ASTRO Workforce Study

[TheWallnerus]

I do love it when a plan comes together. Less rad oncs in private practice: check. More rad oncs in the academic/university setting: check. It's a buyer's market what can I say. Now look, we don't want you practicing in small programs with a "community feel" (not enough residents for a rich learning experience) but after you finish your residency in a large urban academic center, can you guys head out into the woods to practice? Looking sparse out there. We'll buy the practice located 150 miles from the academic mothership. And have you plant your young rear end as far away from us as possible. JK! LOL. Also, we need women. You know what I mean, don't get smart.

Radiation Oncology Workforce Study Indicates Potential Threat to Rural Cancer Care Access

Goo goo g'joob

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Members don't see this ad.

 

[RSAOaky]

I wonder if the ACGME is looking into making a mandatory PGY-7 year of service in rural communities after our PGY-6 fellowship in advanced inpatient radiation oncology.

 

[xrthopeful]

I wonder if the ACGME is looking into making a mandatory PGY-7 year of service in rural communities after our PGY-6 fellowship in advanced inpatient radiation oncology.

if you're gonna troll, at least be ridiculous and OTT like Sphynx.

weak.

 

[RSAOaky]

if you're gonna troll, at least be ridiculous and OTT like Sphynx.

weak.

Just some casual Sunday morning soft trolling

 

[deleted947887]

#ProbationSux

 

[puahate]

Yikes

 

[deleted941485]

I do love it when a plan comes together. Less rad oncs in private practice: check. More rad oncs in the academic/university setting: check. It's a buyer's market what can I say. Now look, we don't want you practicing in small programs with a "community feel" (not enough residents for a rich learning experience) but after you finish your residency in a large urban academic center, can you guys head out into the woods to practice? Looking sparse out there. We'll buy the practice located 150 miles from the academic mothership. And have you plant your young rear end as far away from us as possible. JK! LOL. Also, we need women. You know what I mean, don't get smart.

Radiation Oncology Workforce Study Indicates Potential Threat to Rural Cancer Care Access

Goo goo g'joob

NJ and PA are considered south? Would have lumped them in with North.

The graph tells us nothing new. Hopefully these idiots plan on delving deeper into the data. But not too deep that they’ll undermine their own interests.

I know RO is pretty poor right now but if ASTRO could afford to farm out this kind of study to a third party consultant like a McKinsey or Deloitte it might be worth it. At least theoretically they don’t really have a dog in this fight unless of course ASTRO doesn’t like what they have to say. Then again it might be another few years to get an answer.

 

[radiation]

Interesting data

 

[TheWallnerus]

Interesting data


View attachment 257022

View attachment 257023

Sure most everybody, except the academics, are making less money. But the reason for less money is because there's less work. Bad? Uh no. It doesn't take a D.O. to realize that less work = more professional quality of life. Don't you rural & private practice guys want quality of life? Stop complaining & look on the bright side. I'm going to show this chart to med students that QoL in radiation oncology is on the upswing. If we can get all treatments for every cancer to 5 days or less, work QoL is gonna go through the roof and med students will come pouring in like IMRT reimbursement in 2003. (But don't think with less work you get less WORK HOURS. You still have to be in the office he he.)

Goo goo g'joob

 

[medgator]

. I'm going to show this chart to med students that QoL in radiation oncology is on the upswing. If we can get all treatments for every cancer to 5 days or less, work QoL is gonna go through the roof and med students will come pouring in like IMRT reimbursement in 2003. (But don't think with less work you get less WORK HOURS. You still have to be in the office he he.)

Goo goo g'joob

You forgot the other piece of that qol puzzle... Decreased pay.

I know hospitalists working 7 on/7 off making more than RO as starting salary. Many of them brag about qol too.... And unlike the RO trying to interview for jobs between Rhinelander WI, Salina KS and minot ND, the $300k hospitalist jobs are in TX, FL, GA, Carolinas etc. Probably even Cali, OR and WA

 

[TheWallnerus]

You forgot the other piece of that qol puzzle... Decreased pay.

I know hospitalists working 7 on/7 off making more than RO as starting salary. Many of them brag about qol too.... And unlike the RO trying to interview for jobs between Rhinelander WI, Salina KS and minot ND, the $300k hospitalist jobs are in TX, FL, GA, Carolinas etc. Probably even Cali, OR and WA

The pride in one's self and the warmth filling the cockles of one's heart by giving much less radiation fractions than in the past are worth, like, a million dollars. So what I tell med students is that radiation oncologists are making one point three million dollars a year now, starting out. And I really don't think I could live with myself if I were taking every other week off. That doesn't sound like a "real" doctor to me.

 

[VulgarDisplayOfPower]

"Since 2012, race and gender gaps narrowed, but geographic disparities persisted, with ROs gravitating toward resource-rich suburban and urban locations over rural practices."

