What procedures do Rad Onc do?

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riskybizness

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Current first year med student honing down on specialities I'd like to pursue in the future and I'm really liking rad onc so far.

1. I do like doing procedures and working with my hands and wanted to know if Rad Onc had a large procedural component.

I like surgery but am currently ambivalent about it. Mostly I don't like standing in the OR and most ORs seem like dull places. Maybe this is because I have never scrubbed in and worked on a patient.


2. Also, does one get the feeling of instant gratification in the practice of Rad Onc? Or are most treatments and recoveries done over several months' time?

3. What sort of complications exist when a patient is not responding well to Rad Onc treatment?



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Yea...and don't go into the field. Those facts should probably be updated concerning an over saturation of Rad/Oncs that will continue to grow... Meaning no job at the end of a very long educational road. We are basically going down the road that radiology took. My suggestion is to check out ophthalmology if you like procedures/ lifestyle/clinic care based medicine similar to Rad/Onc.
 
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Yea...and don't go into the field. Those facts should probably be updated concerning an over saturation of Rad/Oncs that will continue to grow... Meaning no job at the end of a very long educational road. We are basically going down the road that radiology took. My suggestion is to check out ophthalmology if you like procedures/ lifestyle/clinic care based medicine similar to Rad/Onc.
Optho is fine, procedurally, but unlike rad onc which is taking the financial hits now (aka there are still well-paid jobs out there, maybe not in the desirable locations for many), optho took those years ago and the salaries are much lower now.
 
Look up the ahead of print article below. It paints the picture of the future very well.

http://www.redjournal.org/article/S0360-3016(16)30289-9/abstract
Good read. Still in press, must be a recent manuscript.

Prob worth posting in the job market threads. There are still good, well-paid jobs out there if you're willing to consider rural locations away from the coasts

http://forums.studentdoctor.net/threads/bloodbath-in-red-journal.1014614/
http://forums.studentdoctor.net/threads/canaries-in-a-coal-mine.1193241/
 
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Look up the ahead of print article below. It paints the picture of the future very well.

http://www.redjournal.org/article/S0360-3016(16)30289-9/abstract


Thank you for posting this and thank you to the authors, who were honest enough to actually spell out the fact that the shortsightedness of our field has made sure a generation of physicians will be taken advantage of in the labor market. It is an excellent article, both more eloquent and in some ways more fatalistic than even my own take on things.

Downside on how they pass the buck... maybe they did float the idea of controlling residency slots (they being SCAROP) and hence the antitrust concern arose from them. I find it hard to believe there are anti trust concerns at this time; the projected over supply was published months back, and now people are finally admitting its true. How can be it anti-competitive for a professional society, which uses government money for trainee expenses (not uniformly but medicare pays for many of our slots) to say that we have too many and that this should be restricted? Is everyone so ignorant of the power to insurance companies now? To have a lack of supply dictate prices is completely unimaginable now with the built in work force.

In any event, here is my take;
If you are just thinking of joining this field now, or if you are 2nd-3rd year MS, and you cannot reasonably get into a top 10-15 institution in residency, do not apply.* The caveat being if you have absolutely no care in the world where you end up, or like rural areas (rural does not equal suburb or extended suburbs, rural equals collection hospitals or midwest locations far from St. Louis or Chicago) then you can accept a slot anywhere. If you can get into a top 10-15 residency slot, your job is going to be much worse than your mentors for years, and get used to people telling you to 'adjust your expectations'.

Now that the cat is officially out of the bag, the greedier PP groups are going to pump and dump us for a while, ala the mid to late 90s (ie: offer a 'partnership' track with low initial salary and 2-3 years of proving yourself, and at the end will either find a reason you did not meet the subjectively defined milestones in the contract or up the buy-in to 7 figures [and maybe even offer a higher interest loan from their own LLC to get you on the interest too!!]).

I love what I do- I have been pretty productive in my time, work hard, the people around me seem to be happy with what I have done and so have patients. And I hate every second that I chose this field- because I feel sold out, and because I know no matter how hard I work or even if I make a true advancement, I'm going to have less opportunity and be required to do more work simply because of when I was born and because everyone in the field had their head in the sand, either through passive ignorance that they should have any responsibility to those who come after them, or actively so they could profit off us.

Here's to all of us going into the labor force bloodbath of the next 10 years (and likely beyond... I'm sure there will be more expansion before it gets better).
 
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Thank you for posting this and thank you to the authors, who were honest enough to actually spell out the fact that the shortsightedness of our field has made sure a generation of physicians will be taken advantage of in the labor market. It is an excellent article, both more eloquent and in some ways more fatalistic than even my own take on things.

