A quick Question About Job Locations

[LightHouse123]

So in terms of the job market for Rad Onc, I already understand there is stiff competition in desirable locations such as SF, LA, San Diego, Miami etc.

However, could someone help me understand if the job market is tightening everywhere?
Let's say Utah for instance...or even North Carolina...or Virginia...or Colorado.

Do those places listed above have wide open opportunities or is the job market moderate to tight everywhere right now (2013)?

(I am not talking about very rural areas. Obviously those ones are almost always open(maybe?). I am referring more to the middle tier of locations---not Chicago (high tier)...but not a rural Montana hamlet either(lower tier)

Thanks!

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[Neuronix]

Based on your posts, you appear to be an MS2. It's way too early to worry about what the job market might look like in another 7 years when you'd be looking for a job. It may be considerably better or worse than it is now. Pick a specialty based on your interests.

 

[LightHouse123]

Neuronix,

Thanks for responding.

I agree with you that the market is fast changing. I just wish to know the current reality.

 

[Sheldor]

Based on your posts, you appear to be an MS2. It's way too early to worry about what the job market might look like in another 7 years when you'd be looking for a job. It may be considerably better or worse than it is now. Pick a specialty based on your interests.

While I agree with ones interests being the primary decider on specialty, I think it is short sighted to not consider location at all in the decision. I chose Rad Onc over other specialties knowing that I may not be able to choose the city, or state that I practice someday. For some, knowing they can't live near family, friends, beaches, etc may outweigh their love of the specialty causing them to do something else.

OP, I can't answer the question because I am just getting started down this road myself, but I can say that it is wise to go in with your eyes open. This is a unique specialty, and one of the things you have to give up to go into it is the certainty of landing a job in your dream city. That said, start early, network, get a residency near where you want to work and for many it works out wonderfully!

 

[Neuronix]

For some, knowing they can't live near family, friends, beaches, etc may outweigh their love of the specialty causing them to do something else.

There is little certainty of getting a job in a competitive location in any field in medicine. Competitive locations are always competitive. General IM and FP might be the only exceptions, but even then it can be tough to get exactly what you want.

If the question is whether you can get any job in Utah for instance...or even North Carolina...or Virginia...or Colorado... Yes. You can.

 

[Gfunk6]

Do those places listed above have wide open opportunities or is the job market moderate to tight everywhere right now (2013)?

In Radiation Oncology there is no such thing as a "wide open" job market except in rural areas. As the market becomes more saturated with trainees it will be harder to obtain a job in the "plum" areas. For instance, if you say that you are "looking for a job in North Carolina" it probably means living in a more cosmopolitan area of the state (Research Triangle or Winston-Salem) than in the middle of nowhere. Jobs in the former category will be harder to come by (not NYC/SF/LA/Miami hard, but still challenging).

There have been many threads on this topic but things you can do to help yourself are:

1. Rank residency programs near your area of interest for jobs
2. Stay in contact with the private/academic groups in your area of interest early
3. Consider doing locums work after residency which can help you transition into a full-time job

 

[LightHouse123]

Thanks for the feedback and advice. It is greatly appreciated.

 

[RadRadRad]

One additional thought. You don't just want a job. You want a good job. Radonc is small enough that there may be entire cities without any jobs I would consider good (for a variety of reasons). These are often the practices advertising for a new radonc. Point being you need to know details about the practices, not just whether they are hiring. These kind of details are hard to have knowledge of during med school.

 

[LightHouse123]

While I agree with ones interests being the primary decider on specialty, I think it is short sighted to not consider location at all in the decision. I chose Rad Onc over other specialties knowing that I may not be able to choose the city, or state that I practice someday. For some, knowing they can't live near family, friends, beaches, etc may outweigh their love of the specialty causing them to do something else.

OP, I can't answer the question because I am just getting started down this road myself, but I can say that it is wise to go in with your eyes open. This is a unique specialty, and one of the things you have to give up to go into it is the certainty of landing a job in your dream city. That said, start early, network, get a residency near where you want to work and for many it works out wonderfully!

Thanks for your comment Sheldor.

I agree with you 100%.

In the book, 7 Habits of Highly Effective People...one of the habits is "Start with the End in Mind." I feel sometimes that on Sdn the philosophy is "find the specialty you love and let the chips fall where they may." That unfortunately, doesn't work for everyone---especially those who believe in staying married till the end, and being an excellent father as well as being a physician.

What you love matters...for sure. But, it should also be in harmony to the vision you have of your future...where you want to live(close to important family members)...etc And although the job market fluctuates...its good to understand the general pattern (if there is one) early on.

Again, thanks Sheldor for your comments. Very wise!

 

[LightHouse123]

.