From the conclusion of the study.

The way phrases like "gender gap" and "race gap" are used ad nauseum in academic publications suggest that there must be some ghost in the machine that is forcefully trying to keep minorities and women out of radiation oncology. What about other factors such as differences between men and women and differences in cultures that may make radiation oncology a more attractive career choice for white, Asian, and Indian males? People are different and people want different things in life, different careers, etc. This is natural. Look at low income jobs. Men may choose to work in factories and women may choose to work in clerical jobs. Both get paid the same for their skill level. Because 90% of machinists are male does not mean that the manufacturing industry discriminates against women. The frustration is that these articles all take a data point, such as the number of black women in the field, note that it is low, and then dog whistle and point the finger making two giant unfounded assumptions: (1) that low numbers of certain "groups" are automatically a real problem, not just a problem of optics, and (2) that this problem is due to the patriachial white male ghost in the machine.

So we need to ask ourselves:
Is there an inequality in terms of "opportunity" for med students to go into radiation oncology or are we just looking at the "outcome" and assuming that an inequality of opportunity (i.e., discrimination) must exist because the numbers aren't balanced the way we think they should be?

I mean, pointing the finger at all the white, Asian, and Indian males in radiation oncology and saying "YOU are oppressing us and trying to keep us out, and we're going to keep on fighting to make things fair" -- That's a pretty horrendous accusation to make without some very clear and non-confounded specific evidence. That our field is filled with and led by such horrible prejudiced bigots. Yet it benignly crammed into the premise of all of these articles. And we just take it. Because if you cry foul then you just get called a sexist, racist, whatever.

Ironically, if you wanted to fix the rural problem in rad onc, you'd try to recruit more Midwestern white males as it has been repeatedly demonstrated that women and non-white races tend to gravitate in larger numbers towards urban areas. So it's pretty amusing to watch this cognitive dissonance play out as they claim we need "collective action" to fix the rural undersupply yet at the same time claim we need "collective action" to stop the evil ghost in the LINAC from erecting barriers to keep women (who make up >50% of med students these days and nearly 60% of college students) and minorities out of the field.

 

[metallica81788]

NJ and PA are considered south? Would have lumped them in with North.

Just came in to comment about the ridiculous geographic distribution labels here. PA, NJ, MD, DE are south? OK not midwest? KY and WV are subjective.

75% of practicing radiation oncologists are in their 50s or younger? Wow. It really will be interesting to see how the job market plays out in the next 10 years.

Carry on.

 

[deleted941485]

"Since 2012, race and gender gaps narrowed, but geographic disparities persisted, with ROs gravitating toward resource-rich suburban and urban locations over rural practices."

From the conclusion of the study.

The way phrases like "gender gap" and "race gap" are used ad nauseum in academic publications suggest that there must be some ghost in the machine that is forcefully trying to keep minorities and women out of radiation oncology. What about other factors such as differences between men and women and differences in cultures that may make radiation oncology a more attractive career choice for white, Asian, and Indian males? People are different and people want different things in life, different careers, etc. This is natural. Look at low income jobs. Men may choose to work in factories and women may choose to work in clerical jobs. Both get paid the same for their skill level. Because 90% of machinists are male does not mean that the manufacturing industry discriminates against women. The frustration is that these articles all take a data point, such as the number of black women in the field, note that it is low, and then dog whistle and point the finger making two giant unfounded assumptions: (1) that low numbers of certain "groups" are automatically a real problem, not just a problem of optics, and (2) that this problem is due to the patriachial white male ghost in the machine.

So we need to ask ourselves:
Is there an inequality in terms of "opportunity" for med students to go into radiation oncology or are we just looking at the "outcome" and assuming that an inequality of opportunity (i.e., discrimination) must exist because the numbers aren't balanced the way we think they should be?

I mean, pointing the finger at all the white, Asian, and Indian males in radiation oncology and saying "YOU are oppressing us and trying to keep us out, and we're going to keep on fighting to make things fair" -- That's a pretty horrendous accusation to make without some very clear and non-confounded specific evidence. That our field is filled with and led by such horrible prejudiced bigots. Yet it benignly crammed into the premise of all of these articles. And we just take it. Because if you cry foul then you just get called a sexist, racist, whatever.

Ironically, if you wanted to fix the rural problem in rad onc, you'd try to recruit more Midwestern white males as it has been repeatedly demonstrated that women and non-white races tend to gravitate in larger numbers towards urban areas. So it's pretty amusing to watch this cognitive dissonance play out as they claim we need "collective action" to fix the rural undersupply yet at the same time claim we need "collective action" to stop the evil ghost in the LINAC from erecting barriers to keep women (who make up >50% of med students these days and nearly 60% of college students) and minorities out of the field.

