Astro Career Center and "A Roadmap for Recruiting Medical Students into Radiation Oncology during a Period of Waning Interest"

fiji128

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Just a point of data to show what is currently out there. Astro Career Center is the single largest source of rad onc jobs so listing them is illustrative of the current market. Probably about 10 positions on there that would be considered fairly desirable and probably 10 to 15 that should be avoided.
 

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elementaryschooleconomics

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I know of several PGY5s who have signed and some of the jobs were not posted on ASTRO. Others were though

Of the people I know who signed, I think only two jobs were advertised.

Even the ones that weren't advertised had multiple prospective hires.

I'm going to start a new business - I compile all the email addresses and phone numbers for every Chair of an academic department and everyone in any sort of private practice gig. I then stratify by region, type of practice, whatever you want. Then, I sell these lists to Radiation Oncology residents for their inevitable job search which entails cold-emailing anyone and everyone.

"You either get the bread or the breadlines, so subscribe to Elementary Lists today, and ensure that those 13 years of training after High School were Worth It "

Edit: To clarify, the applicants (residents) didn't have multiple job offers, the practices who didn't advertise had already received enough cold-call interest they had their pick of people
 
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fiji128

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Using Word Of Mouth To Boost Your Job Search

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RickyScott

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Who wants to go into a field you have to network and self promote in order to out compete others for one of the limited available jobs.
 
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scarbrtj

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Using Word Of Mouth To Boost Your Job Search

Here are five lynchpins of trusted, viral word of mouth that are common sense, timeless, and proven:

Relationships
Build strong relationships with people based on a solid foundation, commonality, respect, and reciprocity.

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This feels like right before Baldwin shows up and entices us with the Glengarry (job) leads. “The jobs are weak!” “Oh yeah pal so are you.”
 
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einsteinm

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You mean every other white collar job in existence?
Does every other white collar job in existence require you to take on a ton of debt, 8 years of school and another 5 years of training? I think it’s pretty reasonable that one should be able to get a job in a desired location after all for that.
 
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OTN

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You mean every other white collar job in existence?

Radonc's comparative "peers" are not other white collar jobs, but rather other MD jobs, as I have zero doubt you know.

Compared with the job market for other MDs coming out of training, radiation oncology offers neither the geographic flexibility, salary, or opportunity for advancement to make it desirable. Compared with coming out of pharmacy training, is it a competitive job marketplace? Is it competitive with, say, someone graduating with a CS degree who wants to work at one of the FANG companies? WHO CARES. The job market in other fields has nothing - zero - to do with the job market for graduating radonc trainees or to do with the discussions on this board.
 
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RickyScott

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You mean every other white collar job in existence?
Maybe we are lucky that we don’t have to do years of post docs like other academic fields. Medstudents could don’t care about other white collar jobs.
 
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fiji128

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Well as you know there are rad onc jobs, white collar jobs... and jobs that other MDs have

Possible sure, likely for 99.8% of MDs at 41, no. Of course whole thing could just be made up as no name is attached to it.
 
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thecarbonionangle

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Some posters here are clearly plants for greedy chairs and the system. It is not difficult to figure out who they are. Their credibility suffers, folks!
 
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RickyScott

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Some posters here are clearly plants for greedy chairs and the system. It is not difficult to figure out who they are. Their credibility suffers, folks!
You are lucky that you don’t have cancer like one of your patients. Now go out there and be exploited.
 
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Krukenberg

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Does every other white collar job in existence require you to take on a ton of debt, 8 years of school and another 5 years of training? I think it’s pretty reasonable that one should be able to get a job in a desired location after all for that.

my response was based on how entitled this all sounds to anyone who isn’t a doctor. Just because you knowingly chose to enter medicine you deserve the job of your dreams? To decide against a specialty that you would otherwise really enjoy (rad onc) because you’re averse to what all your non-medical friends have to do (network) is pretty weak.
 
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Well as you know there are rad onc jobs, white collar jobs... and jobs that other MDs have

God I want a $75K chinchilla comforter so bad right now. It would feel so good sopping up my tears of regret for not going into software or mechanical engineering (or whatever the hell that lady does to make 1.3 mill a year.)
 
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elementaryschooleconomics

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my response was based on how entitled this all sounds to anyone who isn’t a doctor. Just because you knowingly chose to enter medicine you deserve the job of your dreams? To decide against a specialty that you would otherwise really enjoy (rad onc) because you’re averse to what all your non-medical friends have to do (network) is pretty weak.

