question about rads vs radonc

[medstud2012]

I am very interested in rad onc but like IM and rads also. this question is kind of random, but what makes rad onc so much more competitive than rads (not that that isnt competitive itself). it seems like rads is also a lifestyle specialty, and also that salaries are higher in rads. what gives? before someone flames me, this is just an honest question based on curiosity. thanks

---

Members don't see this ad.

 

[JM912]

There are more spots to be had in rads, which makes it less competitive. As for salaries, you have that backwards. Radonc, especially in the private setting, can generate much higher incomes than your average general radiologist (interventionalists make serious bank, however). With regard to the work itself, radonc has all the neat physics/gizmo appeal that you would ever get in rads plus you get to use such technology to treat cancer patients.

 

[Helo]

d

 

[JumpingFrenchmn]

yea im between the two fields too (interventional rads and radiation oncology), and it has been really hard figuring out which way I want to go. any idea as to the outlook of these fields in the long term?

The problem with interventional rads is that these docs have zero ownership of patients. So when they come up with new effective, lucrative procedures, they get taken (e.g., angioplasty/stenting). A very bright friend of mine is very interested in interventional oncology but is really worried about this. He's also concerned they know very little about oncology and thus will likely not ever be able to manage onc patients on their own. He does think the field has a lot of potential, but who knows who will end up doing these procedures in the end.

As for the future of rad onc, read the FAQ above. I think most here will tell you that cancer care requires a combined modality approach - surgery, chemo, xrt (and maybe IR in the future?). Unless a magic bullet is unearthed, which seems pretty unlikely, all of these modalities will continue to be standard of care. Radiation, like surgery and chemo, will only continue to improve as it has over last few decades.

 

[bragmt]

The main reason Rad Onc is far more competitive than Rads is the existence in Rads of smaller and less competitive programs at community hospitals. The top Rads programs at large academic centers are probably about the same as the smaller Rad Onc programs. However what makes Rad Onc really hard is that there are virtually no tiny community based hospitals with programs that you can “fall back on”, and the small Rad Onc programs are always at a large academic center and they usually take 1 resident at most, making even those programs a real challenge. Oftentimes I felt like those spots were already spoke for by a rotating student, and the interviews were just a formality. Also what makes Rad Onc crazy is the research people do in this field. So not only are we the candidates that have great boards (nearly 240 average) and AOA, we also have 7 average publications per matched candidate, and about 20-30 percent MD/PhD’s depending on the year!!!! These numbers are almost double that of any other field, making our matched candidates crazy well qualified.
I also strongly considered Rads, but when I did my rotation it really really let me down. I did not feel like a doctor at all, it was basically sitting in a dark room talking into a microphone, and describing what I was seeing. The reason I went to medical school was I really enjoy taking care of patients directly, talking to their families, answering their questions, seeing them in yearly follow ups, watching them improve, etc. Rads has none of that. You essentially see a patient in a room, and do a procedure, often never to see them again, and know little about who they are. It felt to me like you’re not even a doctor, you prescribe nothing, you don’t do physical exams, and you don’t see patients in follow up. Make sure you do a full Rads rotation, of course, and ignore the financial perks of the field; they just took a huge CMS hit, and I don’t think Obamacare is going to help any.

 

[Rzarecta]

The main reason Rad Onc is far more competitive than Rads is the existence in Rads of smaller and less competitive programs at community hospitals. The top Rads programs at large academic centers are probably about the same as the smaller Rad Onc programs. However what makes Rad Onc really hard is that there are virtually no tiny community based hospitals with programs that you can "fall back on", and the small Rad Onc programs are always at a large academic center and they usually take 1 resident at most, making even those programs a real challenge. Oftentimes I felt like those spots were already spoke for by a rotating student, and the interviews were just a formality. Also what makes Rad Onc crazy is the research people do in this field. So not only are we the candidates that have great boards (nearly 240 average) and AOA, we also have 7 average publications per matched candidate, and about 20-30 percent MD/PhD's depending on the year!!!! These numbers are almost double that of any other field, making our matched candidates crazy well qualified. .

I absolutely disagree that rad onc is way more competitive than radiology. The data from the AAMC Charting Outcomes in the Match does not support any of what you are saying. Both fields have similar success rates for US MDs (~85%) and have similar/same board scores. It is true that many rad onc candidates have PhD degrees, but this does not seem to confer any significant advantage in matching (85% of applicants without PhD's matched).

