M4 thinking strongly about applying to Rad Onc: Why is there so much dissonance between opinions real life and the internet?

[scarbrtj]

The naivety of some on this board... it’s like they look at the Doximity data, conclude medoncs are making $260k and it makes them feel better about choosing a field that’s self immolating.



Literally the best case scenario for this field. In the near future any American grad with a step 1 above 220 will feel embarrassed to match into radonc.

They’re already laying the ground work for it...

Redirecting

doi.org

Radonc 1995-2018: <250 need not apply; radiation oncologists are elite academics
Radonc 2019: Selecting by step 1 scores is actually bad!

"Overemphasis of Step 1 Scores May Impact Application Pool Diversity in Radiation Oncology "
I saw that. How truly ironic. It's like a combination of quotas, "The Bell Curve," and some weird gene pool allusion (they coulda left "pool" outta the title, kind of a loaded word).

---

Members don't see this ad.

 

[deleted956486]

"Overemphasis of Step 1 Scores May Impact Application Pool Diversity in Radiation Oncology "
I saw that. How truly ironic. It's like a combination of quotas, "The Bell Curve," and some weird gene pool allusion (they coulda left "pool" outta the title, kind of a loaded word).

Jefferson went unmatched had this cycle btw. Nice way to save face. "Oh yeah we stopped looking at step scores. It limits diversity." Meanwhile those diverse applicants wont get certified."

Why all the concern about diversity among residents? Why not focus on board certified radiation oncologists? How many minority faculty at Jefferson?

Opinion | Diversity, Inclusion and Anti-Excellence (Published 2019)

A former dean of the Yale Law School sounds a warning.

www.nytimes.com

 

[Lamount]

To med students:

If you are looking to cash-in on high boards scores and AOA by getting a job starting at >700k with a cushy lifestyle, radiation oncology isn't for you. If you are considering this field because you want to be an expert of both cancer anatomy and cancer biology, because you enjoy having time to talk to patients... and are happy with a comfortable lifestyle in a midsized metro, radiation oncology may be a good fit.

As one can see from the above comments, if you expect the former and get the latter, you may be disappointed. But there are many of us (perhaps a silent majority) who are quite happy that we went into this field.

 

[xrthopeful]

Extremely well said Lamount.

Also can we all agree that for the most part ‘If you are looking to cash-in on high boards scores and AOA by getting a job starting at >700k with a cushy lifestyle’ basically doesn’t exist? I mean if you’re making that much starting out then it isn’t likely to be cushy

 

[xrthopeful]

Genuinely feel bad for people who think the day to day practice of med onc aka writing orders for medications is cooler than what we do as rad oncs


Man sucks to be you.

 

[deleted18755]

Genuinely feel bad for people who think the day to day practice of med onc aka writing orders for medications is cooler than what we do as rad oncs


Man sucks to be you.

I personally agree but to each his own.

I don’t want to sound like an old man but I know it’s hard to imagine as a wide eyed 20-25 year old who finds his “calling” in medicine and then discovers how cool radiation oncology is but fast forward 15-20 years to a life that doesn’t resolve around school/work and medicine with a family and writing orders all day while helping cancer patients vs what we do (let’s be honest ... a whole lot of drawing circles and borderline coloring while babysitting a linac) is great ... especially if it pays the bills real well and you can live wherever you want to raise your family.

 

[scarbrtj]

Genuinely feel bad for people who think the day to day practice of med onc aka writing orders for medications

Practice of rad onc = writing orders for radiation.
Occasionally it's procedural, e.g. brachytherapy, going to sim to fashion custom bolus, etc. Most times, not. Drawing a contour is not procedural; it is also simply a way of writing a prescription.

babysitting a linac

What if we "lost" this as job security? In many other countries, the babysitting-a-linac thing is not a thing. I think it's highly, highly likely a rad onc being merely present/doing nothing all day does not improve patient care and only augments cost. If the higher-ups ever truly catch on to this, look out.

At the end of the day the gratification comes from the patient connections

Patient connection rate in radiation oncology continues to fall as we literally hypofractionate patient face-to-face encounters.