 

[LightHouse123]

One additional thought. You don't just want a job. You want a good job. Radonc is small enough that there may be entire cities without any jobs I would consider good (for a variety of reasons). These are often the practices advertising for a new radonc. Point being you need to know details about the practices, not just whether they are hiring. These kind of details are hard to have knowledge of during med school.

In Radiation Oncology there is no such thing as a "wide open" job market except in rural areas. As the market becomes more saturated with trainees it will be harder to obtain a job in the "plum" areas. For instance, if you say that you are "looking for a job in North Carolina" it probably means living in a more cosmopolitan area of the state (Research Triangle or Winston-Salem) than in the middle of nowhere. Jobs in the former category will be harder to come by (not NYC/SF/LA/Miami hard, but still challenging).

There have been many threads on this topic but things you can do to help yourself are:

1. Rank residency programs near your area of interest for jobs
2. Stay in contact with the private/academic groups in your area of interest early
3. Consider doing locums work after residency which can help you transition into a full-time job

Gfunk and RadRadRad,

I have an epiphany!

Since Rad Onc is such a small field with job sites not multiplying outrageously by the day, what is we started a thread about Job Locations in Different States in a manner similar to the "Interview Impressions Thread."

People can submit information anonymously to Gfunk about the job atmosphere in those locations (equipments used, job availability, high frequency disease types treated, average salaries(maybe), desirability of the area, etc)

What do you all think?

Info could trickle in slowly over time and provide a fantastic database for understanding the often obscure rad onc job market!

 

[medgator]

Gfunk and RadRadRad,

I have an epiphany!

Since Rad Onc is such a small field with job sites not multiplying outrageously by the day, what is we started a thread about Job Locations in Different States in a manner similar to the "Interview Impressions Thread."

People can submit information anonymously to Gfunk about the job atmosphere in those locations (equipments used, job availability, high frequency disease types treated, average salaries(maybe), desirability of the area, etc)

What do you all think?

Info could trickle in slowly over time and provide a fantastic database for understanding the often obscure rad onc job market!

Unfortunately, I think the job market is much more fluid than training programs

 

[Neuronix]

those who believe in staying married till the end, and being an excellent father as well as being a physician.

What you love matters...for sure. But, it should also be in harmony to the vision you have of your future...where you want to live(close to important family members)...etc And although the job market fluctuates...its good to understand the general pattern (if there is one) early on.

If location is most important to you, I would recommend FP or general/hospitalist IM. The job markets in those specialties are wide open and will likely continue to improve due to aging population and expansion of insurance coverage.

In radiation oncology the job market collapsed some years ago, and there were few jobs with graduates taking fellowships and whatever else they could find. This could well happen again in the next 5-10 years due to declining reimbursements and the growth in trainees. See: http://www.redjournal.org/article/S0360-3016(12)03897-7/abstract

 

[Gfunk6]

Gfunk and RadRadRad,

I have an epiphany!

Since Rad Onc is such a small field with job sites not multiplying outrageously by the day, what is we started a thread about Job Locations in Different States in a manner similar to the "Interview Impressions Thread."

People can submit information anonymously to Gfunk about the job atmosphere in those locations (equipments used, job availability, high frequency disease types treated, average salaries(maybe), desirability of the area, etc)

What do you all think?

Info could trickle in slowly over time and provide a fantastic database for understanding the often obscure rad onc job market!

While this sounds good in theory, there are several problems with doing this:

1. Reviewing academic Rad Onc programs is one thing - these programs tend to be larger, well-regarded, and between all the attendings, residents, and rotating medical students, anonymity is relatively assured. With smaller private groups these things tend not to be true, meaning that it would be easier to identify reviewers which is something many would prefer to avoid.

2. Salary is a function of regional variance, negotiation, and the skill set/credentials of the Rad Onc (RO) being hired. Therefore, it could be highly misleading to post salary information and, besides, many ROs sign non-disclosure agreements built into their contracts.

3. What types of cases a practice sees is similarly sensitive information. For instance, if a practice is on its last legs they may see a disproportionately high number of a palliative cases. In an attempt to recoup revenue, these patients may have received inappropriate fractionation (e.g. > 10-15 fractions for routine bone mets).

4. Desirability is clearly in the eye of the beholder. If you are just talking about what the 'majority' views as desirable, I think that is fairly obvious.

All in all, Dr. Terry Wall's annual presentation during the ARRO program prior to the ASTRO annual meeting is your best bet for obtaining this type of sensitive information. I attended three years in a row and found it to be invaluable. More recently, ARRO has started bringing in a panel of newly minted attendings in private practice & academics. You can ask them quite specific questions (though some are better done in private) and network.

