62 hour work week for Oncologists? Seems a bit excessive...

Started by randombetch
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It can be very hard to estimate average number of hours worked based by specialty; this number is highly dependent on the doc and practice.

That being said, If you thought oncology was a 45 hr/wk specialty, you are out of luck. Oncology patients are some of the most complicated in all of medicine and cancer is a very emotional disease. Following up labs, psychosocial needs of patients, dealing with cancer related medical issues and seeing complex patients in the hospital adds a lot of time to the normal clinic schedule.

Some groups use a hospitalist type of practice for all of their hospitalized patients which greatly reduces the clinical burden and reduces the number of hours worked on average. If you want to do oncology and have a reasonable lifestyle, look hard for a private practice job connected to only one hospital with a hospitalist type doc (be it either a internist or rotating oncologist) for the hospitalized patients, or do academics and don't let yourself become overwhelmed with research responsibilities. There is always pharma too, they always need oncologists and the lifestyle is usually pretty good.

These days, oncology is becoming more and more a primarily outpatient specialty, but when patients get hospitalized, they usually take a lot of time to deal with.

When I was in med school, I rotated at a private practice where the docs saw all of their own hospitalized patients and were connected with 2 differents hospitals. They would literally do a full clinic schedule and round at two hospitals every day, sometimes twice a day. They were making an ungodly amount of money and took every 5th week off, but they were definitely working 60-80 hrs/wk.
 
randombetch said:
If so, is there anything oncologists can do to lower the number of hours worked, or are these hours pretty set by the demands of the employer?
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It's the demands set by the sickness of the patients. These patients spend most of their time subacutely dying.

I figure if you find a large enough group, you can distribute enough of the call that it wouldn't seem too bad.

Look, man this is medicine. If you're looking for a less hourly kind of job, you'll have to look at other specialties. And I'm not saying this as a "tough guy" or someone who loves to work all the time, but I've come to terms with the time demands of my profession.
 
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jdh71 said:
It's the demands set by the sickness of the patients. These patients spend most of their time subacutely dying.
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And the remainder of their time is spent very acutely dying. Usually (and quite unfortunately, for them and for their providers) in the hospital.

If you want to work "bankers hours" as an oncologist, you need to do it in academics. Make sure there are house staff around 24/7 to do the bulk of the work for you (particularly the middle of the night stuff) and you can easily clock under 50h a week.

Just don't do BMT...for logistical reasons, they always seem to happen between 11p and 2a and, although it's basically as complicated to do as a blood transfusion, a physician is required to be at the bedside...and fellows don't count.
 
jdh71 said:
It's the demands set by the sickness of the patients. These patients spend most of their time subacutely dying.

I figure if you find a large enough group, you can distribute enough of the call that it wouldn't seem too bad.

Look, man this is medicine. If you're looking for a less hourly kind of job, you'll have to look at other specialties. And I'm not saying this as a "tough guy" or someone who loves to work all the time, but I've come to terms with the time demands of my profession.
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I'm glad somebody said it. I worked more than 62 hours/wk as a med student on most rotations, especially my advanced electives because this is what I want to do with my life. I keep seeing these types of posts on forums that express the desire to work as few hours as possible for the most amount money...then why consider medicine? Because if you're looking for easy hours and high pay, IM is not it.
 
Because people get tired, they get older, they get married, have families, etc. They realize they do not want to be all about work, all the time, for the rest of their lives. I don't disagree with you, though...if you want a super-cush lifestyle then IM isn't it, in general. I'd say the most cushy hours would be doing urgent care, endocrine, rheum or allergy/immuno. A sweet hospitalist gig (one with not too many hours nor too many admissions) might fit the bill, too. However, none of these except allergy/immuno private practice is likely to provide a high salary (I mean compared w/other medical specialties).
 
gutonc said:
Just don't do BMT...for logistical reasons, they always seem to happen between 11p and 2a and, although it's basically as complicated to do as a blood transfusion, a physician is required to be at the bedside...and fellows don't count.
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What hospital is it that requires a physician at bedside for the CD34 infusion? that is hilarious.
 
jdh71 said:
It's the demands set by the sickness of the patients. These patients spend most of their time subacutely dying.

