Ask an Radiation Oncologist Anything

[oncologydude2]

In the spirit of similar threads, I thought I would provide a useful service to SDN pre-meds.

Background:
Age: Early 40s
Practicing Oncologist in a Physician owned and operated group
20% Administrative + 80% Clinical

Would be happy to answer questions.

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[samsunimomo]

Do you get to cultivate long-term patient relationships?
Considering that you are in a private practice, how much "unnecessary" care goes on in oncology?

 

[carnivalnorth]

How many hours per week do you work?

 

[Dr. Retractor]

Do you consider your work "exciting"? What drew you to the field?

 

[oncologydude2]

Do you get to cultivate long-term patient relationships?
Considering that you are in a private practice, how much "unnecessary" care goes on in oncology?

Yes, definitely have very long term relationships with my patients, sometimes spanning years.

Not sure what you mean by unnecessary care.

 

[oncologydude2]

How many hours per week do you work?

About 55-60 on most weeks

 

[samsunimomo]

Yes, definitely have very long term relationships with my patients, sometimes spanning years.

Not sure what you mean by unnecessary care.

I mean over-treatment and unnecessary tests, and this question is more toward the nature of private practice than the field of oncology itself.

 

[oncologydude2]

Do you consider your work "exciting"? What drew you to the field?

I love it! Unlike chronic diseases like diabetes, hypertension, etc., cancer engages the patient in a very different way. They are more knowledgeable and motivated.

I originally came from the research end. I worked as an intern in a Pharma company during undergrad which prompted me to go for MD PhD.

 

[oncologydude2]

I mean over-treatment and unnecessary tests, and this question is more toward the nature of private practice than the field of oncology itself.

Our practice closely adheres to NCCN guidelines. This frequently gives a range of diagnostic/therapeutic options. As long as we are within that range, I am comfortable not calling anything unnecessary.

 

[soccerusa]

How often do you deal with patients passing away? How does that affect you personally and professionally?

How frequently do you get a patient who you are able to tell they are in remission?

Are you satisfied with your salary and lifestyle?

I really appreciate you doing this. These threads are both really helpful and interesting for those of us just starting the process.

 

[superpom_7]

At any point did you have any other specialties in mind? Or were you basically set on Oncology?

 

[oncologydude2]

How often do you deal with patients passing away? How does that affect you personally and professionally?

How frequently do you get a patient who you are able to tell they are in remission?

Are you satisfied with your salary and lifestyle?

I really appreciate you doing this. These threads are both really helpful and interesting for those of us just starting the process.

I have had so many patients die that it doesn't impact me anymore. However, I still can't shake it when young adults get terminal cancer. That can still hit hard.

About 60% of patients are in curative situations.

I am extremely satisfied with my salary and lifestyle. However there is always someone who earns more. You have to make peace with that.

 

[Hospitalized]

Was there a turning point during medical school that drove you to oncology? If so, what was it?

How many residency programs did you apply for?

 

[Dr. Retractor]

I love it! Unlike chronic diseases like diabetes, hypertension, etc., cancer engages the patient in a very different way. They are more knowledgeable and motivated.

I originally came from the research end. I worked as an intern in a Pharma company during undergrad which prompted me to go for MD PhD.

With an MD/PhD, what prompted you to go into private practice over academia?

 

[oncologydude2]

At any point did you have any other specialties in mind? Or were you basically set on Oncology?

I seriously considered Neurology, Psychiatry and Surgery though I always had my heart set on Oncology.

 

[oncologydude2]

Was there a turning point during medical school that drove you to oncology? If so, what was it?

How many residency programs did you apply for?

I was always set on Oncology. However, after I completed my 3rd year of med school, I had effectively ruled out everything else. I liked Oncology from a research end but also because I could make an immediate impact on patient's lives.

I'm Rad Onc and I applied to every single program that was open that year.

 

[oncologydude2]

With an MD/PhD, what prompted you to go into private practice over academia?

Location, $$$, practice autonomy, disenchantment with basic research

 

[ShadyLane]

Did you start a family and did your career as an oncologist factor into that decision?

What's the worst part of your job?

 

[nemo123]

I was always set on Oncology. However, after I completed my 3rd year of med school, I had effectively ruled out everything else. I liked Oncology from a research end but also because I could make an immediate impact on patient's lives.

I'm Rad Onc and I applied to every single program that was open that year.

Wait are you a radiation oncologist or an oncologist?