The racial/gender gap fixation along with the constant hammering about the rural undersupply are both designed for the same purpose: they are merely a distraction from the larger issues that everyone on this forum is already aware. It’s a trap and a waste of cognitive effort.

It’s like complaining about the lack of racial and gender parity on the Titanic or shortage of bodies in the cold Atlantic Ocean.

 

[thecarbonionangle]

Wrong thread. The most under-represented groups in medicine are AA, hispanics. As you correctly pointed out, women are on the rise . I find the excessive focus on gender diversity overlooking groups that are far more under-represented.

There is nepotism in field, preference for pedigree in many programs, etc. There are indisputable power dynamics that cannot be ignored but i dont think it is gender.

There is a lot of corruption by white baby boomers who run our field. Ironically some of these women leaders are in cahoots with them. They aren’t leading in the precient issues.

 

[VulgarDisplayOfPower]

Wrong thread. The most under-represented groups in medicine are AA, hispanics. As you correctly pointed out, women are on the rise . I find the excessive focus on gender diversity overlooking groups that are far more under-represented.

There is nepotism in field, preference for pedigree in many programs, etc. There are indisputable power dynamics that cannot be ignored but i dont think it is gender.

There is a lot of corruption by white baby boomers who run our field. Ironically some of these women leaders are in cahoots with them. They aren’t leading in the precient issues.

There certainly was a problem with systematic oppression of women and non-whites in our past. I am not going to deny that.

But to look at the numbers and conclude that those numbers are the way they are because we're not putting applicants on a level playing field when it comes time to make the rank list and factor in their sex and race -- I'm just not seeing that in our modern system. Show me some evidence, but I'm just not seeing it. I am sure their may be one or two legit bigot chairs out there who hate women and minorities. But that's got to be super rare. I don't see it.

It's just really offensive to me to keep having this implicit assumption hurled at me that I'm part of the problem because I'm white and male and I must either consciously or subconsciously want to discriminate. That hurts. Nothing could be farther from the truth. That really hurts. And I'm getting sick of it.

 

[deleted941485]

Just came in to comment about the ridiculous geographic distribution labels here. PA, NJ, MD, DE are south? OK not midwest? KY and WV are subjective.

75% of practicing radiation oncologists are in their 50s or younger? Wow. It really will be interesting to see how the job market plays out in the next 10 years.

Carry on.

I remember a few years ago when the job market concerns began. They used to reassure us that all the baby boomers were gonna retire blah blah blah. News flash they’re still practicing and they ain’t going anywhere until there forced out. That stock market recovery happened and they still didn’t leave. The truth is it was a rubbish theory to begin with. Youngest boomers are in the their mid fifties anyway at least a decade away from even thinking about retirement. Add in all the new govt payment BS and the fact that it’s not a physically demanding job and bam you have yourself a real employment mess.

 

[medgator]

75% of practicing radiation oncologists are in their 50s or younger? Wow. It really will be interesting to see how the job market plays out in the next 10 years.

Carry on.

While the majority of urologists are over the age of 55 and the number of women entering the field is going up.

The American Urological Association Releases 2017 Urology Census Results

/PRNewswire-USNewswire/ -- For the first time, the rising number of women in urology surpassed 20 percent of all practicing urologists under the age of 45....

www.prnewswire.com

Sounds like the AUA could teach ASTRO how to run a professional society in terms of keeping a specialty's longevity healthy

 

[deleted941485]

Wrong thread. The most under-represented groups in medicine are AA, hispanics. As you correctly pointed out, women are on the rise . I find the excessive focus on gender diversity overlooking groups that are far more under-represented.

There is nepotism in field, preference for pedigree in many programs, etc. There are indisputable power dynamics that cannot be ignored but i dont think it is gender.

There is a lot of corruption by white baby boomers who run our field. Ironically some of these women leaders are in cahoots with them. They aren’t leading in the precient issues.

Why is that ironic?

 

[Neuronix]

You forgot the other piece of that qol puzzle... Decreased pay.

I know hospitalists working 7 on/7 off making more than RO as starting salary. Many of them brag about qol too.... And unlike the RO trying to interview for jobs between Rhinelander WI, Salina KS and minot ND, the $300k hospitalist jobs are in TX, FL, GA, Carolinas etc. Probably even Cali, OR and WA

Same. I live in a "desirable" location, and I know EM docs starting out making more than me and working way fewer hours. They have such a short residency too.

Also, regarding that graph in the first post--I don't know anyone that considers PA and NJ part of the south. Why would they do that?

 

[xrthopeful]

I don't really get the point - what's inherently wrong about EM docs making same/more? (we have an elitism problem it seems). If you wanted that sort of work style and work schedule - you would have picked it.

People choose Derm and Rad Onc in part because they like the schedule, don't want to work nights, etc.