Writing scripts vs drawing circles

And what if we lose the "drawing circles" part of the job to HAL-9000's forbear? Not a crazy thought.
Here's another thought: if you weren't needed to babysit a linac (and let's face it we are not "needed" like you "need" a surgeon to do a craniotomy), and you aren't needed to do contouring because a computer does 90+% of it...

 

[Krukenberg]

Genuinely feel bad for people who think the day to day practice of med onc aka writing orders for medications is cooler than what we do as rad oncs


Man sucks to be you.

For the metastatic patient, med oncs are very much their primary care doctor. For me that would f’ing suck. I want to have a problem, fix it, then manage the patient’s surveillance if they’re curative or discharge them after a follow-up or two if metastatic feeling the satisfaction of having improved their QOL. Rad onc is much more similar to a surgical specialty in that respect, which is fundamentally incompatible with most IM specialties.

 

[Krukenberg]

Some of the larger derm practices hire np and pa to help fill the gap with shortages I thought? They do basic stuff and leave mohs etc to the doctors. At least that's the impression I've gotten from what I've seen in practice

No that’s not the PE model, and the # of PE owned practices are literally increasing exponentially. They hire a doc and have them train and manage an army of extenders who are off doing procedures with minimal supervision. It is literally the worst case scenario of extenders run amok and replacing doctors. Also, The vast majority of dermatologists don’t do Mohs

 

[RickyScott]

Genuinely feel bad for people who think the day to day practice of med onc aka writing orders for medications is cooler than what we do as rad oncs


Man sucks to be you.

I dont believe I am very materialstic compared to most docs. Fundamentally, I feel that any medstudent in the top 25% of his class w/260 usmle deerves a specialty with a stable job that pays at leat 300,000 (given debt and opportunity costs)- in the location of his choosing, or a lot more if the location, away from friends and family, sucks. Radonc can not deliver that to most medstudents right now, but plenty of rewarding specialties can . I feel like you are trying to argue otherwise?

Also your conception of medonc is misguided- in many ways more learning and keeping up to date with newer agents and changing treatment, mor risk benefit analysis, more engagemnt with patients and families...

 

[Krukenberg]

Both derm and ophto aren't really hospital based specialties, so essentially PE is doing the corporatization in the same vein of what hospitals have done to many other more "hospital-based" specialties.

No different than 21C or McKesson/US Oncology owning huge stakes in multiple centers around the country. Personally, I'd rather be owned by PE/fortune 500 company than a hospital in terms of physician autotomy....

No...you wouldn’t. At least a hospital has a financial incentive to have a healthy practice over the long-term. PE looks to extract as much $$$ from the practice/business in 3-7 years, often drive it into bankruptcy, then sell it. There is a disincentive for them to build a healthy, sustainable practice.

Read the article, it literally says they like branding dermatology practices because it makes it easier to fire doctors who object to their practice of medicine.

 

[medgator]

No...you wouldn’t. At least a hospital has a financial incentive to have a healthy practice over the long-term. PE looks to extract as much $$$ from the practice/business in 3-7 years, often drive it into bankruptcy, then sell it. There is a disincentive for them to build a healthy, sustainable practice.

Read the article, it literally says they like branding dermatology practices because it makes it easier to fire doctors who object to their practice of medicine.

Then again, those same practices are more likely to reward docs who stay busy (and generate more technical) vs the hospitals who manipulate rvu structures to basically make sure you never make more than your base.

Hospitals are probably more likely to make expensive equipment purchases but in the coming era of APM and possible site neutrality, PE may be able to win the cost control game.....

I guess it comes down to which MBA you want breathing down your neck....

 

[deleted573262]

Patient connection rate in radiation oncology continues to fall as we literally hypofractionate patient face-to-face encounters.

This is huge and not many people have been talking about it. For patients getting SBRT, we see them what - 2, 3, maybe 4 times until they complete treatment? Conventional fractionation for prostates we would see closer to a dozen times and then follow-up. Patient connection is definitely becoming worse in this field.

 

[Krukenberg]

Then again, those same practices are more likely to reward docs who stay busy (and generate more technical) vs the hospitals who manipulate rvu structures to basically make sure you never make more than your base.

Hospitals are probably more likely to make expensive equipment purchases but in the coming era of APM and possible site neutrality, PE may be able to win the cost control game.....