1) The thesis of many posts is not "we deserve the jobs of our dreams" but "we deserve marginally more options when it comes to getting a job", because right now it's "if we want a job we have limited options"

2) Sort of a central transaction in modern society is the understanding that:
a) the bar is really high to become a physician in America
b) to work as a physician in America requires over a decade of training and sacrifice
c) the upside being that, at the end, you have economic security

3) The mere fact that you:
a) got into medical school
b) graduated medical school
c) matched into residency
d) graduated residency

...does buy you some leeway into being averse to what non-medical folks have to do. It's not "weak" at all. That's the trade-off.

My non-medical friends hustling and grinding for a job have to do that because the bar to entry for their job is lower. There's more people vying for the same job, because the base requirement for entry is a 4-year degree or less, something the majority of Americans have these days. The "societal contract" for most physicians is the sacrifice comes up front to narrow the pool at the end.

RadOnc has created an environment where both facets exist - simultaneously, the barrier to entry is high while the pool of people vying for the same job is also high.

If you don't have a problem with it, then nothing we can say will convince you otherwise.

But comparing getting a job to RadOnc to getting a job in a "non-medical" field is not arguing in good faith. Do you also accept when your surgeon friends compare outcomes between surgical and non-surgical candidates in their database studies? I don't think you do.
 
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RadOncDoc21

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Let’s accept the fact that if rad onc was real estate, we pretty much lost our entire investment in resale value. The question is if the plot of land is still valuable or did we just build on top of a toxic waste dump and we are just getting poisoned everyday.

The good news is that it’s still 2020!
 
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Krukenberg

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1) The thesis of many posts is not "we deserve the jobs of our dreams" but "we deserve marginally more options when it comes to getting a job", because right now it's "if we want a job we have limited options"

2) Sort of a central transaction in modern society is the understanding that:
a) the bar is really high to become a physician in America
b) to work as a physician in America requires over a decade of training and sacrifice
c) the upside being that, at the end, you have economic security

3) The mere fact that you:
a) got into medical school
b) graduated medical school
c) matched into residency
d) graduated residency

...does buy you some leeway into being averse to what non-medical folks have to do. It's not "weak" at all. That's the trade-off.

I’m not going to go through all the threads but a VERY common statement is how because rad onc applicants have high performance they deserve to be able to get a job in any city they want. That is entitlement, pure and simple. I’ll re-post this from above:


Does every other white collar job in existence require you to take on a ton of debt, 8 years of school and another 5 years of training? I think it’s pretty reasonable that one should be able to get a job in a desired location after all for that.

what you describe Elementary is a guild. The contract with society is it gives physicians autonomy to govern themselves via boards of medicine rather than relentless legislation. The compact is NOT that doctors are entitled to high pay and job security. That is a function of medicine acting like a guild, and if you read the comments section of any news story about physician income you’ll see that many in the public believe we make too much money.

I absolutely agree that residency expansion is a bad thing, but totally disagree that any graduating medical student, of any specialty, is entitled to the job of their dreams just because they knowingly entered this long process to become a physician.
 
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medgator

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I absolutely agree that residency expansion is a bad thing, but totally disagree that any graduating medical student, of any specialty, is entitled to the job of their dreams just because they knowingly entered this long process to become a physician.
Except that's actually the case in many specialties because their specialty society didn't torch their respective fields.

Want examples? Urology and psychiatry are two big ones.
 
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elementaryschooleconomics

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I’m not going to go through all the threads but a VERY common statement is how because rad onc applicants have high performance they deserve to be able to get a job in any city they want. That is entitlement, pure and simple. I’ll re-post this from above:

what you describe Elementary is a guild. The contract with society is it gives physicians autonomy to govern themselves via boards of medicine rather than relentless legislation. The compact is NOT that doctors are entitled to high pay and job security. That is a function of medicine acting like a guild, and if you read the comments section of any news story about physician income you’ll see that many in the public believe we make too much money.

I absolutely agree that residency expansion is a bad thing, but totally disagree that any graduating medical student, of any specialty, is entitled to the job of their dreams just because they knowingly entered this long process to become a physician.

Again, there's a gap between "job of your dreams" and "struggling to get into a certain geographic area".

No one is entitled to the job of their dreams, I totally agree. But becoming a physician is an investment in yourself - it's a job, not a calling. And if someone is going to invest 13+ years of training after High School into a career (not to mention, literally hundreds of thousands of dollars of student loan debt), then the ROI better be "worth it", however you want to define that. RadOnc isn't any more or less special than any other type of medicine. If someone thinks this is a calling, and they're called to Radiation Oncology, great. If someone thinks this is a job, and they want to invest their time and effort into a worthwhile venture - that is not Radiation Oncology right now. Do you have a 401k? Do you expect it to gain value? How entitled of you.

The public can believe we make too much money if they want, that's a whole separate issue.
 