 

[Neuronix]

The point is that a lot of medical students used to pick this specialty for lifestyle and pay. I average around 60 hours a week and do not make particularly high pay for a physician.

Medical students can evaluate that as they wish.

 

[xrthopeful]

the combination of both lifestyle and pay are still great. anecdotes aside. average/mean salary on the higher side, no matter what survey or national reporting system you look at, with Monday - Friday schedules, with rare emergencies. That has never changed.

I do realize that 'grass is greenerism' is inherent in every part of life, but would encourage people to take stock of our awesome pay for what we have to do, also.

 

[medgator]

I don't really get the point - what's inherently wrong about EM docs making same/more? (we have an elitism problem it seems). If you wanted that sort of work style and work schedule - you would have picked it.

People choose Derm and Rad Onc in part because they like the schedule, don't want to work nights, etc.

The EM doc has much more of an open job market geographically, as does the dermatologist

 

[bluebubbles]

I don't understand "baby boomer rad onc's will retire, opening job market".

Given the expansion of residency slots over the last 10-20 years, practicing radiation oncologists will skew young (30's/40's). Simple maths.

 

[Carotenoid]

"Since 2012, race and gender gaps narrowed, but geographic disparities persisted, with ROs gravitating toward resource-rich suburban and urban locations over rural practices."

From the conclusion of the study.

The way phrases like "gender gap" and "race gap" are used ad nauseum in academic publications suggest that there must be some ghost in the machine that is forcefully trying to keep minorities and women out of radiation oncology. What about other factors such as differences between men and women and differences in cultures that may make radiation oncology a more attractive career choice for white, Asian, and Indian males? People are different and people want different things in life, different careers, etc. This is natural. Look at low income jobs. Men may choose to work in factories and women may choose to work in clerical jobs. Both get paid the same for their skill level. Because 90% of machinists are male does not mean that the manufacturing industry discriminates against women. The frustration is that these articles all take a data point, such as the number of black women in the field, note that it is low, and then dog whistle and point the finger making two giant unfounded assumptions: (1) that low numbers of certain "groups" are automatically a real problem, not just a problem of optics, and (2) that this problem is due to the patriachial white male ghost in the machine.

So we need to ask ourselves:
Is there an inequality in terms of "opportunity" for med students to go into radiation oncology or are we just looking at the "outcome" and assuming that an inequality of opportunity (i.e., discrimination) must exist because the numbers aren't balanced the way we think they should be?

I mean, pointing the finger at all the white, Asian, and Indian males in radiation oncology and saying "YOU are oppressing us and trying to keep us out, and we're going to keep on fighting to make things fair" -- That's a pretty horrendous accusation to make without some very clear and non-confounded specific evidence. That our field is filled with and led by such horrible prejudiced bigots. Yet it benignly crammed into the premise of all of these articles. And we just take it. Because if you cry foul then you just get called a sexist, racist, whatever.

Ironically, if you wanted to fix the rural problem in rad onc, you'd try to recruit more Midwestern white males as it has been repeatedly demonstrated that women and non-white races tend to gravitate in larger numbers towards urban areas. So it's pretty amusing to watch this cognitive dissonance play out as they claim we need "collective action" to fix the rural undersupply yet at the same time claim we need "collective action" to stop the evil ghost in the LINAC from erecting barriers to keep women (who make up >50% of med students these days and nearly 60% of college students) and minorities out of the field.

Extremely well said!
From my experience sifting through residency applications, only about 25-30% are women. And this is not because women are afraid that they will be passed over for admission - on the contrary, the push for diversity may - unfortunately - make it easier for even for a less qualified female to obtain a residency spot.

I think the push for diversity is doing a disservice for all those it is designed to help.
I am myself a minority, and it is constantly at the back of my mind. "Did I get this position because I am good or because I am a Pacific Islander/female/Zoroastrian?" Am I intrinsically so inferior to the "regular people" that there needs to be a special escalator to lift me into the orbit of this coveted profession?

I think any instances of bigotry and prejudice ("let's not interview him because he is a Native American") need to be stamped out.

But beyond that people need to chill. Minorities are smart enough and capable enough to make it without someone lowering the bar for them. Don't be condescending to us.

 

[puahate]

I'm a minority and i was discouraged from entering this field. I am thankful for the guidance. They encouraged me to go into med onc since its more flexible.

 

[metallica81788]

Extremely well said!
From my experience sifting through residency applications, only about 25-30% are women. And this is not because women are afraid that they will be passed over for admission - on the contrary, the push for diversity may - unfortunately - make it easier for even for a less qualified female to obtain a residency spot.

I think the push for diversity is doing a disservice for all those it is designed to help.
I am myself a minority, and it is constantly at the back of my mind. "Did I get this position because I am good or because I am a Pacific Islander/female/Zoroastrian?" Am I intrinsically so inferior to the "regular people" that there needs to be a special escalator to lift me into the orbit of this coveted profession?