I guess it comes down to which MBA you want breathing down your neck....

Whatever you say... all the docs in derm without an equity stake in PE (I.e. the vast majority) are highly concerned by this trend.

 

[medgator]

Whatever you say... all the docs in derm without an equity stake in PE (I.e. the vast majority) are highly concerned by this trend.

At least their specialty is smart enough to manage the residency pipeline/supply.

Imagine having residency slot expansion to contend with on top of
the issue of corporate/hospital takeover of your specialty. Music to the ears of any health system or PE CEO....

 

[xrthopeful]

Medgator in this thread: (with hands on ears) nah nah nah nah can’t hear you rad onc is the worst one

 

[Krukenberg]

At least their specialty is smart enough to manage the residency pipeline/supply.

Imagine having residency slot expansion to contend with on top of
the issue of corporate/hospital takeover of your specialty. Music to the ears of any health system or PE CEO....

Posted by a path resident on the derm board: “Private equity is your enemy.

Pathology sucks because private equity got involved. They control CAP which is supposed to be our professional society but now lobbies for residency expansions for a 'looming shortage'. In reality, more pathology spots = more cheap labor for private equity.

Dermatology should be very careful.”

 

[medgator]

Posted by a path resident on the derm board: “Private equity is your enemy.

Pathology sucks because private equity got involved. They control CAP which is supposed to be our professional society but now lobbies for residency expansions for a 'looming shortage'. In reality, more pathology spots = more cheap labor for private equity.

Dermatology should be very careful.”

Same could be said about ASTRO controlled by hospital based RO and academic chairs telling us they can expand as much as they want at a program level and throw their hands up in the air about being able to consider supply and demand of the specialty

 

[medgator]

Medgator in this thread: (with hands on ears) nah nah nah nah can’t hear you rad onc is the worst one

C'mon, tell us how "everything is awesome" in rad onc...

 

[xrthopeful]

Lol yes Kazakhstan how intellectually dishonest.

‘For most others there is a balance between professional aspirations, compensation, quality of life, and intrinsic aspects of the job that go into deciding on a specialty.’

Yep this is why most of us went into rad onc and most of us are happy in our choices.

 

[Neuronix]

C'mon, tell us how "everything is awesome" in rad onc...

No personal callouts please medgator and xrthopeful. Please state your opinions without devolving into personal attacks.

 

[PleaseRemainCalm]

Our graduating residents are all struggling to find jobs they can live with. Most have been looking since last year and dozens of emails, recruiting events, etc. later most have 1 take it or leave it offer for around $280k with limited upside. We are a good program and it is early in the year so they will probably eventually find something, but the cognitive dissonance that this is anything but a CRISIS is insane. I talked to some of the heme onc docs and their fellows have practices knocking down their doors from the time they start talking $400-500 and up.

When I applied into radonc many years ago there were rumblings on SDN that this was the future, but was told by everyone I met in the field that these concerns were overblown. Wish I had listened to this board.

Medical students: please stay away. If you want an actual reward for your decades of academic toil, find another, healthier field than radonc.

It only gets worse from here.

If they have been PGY5s for a month sounds like they were looking way early, perhaps too early to get very serious offers?

 

[xrthopeful]

yes of course way too early to have determined that the job search has been a ‘struggle’. We still have six weeks to ASTRO, forgetting the rest of the academic year....


We simply aren't operating on the level of mutual respect or intellectual honesty I assumed on this forum when I first started reading here in 2011 or so

 

[deleted956486]

yes of course way too early to have determined that the job search has been a ‘struggle’. We still have six weeks to ASTRO, forgetting the rest of the academic year....


We simply aren't operating on the level of mutual respect or intellectual honesty I assumed on this forum when I first started reading here in 2011 or so

I have a hard time believing that a new grad or current resident is so in love with radiation oncology that any criticism of the job market is construed as disrespect. Are you really that much a "protector of the field."

Or let's just say that everything negative being posted is false (hypothetically speaking, despite the articles and data to the contrary), and you are indeed a "protector of truth," how much free time do have?

If you dont have an agenda I'd be surprised

 

[xrthopeful]

I believe in healthy criticism. The field is far from perfect.

