Location after residency

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NonTradJp

NonTradJp

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One of the cons I read about rad onc is that its difficult to get a desired location. Is that because of the combination limited spots and expensive tech?
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NonTradJp said:
One of the cons I read about rad onc is that its difficult to get a desired location. Is that because of the combination limited spots and expensive tech?
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What I've been told by a multitude of Rad Oncs is essentially this: You have a fairly good chance of getting to the region you want (West, South, East, etc.), but the specific city will be much harder/based on luck that year. Now, they've all said that if you expand the time out 10 years, nearly everyone can get where they want through persistent networking, and being able to follow up on jobs at the non-standard time of year once in practice. This is obviously much different than a lot of fields of medicine, but you have decide if you are willing to wait up to a decade to live in the exact city you want to live in in order to practice Rad Onc.
 
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These discussions of rad onc saturation and the market in general have been too timely. For people interested in the field you really should consider how this could affect you. The market is tight but even still everyone I know over the last two-three years has still gotten good jobs they were very happy about. That said, they were all flexible where they wanted to go and mostly wanted to stay in the south east. If you have some flexibility or are drawn to a modest sized location then I honestly don't see it being a huge problem for you in the near future.

But, life can change for you in the blink of an eye. Our long term goal has been to stay in this area for years. Then my (soon to be) wife's large sponsor company (in pharmaceuticals) decided they only needed one major center in the US which will be in Philadelphia, not our current location. Then her management strongly encouraged her to apply for a director position which would be in PA. Im so proud of her and if she gets I want her to take it. Making that step is a really big deal and those opportunities rarely come around. But you can see what that means for me. Despite all my careful strategic planning, now I may find myself in a much more difficult situation when it comes time to find a job. For my friends in other fields like neuro, IM, EM...this wouldn't be a big deal.

Bottom line, a specialty-wide problem like over saturation affects everyone in the field. Don't think you will be immune to it because you don't see how at the time. Its a great field and I would still do it again. But if you are thinking of entering the field you need to consider what this might mean for you, your family, and your life as a whole.
 
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ramsesthenice said:
These discussions of rad onc saturation and the market in general have been too timely. For people interested in the field you really should consider how this could affect you. The market is tight but even still everyone I know over the last two-three years has still gotten good jobs they were very happy about. That said, they were all flexible where they wanted to go and mostly wanted to stay in the south east. If you have some flexibility or are drawn to a modest sized location then I honestly don't see it being a huge problem for you in the near future.

But, life can change for you in the blink of an eye. Our long term goal has been to stay in this area for years. Then my (soon to be) wife's large sponsor company (in pharmaceuticals) decided they only needed one major center in the US which will be in Philadelphia, not our current location. Then her management strongly encouraged her to apply for a director position which would be in PA. Im so proud of her and if she gets I want her to take it. Making that step is a really big deal and those opportunities rarely come around. But you can see what that means for me. Despite all my careful strategic planning, now I may find myself in a much more difficult situation when it comes time to find a job. For my friends in other fields like neuro, IM, EM...this wouldn't be a big deal.

Bottom line, a specialty-wide problem like over saturation affects everyone in the field. Don't think you will be immune to it because you don't see how at the time. Its a great field and I would still do it again. But if you are thinking of entering the field you need to consider what this might mean for you, your family, and your life as a whole.
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I am married with children and this aspect of the field has been a very real issue in terms of stress. I may get lucky when I end up applying for jobs, but it is extremely stressful for our family to think that after a decade of hard work I wouldn't be able to live within a days drive of them. I love what I do, so I made the trade off, but there are days that I wonder "what if" about applying to EM and having the freedom to live wherever I want.
 
Its a real issue. Make no mistake, I think I have an incredible job and I love what I do. However, no matter how intelligent, friendly, hard working, or good looking you are, you will be at the complete mercy of the regional market. As I said in another thread, its not just east/west coast. It may very well surprise you how tight some of the midwest job markets are, so there are absolutely no guarantees.
 