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OTN

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I’m not going to go through all the threads but a VERY common statement is how because rad onc applicants have high performance they deserve to be able to get a job in any city they want. That is entitlement, pure and simple. I’ll re-post this from above:




what you describe Elementary is a guild. The contract with society is it gives physicians autonomy to govern themselves via boards of medicine rather than relentless legislation. The compact is NOT that doctors are entitled to high pay and job security. That is a function of medicine acting like a guild, and if you read the comments section of any news story about physician income you’ll see that many in the public believe we make too much money.

I absolutely agree that residency expansion is a bad thing, but totally disagree that any graduating medical student, of any specialty, is entitled to the job of their dreams just because they knowingly entered this long process to become a physician.

You are not arguing in good faith. No one here has said radiation oncologists should be able to get a job in the city we want. We know geographic determination is a problem in radonc and always will be.
 
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Dear medical students -

Choose radiation oncology. Our motto is #radoncrocks and YOU'RE NOT ENTITLED TO A JOB!
 
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RickyScott

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You are not arguing in good faith. No one here has said radiation oncologists should be able to get a job in the city we want. We know geographic determination is a problem in radonc and always will be.
1)there was a time when I applied that you could get a job in any city which is why field became competitive.
2) the dynamic here is that the field is worsening every year! However bad it is today, it will be worse tomorrow.
3) medical oncology, for those interested in cancer, does provide jobs in every city, and has a very bright future. Regardless of whether doctors should feel "entitled" to a good paying job and geographic preference, both of those await them in medical oncology.
 
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medgator

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1)there was a time when I applied that you could get a job in any city which is why field became competitive.
2) the dynamic here is that the field is worsening every year! However bad it is today, it will be worse tomorrow.
3) medical oncology, for those interested in cancer, does provide jobs in every city, and has a very bright future. Regardless of whether doctors should feel "entitled" to a good paying job and geographic preference, both of those await them in medical oncology.
Med onc is saturating in certain areas but i get your jist. Fwiw, both are tight job market wise in my neck of the woods and other metros nearby I'm aware of
 

RickyScott

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Med onc is saturating in certain areas but i get your jist. Fwiw, both are tight job market wise in my neck of the woods and other metros nearby I'm aware of
fair enough, but there are plenty of amazing fields in medicine with great futures. US only trains enough MDs for 75-80% of its needs, so yes, virtually no US MDs should be worrying about landing a job! No one was born to be a radonc. Also to those who claim it was always tough to land a job or a preferred geography, it was not! That is precisely why it became so competitive.
 
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scarbrtj

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fair enough, but there are plenty of amazing fields in medicine with great futures. US only trains enough MDs for 75-80% of its needs, so yes, virtually no US MDs should be worrying about landing a job! No one was born to be a radonc. Also to those who claim it was always tough to land a job or a preferred geography, it was not! That is precisely why it became so competitive.
The competitiveness and tightness of rad onc will now be migrating from getting into residency and into the job market. The "problem" as it were is that residency competitiveness was based somewhat on artificial man-made constraints (which were modifiable) but job market competitiveness is based much more on real-world factors (declining fractions, RT utilization, cancer incidences, etc.) that are comparatively more rigid.
 
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RadOncDoc21

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The competitiveness and tightness of rad onc will now be migrating from getting into residency and into the job market. The "problem" as it were is that residency competitiveness was based somewhat on artificial man-made constraints (which were modifiable) but job market competitiveness is based much more on real-world factors (declining fractions, RT utilization, cancer incidences, etc.) that are comparatively more rigid.

We should hold a hunger games/gladiator style event every 10-15 years where the new grads fight to the death for jobs. It’s either that or obtain a fellowship in palliation of bone mets.
 
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ramsesthenice

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medical oncology, for those interested in cancer, does provide jobs in every city, and has a very bright future

A few very thoughtful medical oncologists I work with are concerned that immunotherapy could end up limiting their job market in the not too distant future. Compared to chemo it is relatively benign. Make a few tweaks to oversight requirements and it becomes a question of how many MDs are needed to staff a busy immunotherapy clinic?

There is absolutely no question for people in medical school and residency right now that medical oncology has a much better job outlook than radiation oncology. This post has nothing to do with radiation oncology. I just think its an interesting perspective worth sharing.
 
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scarbrtj

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A few very thoughtful medical oncologists I work with are concerned that immunotherapy could end up limiting their job market in the not too distant future. Compared to chemo it is relatively benign. Make a few tweaks to oversight requirements and it becomes a question of how many MDs are needed to staff a busy immunotherapy clinic?