Downside on how they pass the buck... maybe they did float the idea of controlling residency slots (they being SCAROP) and hence the antitrust concern arose from them. I find it hard to believe there are anti trust concerns at this time; the projected over supply was published months back, and now people are finally admitting its true. How can be it anti-competitive for a professional society, which uses government money for trainee expenses (not uniformly but medicare pays for many of our slots) to say that we have too many and that this should be restricted? Is everyone so ignorant of the power to insurance companies now? To have a lack of supply dictate prices is completely unimaginable now with the built in work force.

In any event, here is my take;
If you are just thinking of joining this field now, or if you are 2nd-3rd year MS, and you cannot reasonably get into a top 10-15 institution in residency, do not apply.* The caveat being if you have absolutely no care in the world where you end up, or like rural areas (rural does not equal suburb or extended suburbs, rural equals collection hospitals or midwest locations far from St. Louis or Chicago) then you can accept a slot anywhere. If you can get into a top 10-15 residency slot, your job is going to be much worse than your mentors for years, and get used to people telling you to 'adjust your expectations'.

Now that the cat is officially out of the bag, the greedier PP groups are going to pump and dump us for a while, ala the mid to late 90s (ie: offer a 'partnership' track with low initial salary and 2-3 years of proving yourself, and at the end will either find a reason you did not meet the subjectively defined milestones in the contract or up the buy-in to 7 figures [and maybe even offer a higher interest loan from their own LLC to get you on the interest too!!]).

I love what I do- I have been pretty productive in my time, work hard, the people around me seem to be happy with what I have done and so have patients. And I hate every second that I chose this field- because I feel sold out, and because I know no matter how hard I work or even if I make a true advancement, I'm going to have less opportunity and be required to do more work simply because of when I was born and because everyone in the field had their head in the sand, either through passive ignorance that they should have any responsibility to those who come after them, or actively so they could profit off us.

Here's to all of us going into the labor force bloodbath of the next 10 years (and likely beyond... I'm sure there will be more expansion before it gets better).

MSIII here, I've been interested in Radonc since starting Med school and in a perfect world it would easily be my top choice specialty. That being said, location is somewhat important to my family and I and the job market has been a major thorn in my side in this decision. (Not on the coast, but the area is still competitive). Of necessity I've been considering other specialties but would be open to suggestions lol (radiology might be a second choice as of right now...). Anyway, my question is what are the top 10-15 residencies considered to be now generally? I've seen other threads on it but they seemed a little dated? And what in general is required to place those positions? I suspect high board scores of course as well as stellar letters and research but anything in specific that would make or break the possibility of going to these programs?


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MSIII here, I've been interested in Radonc since starting Med school and in a perfect world it would easily be my top choice specialty. That being said, location is somewhat important to my family and I and the job market has been a major thorn in my side in this decision. (Not on the coast, but the area is still competitive). Of necessity I've been considering other specialties but would be open to suggestions lol (radiology might be a second choice as of right now...). Anyway, my question is what are the top 10-15 residencies considered to be now generally? I've seen other threads on it but they seemed a little dated? And what in general is required to place those positions? I suspect high board scores of course as well as stellar letters and research but anything in specific that would make or break the possibility of going to these programs?


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10-15 is very subjective. The big 3 are MSKCC / MGH / MDACC (in no order)
From there take your pick, but its essentially a bigger name place in a metropolitan area (Uchicago, Upenn, Stanford).
Be aware its not simply having the name will get you a job - its generally the opportunities to either be productive in meaningful research, make contacts, or rely on a robust and respected alumni network. If you have a geographic area see how many programs are close and if there is clearly a dominant one.

I post a lot of things online, and you can tell from my posts I am quite emotional / angry about this, so take mine with a grain of salt. But unless your location is expansive or you are a stellar applicant (read: caveat good resume with meaningful research WITH a strong research mentor who will vouch for you / help provide mentoring in future) then you should look to another field. If you are an MSIII you are 6 years away from applying to jobs in a field that is oversupplied, increased residency spots by ~50% in spite of this, and continues to expand today with diminishing reimbursement and less physical demands than other specialties which allows people to practice drastically longer. To expect employment opportunities to be good at that time is lunacy barring a dramatic change.

In other words, there are enough objective data points outside my emotion that unless you you have ZERO geographic limitations, the chances of you finding a decent job when you will be graduating are abysmally low.
 
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10-15 is very subjective. The big 3 are MSKCC / MGH / MDACC (in no order)
From there take your pick, but its essentially a bigger name place in a metropolitan area (Uchicago, Upenn, Stanford).
Be aware its not simply having the name will get you a job - its generally the opportunities to either be productive in meaningful research, make contacts, or rely on a robust and respected alumni network. If you have a geographic area see how many programs are close and if there is clearly a dominant one.