Sheldor said:
I love what I do, so I made the trade off, but there are days that I wonder "what if" about applying to EM and having the freedom to live wherever I want.
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Cant agree more. I think about what if a lot. But, Im still glad I made the choice I did. If everything works out, I will be happiest in the end. Im just going to have to decide whats most important when the time comes. I really want to be doing research and practicing medicine so ideally I would love to do academics. But, if it comes down to it I may have to consider a post-doc, PP, or even industry jobs if its best for my family (I won't live apart for more than a very short period). No point worrying about it now though. I'll just keep working hard, networking, and Im sure something that makes me happy will work out. It may not be what I am expecting, but sometimes the best things are not.
 
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This is important to know when family is involved. Thank you guys.
 
One irony I would like to point out is that individual residency programs contribute to this problem by expanding their resident pool and also take advantage of graduating resident 'joblessness' to make them work like dogs and paying them ridiculously low wages. For instance, if you "need" to be in a specific location without a job opening you may have to join your local academic center as a PGY-6 'fellow' or a 'pre-junior faculty' where they will work you to the bone and pay you FAR less than one a tenure-track junior attending would make.

Sad.
 
It's funny bc a few years ago nobody wanted to talk about this topic. Now that is is affecting the SDN generation it is good to see so many people interested in it. Radiology fell into the hole too fast before the SDN generation knew what was happening, but we see it and we should be vocal about it, because the way it's looking our specialty is in a world of hurt soon and trainees lives are being ruined by the situation.

One of the responses to the red journal article said this: "unfortunately he has made several incorrect assumptions and statements. In an era of instant access to a wide variety of information and social networking, first-year medical students are acutely aware of job availability in every medical specialty and subspecialty, the location of these opportunities, and their general starting salaries." Do they really? Can you go on ASTRO as a med student and just figure out that you are getting screwed in the job postings or do you have to wait a few years out of residency to realize it. I agree with Gfunk. We all know who some of these programs that are exploiting the situation are too. So perhaps we should call them out 'in this era of instant access to a wide variety of information and social networking'.
 
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jjborden101 said:
I agree with Gfunk. We all know who these programs that are exploiting the situation are too. So perhaps we should call them out 'in this era of instant access to a wide variety of information and social networking'.
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I'll bite. What are some of the programs that are exploiting the situation? To be honest it would make me less inclined to favor those programs.
 
jjborden101 said:
It's funny bc a few years ago nobody wanted to talk about this topic. Now that is is affecting the SDN generation it is good to see so many people interested in it. Radiology fell into the hole too fast before the SDN generation knew what was happening, but we see it and we should be vocal about it, because the way it's looking our specialty is in a world of hurt soon and trainees lives are being ruined by the situation.

One of the responses to the red journal article said this: "unfortunately he has made several incorrect assumptions and statements. In an era of instant access to a wide variety of information and social networking, first-year medical students are acutely aware of job availability in every medical specialty and subspecialty, the location of these opportunities, and their general starting salaries." Do they really? Can you go on ASTRO as a med student and just figure out that you are getting screwed in the job postings or do you have to wait a few years out of residency to realize it. I agree with Gfunk. We all know who some of these programs that are exploiting the situation are too. So perhaps we should call them out 'in this era of instant access to a wide variety of information and social networking'.
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I was a medical student who decided relatively early, so I'd say I've known about this problem for at least 5-6 years. I chose to still go into Radiation Oncology primarily because in the end, I weighed my happiness doing my job more than where I could end up in the country. Of course, I have a family so I have a support system wherever I go. I really feel for co-residents and friends that are single who are getting ready to look for jobs. They obviously want to end up in a bigger city so they can continue to meet people and I think they will have a hard time.
 
I agree that although things have escalated recently with the explosion of residency positions and delayed retirement, I was cationed about this a decade ago.

Basically, my mentor asked me if I would be "happy living in Georgia, but not Atlanta, Arizona but not Phoenix, or New York State but not NYC and furthermore maybe not even being able to pick among which of those three it might be in any given year to have the most incredible job in the world."

I was already sold but when I realized that radiation oncologists in Utica actually make more than those in Manhatten for the exact same hours and patient load I almost lost my mind.

Of course, my family moved around a lot growing up, neither my wife nor I like living in big cities, and she planned to go into internal medicine so she could get a job anywhere I could. This field is incredible and I love my job. I would do it with a smile on my face everyday even if my salary dropped by 1/3 tomorrow (I would still be paid 50% more than my wife, whose job is at least as difficult and stressful as mine).