Anyways, how involved are you in the palliative care of your patients/palliative care doctors?

 

[oncologydude2]

Did you start a family and did your career as an oncologist factor into that decision?

What's the worst part of your job?

Had my first kid in residency. Second kid a couple of years into my practice. Career didn't factor into timing as much as wanted to have kids while wife was still relatively young.

Worst part is fear of losing autonomy by being bought out by large healthcare system.

 

[oncologydude2]

Wait are you a radiation oncologist or an oncologist?

Anyways, how involved are you in the palliative care of your patients/palliative care doctors?

I'm an Oncologist first and a Radiation Oncologist second.

I'm very involved in palliative care. Our practice brought in palliative care MD and social worker. This is rare for private practice.

 

[karayaa]

Do you do hypofractionated therapy?
Are you hospital-based, or do you have your own center?
Where do your patients come from? Ie all referrals from primary care, or something else?

 

[ShadyLane]

Had my first kid in residency. Second kid a couple of years into my practice. Career didn't factor into timing as much as wanted to have kids while wife was still relatively young.

Worst part is fear of losing autonomy by being bought out by large healthcare system.

Thanks for answering!

 

[oncologydude2]

Do you do hypofractionated therapy?
Are you hospital-based, or do you have your own center?
Where do your patients come from? Ie all referrals from primary care, or something else?

I hypo-fractionate all the time - breast, prostate, you name it.

We have multiple centers with accelerators, chemo infusion, imaging, lab, etc. We are not hospital-based though we are affiliated with numerous nearby hospitals.

Referrals come from a variety of sources. Most of my referrals as a Rad Onc come from inside the practice (our own Med Oncs/Surgeons), through contracts we have with health systems, and also through surgeons outside our practice.

 

[AlteredScale]

Location, $$$, practice autonomy, disenchantment with basic research

Was this something that occurred because of the PhD track of your training?

 

[Make Or Break]

Alright, so I'm not going to beat around the bush here and I'm sure many others are curious as well. What is your pay? This is an AMA of course.

 

[oncologydude2]

Alright, so I'm not going to beat around the bush here and I'm sure many others are curious as well. What is your pay? This is an AMA of course.

North of $500k

 

[oncologydude2]

Was this something that occurred because of the PhD track of your training?

I only slightly burned out of basic research after my PhD. I completely burned out by the time I completed residency.

 

[Make Or Break]

North of $500k

Wow

 

[Lucca]

Thanks for doing this!

I'm curious as to what made you choose Radiation Oncology as opposed to the IM --> hematology/oncology fellowship route.

 

[FutureOncologist]

Can't be asked to see if these questions have been asked already. Currently in a naval rotation in medical school so I get little time to myself....

What do you think of PAS (Patient Assisted Suicide)? If a patient came up to you and said "I want to go through with this," would you go through with it (assume the patient fits all criteria for PAS)?

How competitive are programs, in general?

 

[oncologydude2]

Thanks for doing this!

I'm curious as to what made you choose Radiation Oncology as opposed to the IM --> hematology/oncology fellowship route.

I don't like internal medicine. An intern year was more than enough for me.

 

[oncologydude2]

Can't be asked to see if these questions have been asked already. Currently in a naval rotation in medical school so I get little time to myself....

What do you think of PAS (Patient Assisted Suicide)? If a patient came up to you and said "I want to go through with this," would you go through with it (assume the patient fits all criteria for PAS)?

How competitive are programs, in general?

I have mixed feelings on PAS. I think it should be available but should be used as a last resort if a patient has tremendous pain or distress. I've seen patients with a "terminal" diagnoses live for > 5 year with a good quality of life. I'd hate for such a person to commit suicide.

Programs are quite competitive but it is highly self selecting.

 

[justadream]

North of $500k

Do you expect this to change significantly in the next 10 years?

 

[Dr. Retractor]

North of $500k

How long have you been in practice?
Have you been with the same practice since you left residency?
Also, did you pursue a post-doc after your MD/PhD or during residency?
Do you get to do any sort of research (clinical or basic science or otherwise)?

 

[nemo123]

I'm an Oncologist first and a Radiation Oncologist second.

I'm very involved in palliative care. Our practice brought in palliative care MD and social worker. This is rare for private practice.

Thank you!

Because rad onc is a very literature/research based field, how much would you say you spend reading papers?

Also for procedures like brachytherapy, do you place radioactive seeds yourself or is there a tech who does that for you (also for simulating treatment like fluoroscopy)?