I figure if you find a large enough group, you can distribute enough of the call that it wouldn't seem too bad.

Look, man this is medicine. If you're looking for a less hourly kind of job, you'll have to look at other specialties. And I'm not saying this as a "tough guy" or someone who loves to work all the time, but I've come to terms with the time demands of my profession.
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Radiation oncology, here I come!
 
I swear I hate it when premeds/med students/doctors complain about their work hours. I mean seriously, 60 hours is not bad compared to other careers that make as much. If you want to make 6 figures in business, go ahead and enjoy your 80 hour work week and lack of job security. Any big firm lawyer will be working at least 60 hours a week. In fact, medicine is the only field I can think of that you can possibly work 40 hours a week, and still make 100K. So man up, for the money you would be making, 60 hours is good
 
chrslbrt said:
I swear I hate it when premeds/med students/doctors complain about their work hours. I mean seriously, 60 hours is not bad compared to other careers that make as much. If you want to make 6 figures in business, go ahead and enjoy your 80 hour work week and lack of job security. Any big firm lawyer will be working at least 60 hours a week. In fact, medicine is the only field I can think of that you can possibly work 40 hours a week, and still make 100K. So man up, for the money you would be making, 60 hours is good
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"man up"? you already know you're a tough guy at your age?
 
jdh71 said:
good luck getting in
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Really? I feel like getting a Hem/Onc fellowship isn't that much easier. Hem/Onc: 270 out of 649 went unmatched (41.6%) as opposed to radiation oncology where only 21/155 went unmatched (13.5%). Of course, radiation oncology applicants have higher stats on average, but still...
 
randombetch said:
Really? I feel like getting a Hem/Onc fellowship isn't that much easier. Hem/Onc: 270 out of 649 went unmatched (41.6%) as opposed to radiation oncology where only 21/155 went unmatched (13.5%). Of course, radiation oncology applicants have higher stats on average, but still...
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Heme/Onc is WAY easier to get into. Your numbers are fairly meaningless in this context.
 
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randombetch said:
Want to explain why the match % is meaningless?
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Rad Onc is a residency program (1 Internship year + 4 years) whereas Hem/Onc is a fellowship you do after IM residency.

Rad Onc is as competitive as Radiology, Ortho, Plastics, Derm.
 
docbill said:
Rad Onc is a residency program (1 Internship year + 4 years) whereas Hem/Onc is a fellowship you do after IM residency.

Rad Onc is as competitive as Radiology, Ortho, Plastics, Derm.
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Yes, I know that. Actually, Plastic/Derm are slightly more competitive, and ortho is slightly less.

Are you implying that it's more competitive because the applicants are more self-selective since they won't have a fall-back specialty? I want to know why the 42% unmatched Hem/Onc vs 13.5% unmatched Rad-Onc is meaningless.
 
chrslbrt said:
I swear I hate it when premeds/med students/doctors complain about their work hours. I mean seriously, 60 hours is not bad compared to other careers that make as much. If you want to make 6 figures in business, go ahead and enjoy your 80 hour work week and lack of job security. Any big firm lawyer will be working at least 60 hours a week. In fact, medicine is the only field I can think of that you can possibly work 40 hours a week, and still make 100K. So man up, for the money you would be making, 60 hours is good
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thank you for commenting, premedical student. come back and talk after you've done any work. premed students should be banned from discussions like this.
 
chrslbrt said:
If you want to make 6 figures in business, go ahead and enjoy your 80 hour work week and lack of job security. Any big firm lawyer will be working at least 60 hours a week. In fact, medicine is the only field I can think of that you can possibly work 40 hours a week, and still make 100K. So man up, for the money you would be making, 60 hours is good
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I care more about the life-work balance than the $$$. I'd rather work 50 hrs a week and make $200k than work 62 hrs a week and make $300k, all else equal. I want to do oncology because it's the most appealing specialty to me.