That being said I don't envy you guys with strong geographic restrictions as a poster noted above things can change.
 
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Remember, the mid 90s job crisis wasn't that long ago. Even in a robust job market, it will never be like primary care where there are lots of jobs to choose from in each city. The market tightening we are seeing now is dropping 1-2 positions a couple of years ago to 0 now in our neck of the woods and many other smaller metro areas I know of.

It always comes back to those 3 critical factors in any job.... location, job quality, and income level. Take a sacrificial hit on one of those and you can improve the others. The key is to find that balance. Find a job you like, in a region you can tolerate, with an income level that meets your needs and nothing will beat it.
 
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There has been a huge influx of talent into Radiation Oncology the past 8 years or so. This is great for our field in attracting some of the best and brightest doctors. I could be totally wrong but I get the sense that the interest peaked maybe 2-3 years ago and now remains high but has leveled off? Please correct me if I'm wrong. In any case, there has been an increase in the overall number of programs as well as spots per program which is certainly concerning if job prospects are limited. I guess one optimistic thought would be that the smart new doctors may be able to educate med onc's and surgeons as to the evidenced based benefits of radiation for specific sites and increase or change referral patterns to effectively create volume to support new positions. For example I have personally seen how an educated radiation oncologist who is vocal and participates in tumor boards can either run the tumor board, or at the very least increase referrals. So I think there may be hope. However, its a slippery slope towards something like Radiology where you can't get a real job unless you do a fellowship... and for Rad Onc what would a bunch of fellows really do?
 
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Phantom1 said:
There has been a huge influx of talent into Radiation Oncology the past 8 years or so. This is great for our field in attracting some of the best and brightest doctors. I could be totally wrong but I get the sense that the interest peaked maybe 2-3 years ago and now remains high but has leveled off? Please correct me if I'm wrong. In any case, there has been an increase in the overall number of programs as well as spots per program which is certainly concerning if job prospects are limited. I guess one optimistic thought would be that the smart new doctors may be able to educate med onc's and surgeons as to the evidenced based benefits of radiation for specific sites and increase or change referral patterns to effectively create volume to support new positions. For example I have personally seen how an educated radiation oncologist who is vocal and participates in tumor boards can either run the tumor board, or at the very least increase referrals. So I think there may be hope. However, its a slippery slope towards something like Radiology where you can't get a real job unless you do a fellowship... and for Rad Onc what would a bunch of fellows really do?
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The problem is that, by and large, the current group of Rad Onc residents is looking for salary and lifestyle. The sense of entrepreneurship, practice building, and physician autonomy is rapidly dying off. Furthermore, ASTRO is doing its best to further the interests of hospital-based Rad Oncs and academic centers and is throwing free-standing centers under the bus. This is best demonstrated by their incessant support of the proton 'boondoggle' while at the same time making a hard push to limit reimbursement of photon based centers by encouraging hypofractionation and opposing capitated payments.

These processes are inexorably locking Rad Oncs into hospital based positions where "referral patterns" are completely subservient to corporate interests.

Also, I have to throw in my two cents about the "best and brightest." This should be simply rephrased to say "medical students who work hard, are good at taking tests, publish the requisite research, and can network well." It says absolutely nothing about their ability to garner referrals or be business savvy. I have interviewed a lot of a candidates and I would always take one with a "fire in their belly" over one who is well-trained and affable but expects their clinics to be filled with patients week after week without lifting a finger to get them through the door.
 
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Gfunk6 said:
Also, I have to throw in my two cents about the "best and brightest." This should be simply rephrased to say "medical students who work hard, are good at taking tests, publish the requisite research, and can network well." It says absolutely nothing about their ability to garner referrals or be business savvy. I have interviewed a lot of a candidates and I would always take one with a "fire in their belly" over one who is well-trained and affable but expects their clinics to be filled with patients week after week without lifting a finger to get them through the door.
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Couldn't have said it better myself. A residency in an academic rad onc center with fixed referral patterns and multidisciplinary tumor boards is a different beast than community practice. Most of us don't learn those nuances in residency.