Finally, graduated residents are your best resource. When I was in the midst of the job hunt, I heavily leaned on several graduating residents. We had very frank and sensitive conversations about contracts, salary, reputations of certain groups, etc. Since I've graduated, I've held similar sensitive conversations with PGY-4s and PGY-5s.

Therefore, I humbly submit that this forum is probably not the best venue for such information.

 

[Gfunk6]

If location is most important to you, I would recommend FP or general/hospitalist IM. The job markets in those specialties are wide open and will likely continue to improve due to aging population and expansion of insurance coverage.

While I've no doubt the job market is 'wider' for IM/FM than Rad Onc, it is all relative. If you really want to get into a 'desirable' area, even primary care can be difficult to break into.

 

[smq123]

While I've no doubt the job market is 'wider' for IM/FM than Rad Onc, it is all relative. If you really want to get into a 'desirable' area, even primary care can be difficult to break into.

I think that that's overstating it a little. Sure, you may not be able to get the fancy Park Avenue job in Manhattan, at the exact salary you want, with the exact number of hours you want, with the exact partnership track you want. But will you be able to find a decent job in the NYC area as a primary care physician? Yes, absolutely. Same goes for all major cities - Chicago, Boston, Philly, DC, LA, Miami, San Francisco.

I don't think it's relative at all. If you're in primary care, if you have your eye set on a particular part of the country, chances are extremely high that you'll find something decent. My impression is that you can't say anything even remotely close about rad onc.

 

[napoleondynamite]

As an aside, Utah is actually an extremely competitive market, every bit along the lines of the big cities mentioned. Just FYI since it was mentioned above as a lesser-competetive market and I know several people who tried unsuccessfully to get a job there.

 

[medgator]

As an aside, Utah is actually an extremely competitive market, every bit along the lines of the big cities mentioned. Just FYI since it was mentioned above as a lesser-competetive market and I know several people who tried unsuccessfully to get a job there.

A big problem with Utah is the relative lack of tobacco use in the population, and the fact that the population skews younger. Even though it's a growth state, that doesn't help if you're a rad onc as much as it might help if you are doing peds

 

[deleted4401]

When I was applying there was lit-ruh-ly 3 jobs available in the DC area (I'm talking 35 mile radius, including northern Virginia and Maryland). 3 more opened up my first year in practice, though one was in Annapolis and the other closer to Baltimore. This is the problem with the big cities. In a given year, there may be 3-5 jobs in Chicago. Or none. What if you hate the guy you interview with or they don't have any SRS or give 40 Gy in 20 to a femur met? This ain't primary care. It's tough, and the market is tight. I am an optimist and think it will get better. 5 to 10 years from now, many of the people that feel entitled to 750k a year will be retired, lifestyle practices will be more vogue (earn 350k, with a 4 to 4.5 day work week and lots of vaca), and it will normalize. Too many of the docs were used to an escalated compensation structure and that's why it is tight. They still want theirs. I don't blame them. Easier to adjust from lower end (residency) then from the other end.

Although, I do disagree with esteemed moderator. I think an anonymous thread for this information would be very valuable, for those that want to contribute. Some will, some won't - there was a similar post a few years ago with a smattering of responses. Information is good. The asymmetry that exists between the applicant and the employer are being exploited at times. On the other hand, sometimes the employer doesn't know what to offer and it could offer a benefit to them, too. A practice that turned me down was ready to hire someone and asked me what was the going rate and what they should offer the graduate.

 

[Gfunk6]

Although, I do disagree with esteemed moderator. I think an anonymous thread for this information would be very valuable, for those that want to contribute. Some will, some won't - there was a similar post a few years ago with a smattering of responses. Information is good. The asymmetry that exists between the applicant and the employer are being exploited at times.

If you want to start the ball rolling, I will contribute.

 

[Cancerdancer]

On the flip side, I think a forum like this would have potential to have some negative impact on job seekers. I would think private groups might be a bit more hesitant to 'show their hand' to future applicants if they knew there was a likelihood that details would be shared in any kind of public forum. This interaction is different than between the residency/med student applicant where things are out in the open in a sanctioned format, and I'm not sure that comparing notes on an internet forum will be looked at kindly...

 

[deleted4401]

Good point. People are definitely strange about it.

It's strange how funny people are about money in the US, when it is obviously such a big deal. In India and in the country in western Europe I lived in, people were so frank about how much they made, there was no embarrassment or hemming and hawing. Here at these interviews, its like this big no-no to talk about, when it is one of the primary factors in how you select a job. But all this stuff has to go down, 2 interviews, the dog and pony show with the realtor, the thank you letters, and finally the big tell.

