a physics background (which is why I was drawn to the field)... it was mostly the champagne crew back then. With this cohort, it seems like physics/engineering/CS background are the norm. Also a fair number of folks applying for Holman (believe it or not).

Not sure if this is true across the board... just the folks that we are interviewing.
 
Lamount said:
It seems like a lot of folks who just think the field is cool -less so the folks who are expecting champagne to pour from the heavens.

When I was in residency, I was one of the few folks who had a physics background (which is why I was drawn to the field)... it was mostly the champagne crew back then. With this cohort, it seems like physics/engineering/CS background are the norm. Also a fair number of folks applying for Holman (believe it or not).

Not sure if this is true across the board... just the folks that we are interviewing.
Click to expand...
Don’t they care about geographic flexibility? Most medical students place a higher priority on location than salary.
 
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Lamount said:
It seems like a lot of folks who just think the field is cool -less so the folks who are expecting champagne to pour from the heavens.

When I was in residency, I was one of the few folks who had a physics background (which is why I was drawn to the field)... it was mostly the champagne crew back then. With this cohort, it seems like physics/engineering/CS background are the norm. Also a fair number of folks applying for Holman (believe it or not).

Not sure if this is true across the board... just the folks that we are interviewing.
Click to expand...
Holman has really been declining in terms of PhD holders. Have interviewees been as PhD rich as in past?
 
metview said:
As someone in the job search, I can safely say that the average starting base for academic places is around 330k with the ability to make 80-100k in bonuses if you work hard. Satellites get a 30k bump. There are a few places that pay a lot worse with base sub 200k.
Click to expand...
Pretty accurate. My region is ~340 + incentive for starting satellite, 300-340 for academic.
 
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McDonalds will pay minimum wage because there will always be someone to take that job. And Satellites with 30 on treatment will continue to profit off new grads who accept half or less of what they should because they feel they have no other choice. And so the exploitation continues.

Meanwhile, an wRVU is an wRVU. Neither CMS (nor payors) care about quality or experience, just that billing is accurately reflecting work performed.
 
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TheWallnerus said:
Holman has really been declining in terms of PhD holders. Have interviewees been as PhD rich as in past?
Click to expand...
This is only my second cycle interviewing, but def more PhDs this year than last.
 
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Lamount said:
This is only my second cycle interviewing, but def more PhDs this year than last.
Click to expand...

I will never understand the PhDs that continue to come here. The only thing I can think is that they don’t have a heavy clinic and can pursue their own academic interests.
 
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sirspamalot said:
McDonalds will pay minimum wage because there will always be someone to take that job. And Satellites with 30 on treatment will continue to profit off new grads who accept half or less of what they should because they feel they have no other choice. And so the exploitation continues.

Meanwhile, an wRVU is an wRVU. Neither CMS (nor payors) care about quality or experience, just that billing is accurately reflecting work performed.
Click to expand...
Good luck hiring someone at McD’s for minimum wage. It’s getting close to a $15 to $20/hr job these days.
 
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Fpg1245 said:
I will never understand the PhDs that continue to come here. The only thing I can think is that they don’t have a heavy clinic and can pursue their own academic interests.
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A phd in radonc is so much more likely to end up at a satellite in Kansas than with their own lab.
 
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If you look at this year’s Reddit applicant spread sheet it looks like most of the chatter is about how nice and chill all the residents/attendings are and this is what programs are to be judged on. Anyone who claims that any sort of objectively based standard be applied is called out as an out of touch elitist. Also, SDN is not to be trusted.
 
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RSAOaky said:
Pretty accurate. My region is ~340 + incentive for starting satellite, 300-340 for academic.
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The weird thing is there are some midwest academic places that will pay like PP (if you're busy or forced to staff the clinic in Methville, you will be paid close to appropriately) and then you hop over to the next square state, possibly even less desirable, and it's literally half. I don't understand the economics of how that is possible.
 
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Moonbeams said:
The weird thing is there are some midwest academic places that will pay like PP (if you're busy or forced to staff the clinic in Methville, you will be paid close to appropriately) and then you hop over to the next square state, possibly even less desirable, and it's literally half. I don't understand the economics of how that is possible.
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who pays well in the midwest? I've heard case is really fair under spratt...but place like michigan, washu, iowa (well just look at the job postings for that sateliite position) pay not so well.
 
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radoncftw said:
who pays well in the midwest? I've heard case is really fair under spratt...but place like michigan, washu, iowa (well just look at the job postings for that sateliite position) pay not so well.
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Go work in rural hospital settings and you'll start at 650..
 
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radoncftw said:
who pays well in the midwest? I've heard case is really fair under spratt...but place like michigan, washu, iowa (well just look at the job postings for that sateliite position) pay not so well.
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Any non academic hospital employed position in the Midwest should be showing you the cheddar. @sirspamalot is correct
 
medgator said:
Any non academic hospital employed position in the Midwest should be showing you the cheddar. @sirspamalot is correct
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I'm over a decade out and I seem to remember the Chilicothe, OH job was offering 800k back then. That's probably down to 550k at this point.
 
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Mandelin Rain said:
I'm over a decade out and I seem to remember the Chilicothe, OH job was offering 800k back then. That's probably down to 550k at this point.
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That job has been filled and hasn’t advertised in almost 10 years at this point but yet it still constantly gets brought up. After a quick google search, the same doc has been there for about 10 years. I would say Chilicothe has probably done a good job in keeping its doc happy in a place that is about a 1 hour drive from Columbus Ohio. I will just hazard a guess that the dude who took that position is probably doing a lot better financially then the dozens of rad oncs who have passed through the James Cancer Center during that same time.
 
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fiji128 said:
That job has been filled and hasn’t advertised in almost 10 years at this point but yet it still constantly gets brought up. After a quick google search, the same doc has been there for about 10 years. I would say Chilicothe has probably done a good job in keeping its doc happy in a place that is about a 1 hour drive from Columbus Ohio. I will just hazard a guess that the dude who took that position is probably doing a lot better financially then the dozens of rad oncs who have passed through the James Cancer during that same time.
Click to expand...
Yep, currently university base is 380K
 
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