 

[oncologydude2]

Do you expect this to change significantly in the next 10 years?

Yes, it will probably go up a few more years followed by a slow, inexorable trend downwards. I don't see myself ever making less than $350k.

 

[oncologydude2]

How long have you been in practice?
Have you been with the same practice since you left residency?
Also, did you pursue a post-doc after your MD/PhD or during residency?
Do you get to do any sort of research (clinical or basic science or otherwise)?

< 5 years in practice. I've been with same group all this time. I didn't do a post doc though I was briefly tempted. I currently participate in clinical trials. If I really wanted to I could perform retrospective studies, but I don't want to.

 

[oncologydude2]

Thank you!

Because rad onc is a very literature/research based field, how much would you say you spend reading papers?

Also for procedures like brachytherapy, do you place radioactive seeds yourself or is there a tech who does that for you (also for simulating treatment like fluoroscopy)?

I spend maybe 15-30 minutes each weekday reviewing literature. For brachy, we do it in conjunction with a Urologist. However, if push comes to shove we can do the entire procedure solo except for the cystoscopy at the end.

 

[soccerusa]

What is the job market for rad onc like these days? Especially on regards to flexibility and finding a position in large, desirable cities?

 

[NontradCA]

In the spirit of similar threads, I thought I would provide a useful service to SDN pre-meds.

Background:
Age: Early 40s
Practicing Oncologist in a Physician owned and operated group
20% Administrative + 80% Clinical

Would be happy to answer questions.

Do you deal with anemic/coagulative diseases as well as all types of cancers in practice? How does this work in Heme/Onc?

 

[NontradCA]

I have had so many patients die that it doesn't impact me anymore. However, I still can't shake it when young adults get terminal cancer. That can still hit hard.

About 60% of patients are in curative situations.

I am extremely satisfied with my salary and lifestyle. However there is always someone who earns more. You have to make peace with that.

Would you say in general, that more attention is given to cancers of the affecting the young and women?- as far as research and general information to the public.

 

[oncologydude2]

What is the job market for rad onc like these days? Especially on regards to flexibility and finding a position in large, desirable cities?

Tight job market. Not hard to find a job overall, but difficult in desirable cities without pre-existing connections.

 

[oncologydude2]

Do you deal with anemic/coagulative diseases as well as all types of cancers in practice? How does this work in Heme/Onc?

Personally, no. Benign heme in Med Onc is wildly variable depending on your market. I've seen between 20% - 60%.

 

[oncologydude2]

Would you say in general, that more attention is given to cancers of the affecting the young and women?- as far as research and general information to the public.

Cancers that get the most money are those that are considered "not your fault." Also cancers of women get more money generally. Breast is by far the most probably followed by prostate. Lung cancer, though very common and highly lethal, falls into "you deserve it bc you smoke(d)."

 

[Winged Scapula]

I'm an Oncologist first and a Radiation Oncologist second.

I'm very involved in palliative care. Our practice brought in palliative care MD and social worker. This is rare for private practice.

Might I suggest that you change the title of your thread to say "Radiation Oncologist" as the term "Oncologist" is typically assumed to be Med Onc especially to the lay public (which Pre Med students would be).

 

[NontradCA]

Cancers that get the most money are those that are considered "not your fault." Also cancers of women get more money generally. Breast is by far the most probably followed by prostate. Lung cancer, though very common and highly lethal, falls into "you deserve it bc you smoke(d)."

How do you feel about that? Are you doing anything to change that? Is there a big push from oncology to change it?

 

[NontradCA]

Besides radiation, what other decisions are you helping patients make with their cancer treatment? Other than the therapy used, what major differences are there between med onc and rad onc?

 

[smarts1]

How involved are you in the follow-up of your patients after they are given radiation? I've read before that since med oncs pretty much become cancer patients' primary doctors, med oncs often are the ones who deal with the side effects associated with radiation.

Also, if you do some of these procedures yourself like brachytherapy, do you get exposed to a lot of radiation in your practice? Would someone else be doing these in a hospital?

Lastly, once you finished residency, how easy was it to find your current job (considering the saturation of rad oncs in the field)?

 

[smarts1]

Might I suggest that you change the title of your thread to say "Radiation Oncologist" as the term "Oncologist" is typically assumed to be Med Onc especially to the lay public (which Pre Med students would be).

Even among doctors, wouldn't you refer to yourself as a radiation oncologist even though the word oncology encompasses all the oncology-related fields?