I think any instances of bigotry and prejudice ("let's not interview him because he is a Native American") need to be stamped out.

But beyond that people need to chill. Minorities are smart enough and capable enough to make it without someone lowering the bar for them. Don't be condescending to us.

I personally know of particular residency programs that order rank lists based on diversity for diversity's sake. Oftentimes they don't match these candidates but that pattern is real. I doubt it is the only one.

 

[radbioistheworst]

The EM doc has much more of an open job market geographically, as does the dermatologist

Respectfully, I don’t understand the comparisons with EM/hospitalists. Of course they have more geographic opportunities, they’re much more needed. It’s primary care. This has always been the case.

When I applied to rad onc 5 years ago the hospitalist “half on half off” job was a sweet gig and geographic restrictions in rad onc were well known. That didn’t just happen this year. Perhaps it was completely different decades ago but I can’t imagine how.

With respect to lifestyle, it’s not just about the hours you work and how much you make - it’s the job itself. I too have hospitalist/EM friends in cool cities that make more than I will, but they have to manage CHF/COPD/sepsis all day while playing social worker/scribe half the time and without developing any kind of rapport with their patients. There’s a reason none of us signed up for that. And emergency medicine is way more intense/stressful than what we do. There’s a reason why that specialty consistently has among the highest burnout/suicide/early retirement rates.

Before I get crushed I’m not saying everything’s all gravy in our field, the job market’s fine, expansion/oversupply isn’t a problem, etc. And yes I’m still just a PGY5 but I feel like we’re making these irrelevant apples to oranges comparisons to prove a point.

 

[KHE88]

Respectfully, I don’t understand the comparisons with EM/hospitalists. Of course they have more geographic opportunities, they’re much more needed. It’s primary care. This has always been the case.

When I applied to rad onc 5 years ago the hospitalist “half on half off” job was a sweet gig and geographic restrictions in rad onc were well known. That didn’t just happen this year. Perhaps it was completely different decades ago but I can’t imagine how.

With respect to lifestyle, it’s not just about the hours you work and how much you make - it’s the job itself. I too have hospitalist/EM friends in cool cities that make more than I will, but they have to manage CHF/COPD/sepsis all day while playing social worker/scribe half the time and without developing any kind of rapport with their patients. There’s a reason none of us signed up for that. And emergency medicine is way more intense/stressful than what we do. There’s a reason why that specialty consistently has among the highest burnout/suicide/early retirement rates.

Before I get crushed I’m not saying everything’s all gravy in our field, the job market’s fine, expansion/oversupply isn’t a problem, etc. And yes I’m still just a PGY5 but I feel like we’re making these irrelevant apples to oranges comparisons to prove a point.

This is all true. I do have to remember to keep some perspective.
If we had pursued other elite professions like engineering, IT, law, consulting, finance, etc, our incomes would likely max out in the $200k range. Whereas we are (and should be) maxing out at at least double that (and likely triple) and at much younger ages. Sure, some make it big with risks that pay off, but most don't and end up as rank and file employees, and it's rare to see W2 income > $300k in any profession besides medicine. Physicians, for now at least, have that unique essentially "guarantee" of a top 1-2% income that just doesn't exist in any other industry.

All that said, I'd rather bang out database code for $150k/year 40 hours a week than be an ED physician for triple the pay unless I had some surefire way to retire in 5 years or less (I think some can do FIRE in 10 years, but I think 5 is about the max I'd be willing to sacrifice) -- isn't it funny the ED docs are the ones that are always obsessing about FIRE meanwhile rad oncs are working until the state takes their driver's license away? That says something right there. And between banging out database code for $150k/year and being a rad onc for $150k/year, I'd rather be a rad onc, hands down. But lets hope it never comes to that as I think we can all agree the value of our labor and investment to create said labor isn't comparable to what a coder invests in him/herself and produces. But who knows, we'll see how far the exploitation trend and siphoning off of greater chunks of rad onc professional fees by hospitals goes.

 

[medgator]

Respectfully, I don’t understand the comparisons with EM/hospitalists. Of course they have more geographic opportunities, they’re much more needed. It’s primary care. This has always been the case.

When I applied to rad onc 5 years ago the hospitalist “half on half off” job was a sweet gig and geographic restrictions in rad onc were well known. That didn’t just happen this year. Perhaps it was completely different decades ago but I can’t imagine how.

The geographic restrictions have only gotten worse while the availability of quality pp and academic jobs has gone down in the last decade. This is both subjectively and objectively happening when you talk to recent grads and you look at the surveys that have come out: More people aren't finding jobs in their preferred geographic area, and the number of people in pp is going down as groups get bought out by the hospital or nearby major academic medical center.