The top Rads programs at large academic centers are probably about the same as the smaller Rad Onc programs.

I think your reasoning is backwards for the competitiveness of academic radiology positions. If all of the radiology spots are as competitive/slightly less competitive than the radiation oncology spots (which are at academic centers), then it stands that the academic radiology positions (which one could reason would be more competitive/desired than community programs) would be as competitive if not more so than the academic radiation oncology programs. I am not trying to get into a pissing match, I just don't think that you can say that radiology is "so much easier" to attain than rad onc, especially when the data doesn't support your conclusion.


I do agree, however, that there is a significant research component to the successful radiation oncology applicant's CV that is not as necessary for radiology.

 

[bragmt]

You essentially spelled out the reason why Rad Onc is more competitive. Absolutely the board scores, match rates, and percentage of applicants are about the same, however there are several critical differences which make Rad Onc more competitive.

The first comes in the last point you mentioned…publications. The average this past year published by the NRMP for Rad Onc was 8.0…this was in comparison to Rads 3.5 Also a critical difference is the number of applicants with a PhD, Rad Onc 20%, Rads 5%. Essentially Rad Oncers have the same benchmark numbers, however we dwarf Rads in terms of research. So if you were to take the average Rads candidate with three publications/presentations its pretty unlikely they would match in Rad Onc, let alone match well. On the flip side if you take the average Rad Onc candidate they would very likely match extremely well in Rads. Publications are a great reflection of true competitiveness of a specialty; the top two being Categorical Plastics and Rad Onc.

Anyone can score a 240 on step 1 and get AOA, however very few can do that while at the same time juggling 8 research projects. Having a smaller total percentage matched does not mean that a specialty is necessarily more competitive, just because more poorly qualified people apply for that specialty does not mean its more difficult, its just more rejection emails the programs have to send.

 

[Rzarecta]

You essentially spelled out the reason why Rad Onc is more competitive. Absolutely the board scores, match rates, and percentage of applicants are about the same, however there are several critical differences which make Rad Onc more competitive.

The first comes in the last point you mentioned…publications. The average this past year published by the NRMP for Rad Onc was 8.0…this was in comparison to Rads 3.5 Also a critical difference is the number of applicants with a PhD, Rad Onc 20%, Rads 5%. Essentially Rad Oncers have the same benchmark numbers, however we dwarf Rads in terms of research. So if you were to take the average Rads candidate with three publications/presentations its pretty unlikely they would match in Rad Onc, let alone match well. On the flip side if you take the average Rad Onc candidate they would very likely match extremely well in Rads. Publications are a great reflection of true competitiveness of a specialty; the top two being Categorical Plastics and Rad Onc.

Anyone can score a 240 on step 1 and get AOA, however very few can do that while at the same time juggling 8 research projects. Having a smaller total percentage matched does not mean that a specialty is necessarily more competitive, just because more poorly qualified people apply for that specialty does not mean its more difficult, its just more rejection emails the programs have to send.

As I pointed out that PhD did not have an significant effect in terms of match success in rad onc. Look at page 264 of Charting Outcomes. 81% matched without a PhD versus 85% matched with a PhD. Doesn't seem that impressive of an advantage to me.

Look at page 260, which details the success of applicants based on the number of research projects and page 261 which details the number of abstracts, presentations, and publications. Applicants having 5 or more publications had an 87% success rate. Those with 4 had 83%. Those with 3 had 100%. Those with 2 had 69%. Those with 1 had 58%. Those with 0 had 78%. So it seems that having 3 or more was the success threshold according to that data.

Anyone can score a 240 on step 1 and get AOA, however very few can do that while at the same time juggling 8 research projects.

Come on, this is laughable. AOA is reserved for the top 16% of a medical school class. And a 240 for my year was half a standard deviation from the mean. Again, I am not saying that rad onc isn't more competitive than radiology. I just take some offense to your allegation that it is WAY more competitive than rads.

Publications are a great reflection of true competitiveness of a specialty; the top two being Categorical Plastics and Rad Onc.

In terms of publications, the highest are derm (7.4), neurosurg (7.8), plastics (8.1), rad onc (8.2). As these values are very similar/same, by your reasoning these are the most competitive. However, looking at the stats of the matched applicants we see a significant difference. Plastic surgery and derm have many more applicants per spot and higher step 1/AOA likelihood.