Also, as others have mentioned, there are plenty of fields where you can work 40 hrs a week and make >100k - all of them are far less time consuming and debt-accruing than medicine. Engineering (if you have a management degree or a PhD), computer science (Microsoft, Google start at $100k), law (non-partner track), pharmacy, dentistry, etc.

And what gives you the right to criticize doctors for complaining about their work hours? Like you really know what it's like?
 
randombetch said:
Yes, I know that. Actually, Plastic/Derm are slightly more competitive, and ortho is slightly less.

Are you implying that it's more competitive because the applicants are more self-selective since they won't have a fall-back specialty? I want to know why the 42% unmatched Hem/Onc vs 13.5% unmatched Rad-Onc is meaningless.
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It is because it is self selective. Trust us when we say Rad Onc is much more competitive, we know. If you do get to the point where you actually have to make this decision, you will understand and also be considering a lot of other factors you can't even think of yet.
 
randombetch said:
Are you implying that it's more competitive because the applicants are more self-selective since they won't have a fall-back specialty? I want to know why the 42% unmatched Hem/Onc vs 13.5% unmatched Rad-Onc is meaningless.
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Basically, yes. There's the selection bias up-front (people with Step 1 scores of 215 and average grades just don't bother w/ Rad Onc) but also the fellowship selection bias that actually goes the other way.

Since, when you finish a residency, you can get a job, there's not really any reason to NOT apply for a fellowship if you're interested in one. If you get a spot, great, you get a spot. If not, you're a hospitalist/PCP and maybe you'll try again, or maybe not. This attracts a fair number of sub-par applicants as well as people who will suicide match (ranking only a single program) since there's always a back-up.

Anecdotally, I've seen what seems like a lot more re-applicants in fellowship compared to residency, simply because the stakes aren't as high. Both of these things will skew the "% un-matched" number making it not a useful/relevant comparison. If you only look at the applicants for Hem/Onc fellowships that have "Rad Onc Stats," my guess is that you'd see an unmatched percentage near 0.
 
Strength&Speed said:
thank you for commenting, premedical student. come back and talk after you've done any work. premed students should be banned from discussions like this.
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LOL:laugh: but keep in mind this thread was started by a premed student who's concerned about working too many hours...

With reference to Rad Onc, everyone I know that matched into that specialty walked on water academically...it's accomplishment to match period, yet alone match into a strong program. Matching into Rad Onc residency can't really compared to matching into Heme/Onc fellowship after IM residency statistically.
 
futureres said:
LOL:laugh: but keep in mind this thread was started by a premed student who's concerned about working too many hours...

With reference to Rad Onc, everyone I know that matched into that specialty walked on water academically...it's accomplishment to match period, yet alone match into a strong program. Matching into Rad Onc residency can't really compared to matching into Heme/Onc fellowship after IM residency statistically.
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Is there something wrong with not wanting to be a workaholic?

Guess I'll have to walk on water then if I want a cush specialty.
 
randombetch said:
Is there something wrong with not wanting to be a workaholic?

Guess I'll have to walk on water then if I want a cush specialty.
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No, you just have to pick your post-training practice setting appropriately.

Keep in mind that the numbers you referenced are averages. Assuming a normal distribution, this means there are plenty of folk working 40-50h a week and plenty working 70-80+h a week.

I know practicing oncologists who work 12-14h days 5-6 days a week (plus call) and I know others who work 3-4 days a week and only 2-3 weekends of inpatient coverage a year. The folks in the former group make 2-4x what the folks in the latter group do, but the ones in the latter group make more than enough money. So do whatever you want to do, you'll be able to find a job that fits your lifestyle desires.

Besides, you're not even in med school yet. Who knows what you'll end up doing. The best advice is to aim high so you're not limited by your numbers and then do whatever interests you. If you have 260s on the Steps and are AOA and you end up wanting to do Rad Onc, you'll be able to. Want to do Family Med with those scores? You can do that too.
 
gutonc said:
No, you just have to pick your post-training practice setting appropriately.