We all knew about getting 1-2/3 of money /lifestyle /location when it came to getting an RO job. That's ALWAYS been the case. Now it is more like 0-1 for many people. When I graduated last decade, there were still good partnership track pp positions in second tier cities an hour outside of a major metro. Much harder to find now.

Many of us will tell you, this has all changed in a decade with the simultaneous increase in the use of hypofx/sbrt and no ebrt/observation in the patients we treat along with the increase in the number of residents coming out. It's been one big perfect storm. And while the above is better for patients and the system, it is not better for increasing numbers of residents looking for jobs in desirable and semi desirable locales.

Personally, I couldn't do EM or derm, but I'm not sure I could restrict myself to rural locations to find a high quality, well-paid pp position. There is only so much demand for RO in any given area of the country and we aren't in demand the way uro/IM/psych is.

 

[bluebubbles]

If we had pursued other elite professions like engineering, IT, law, consulting, finance, etc, our incomes would likely max out in the $200k range. [...] It's rare to see W2 income > $300k in any profession besides medicine. Physicians, for now at least, have that unique essentially "guarantee" of a top 1-2% income that just doesn't exist in any other industry.

 

[scarbrtj]

This is all true. I do have to remember to keep some perspective.
If we had pursued other elite professions like engineering, IT, law, consulting, finance, etc, our incomes would likely max out in the $200k range. Whereas we are (and should be) maxing out at at least double that (and likely triple) and at much younger ages. Sure, some make it big with risks that pay off, but most don't and end up as rank and file employees, and it's rare to see W2 income > $300k in any profession besides medicine. Physicians, for now at least, have that unique essentially "guarantee" of a top 1-2% income that just doesn't exist in any other industry.

Except at the industry of Netflix. Medicine? Fuhgeddaboutit. Get a job at Netflix instead of being a rad onc if $ is a concern.

According to employees, managers make roughly $150,000 to $400,000, directors from $400,000 to $800,000, and vps can easily make $1 million or more, with department heads like Cindy Holland, Lisa Nishimura, Bela Bajaria and Scott Stuber said to be cashing multimillion-dollar paychecks. One top publicity exec, for example, makes a base salary of $1.5 million, per sources, with Bloomberg reporting earlier this year that the streaming service was hiring a movie publicist for $400,000. "It's not comparable to anywhere else," says an insider. "It's like play money."

 

[medgator]

Except at the industry of Netflix. Medicine? Fuhgeddaboutit. Get a job at Netflix instead of being a rad onc if $ is a concern.

According to employees, managers make roughly $150,000 to $400,000, directors from $400,000 to $800,000, and vps can easily make $1 million or more, with department heads like Cindy Holland, Lisa Nishimura, Bela Bajaria and Scott Stuber said to be cashing multimillion-dollar paychecks. One top publicity exec, for example, makes a base salary of $1.5 million, per sources, with Bloomberg reporting earlier this year that the streaming service was hiring a movie publicist for $400,000. "It's not comparable to anywhere else," says an insider. "It's like play money."

Of course then you have to buy a house in the bay area.... Which for a 3/2 is a comfortable 7-figure proposition

 

[RANDO_Phantom]

Extremely well said!
From my experience sifting through residency applications, only about 25-30% are women. And this is not because women are afraid that they will be passed over for admission - on the contrary, the push for diversity may - unfortunately - make it easier for even for a less qualified female to obtain a residency spot.

I think the push for diversity is doing a disservice for all those it is designed to help.
I am myself a minority, and it is constantly at the back of my mind. "Did I get this position because I am good or because I am a Pacific Islander/female/Zoroastrian?" Am I intrinsically so inferior to the "regular people" that there needs to be a special escalator to lift me into the orbit of this coveted profession?

I think any instances of bigotry and prejudice ("let's not interview him because he is a Native American") need to be stamped out.

But beyond that people need to chill. Minorities are smart enough and capable enough to make it without someone lowering the bar for them. Don't be condescending to us.

A colleague once told me that at a place she interviewed, the chairman kept referring to her as a "girl," how they need a "girl" on faculty, and how having a "girl" will be good for the team, etc. She felt completely infantilized.

 

[evilbooyaa]

Respectfully, I don’t understand the comparisons with EM/hospitalists. Of course they have more geographic opportunities, they’re much more needed. It’s primary care. This has always been the case.

When I applied to rad onc 5 years ago the hospitalist “half on half off” job was a sweet gig and geographic restrictions in rad onc were well known. That didn’t just happen this year. Perhaps it was completely different decades ago but I can’t imagine how.

With respect to lifestyle, it’s not just about the hours you work and how much you make - it’s the job itself. I too have hospitalist/EM friends in cool cities that make more than I will, but they have to manage CHF/COPD/sepsis all day while playing social worker/scribe half the time and without developing any kind of rapport with their patients. There’s a reason none of us signed up for that. And emergency medicine is way more intense/stressful than what we do. There’s a reason why that specialty consistently has among the highest burnout/suicide/early retirement rates.