The "Great reflection" is more likely based on the number of applicants per spot along with the baseline characteristic of the matched applicants. Both plastics and derm have the most applicants per spot at 1.9 and 1.7, respectively (rad onc has 1.1 applicants per spot). This is coupled with the fact that their matched groups have the highest stats in terms of AOA and Step 1 scores.

Dude, rad onc is a very competitive specialty. But it is not plastics or derm.

 

[Gfunk6]

Dude, rad onc is a very competitive specialty. But it is not plastics or derm.

I would not disupte this statment.

Frankly, it seems absurd to compare which speciality is more competitive. A far more germane question is if YOU are competitive for whatever speciality you are applying for.

 

[bragmt]

My bad. In no way was I saying its the same as Derm or Plastics, they are clearly more competitive. I was simply trying to make the argument that it is more competitive than Diagnostic Rads.

I don't know if I agree with the point about the number of applicants per spot as being the best indicator though...just because more people apply does not mean they are more qualified. For example if a Walmart opens in a rural area and 2000 people apply for 100 jobs does it make those jobs harder to get than say a chairman of a department were 5-10 people apply? By the applicant per spot number yes…but reality is no. Looking at qualifications is critical.

I agree with our fearless leader Gfunk though, this is a stupid conversation. I just think the Rad Onc applicants consistently blow away the diagnostic Rads apps and I don't want future applicants to be mislead in thinking the two applicant pools are the same caliber.

You know the forums hit a new low when I have brought up Walmart openings.

 

[Rzarecta]

My bad. In no way was I saying its the same as Derm or Plastics, they are clearly more competitive. I was simply trying to make the argument that it is more competitive than Diagnostic Rads.

I don't know if I agree with the point about the number of applicants per spot as being the best indicator though...just because more people apply does not mean they are more qualified. For example if a Walmart opens in a rural area and 2000 people apply for 100 jobs does it make those jobs harder to get than say a chairman of a department were 5-10 people apply? By the applicant per spot number yes…but reality is no. Looking at qualifications is critical.

I agree with our fearless leader Gfunk though, this is a stupid conversation. I just think the Rad Onc applicants consistently blow away the diagnostic Rads apps and I don't want future applicants to be mislead in thinking the two applicant pools are the same caliber.

You know the forums hit a new low when I have brought up Walmart openings.

Fair enough. We can agree to disagree. I don't want future applicants to think that these two fields are of such different caliber. Both require dedicated applicants.

 

[OTN]

Relative competitiveness between specialties when it comes to residency spots doesn't matter.

The main question between rads and radonc: Do you like talking with patients? Seeing them in clinic? Prescribing a treatment, seeing them through the course, then monitoring afterwards for success/side effects? If all that sounds appealing, radonc is a good bet. If seeing a patient in clinic makes you want to break out in hives, rads would be a better choice.

Both can be procedural, both involve imaging pretty heavily, and both are well-compensated, but the similarities end there.

 

[JDUB44]

deleted

 

[deleted4401]

Hmm.

This is kind of crap comparing the two specialties by looking at means/medians and the highest ends of who matched.

If there was a somewhat accurate way to compare the two fields it would involve comparing the bottom 10% of matched applicants in each field. My presumption is that the 10th percentile of each field had a very poor chance of matching, but just barely made it. The tabulation of their statistics (board scores, percent AOA, publications) and their subsequent comparison to each other would allow one to better gauge which is more competitive.

It's really a dumb game to play, but my presumption is that derm and integrated plastics bottom 10% is better than the bottom 10% of rads or rad onc. Some really average people get into rads and rad-onc ...

I'm not disparaging my field or saying its not competitive, but comparing the middle/mean isn't really fair. The top rad-onc candidates are some amazing human beings - Harvard grads with MD/PhDs, 10 publications, and AOA ...

But the statistical non-giants - some gal who is just a nice person and will take great care of cancer patients and pass her boards from Louisville or Kansas or MUSC that happens to have a 210 and no publications is going to have a great shot at the one spot at their home institution. It happens a lot and is not at all a bad thing.

Rad onc is competitive, but not in the same way other fields may be. Sometimes the spot at Wayne State is competitive because there are 3 really great future physicians with nice personalities that come from that school that are applying, not because any of them have MD-PhDs or 260 board scores.

-S