Keep in mind that the numbers you referenced are averages. Assuming a normal distribution, this means there are plenty of folk working 40-50h a week and plenty working 70-80+h a week.

I know practicing oncologists who work 12-14h days 5-6 days a week (plus call) and I know others who work 3-4 days a week and only 2-3 weekends of inpatient coverage a year. The folks in the former group make 2-4x what the folks in the latter group do, but the ones in the latter group make more than enough money. So do whatever you want to do, you'll be able to find a job that fits your lifestyle desires.

Besides, you're not even in med school yet. Who knows what you'll end up doing. The best advice is to aim high so you're not limited by your numbers and then do whatever interests you. If you have 260s on the Steps and are AOA and you end up wanting to do Rad Onc, you'll be able to. Want to do Family Med with those scores? You can do that too.
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Thanks for the advice!
 
Getting a rad/onc residency is orders of magnitude harder than getting a hem/onc fellowship. Hem/onc you do after IM residency (which is easy to get into, if you are a US medical grad). Rad/onc has a tiny number of spots for which you'd be competing with US med students who have top grades and board scores. To get into a hem/onc fellowship somewhere halfway decent from a decent internal med residency at a decent US academic teaching hospital is not generally that hard. If you want to go some place famous like Harvard then yes, it could be challenging to get in, but if you just want to get in somewhere, then not so much so. Right now cards, GI and maybe allergy/immunology are the only IM specialties where people have to worry much about not matching somewhere. A lot of the people who didn't match into hem/onc were either at some unknown community IM program and/or they were foreign medical grads.
 
There are simply a lot of Heme/Onc fellowships, every major program offers one; there's a lot of cancer out there. A clinical oncologist works hard for his money, and the never ending morbidity and mortality really gets to you.
 
dragonfly99 said:
Because people get tired, they get older, they get married, have families, etc. They realize they do not want to be all about work, all the time, for the rest of their lives. I don't disagree with you, though...if you want a super-cush lifestyle then IM isn't it, in general. I'd say the most cushy hours would be doing urgent care, endocrine, rheum or allergy/immuno. A sweet hospitalist gig (one with not too many hours nor too many admissions) might fit the bill, too. However, none of these except allergy/immuno private practice is likely to provide a high salary (I mean compared w/other medical specialties).
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I was under the impression allergists were pretty low on the totem pole, salary wise. I remember seeing numbers putting them at/below FP salaries. No offense, just curious.

chrslbrt said:
I swear I hate it when premeds/med students/doctors complain about their work hours. I mean seriously, 60 hours is not bad compared to other careers that make as much. If you want to make 6 figures in business, go ahead and enjoy your 80 hour work week and lack of job security. Any big firm lawyer will be working at least 60 hours a week. In fact, medicine is the only field I can think of that you can possibly work 40 hours a week, and still make 100K. So man up, for the money you would be making, 60 hours is good
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Says the guy accepted for UNDERGRAD for class of 2014? By the way, dentists work an average of 36 hours/week and average just under $200k/year. So...
 
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Let me start by apologizing if I offended anyone, that wasn't my intention. My intention was to tell you that medicine isn't the only field that works long hours. The outstanding majority of people don't make 100k. Last time I checked, 5% of the working population makes six figures or more. Now, let's set the record straight. The vast majority of people in that percentile work similar hours to doctors. The majority of them don't see six figures until their forty's, work the same amount of hours, can get laid off easily, and have the luck of the draw in terms of getting those jobs. There are many people who have the same qualifications who do the exact same job who never see six figures. You guys make it seem like 100K jobs get passed out like candy. Most of the "non-doctors" in that 5% work roughly the same hours, see that money at a later age, and have struggled to stand out with plenty of people with the exact same qualifications with alot of luck. If anyone here is too ignorant to agree with this, I'm sorry to bust your bubble. You can't pull my premedical status, because it doesnt require a college degree to realize this. When people start making 100K straight outta college working 40 hours a week rolling around with Mercedes Benz's, I'll agree with you. Until then, you can't complain.
 