In the recent and current environment, patients don't just show up on your doorstep anymore in many areas of the country. Building up referrals takes planning, time and effort. There's a reason why certain community/pp astro job postings high seek out seasoned rad oncs rather than fresh grads. It's amazing how much you learn the first couple of years out from residency (and I'm not just talking about patient care)....
 
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Gfunk6 said:
These processes are inexorably locking Rad Oncs into hospital based positions where "referral patterns" are completely subservient to corporate interests.
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I'd like to add that a lot of this is facilitated by the emphasis on "prestige" and elite programs over productive and efficient groups. Private practice is typically denigrated as inferior, despite higher salaries and greater independence from hospital bureaucracy. A great example of this takes place on these very forums, in how we typically elevate programs that place people in academic positions as superior, even if these may be lower-paying jobs in regions not desired by the finishing resident. Could it be that we've been looking at it the wrong way, i.e. programs that send residents to hot private groups should receive more attention from applicants?

It's a culture issue, and we're part of the problem.
 
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It's funny how there's some programs out there with excellent private practice placement in very desirable areas but a "poor" track record of "academic placement", per almighty academics and I was discouraged from applying to such programs. I still went to check them out regardless ;). Applicants all tell everyone they are interested in academics when the majority of the specialty is done in the private practice setting.
 
baculum1 said:
It's funny how there's some programs out there with excellent private practice placement in very desirable areas but a "poor" track record of "academic placement", per almighty academics and I was discouraged from applying to such programs. I still went to check them out regardless ;). Applicants all tell everyone they are interested in academics when the majority of the specialty is done in the private practice setting.
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Soooooo true. My alma mater is a lower tier program whose graduates staff a very good percentage of the private practice positions in the immediate area...which happens to be a very desirable area of the country. If you're looking to go into PP, a Harvard, MDACC, MSKCC, etc. pedigree just isn't as important as having the opportunity to work closely with attendings who personally know all the private practice guys in the area.
 
I noticed that residency interviews were largely regional. Are you also more likely to find an Attending job near where you trained? I am from the rustbelt, will train there, and plan on staying there. I presumed it's a less desirable location but is it also a saturated market?

Also, can anyone offer suggestions about what to do during residency to make us more marketable (from a business-savy sense)? Apparently racking up manuscripts won't be appealing enough on a CV. Great insight from everyone btw, thanks for the posts!
 
Does anything help besides dashingly good looks?
 
medgator said:
Couldn't have said it better myself. A residency in an academic rad onc center with fixed referral patterns and multidisciplinary tumor boards is a different beast than community practice. Most of us don't learn those nuances in residency.

In the recent and current environment, patients don't just show up on your doorstep anymore in many areas of the country. Building up referrals takes planning, time and effort. There's a reason why certain community/pp astro job postings high seek out seasoned rad oncs rather than fresh grads. It's amazing how much you learn the first couple of years out from residency (and I'm not just talking about patient care)....
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Alot of the older pp docs pride themselves on having built referral patterns. In fact they spent so much time doing it that they lost sight of how to practice medicine and rad onc. Speak with a pp or satellite doc and the insecurity is very obvious. So they make it seem like garnering referrals is this herculean task that takes skill that 'they dont teach in residency' and close new grads out of jobs bc no way can you be as amazing (often lucky) as they are at getting referrals. Then you end up pandering to your referrings which has the potential of being a sad sight (confused for as effort/patience/hard work). These are groups you ideally want to avoid. When youre a couple years out these things are easier to see. It's really stacked against you right now if you're in training and the culprit is greedy older docs who talk about the old days, blame the 'new group of residents' for being about salary and lifestyle (these guys are the ones clearing ridiculous sums), and have minimal skill.