I call out things/statements that deserve to be called out. There’s a silent but large group of people that read these threads, most don’t bother replying to the echo chamber. But I have gotten many private messages from people who don’t post but agree with or respect my voice on these threads.

I have no agenda at all and no connection at all to ASTRO.(haven’t even paid my dues). I just like finding the things that are the closest to the truth as possible, and I’m not always right at all.

 

[deleted956486]

Yeah, no...I'm gonna say PD

 

[Neuronix]

If they have been PGY5s for a month sounds like they were looking way early, perhaps too early to get very serious offers?

I agree. The job market is tough, but it's too early to assess prospects for 2020 grads.

Please no personal attacks or doxxing (or attempts at doxxing).

 

[TheIllusionist]

I agree. The job market is tough, but it's too early to assess prospects for 2020 grads.

Please no personal attacks or doxxing (or attempts at doxxing).

What do you think of possibly double applying IM and high tier rad onc?

 

[deleted941485]

What do you think of possibly double applying IM and high tier rad onc?

My unsolicited opinion is drop the tiering assumption. First class or steerage. A sinking ship is still a sinking ship.

 

[TheIllusionist]

My unsolicited opinion is drop the tiering assumption. First class or steerage. A sinking ship is still a sinking ship.

In general, have I shot myself in the foot for top IM programs, given the rad onc heavy bent of my application?

 

[medgator]

In general, have I shot myself in the foot for top IM programs, given the rad onc heavy bent of my application?

If you have solid step and im rotation scores, guessing no

 

[deleted573262]

In general, have I shot myself in the foot for top IM programs, given the rad onc heavy bent of my application?

no. IM is very easy to match into top programs with good scores, honors in clerkship, and research. people change their mind all the time and all you will need to do is explain why you prefer medicine over rad onc. my buddy matched a harvard program with less research and 240s/250s step scores.

 

[TheIllusionist]

People are right about one thing though. I feel an attachment to rad onc. I genuinely enjoy the field, and I'm having a great time on my aways. Letting it go entirely would be hard. Are things really that bad that I won't be able to get out a good program and not even make the rad onc median? AMGA data has it at a 533k median. Doximity shows a high number too

Now I am not super savvy about physician compensation nor is it the only factor in my choosing a specialty. But who is making all this money? Someone quoted Terry wall said new grads are being hired at 300-350k. That doesn't sound too bad. Do people just not move up from that point? Is locums offering really low rates too? I am confused about this aspect. I get there is oversupply, but is it so that it really hasn't hit the job market fully yet? Is armageddon still yet to come?

 

[deleted18755]

People are right about one thing though. I feel an attachment to rad onc. I genuinely enjoy the field, and I'm having a great time on my aways. Letting it go entirely would be hard. Are things really that bad that I won't be able to get out a good program and not even make the rad onc median? AMGA data has it at a 533k median. Doximity shows a high number too

View attachment 274845

Now I am not super savvy about physician compensation nor is it the only factor in my choosing a specialty. But who is making all this money? Someone quoted Terry wall said new grads are being hired at 300-350k. That doesn't sound too bad. Do people just not move up from that point? Is locums offering really low rates too? I am confused about this aspect. I get there is oversupply, but is it so that it really hasn't hit the job market fully yet? Is armageddon still yet to come?

People who are geographically flexible and/or lucky are definitely starting at 300-350+. My concern is not for mid-career or later doctors (it takes more then a few years for even rapidly declining compensation to infiltrate every corner of the country and even more years for it to make it into published surveys, especially when most physicians will just work more/hire less to make up for falling compensation) or even current graduates who wouldn’t mind working for example in the mid-West outside of Chicago or Detroit or whatever but medical students who plan to graduate in 6-7 years and have a dream job in radiation oncology in a big city (especially when so many other great specialties are out there).