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chrslbrt said:
Let me start by apologizing if I offended anyone, that wasn't my intention. My intention was to tell you that medicine isn't the only field that works long hours. The outstanding majority of people don't make 100k. Last time I checked, 5% of the working population makes six figures or more. Now, let's set the record straight. The vast majority of people in that percentile work similar hours to doctors. The majority of them don't see six figures until their forty's, work the same amount of hours, can get laid off easily, and have the luck of the draw in terms of getting those jobs. There are many people who have the same qualifications who do the exact same job who never see six figures. You guys make it seem like 100K jobs get passed out like candy. Most of the "non-doctors" in that 5% work roughly the same hours, see that money at a later age, and have struggled to stand out with plenty of people with the exact same qualifications with alot of luck. If anyone here is too ignorant to agree with this, I'm sorry to bust your bubble. You can't pull my premedical status, because it doesnt require a college degree to realize this. When people start making 100K straight outta college working 40 hours a week rolling around with Mercedes Benz's, I'll agree with you. Until then, you can't complain.
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You'd be a good spokesperson for slavery: "none of the other slaves are any better off than you, so until you see n*****s rolling around with Mercedes Benz's, get the hell back to work or you'll get another whipping."

First of all, I'd argue most doctors have better qualifications than most people in other fields. Secondly, doctors invest 7 to 11 years after college and go into hundreds of thousands in debt. As many people have already said, there are professions where you make just as much money and make it faster, and professions where you can make just as much money for fewer hours. Your entire argument of "other people work hard so you should want to work hard" just doesn't fly with me. Sure, only 15.8% (not 5% lol, where'd you get that number? Out of your ass?) of the working population makes >$100k, but there's no way that most of them work 62 hours a week on average or spent 10 years after college making negative money.
 
chrslbrt said:
Let me start by apologizing if I offended anyone, that wasn't my intention. My intention was to tell you that medicine isn't the only field that works long hours. The outstanding majority of people don't make 100k. Last time I checked, 5% of the working population makes six figures or more. Now, let's set the record straight. The vast majority of people in that percentile work similar hours to doctors. The majority of them don't see six figures until their forty's, work the same amount of hours, can get laid off easily, and have the luck of the draw in terms of getting those jobs. There are many people who have the same qualifications who do the exact same job who never see six figures. You guys make it seem like 100K jobs get passed out like candy. Most of the "non-doctors" in that 5% work roughly the same hours, see that money at a later age, and have struggled to stand out with plenty of people with the exact same qualifications with alot of luck. If anyone here is too ignorant to agree with this, I'm sorry to bust your bubble. You can't pull my premedical status, because it doesnt require a college degree to realize this. When people start making 100K straight outta college working 40 hours a week rolling around with Mercedes Benz's, I'll agree with you. Until then, you can't complain.
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You know, to get out of a hole you usually don't keep digging:idea:. Some advice: in the future if you're going to post outside of hSDN or pre-allo do it with the goal of learning something, not attempting to tell more experienced individuals what's what.
 
60 hours is 7a-7p M-F with a full weekend, and as someone nearing the end of his intern year, that actually sounds pretty sweet.

That being said, the high school kid has a point: people in *certain* other fields (i.e., business and law, not dentistry) would have to work similar hours for a similar period of time to enjoy the same salary as an established run-of-the-mill IM physician, and may have to continue working similar hours (to make partner, make deals happen, etc) after a physician is fully certified and can start to have a more normal schedule.

Bottom line is, you have to work hard until you prove you're worth the salary, so you might as well go into something you like.
 
Bumping this thread to see if these numbers still hold up. Does the average oncologist still work 62 hours per week to make the average salary? Or have hours per week decreased due to increased hospitalist usage/midlevels/increased emphasis on work life balance among the younger generation? Speaking anecdotally, I don't know a single oncologist working that much. Most I have talked to work 4 days a week and spend a few hours per week at home charting.

62 just seems very high, given that the most recent data for orthopedic surgery, a specialty known to have a poor lifestyle, was 52 hours per week.
 