Gfunk6 said:
The problem is that, by and large, the current group of Rad Onc residents is looking for salary and lifestyle.
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not trying to single you out bc I know you're not like that but really Gfunk; you had just said with regard to older academic docs "make them work like dogs and paying them ridiculously low wages". Personally, I think the current group of residents is looking for respect in an environment where physicians have lost respect on every front, including even that of the mentors in their field
 
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jjborden101 said:
Alot of the older pp docs pride themselves on having built referral patterns. In fact they spent so much time doing it that they lost sight of how to practice medicine and rad onc. Speak with a pp or satellite doc and the insecurity is very obvious. So they make it seem like garnering referrals is this herculean task that takes skill that 'they dont teach in residency' and close new grads out of jobs bc no way can you be as amazing (often lucky) as they are at getting referrals. Then you end up pandering to your referrings which has the potential of being a sad sight (confused for as effort/patience/hard work). These are groups you ideally want to avoid. When youre a couple years out these things are easier to see. It's really stacked against you right now if you're in training and the culprit is greedy older docs who talk about the old days, blame the 'new group of residents' for being about salary and lifestyle (these guys are the ones clearing ridiculous sums), and have minimal skill.


not trying to single you out bc I know you're not like that but really Gfunk; you had just said with regard to older academic docs "make them work like dogs and paying them ridiculously low wages".
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Gfunk is correct. Do you want to be responsible for hiring and firing everyone in your practice (nurses, therapists, physics etc) and be responsible for seven figure capital investments? Most don't, or they'd rather be minority stakeholders, if at all.

As for your previous post, I'm not really sure what you are trying to imply against pp/community docs. I'm not insecure at all, nor have I really seen what you are talking about. It does in fact take a couple of years to get your feet wet post residency in the community
 
jjborden101 said:
Alot of the older pp docs pride themselves on having built referral patterns. In fact they spent so much time doing it that they lost sight of how to practice medicine and rad onc. Speak with a pp or satellite doc and the insecurity is very obvious. So they make it seem like garnering referrals is this herculean task that takes skill that 'they dont teach in residency' and close new grads out of jobs bc no way can you be as amazing (often lucky) as they are at getting referrals. Then you end up pandering to your referrings which has the potential of being a sad sight (confused for as effort/patience/hard work). These are groups you ideally want to avoid. When youre a couple years out these things are easier to see. It's really stacked against you right now if you're in training and the culprit is greedy older docs who talk about the old days, blame the 'new group of residents' for being about salary and lifestyle (these guys are the ones clearing ridiculous sums), and have minimal skill.


not trying to single you out bc I know you're not like that but really Gfunk; you had just said with regard to older academic docs "make them work like dogs and paying them ridiculously low wages". Personally, I think the current group of residents is looking for respect in an environment where physicians have lost respect on every front, including even that of the mentors in their field
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There is no "luck" in garnering referrals. It's a skill most young rad oncs today don't seem to have. Too many academic types with no social skills in our field now. Sorry, but that's the truth; I've been interviewing you guys. That's the problem a lot of older guys have with the new crowd. I'm not old, but I can relate. I work in a very competitive area where I built my practice almost from scratch. I had no income guarantees, and I received no payment for nearly 6 months. I made ends meet by doing locums work for several local docs, often asking substantially less than the going locums rate to ensure I had work. I'd drive 60+ miles to work half day locums for like $400. Sounds crazy, but I built a lot of connections that way which are more than paying off for me now.

I've worked my ass off and opened additional offices, and now I'm looking for an associate. I try to give new grads a chance, but the residents I meet today want too much. Don't come to me asking for income guarantees, 8 weeks off, and 300k. Don't complain when I ask you to drive around to different satellites. It's not about greed, but I sure as hell an not handing to you on a silver platter what I built with blood, sweat, and tears.
 
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Spoken like a true 'reaganite'

' pull yourself up by your bootstraps!'
 
I realize a lot of you guys are restricted in regards to where your extended family lives and/or where your spouse can find work, but for everybody else you might want to reconsider what you really consider an "undesirable location."

I just reconnected with a friend from medical school (he is a first generation Korean who grew up in Queens) and was shocked to find out
 
Shocked to find out what? Did you finish your post?
 
Sorry I have a four year old and twin 18 month olds and it just got real for a bit (I live in a medium sized city in the "rust belt" with something like 250,000 people in the city and 1,000,000 within the surrounding counties ... great place to raise a family and you can build a nice new 5 bedroom 4,000+ sq ft house for less than 18 months starting radiation oncology salary ... I couldn't be happier but it wouldn't work for everybody).

Again, nothing glamorous about my neck of the woods but my buddy ended up in Fayetteville Arkansas and claims it's actually a very nice and welcoming place even for a Korean family from NYC.