Before I get crushed I’m not saying everything’s all gravy in our field, the job market’s fine, expansion/oversupply isn’t a problem, etc. And yes I’m still just a PGY5 but I feel like we’re making these irrelevant apples to oranges comparisons to prove a point.

Completely agree. Despite hospitalists and EMs making more on a per hour basis than what I likely will coming out of residency, I would not entertain the idea of switching careers with them for one second.

 

[RadOncMegatron]

Extremely well said!
From my experience sifting through residency applications, only about 25-30% are women. And this is not because women are afraid that they will be passed over for admission - on the contrary, the push for diversity may - unfortunately - make it easier for even for a less qualified female to obtain a residency spot.

I think the push for diversity is doing a disservice for all those it is designed to help.
I am myself a minority, and it is constantly at the back of my mind. "Did I get this position because I am good or because I am a Pacific Islander/female/Zoroastrian?" Am I intrinsically so inferior to the "regular people" that there needs to be a special escalator to lift me into the orbit of this coveted profession?

I think any instances of bigotry and prejudice ("let's not interview him because he is a Native American") need to be stamped out.

But beyond that people need to chill. Minorities are smart enough and capable enough to make it without someone lowering the bar for them. Don't be condescending to us.

Completely agree with this post. If there isn't enough diversity of certain ethnic groups, the uncomfortable question of is there too much of another minority comes up ie too many Asians and is this a problem? The government census data can be found here: U.S. Census Bureau QuickFacts: UNITED STATES

Asians are only 5.8% and make up 21% of rad oncs!

By the way the white population is 76.6%, but make up only 68% of rad oncs. Is this a problem? Do we need more white people?

The answer of course is that this is NOT a problem, but alas the dance of diversity, equity, and inclusion continues...

 

[Carotenoid]

A colleague once told me that at a place she interviewed, the chairman kept referring to her as a "girl," how they need a "girl" on faculty, and how having a "girl" will be good for the team, etc. She felt completely infantilized.

Well it's an old boys' club, isn't it?

 

[medgator]

Completely agree with this post. If there isn't enough diversity of certain ethnic groups, the uncomfortable question of is there too much of another minority comes up ie too many Asians and is this a problem? The government census data can be found here: U.S. Census Bureau QuickFacts: UNITED STATES

Asians are only 5.8% and make up 21% of rad oncs!

By the way the white population is 76.6%, but make up only 68% of rad oncs. Is this a problem? Do we need more white people?

The answer of course is that this is NOT a problem, but alas the dance of diversity, equity, and inclusion continues...

It's hard to find the balance.... Just look at the interesting thread over on ROhub of the rad onc who thinks there is zero discrimination at all in this country or in RO (and the colorful replies after)

 

[RadOncMegatron]

It's hard to find the balance.... Just look at the interesting thread over on ROhub of the rad onc who thinks there is zero discrimination at all in this country or in RO (and the colorful replies after)

I completely agree. This is a difficult and complex issue that needs discussion from both sides of the table. Unfortunately, it seems that we are unable to have these conversations.

 

[thecarbonionangle]

Completely agree with this post. If there isn't enough diversity of certain ethnic groups, the uncomfortable question of is there too much of another minority comes up ie too many Asians and is this a problem? The government census data can be found here: U.S. Census Bureau QuickFacts: UNITED STATES

Asians are only 5.8% and make up 21% of rad oncs!

By the way the white population is 76.6%, but make up only 68% of rad oncs. Is this a problem? Do we need more white people?

The answer of course is that this is NOT a problem, but alas the dance of diversity, equity, and inclusion continues...

you seem to have a lot of opinions regarding this issue. Why don't you go to ROHUB and back up your colleague who posted a similar opinion? gun shy? Real interesting thread.

 

[Ray D. Ayshun]

Completely agree with this post. If there isn't enough diversity of certain ethnic groups, the uncomfortable question of is there too much of another minority comes up ie too many Asians and is this a problem? The government census data can be found here: U.S. Census Bureau QuickFacts: UNITED STATES

Asians are only 5.8% and make up 21% of rad oncs!

By the way the white population is 76.6%, but make up only 68% of rad oncs. Is this a problem? Do we need more white people?

The answer of course is that this is NOT a problem, but alas the dance of diversity, equity, and inclusion continues...

77% white felt a little high, and apparently that includes the Hispanic and Latino culture, which is important in this discussion as it likely disproportionately affects the racial/cultural makeup of the US versus radiation Oncology. In fact, it says further down 61% are white alone. This is not to say that I disagree with your overarching point, but I think it's incorrect to say the US is 77% white, and it also feels like whites, as in people who look like white people, are over-represented in rad onc.