I post a lot of things online, and you can tell from my posts I am quite emotional / angry about this, so take mine with a grain of salt. But unless your location is expansive or you are a stellar applicant (read: caveat good resume with meaningful research WITH a strong research mentor who will vouch for you / help provide mentoring in future) then you should look to another field. If you are an MSIII you are 6 years away from applying to jobs in a field that is oversupplied, increased residency spots by ~50% in spite of this, and continues to expand today with diminishing reimbursement and less physical demands than other specialties which allows people to practice drastically longer. To expect employment opportunities to be good at that time is lunacy barring a dramatic change.

In other words, there are enough objective data points outside my emotion that unless you you have ZERO geographic limitations, the chances of you finding a decent job when you will be graduating are abysmally low.

Thanks for the reply and I appreciate the insight! It's really a shame, none of the other fields have the same draw to me...but what can you do I suppose. Time to go specialty exploring :/


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10-15 is very subjective. The big 3 are MSKCC / MGH / MDACC (in no order)
From there take your pick, but its essentially a bigger name place in a metropolitan area (Uchicago, Upenn, Stanford).
Be aware its not simply having the name will get you a job - its generally the opportunities to either be productive in meaningful research, make contacts, or rely on a robust and respected alumni network. If you have a geographic area see how many programs are close and if there is clearly a dominant one.

I post a lot of things online, and you can tell from my posts I am quite emotional / angry about this, so take mine with a grain of salt. But unless your location is expansive or you are a stellar applicant (read: caveat good resume with meaningful research WITH a strong research mentor who will vouch for you / help provide mentoring in future) then you should look to another field. If you are an MSIII you are 6 years away from applying to jobs in a field that is oversupplied, increased residency spots by ~50% in spite of this, and continues to expand today with diminishing reimbursement and less physical demands than other specialties which allows people to practice drastically longer. To expect employment opportunities to be good at that time is lunacy barring a dramatic change.

In other words, there are enough objective data points outside my emotion that unless you you have ZERO geographic limitations, the chances of you finding a decent job when you will be graduating are abysmally low.

Agree that the subjective ranking list hasn't changed much. Big 3 then some combo of Penn, Stanford, UCSF, etc.


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I'm unclear that this top 10-15 thing is particularly meaningful in the job hunt. I think regional bias is generally more meaningful. That is, you've got a good shot at staying wherever you did residency or that area. But, SDN is pretty obsessed with rankings, so carry on.
 
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I'm unclear that this top 10-15 thing is particularly meaningful in the job hunt. I think regional bias is generally more meaningful. That is, you've got a good shot at staying wherever you did residency or that area. But, SDN is pretty obsessed with rankings, so carry on.

This is maybe the 3rd or 4th best post of the thread.
 
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are you suggesting that only "top 15" get good jobs?, because that certainly isn't true at all. I know multiple people who got good jobs in cities and did not graduate from a "top 15".
 
Original OP here and wow, thank you to all for the candid responses. I'm an M1 and like the m3 who commented, no other speciality really had the draw for me as much as rad onc did. It's a shame that it's taking the path it is now but I suppose this is just a fact of life, out with the old and in with the new.
 
To those residents and attendings who've commented, if you had a chance to do things over, what speciality would you have considered besides Rad Onc? I assume rad onc attracts a certain kind of student (research oriented -read: academic, passionate about cancer care --> also compassionate) and feel that your perspective would overlap with mine.
 
Heme Onc, ENT, Urology. I imagine most of us wanted to be "cancer doctors" first, and radiation oncologists second, so we were drawn to specialties that involved us being "cancer doctors"
 
I probably would have gone into either diagnostic radiology, IM (med onc fellowship), Optho or PMR. No real clear 2nd specialty choice though since I was going to go all in for radiation oncology.
 
Heme/Onc or Urology, but after being in rad onc, those would be distant 2nd/3rd choices. Most people who go into rad onc don't regret their choice in terms of preferring the specialty, the issues are other things like job market/geography etc.

I've never liked neurology personally, a lot of diagnostics, not as much intervention. In Rad Onc, whether it's curative or palliative, we intervene to make a patient's problem better or go away.
 
onc related: urology onc, ENT onc, surg onc, med onc (I did not enjoy internal medicine, so that would be a last resort)
non-onc related but satisfying: anesthesia, PMR, psychiatry, diagnostic rads
You would have to shoot me before i do it: OBGYN, neurology.
 
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