TexasMed22 said:
Bumping this thread to see if these numbers still hold up. Does the average oncologist still work 62 hours per week to make the average salary? Or have hours per week decreased due to increased hospitalist usage/midlevels/increased emphasis on work life balance among the younger generation? Speaking anecdotally, I don't know a single oncologist working that much. Most I have talked to work 4 days a week and spend a few hours per week at home charting.

62 just seems very high, given that the most recent data for orthopedic surgery, a specialty known to have a poor lifestyle, was 52 hours per week.
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JFC I hope not. I work ~30 a week for a ~50th%ile job.
 
GutOnc in 2010: "If you want to work 'bankers hours' as an oncologist, you need to do it in academics. Make sure there are house staff around 24/7 to do the bulk of the work for you (particularly the middle of the night stuff) and you can easily clock under 50h a week."

GutOnc in 2020: "Dudes if you work more than 30 hours a week in my community job you done effed up"

The dude abides!
 
HemeOncHopeful19 said:
GutOnc in 2010: "If you want to work 'bankers hours' as an oncologist, you need to do it in academics. Make sure there are house staff around 24/7 to do the bulk of the work for you (particularly the middle of the night stuff) and you can easily clock under 50h a week."

GutOnc in 2020: "Dudes if you work more than 30 hours a week in my community job you done effed up"

The dude abides!
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Don't forget 2023 me: "Dudes, if you're not making >50th %ile comp for seeing 25th%ile volume, you're doing it wrong!"

But seriously, I'm hiring.

Also, 2010 me was a pretentious dickhead who didn't know s***. 2020 me was a pretentious dickhead with a lot of experience. 2023 me is a pretentious dickhead who burned out of hospital leadership, found a unicorn job and is now pretending all of the jobs out there are the same.
 
60 hours is a bit much. Probably the average hem onc in the community is at 45 hour to 50 hours, counting everything (rounding on weekends, reading, participation with professional orgs, teaching etc).

60 hours is sustainable for a period, and perhaps a unique person could do that for a whole career. For most of us, the combination of the monotony of most cases and the occasional toxic patient/family is such that your concentration (and life force) will fade after about hour 50.
 
Ubba said:
The wheel is turning. On the Rad Onc forum, many are (begrudgingly) admitting that demand is higher than ever. Offers improving, etc. Expect to see Rad Onc competitiveness bump up in a few years.
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Dunno about this. A lot of cancer care is favoring systemic therapy (immuno/targeted > chemo) over surgery or radiation. Look at the neoadjuvant and adjuvant studies for early stage lung cancer. 10 years ago, it would have surgery->obs. Also, PROSPECT trial for locally advanced rectal cancer trying to take out radiation altogether.

I think over time, there'll be more systemic therapies (ie need for med oncs) and fewer and fewer indications for surgery/radiation.
 
osprey099 said:
Dunno about this. A lot of cancer care is favoring systemic therapy (immuno/targeted > chemo) over surgery or radiation. Look at the neoadjuvant and adjuvant studies for early stage lung cancer. 10 years ago, it would have surgery->obs. Also, PROSPECT trial for locally advanced rectal cancer trying to take out radiation altogether.

I think over time, there'll be more systemic therapies (ie need for med oncs) and fewer and fewer indications for surgery/radiation.
Click to expand...

You may be more optimistic than I about the future population at large's fitness for systemic therapy and/or surgery.
 
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Ubba said:
The wheel is turning. On the Rad Onc forum, many are (begrudgingly) admitting that demand is higher than ever. Offers improving, etc. Expect to see Rad Onc competitiveness bump up in a few years.
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As I have (unpopularly) pointed out in their forum, I am still waiting for the MGMA survey that shows median Heme/Onc higher than median Rad Onc for any region… still have yet to see it but I probably don’t have the latest data.

They definitely have less choice these days in location where they end up, though.
 
Ubba said:
You may be more optimistic than I about the future population at large's fitness for systemic therapy and/or surgery.
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Immunotherapy is generally super well tolerated. I give it to ECOG 3s without blinking an eye. Radiation on the other hand, not so much. Unless we talking protons but even then, tons of side effects
 
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