 

[scarbrtj]

I don't know but it feels like Student Doctor Network is microaggressing me?

A push for the end of microaggressions in radiology

 

[Ray D. Ayshun]

I don't know but it feels like Student Doctor Network is microaggressing me?

A push for the end of microaggressions in radiology

I think you're a white dude, right?

“A microaggression is a comment or an action that subtly and often unconsciously or unintentionally expresses a prejudiced attitude toward a member of a marginalized group”

If so, you can't be. Though maybe it's fair to say that you're marginalized as a Southerner (again, I'm presuming).

 

[RadOncMegatron]

77% white felt a little high, and apparently that includes the Hispanic and Latino culture, which is important in this discussion as it likely disproportionately affects the racial/cultural makeup of the US versus radiation Oncology. In fact, it says further down 61% are white alone. This is not to say that I disagree with your overarching point, but I think it's incorrect to say the US is 77% white, and it also feels like whites, as in people who look like white people, are over-represented in rad onc.

No disagreement... But them Asians!

 

[RadOncMegatron]

you seem to have a lot of opinions regarding this issue. Why don't you go to ROHUB and back up your colleague who posted a similar opinion? gun shy? Real interesting thread.

I tried to sign in, but it says I cannot access the conversation. I am not a paid ASTRO member perhaps that is why I can't join this conversation.

 

[scarbrtj]

I think you're a white dude, right?

“A microaggression is a comment or an action that subtly and often unconsciously or unintentionally expresses a prejudiced attitude toward a member of a marginalized group”

If so, you can't be. Though maybe it's fair to say that you're marginalized as a Southerner (again, I'm presuming).

Man, I'm marginalized as a radiation oncologist.

 

[RadOncMegatron]

I don't know but it feels like Student Doctor Network is microaggressing me?

A push for the end of microaggressions in radiology

My goodness, how this nonsense has infiltrated academic medicine. I am not surprised as we are all human after all that our deepest held convictions blind us.

For those interested microaggressions was started by (term was coined in the 70's, but like Michael Jackson and the moon walk, it's attributed to him) Dr. Derald Wing Sue at Columbia. I strongly believe that it knocks the wind out of these ideas (at least in your own head) when you can name the theorists behind these ideas. I don't say just "microaggression," but note that this is merely "Dr. Sue's hypothesis"

Here is the original paper that launched microaggressions into the mainstream : https://world-trust.org/wp-content/uploads/2011/05/7-Racial-Microagressions-in-Everyday-Life.pdf

Critique noting there is not enough evidence to support its widespread use: SAGE Journals: Your gateway to world-class journal research

Response by Dr. Sue: SAGE Journals: Your gateway to world-class journal research

Dr. Sue's response is telling. "That is why a holistic approach to understanding MRP has relied primarily on qualitative studies of participants who have experienced microaggressions... Third, I am greatly disturbed by Lilienfeld’s call for a moratorium on institutional policies and practices aimed at ameliorating the harmful impact of microaggressions until adequate scientific evidence exists..." He admits that there is a lack of empirical evidence, but due to experiential knowledge it should be implemented.

If you want the TLDR version go here:

 

[PleaseRemainCalm]

My goodness, how this nonsense has infiltrated academic medicine. I am not surprised as we are all human after all that our deepest held convictions blind us.

For those interested microaggressions was started by (term was coined in the 70's, but like Michael Jackson and the moon walk, it's attributed to him) Dr. Derald Wing Sue at Columbia. I strongly believe that it knocks the wind out of these ideas (at least in your own head) when you can name the theorists behind these ideas. I don't say just "microaggression," but note that this is merely "Dr. Sue's hypothesis"

Here is the original paper that launched microaggressions into the mainstream : https://world-trust.org/wp-content/uploads/2011/05/7-Racial-Microagressions-in-Everyday-Life.pdf

Critique noting there is not enough evidence to support its widespread use: SAGE Journals: Your gateway to world-class journal research

Response by Dr. Sue: SAGE Journals: Your gateway to world-class journal research

Dr. Sue's response is telling. "That is why a holistic approach to understanding MRP has relied primarily on qualitative studies of participants who have experienced microaggressions... Third, I am greatly disturbed by Lilienfeld’s call for a moratorium on institutional policies and practices aimed at ameliorating the harmful impact of microaggressions until adequate scientific evidence exists..." He admits that there is a lack of empirical evidence, but due to experiential knowledge it should be implemented.

If you want the TLDR version go here:

The AEI...not sure why a faux academic thinktank is being treated as a trustworthy source for a sociological question...this is like cutting and pasting from Democratic Socialists of America paper to explain capitalism.

 

[thecarbonionangle]

The AEI...not sure why a faux academic thinktank is being treated as a trustworthy source for a sociological question...this is like cutting and pasting from Democratic Socialists of America paper to explain capitalism.

the DSA is TRUTH!