 

[deleted941485]

People are right about one thing though. I feel an attachment to rad onc. I genuinely enjoy the field, and I'm having a great time on my aways. Letting it go entirely would be hard. Are things really that bad that I won't be able to get out a good program and not even make the rad onc median? AMGA data has it at a 533k median. Doximity shows a high number too

View attachment 274845

Now I am not super savvy about physician compensation nor is it the only factor in my choosing a specialty. But who is making all this money? Someone quoted Terry wall said new grads are being hired at 300-350k. That doesn't sound too bad. Do people just not move up from that point? Is locums offering really low rates too? I am confused about this aspect. I get there is oversupply, but is it so that it really hasn't hit the job market fully yet? Is armageddon still yet to come?

Terry wall survey has trended down over the years for the new grads. Can’t wait to hear what he has in store for the residents survey this year at ASTRO. Also AGMA is too high and isn’t even realistic I’d say. Doximity really hasn’t been doing this very long wouldn’t trust them either. Both are probably inflated.

Even a middle tier IM program will open up far more doors for you clinical and non clinical.

 

[deleted941485]

I also don’t understand why you think you shot yourself in the foot. If your a decent applicant it shouldn’t be difficult to land a solid IM program.

You can afford to vacillate although I don’t really quite get why.

 

[Neuronix]

What do you think of possibly double applying IM and high tier rad onc?

I'm just a random faculty member with an opinion. Keep in mind that opinions always vary. I also have very little to do with the residency program where I work, so my opinion comes from my own experience and word of mouth.

There are several major issues with double applying. Most faculty are ignorant of the job market issues (willfully so or because job market issues never applied to them). If you double apply nobody can know about it on either side. That means applying to different residency programs at different universities (don't apply IM and rad onc at the same place). Rad onc programs expect full commitment to the specialty and will not understand this concept of I'm only doing rad onc if it's a top program. This is not only ignorance of the issues, but also many of us don't see this issue as cut and dry (i.e. top program doesn't automatically make things better OR low tier program isn't automatically bad), and everyone hates having a resident switch out of the specialty during the residency program because they weren't committed in the first place. On the IM side it's the same--I assume you're planning for med onc, but they want you to have made that decision since the practice of rad onc and med onc are so different. So this means applying with two sets of letters which is also tricky.

Therefore, I think you need to decide what you want. If you love rad onc, decide if it's worth half the pay compared to med onc and working whatever location is available (compared to med onc which is wide open). Also you may possibly need to do a fellowship year as this job market worsens. It may not actually be this bad (or med onc may not be this good) when you graduate, but nobody really knows and med onc is super hot and rad onc is cold right now with no indications that this will change in the near term.

You'll still be competitive for IM. Just tell them you were thinking rad onc but changed your mind to med onc.

 

[TheIllusionist]

I'm just a random faculty member with an opinion. Keep in mind that opinions always vary. I also have very little to do with the residency program where I work, so my opinion comes from my own experience and word of mouth.

There are several major issues with double applying. Most faculty are ignorant of the job market issues (willfully so or because job market issues never applied to them). If you double apply nobody can know about it on either side. That means applying to different residency programs at different universities (don't apply IM and rad onc at the same place). Rad onc programs expect full commitment to the specialty and will not understand this concept of I'm only doing rad onc if it's a top program. This is not only ignorance of the issues, but also many of us don't see this issue as cut and dry (i.e. top program doesn't automatically make things better OR low tier program isn't automatically bad), and everyone hates having a resident switch out of the specialty during the residency program because they weren't committed in the first place. On the IM side it's the same--I assume you're planning for med onc, but they want you to have made that decision since the practice of rad onc and med onc are so different. So this means applying with two sets of letters which is also tricky.

Therefore, I think you need to decide what you want. If you love rad onc, decide if it's worth half the pay compared to med onc and working whatever location is available (compared to med onc which is wide open). Also you may possibly need to do a fellowship year as this job market worsens. It may not actually be this bad (or med onc may not be this good) when you graduate, but nobody really knows and med onc is super hot and rad onc is cold right now with no indications that this will change in the near term.

You'll still be competitive for IM. Just tell them you were thinking rad onc but changed your mind to med onc.

How would they know I am double applying?

 

[xrthopeful]

‘Half the pay’ lol.

Also btw I’ve known a few people apply double fields and no one has the ability to know until you match, then they’ll know you potentially matched in something other than what you interviews with them for, but at that point it’s like who cares?

 

[Neuronix]

How would they know I am double applying?