Just a very random single example I know but especially for you younger guys keep your mind open (just think about how much things have changed in the past decade ... Some of these "undesirable" locations may not be so bad in the near future, especially when you go from single and 24 to married with children and 34)!
 
oldking said:
Sorry I have a four year old and twin 18 month olds and it just got real for a bit (I live in a medium sized city in the "rust belt" with something like 250,000 people in the city and 1,000,000 within the surrounding counties ... great place to raise a family and you can build a nice new 5 bedroom 4,000+ sq ft house for less than 18 months starting radiation oncology salary ... I couldn't be happier but it wouldn't work for everybody).

Again, nothing glamorous about my neck of the woods but my buddy ended up in Fayetteville Arkansas and claims it's actually a very nice and welcoming place even for a Korean family from NYC.

Just a very random single example I know but especially for you younger guys keep your mind open (just think about how much things have changed in the past decade ... Some of these "undesirable" locations may not be so bad in the near future, especially when you go from single and 24 to married with children and 34)!
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As a family guy I agree with you, but I think the problem is that most folks don't feel they can go from single --> Married in these smaller towns. (At least thats what I hear from my single friends who want to primarily end up in bigger cities.)
 
Sheldor said:
As a family guy I agree with you, but I think the problem is that most folks don't feel they can go from single --> Married in these smaller towns. (At least thats what I hear from my single friends who want to primarily end up in bigger cities.)
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Correct. Fine to end up there when you're already married. Rough proposition when you are single.
 
medgator said:
Correct. Fine to end up there when you're already married. Rough proposition when you are single.
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That's what everybody says, but you never know since it only takes one . . . I realize that again this is just one example but my sister lived in Manhattan for a decade while climbing the corporate ladder but said it was paradoxically the liveliest and loneliest place on earth, so she took a huge pay cut, moved to my town, met an awesome guy, got married, and is due any second now (all within 2-3 years).

My point is, especially when it comes to major life events you never know so for the medical students out there already thinking of avoiding radiation oncology just for this one reason please keep an open mind.
 
Reaganite said:
There is no "luck" in garnering referrals. It's a skill most young rad oncs today don't seem to have. Too many academic types with no social skills in our field now. Sorry, but that's the truth; I've been interviewing you guys. That's the problem a lot of older guys have with the new crowd. I'm not old, but I can relate. I work in a very competitive area where I built my practice almost from scratch. I had no income guarantees, and I received no payment for nearly 6 months. I made ends meet by doing locums work for several local docs, often asking substantially less than the going locums rate to ensure I had work. I'd drive 60+ miles to work half day locums for like $400. Sounds crazy, but I built a lot of connections that way which are more than paying off for me now.

I've worked my ass off and opened additional offices, and now I'm looking for an associate. I try to give new grads a chance, but the residents I meet today want too much. Don't come to me asking for income guarantees, 8 weeks off, and 300k. Don't complain when I ask you to drive around to different satellites. It's not about greed, but I sure as hell an not handing to you on a silver platter what I built with blood, sweat, and tears.
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As a resident starting to look for jobs, I am curious if you are willing to share what kind of arrangement you offer a new graduate. Thanks.
 
Hoping this thread isn't entirely dead. Is this the kind of problem that could shift in the next eight to ten years or do you think it's going to stagnate for longer? I'm just a first year thinking about the field, but my fiancee and her entire side of the family live in south Jersey so I want to try to end up near there.
 
Reaganite said:
There is no "luck" in garnering referrals. It's a skill most young rad oncs today don't seem to have. Too many academic types with no social skills in our field now. Sorry, but that's the truth; I've been interviewing you guys. That's the problem a lot of older guys have with the new crowd. I'm not old, but I can relate. I work in a very competitive area where I built my practice almost from scratch. I had no income guarantees, and I received no payment for nearly 6 months. I made ends meet by doing locums work for several local docs, often asking substantially less than the going locums rate to ensure I had work. I'd drive 60+ miles to work half day locums for like $400. Sounds crazy, but I built a lot of connections that way which are more than paying off for me now.