I interviewed with this group in Chicago and he said how much they'd offer in the first 5 minutes. Made the rest of the interview so much simpler. Just focused on non-money stuff.

 

[OTN]

Colorado and Utah are very, very difficult job markets. When I was coming out of residency I tried very hard to find a job in CO. None were available.

 

[LightHouse123]

Colorado and Utah are very, very difficult job markets. When I was coming out of residency I tried very hard to find a job in CO. None were available.

So, which states are generally NOT considered to be "very, very difficult job markets?"

I think I will be happy anywhere in the western US:
Idaho
Utah
California
Nevada
New Mexico
Arizona
Washington
Oregon

And maybe even:
Wyoming
Texas
Virginia
NC

Could you comment on the Western States situation?

 

[medgator]

So, which states are generally NOT considered to be "very, very difficult job markets?"

I think I will be happy anywhere in the western US:
Idaho
Utah
California
Nevada
New Mexico
Arizona
Washington
Oregon

And maybe even:
Wyoming
Texas
Virginia
NC

Could you comment on the Western States situation?

Wyoming, Texas, Arizona, Virginia have seen pretty decent job postings from what I can tell, also more "rural" areas of California, Washington and Oregon

 

[Reaganite]

So, which states are generally NOT considered to be "very, very difficult job markets?"

I think I will be happy anywhere in the western US:
Idaho
Utah
California
Nevada
New Mexico
Arizona
Washington
Oregon

And maybe even:
Wyoming
Texas
Virginia
NC

Could you comment on the Western States situation?

Good California locations...better know somebody or be a grad of a local residency program. Otherwise, almost impenetrable these days. Contrary to what people think, though, there are actually a reasonable number of cali radonc jobs in desirable areas, but they are rarely advertised and are usually filled by a friend or friend of a friend.

 

[OTN]

So, which states are generally NOT considered to be "very, very difficult job markets?"

I think I will be happy anywhere in the western US:
Idaho
Utah
California
Nevada
New Mexico
Arizona
Washington
Oregon

And maybe even:
Wyoming
Texas
Virginia
NC

Could you comment on the Western States situation?

Idaho would be possible, Utah tough, California next to impossible, Nevada no problem, parts of New Mexico would be possible, Arizona always has jobs, rural Washington would be fine, Oregon is very hit and miss, Wyoming will be tough, just because of such a small population, Texas is a huge state so there will be jobs somewhere. I see jobs pop up in NC from time to time, but can't comment on Virginia.

 

[Gfunk6]

The problem with many West coast states (though Nevada and Arizona are exceptions) is that people generally want to go to one or two major metropolitan areas in each state. However, many positions that are publicly advertised are in the boonies. Therefore, while you may technically live in a state you want, it may be far from your actual desired locale.

 

[JustAdocInBox]

Does anyone have any insight on job availability in the Southeast? Are jobs in metropolitan regions still more difficult to come by? Also, in general, if one has a strong preference to end up in a given metropolitan region due to family ties, how important is it to try to match into a program in that region?

Thanks

 

[napoleondynamite]

FROG is a very good private group and seems to be hiring about every year in Florida. I interviewed with them and was impressed by their operation. They are all over Florida and I hear are expanding..I think to NYC.

 

[ziggyzhao]

In 2013, are there differences in job placement possibilities appreciated among the top-10 programs?

In other words, does the average resident from HROP entertain more offers than the average UCSF resident?

Does the UCSF resident receive more west coast offers and the HROP resident more east coast offers assuming they applied to an equal number of places on each coast? Does the answer depend on whether an academic vs private practice job is desired?

 

[Cancerdancer]

It's not like you just send out an application saying "Harvard" or "UCSF" on it and then places beg you to join them and you 'entertain' offers. Finding a job is work, you have to convey (and have) legitimate interest, interview well (usually x 2), and continue to convey interest for good jobs. As has been said many times, if you're interested in a job in a certain region, go to the best program you can in that region. Make good contacts, be a good person, a good doctor and you'll likely end up happy. If you go to a residency expecting to be able to 'entertain' multiple offers just by the name of your institution, you'll be disappointed.

 

[medgator]

In 2013, are there differences in job placement possibilities appreciated among the top-10 programs?

In other words, does the average resident from HROP entertain more offers than the average UCSF resident?

Does the UCSF resident receive more west coast offers and the HROP resident more east coast offers assuming they applied to an equal number of places on each coast? Does the answer depend on whether an academic vs private practice job is desired?

Depending on the practice,pedigree may be much less important than your personality and fit for the group. When you go to the arro talk at astro, you'll hear about the "3 A's" of private practice ( availability, affability and ability, with some joking that to be the order of importance)

A private group may not want your Harvard training if you're a jerk that annoys referrings