Either the GME office notices, you run into the same people on two interviews, or you have a letter or interview mixup.

Regarding salary I've posted about my experience before. I have friends in med onc. When I graduated from residency, all of my salary discussions were very similar. The PP med onc offers were double mine. A few med oncs where i work just left academics for salaries over double mine.

 

[xrthopeful]

Yeah, no...I'm gonna say PD

Guess like many things here facts don’t matter. Okay.

 

[xrthopeful]

Luckily when it comes to salary there is no need to look at anecdotes.

There is data. Pick your source. You’ll see the facts.

But let’s dissect your anecdote. Say you’re making 325k in your academic position. So your colleague in academic med onc is leaving to make 600k in PP.

You can go to ASTRO and sneeze and most rad oncs that get hit with your spittle who are out in practice in PP are making 500-600k.

I don't think your anecdote is reflective of anything significant.

 

[medgator]

You can go to ASTRO and sneeze and most rad oncs that get hit with your spittle who are out in practice in PP are making 500-600k.

I don't think your anecdote is reflective of anything significant.

And you can get that 500-600k in any city where the med onc is being hired at that salary target? Care to prove that?

 

[scarbrtj]

People are right about one thing though. I feel an attachment to rad onc. I genuinely enjoy the field, and I'm having a great time on my aways. Letting it go entirely would be hard. Are things really that bad that I won't be able to get out a good program and not even make the rad onc median? AMGA data has it at a 533k median. Doximity shows a high number too

View attachment 274845

Now I am not super savvy about physician compensation nor is it the only factor in my choosing a specialty. But who is making all this money? Someone quoted Terry wall said new grads are being hired at 300-350k. That doesn't sound too bad. Do people just not move up from that point? Is locums offering really low rates too? I am confused about this aspect. I get there is oversupply, but is it so that it really hasn't hit the job market fully yet? Is armageddon still yet to come?

You can not find a locums job making more than $2000 a day, therefore about $40,000 month max. (This is WAY generous but play along for now.)
In general locums pays ~50% more than typical salary, any locums in any specialty.
Assuming locums market is following typical market forces, in theory typical monthly rad onc salary would be: X * 1.5 = $40,000, or $27K a month. This works out to $320K a year. If typical/median rad onc salary was truly 450K a year, then locums salary would be 2500-plus a day. Again, not a real number. Somewhere in 1500-2000 a day neighborhood is not only typical, it's the max achievable.

This is only one piece of the salary information puzzle. I don't know what to make of this rad onc salary data. I do know this: typical number of respondents they get is in the neighborhood of 20 rad onc doctors, nationwide, answering the salary survey. The number of rad onc salary survey respondents is BY FAR the lowest of any specialty. So it may not be a true representative sample.

 

[PleaseRemainCalm]

People are right about one thing though. I feel an attachment to rad onc. I genuinely enjoy the field, and I'm having a great time on my aways. Letting it go entirely would be hard. Are things really that bad that I won't be able to get out a good program and not even make the rad onc median? AMGA data has it at a 533k median. Doximity shows a high number too

View attachment 274845

Now I am not super savvy about physician compensation nor is it the only factor in my choosing a specialty. But who is making all this money? Someone quoted Terry wall said new grads are being hired at 300-350k. That doesn't sound too bad. Do people just not move up from that point? Is locums offering really low rates too? I am confused about this aspect. I get there is oversupply, but is it so that it really hasn't hit the job market fully yet? Is armageddon still yet to come?

What are you expecting out of your career? If it is really critical to you that you make $535k at your job understand that medicine in general is a very unstable environment. A specialty that reimburses well can suddenly have the people in Washington make drastic specialty specific cuts or edicts that drastically alter your income or what you are allowed to bill for. Some senior rad oncs have told me they are making hundreds of thousands less than they did 10 years ago but similar things have happened in other fields, for example CT surgery.

I think you should choose a field where even if your salary gets cut, you at least will still enjoy the work, the patients, the working environment, and yes where you are able to live. There is nothing wrong with wanting to make as much money as possible but your income to effort ratio longterm is the thing that you have the least control over.

