Radiation Oncology FAQ

Gfunk6 said:

OBSERVATION #2: Use a diverse, multi-pronged approach in your job search. I wrote down academic places I would like to work and sent my CV and cover letter to the Chair. I got a 90% response rate (both positive and negative) from doing this. I also spoke to residents/attendings in areas I was applying to private jobs and sent my CV and cover letter to the managing partner or deparment head. Also, I made liberal use of head hunting firms. This was not particularly high-yield, but I figured what the hell since it was free. Finally, the ASTRO job center is quite good and user-friendly. I checked it daily.

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Gfunk6 said:

Affability, availability, ability

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Gfunk6 said:

Okay, the title of this thread is a little over the top, I'll admit.

However, this thread is officially #2,000 in this forum, so I thought I would make it something special.

My job search officially concluded last week and I couldn't be happier with the outcome. The journey, however, has been long and difficult and I thought it would be worth sharing with all of you. Please keep in mind that this post represents a single person's experience and should be taken with a healthy dose of skepticism and a critical eye. Hopefully, others will add to this thread which will increase utility.

OK, here goes . . .

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One of my main recommendations to senior residents is to clearly establish what type of job you want. A problem I encountered was I had no freaking idea what I wanted to do. Honestly, some days I felt like doing a 2 year lab research-based post-doc and others going into a partnership-track private group. Because of this indecision, I ended up interviewing at a broad range of practice settings from the top academic centers to private groups to physician-employee hospital positions.

This breath of experience leads me to my first observation,

OBSERVATION #1: It is not terribly useful to simply divide jobs into academics vs private practice because there is so much more to each job than a simple "label." Therefore, it is better to make a list of things that you enjoy about the field and try to identify the job which will give you most of them.

For instance, here was my list:

1. I enjoyed the academic environment - working with trainees, discussing complex cases in a multi-disciplinary setting, and having colleagues well-versed in the literature.

2. I did not like the academic grind - constantly working on publishing the next paper, writing the next grant, sitting on another committee all while seeing a ton of patients.

3. I wanted to practice in an ethical manner - no gratuitously increasing the # of fractions for financial gain (and no pressure to do so), the freedom to r/c against XRT in borderline cases, and the freedom to choose the most appropriate modality (not just IMRT by default)

4. I wanted to work in a merit-based environment - if an employee was incompetent or was otherwise a poor-fit, I wanted to be able to fire them; I didn't want to keep poor workers just because of union rules or seniority; note this includes radiation oncologists

5. I had specific geographic restrictions and an order of preference between them

6. I wanted to benefit financially from my work - if I am going to work like a dog, then I want a cut of the profits or fair compensation from it

7. If possible, I wanted the majority of my work to be in SRS, SBRT, and Neuro-Oncology

As you can see, there a number of practice types that could fit into the above model including clinical academic positions and certain private groups or hospital physician-employed jobs.

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I started my job search early. I put together my CV in February of my PGY-4 year and started sending out cover letters and applications in April. For the most part, it was low yield to start this early as very few places are able to predict their employment needs 15 months in advance. Nevertheless, I had a few hits and went on a few early interviews. Starting in about late August or so, things began to escalate and things picked up. In the week before ASTRO, there was another burst of activity and by early December things died down again.

With that said, here is my second observation,

OBSERVATION #2: Use a diverse, multi-pronged approach in your job search. I wrote down academic places I would like to work and sent my CV and cover letter to the Chair. I got a 90% response rate (both positive and negative) from doing this. I also spoke to residents/attendings in areas I was applying to private jobs and sent my CV and cover letter to the managing partner or deparment head. Also, I made liberal use of head hunting firms. This was not particularly high-yield, but I figured what the hell since it was free. Finally, the ASTRO job center is quite good and user-friendly. I checked it daily.

Many of the best places that offered me an interview did not advertise. The Chairs/Partners at those places told me that great applicants are always breaking down their door for a position, so why would they bother to advertise? Some of these places tend to be very elitist (e.g. they don't consider applicants from non-top programs). Still, I would apply everywhere because the worst you'll get is a politely worded rejection.

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Even if you are totally confident what type of position you want, I strongly encourage you to apply to at least one or two other practice types. For instance, even if you are 100% certain you will be a physician scientist, why not apply to a few private groups just to see what you are turning down? Even if nothing comes from it, you can at least be certain you considered alternatives.

OBSERVATION #3: Apply to at least a couple of positions which sound interesting, but you would not consider otherwise. You will learn something.

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Med students and residents always want to know about salary. Ironically, I found such conversations counter-productive. No matter how much you are paid, you will not be happy in a practice that doesn't suit you. However, if you find a dream position, salary might be a deal breaker so you should know what you're worth and what the regional salaries are. Also, new grads generally don't have much leeway when negotiating salaries.

OBSERVATION #4: Have some idea of what salaries to expect for the job you want. That way, you can gloss over salary until negotiation time.

For academic positions (clinical or physician-scientist) starting salaries are generally in the range of $220K - $250K for assistant professors. Anecdotally, I've heard that some places (notably MDACC and MSKCC) offer $300K+. Obviously, though, people don't go to these places for the money though it is a nice bonus.

If you are in a partnership track for a private group, the salary range is a bit wider than for academics. I've seen $200K - $300K. These salaries are largely a function of regional variance. You will get paid much higher living in Idaho than San Diego. For three year partnership tracks, your salary usually goes up $25K per year. The national mean for partnership revenue per person is $450k for multi-specialty groups and $650K for Rad Onc only groups.

If you accept a physician-employed position then your starting salary will be higher than the above. At a minimum it will be $300K and I've seen as high as $410K. However, this is a salary and they will not let you touch technical fees. Generally, some incentives are built in for productivity but your salary will not usually be as high as partners in private groups.

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