There is absolutely no question for people in medical school and residency right now that medical oncology has a much better job outlook than radiation oncology. This post has nothing to do with radiation oncology. I just think its an interesting perspective worth sharing.
many CT surgeons now openly pontificating re: their prescribing and overseeing immunotx themselves for lung ca patients
 
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Lamount

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A couple of thoughts:

1) Some people went into rad onc purely because they loved oncology, others purely because loved the research, and others purely because they loved the lifestyle/flexibility (as it was promised when they applied). For most, it was combination of these and other factors. Considering that everyone has different reasons for going into this field, the collapse the lifestyle/flexibility will bother some more than others. It's not impure to be frustrated, and it's not naive to be stoic.

2) Immunotherapy is not curative.
 
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medgator

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A couple of thoughts:

1) Some people went into rad onc purely because they loved oncology, others purely because loved the research, and others purely because they loved the lifestyle/flexibility (as it was promised when they applied). For most, it was combination of these and other factors. Considering that everyone has different reasons for going into this field, the collapse the lifestyle/flexibility will bother some more than others. It's not impure to be frustrated, and it's not naive to be stoic.

2) Immunotherapy is not curative.
For many though, geography was as important as those factors listed, and the idea was that you could take a hit on one factor to get improvement in the other 2. Now ASTRO leadership tells us any job is mission accomplished.
 

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In most physician specialties you can pick 2 of 3: location, lifestyle, and pay (higher than median for specialty). You might get lucky and get all 3.

In rad onc you are lucky to get 1 of those 3.

If you are willing to take any job, anywhere, and for less than MGMA median (I have never been offered anywhere close to MGMA median even at "partnership"/full production), just to be a rad onc, then rad onc might be for you. Maybe you'll get lucky, maybe you won't.
 
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thecarbonionangle

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In most physician specialties you can pick 2 of 3: location, lifestyle, and pay (higher than median for specialty). You might get lucky and get all 3.

In rad onc you are lucky to get 1 of those 3.

If you are willing to take any job, anywhere, and for less than MGMA median (I have never been offered anywhere close to MGMA median even at "partnership"/full production), just to be a rad onc, then rad onc might be for you. Maybe you'll get lucky, maybe you won't.
What are you calling MGMA median?
 
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Ray D. Ayshun

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What are you calling MGMA median?
Employer: What are you hoping to make?

Applicant: im trying to get something around nowhere close to mgma median.

Employer: Straight out of residency? Maybe with 5 years experience we'd be nowhere close to mgma median. Starting out, you should aim a little lower. The good news is, you're only 30 feet from a window.
 
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Lamount

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For many though, geography was as important as those factors listed, and the idea was that you could take a hit on one factor to get improvement in the other 2. Now ASTRO leadership tells us any job is mission accomplished.

I don’t disagree with you. I didn’t omit geography by design. My point was only to say that everyone came into this with different expectations... so the job market collapse is more disappointing for some than others.
 

medgator

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I don’t disagree with you. I didn’t omit geography by design. My point was only to say that everyone came into this with different expectations... so the job market collapse is more disappointing for some than others.
It's an important point though.... Probably the single most important factor overall... Like real estate, location, location location
 

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I’m not going to go through all the threads but a VERY common statement is how because rad onc applicants have high performance they deserve to be able to get a job in any city they want. That is entitlement, pure and simple.

Medicine is, for the most part, a safe career. It is a meritocracy. One is successful in medicine due to some combination of hard work and intelligence over a prolonged period of time, and there is generally very little luck involved. The barrier to entry is high and the barriers to continued success continue to get more challenging, but it has always been a field where intelligence and hard work pay off in the end. This is why it is attractive to many of us who are intelligent, hard working, but risk averse.

The reason that this field is no longer attractive to medical students is that this equation has been flipped. There is far more luck involved, and so why would someone who is intelligent and has worked their ass off for a decade to be top of their class just suddenly roll the dice?

It is not entitlement to expect to be appropriately rewarded for your hard work with job opportunities you are satisfied with. Almost every other medical specialty has a robust job market. You may not get your dream job off the bat, but it is not a pipe dream either and there is not a constant lowering of expectations of what that dream job actually looks like.

If we graduated at the bottom of our class, scrambled into a family practice residency in the middle of nowhere South Dakota, and expected to get a top job, making a ton of money, in the city of our dreams, with excellent work life balance, then that would be entitlement. However, for people who graduate near the top of their class in medical school, the 1% of the 1%, to not be able to get a job IN THEIR REGION? That is not entitlement. That is a reasonable expectation. Now, in 5 years time when it's a bunch of IMGs and SOAPers that are complaining about only being able to get jobs in McAllen, TX and Minot, ND, I would agree. That sounds pretty entitled.

Edit: Apparently Minot is in ND not SD, apologies for the oversight. It has been corrected
 
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