As for dual applying if you apply to IM programs where you applied to rad onc programs and they find out then yes your IM app at that institution is over. Consider if that is truly worth the effort.

 

[TheIllusionist]

What are you expecting out of your career? If it is really critical to you that you make $535k at your job understand that medicine in general is a very unstable environment. A specialty that reimburses well can suddenly have the people in Washington make drastic specialty specific cuts or edicts that drastically alter your income or what you are allowed to bill for. Some senior rad oncs have told me they are making hundreds of thousands less than they did 10 years ago but similar things have happened in other fields, for example CT surgery.

I think you should choose a field where even if your salary gets cut, you at least will still enjoy the work, the patients, the working environment, and yes where you are able to live. There is nothing wrong with wanting to make as much money as possible but your income to effort ratio longterm is the thing that you have the least control over.

As for dual applying if you apply to IM programs where you applied to rad onc programs and they find out then yes your IM app at that institution is over. Consider if that is truly worth the effort.

Yeah I won't double apply to same hospital. I talked to 4 different people this afternoon, all much more experienced than me that are in academics. They explained these same cons verbally. But I am not applying to that many rad onc programs, maybe like 10 that are in the geographic area of my preference and also with a strong name. For IM, I am applying all over, because I know despite where I train, I can go back to the geography of my liking. Whereas, rad onc is restrictive and based more on local connections. So for those 10 or so rad onc places, I won't apply IM. Still lot of IM space.

 

[winstonfoot5]

Terry wall survey has trended down over the years for the new grads.

Not true. To the OP, this is exactly why "there is so much dissonance between opinions in real life and the internet"

The Employment Experience of Recent Graduates From US Radiation Oncology Training Programs: The Practice Entry Survey Results From 2012 to 2017 - PubMed

These data can help gauge the competitiveness of an offer as well as what to expect during the job hunt and interview process.

www.ncbi.nlm.nih.gov

 

[medgator]

Not true. To the OP, this is exactly why "there is so much dissonance between opinions in real life and the internet"

The Employment Experience of Recent Graduates From US Radiation Oncology Training Programs: The Practice Entry Survey Results From 2012 to 2017 - PubMed

These data can help gauge the competitiveness of an offer as well as what to expect during the job hunt and interview process.

www.ncbi.nlm.nih.gov

Would be interesting to have the last couple of years of date thrown in. Honestly that pp average isn't far off from where I started practicing a decade ago. So starting salaries have been flattish the last decade in pp?

 

[Neuronix]

For those of you who don't have access, I have attached the salary figure from the paper. The numbers bounce around quite a bit because it is a survey with a limited response rate. For example, I don't remember ever receiving this survey despite keeping an eye out for it.

The average for academics in 2012 is the same as it is in 2017. Private shows a better trend upwards, especially if you take into account 2017.

If you take the overall change from 2012 to 2017, that's $31,333. Divide by 5 years and that's a growth of $6,266.60 per year. Divide that by the 2017 overall at $324,546 and we get... 0.0193. So starting salaries are growing roughly at a rate of 1.93%--roughly the rate of inflation.

Still, there's a lot of noise in this data. For example, if you look at 2012 to 2016, the overall change is only $16,549 or $4,137.25 per year. Divided by overall salary in 2016, that's a growth rate of roughly 1.33% per year which is less than inflation.


My other random observations on this topic below.

I graduated in 2016 and can say that all my private and academic discussions were almost exactly at $300k (+/- $10k), which is pretty consistent with this chart. Nobody was offering me technical even at partnership, so the expected salary after a few years full production was much more limited than one might expect.

I know several academic places that like to hire at AAMC 25th percentile for assistant professor, which is slightly higher than the numbers on this chart. That metric has ticked upwards more or less $5,000/year, consistent with the data. If it doesn't go up, they don't go up that year.

I've always wondered how to account in these surveys for contracts that are penalized for not meeting productivity. There's at least one academic conglomerate that gives starting satellite salaries in the 200s, but only after you make a certain number of RVUs. It's expected your first few years that you won't even make that number of RVUs and hence not make that number.

 

[thecarbonionangle]

With my teamfoil hat on, are PDs infiltrating SDN?

A while back there was a guy who spoke about “very good people” over at the ABR. where you at?