I've worked my ass off and opened additional offices, and now I'm looking for an associate. I try to give new grads a chance, but the residents I meet today want too much. Don't come to me asking for income guarantees, 8 weeks off, and 300k. Don't complain when I ask you to drive around to different satellites. It's not about greed, but I sure as hell an not handing to you on a silver platter what I built with blood, sweat, and tears.
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How'd you repay the banks loans if you weren't generating income? It costs money to buy a linac and a CT sim.
 
engineer16 said:
Hoping this thread isn't entirely dead. Is this the kind of problem that could shift in the next eight to ten years or do you think it's going to stagnate for longer? I'm just a first year thinking about the field, but my fiancee and her entire side of the family live in south Jersey so I want to try to end up near there.
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Heres the conclusion I've drawn after MANY conversations with attending over the years.

1) You have to do what you are passionate about, otherwise work will suck. (For example, I just couldn't have done IM. I love Rad Onc though and "look forward" to work.)

2) Out of residency you will be able to get in the general region you want, i.e. the quarter of it.

3) 2 years out you will be able to get to the state or likely one of the surrounding states to where you want.

4) 5 years out, if not already in the sate you want, you get there

5) 7-10 years you could be in the greater city area where you want.

If you are okay with that, then Rad Oncs for you. If it is absolutely imperative you skip to step 5, then you may want to consider another field. For me, I decided that not necessarily being in the exact city I wanted after finishing was a trade off I was willing to make to do something I love from 8-5, 5 days week. Also, good networking and training where you want to practice can do a good job at accelerating the time table above and there are plenty of people who through luck or hard work end up at the dream job in the dream city straight away.

Someone who was at ASTRO this year, what the current percentage of people who leave their first job within 2 years? Is it 70%?
 
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As someone who is a current intern, I look forward to starting RadOnc every day.

I agree with what Sheldor says. To be honest, eventual location isn't a reason to not do the field. It's so much better than everything else - you WILL make it eventually work.
 
engineer16 said:
Hoping this thread isn't entirely dead. Is this the kind of problem that could shift in the next eight to ten years or do you think it's going to stagnate for longer? I'm just a first year thinking about the field, but my fiancee and her entire side of the family live in south Jersey so I want to try to end up near there.
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To be fair, in my unscientific recollection of recent astro job postings, I've definitely seen a few Jersey/ny jobs over the last few years, but sheldors advice is spot on
 
Sheldor said:
Heres the conclusion I've drawn after MANY conversations with attending over the years.

1) You have to do what you are passionate about, otherwise work will suck. (For example, I just couldn't have done IM. I love Rad Onc though and "look forward" to work.)

2) Out of residency you will be able to get in the general region you want, i.e. the quarter of it.

3) 2 years out you will be able to get to the state or likely one of the surrounding states to where you want.

4) 5 years out, if not already in the sate you want, you get there

5) 7-10 years you could be in the greater city area where you want.

If you are okay with that, then Rad Oncs for you. If it is absolutely imperative you skip to step 5, then you may want to consider another field. For me, I decided that not necessarily being in the exact city I wanted after finishing was a trade off I was willing to make to do something I love from 8-5, 5 days week. Also, good networking and training where you want to practice can do a good job at accelerating the time table above and there are plenty of people who through luck or hard work end up at the dream job in the dream city straight away.

Someone who was at ASTRO this year, what the current percentage of people who leave their first job within 2 years? Is it 70%?
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That's encouraging. I just want to be able to land a residency and then subsequently a job in the same region. I've lived all over the place but we'll want to start a family after med school is over.
 
I want to stay in the midwest (ex. Milwakee, Detroit, St. Louis, Indianapolis, Kansas City). Does what you are all saying apply to towns this size?
 
Entering2019MD said:
I want to stay in the midwest (ex. Milwakee, Detroit, St. Louis, Indianapolis, Kansas City). Does what you are all saying apply to towns this size?
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Yes. You are absolutely not guaranteed to live in a specific city, even one of those. However, if your target was ANY of those, you would be likely be fine, and could probably lock down your specific city of interest within a few years.
 
If you start med school in 2019, you might finish residency in 2024. That assumes that you continue to have an interest in rad onc, though odds are that you'll go into something else.

Nobody here can have any idea what the job market for rad onc will be like in 10 years.

Remember, this forum is for questions from senior med students or above.
 
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