Can you take a 2 week vacation in rad onc?

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I moved to the USA from overseas. Was thinking of doing rad onc. Is it possible to take 2 week vacation every year as an attending to visit family? Or can you only really take 1 week vacations at a time?

 

[alwaysbeIMRTing]

I moved to the USA from overseas. Was thinking of doing rad onc. Is it possible to take 2 week vacation every year as an attending to visit family? Or can you only really take 1 week vacations at a time?

Last year was the first year I had more than 5 contiguous days off since finishing training. It's really hard for a variety of reasons.
Rad onc is not shift work. Good rad onc has continuity of care and you are managing patients receiving daily treatments for 4-8 weeks in many cases. I am checking images and signing plans from the ski slopes.

In other shift-based fields 10-16 weeks of vacation is the norm.
If you want to go into rad onc, find a job that only requires 3-4 days on site and get used to long weekend trips vs. 3 week European vacations where your phone is off. If your priority is travelling back to India or Egypt or whereever multiple times a year for weeks at a time, this is not going to be a good field for you. Plenty of other fields will allow that no sweat.

 

[maxwellradonc]

You can take several weeks off in a row. Even if you have a solo rural job, I think it's reasonable to have locums provide coverage, every other field does this. You'd be an asset to a rural job as opposed to perma-locums. In fact in a rural solo job they might prefer this as it would make scheduling and locums easier to block off for a chunk of time. I estimate probably standard vacation is maybe ~6wks +1wk CME, that's just my guess.

When you interview if you want a geographically wanted location you will have less flexibility and negotiation. But if you're open to be 1hr away from x city or whatever and when you interview you list what's important to you, I don't think you'll have a hard time getting it.

 

[BobbyHeenan]

Last year was the first year I had more than 5 contiguous days off since finishing training. It's really hard for a variety of reasons.
Rad onc is not shift work. Good rad onc has continuity of care and you are managing patients receiving daily treatments for 4-8 weeks in many cases. I am checking images and signing plans from the ski slopes.

In other shift-based fields 10-16 weeks of vacation is the norm.
If you want to go into rad onc, find a job that only requires 3-4 days on site and get used to long weekend trips vs. 3 week European vacations where your phone is off. If your priority is travelling back to India or Egypt or whereever multiple times a year for weeks at a time, this is not going to be a good field for you. Plenty of other fields will allow that no sweat.

Same experience here.

Ability to do long weekends even frequently exists, but 2 weeks at once has been very hard to come by in my extremely busy practice (i'm >90th %ile MGMA RVU).

I did a 9 day European vacation made only possible by an incredibly good semi-retired senior partner that covered. One of my partners who has a sleepier practice does take about 10-14 day trips every other year and makes it work .

With that said, different practice set ups do exist to take extended vacations, but it involves flexible partners, similar styles of treatment, often multiple docs covering a single site, etc. A lot will come down to your comfort level for how long you're away and wht kind of staff you have covering. There are reasonable different opinions on this and I tend to be more of a micro-manager/worrier, borderline pathological worrying about my patients/clinic.

 

[OTN]

I've done it, but it's tough. I find that being able to continue treatment planning while on vacation helps a ton, so I always bring my laptop to contour/plan remotely. Having a partner who is willing and able to cover your practice while you're gone is also super important, naturally.

 

[alwaysbeIMRTing]

Same experience here.

Ability to do long weekends even frequently exists, but 2 weeks at once has been very hard to come by in my extremely busy practice (i'm >90th %ile MGMA RVU).

I did a 9 day European vacation made only possible by an incredibly good semi-retired senior partner that covered. One of my partners who has a sleepier practice does take about 10-14 day trips every other year and makes it work .

With that said, different practice set ups do exist to take extended vacations, but it involves flexible partners, similar styles of treatment, often multiple docs covering a single site, etc. A lot will come down to your comfort level for how long you're away and wht kind of staff you have covering. There are reasonable different opinions on this and I tend to be more of a micro-manager/worrier, borderline pathological worrying about my patients/clinic.

I'm same volume as you and same mindset.

I want to clarify to the OP: If your goal is a single 2 week vacation back home a year, that's a reasonable goal. You can do it, but it's hard. There are a few practices where this basically won't be possible (I worked for one where basically nobody took vacation, they wouldn't pay for locums, and having a partner cover for you was frowned upon). Multiple trips >2 weeks each per year, this probably isn't a great field for you.

If you are a hospital employee, you will typically get 25-35 days of PTO in your contract then technically you can tell admin I will be gone for 3 weeks in a row these days, I'm not asking, I'm telling you -- It's your problem to deal with it now and find someone to fill in for me and if you don't you are in breach of contract. So far, I have not been able to do this in good conscience. For two main reasons: (1) I care about my patients, and (2) I don't have full faith that the hospital will fail to staff it and blow up my vacation plans at the last minute.

The other option is to work part-time/locums. I don't know how old you are, but if you don't need a full-time income and benefits, you can do short term locums positions for a few months at a time and set your own schedule. There are also practices where you can split the assignment (a few months at a time, typically in pretty remote locations). But unless you really love rad onc, why? Just do radiology or anesthesia.

 

[A_DeMichele]

2 weeks off in a row once a year is relatively common at a large hospital-employed group (or a university)

 

[drowsy12]

it's possible for sure. should come into your plans as you pick a place to practice. practicing in a larger group will help.

 

[metallica81788]

I'm solo at a fairly busy rural clinic and need locums when I take time off.
Most I've done at once was 1.5 weeks (7 clinic days) and it went quite smoothly.

I would like to do a 2 week international trip in the next year or so, but it does give me some concerns. I trust my team to run the clinic while I'm out but I do worry about more complex cases and new starts/plans when I'm not there. My locums are not the type to contour a head/neck or do a brain SRS. However, in that situation I would rather plan a complex case remotely but cross my fingers it doesn't need to happen. It will be luck of the draw. While I hate stuff like that on my time off, it's either do it that way or don't take the trip.

 

[Neuronix]

If you are a hospital employee, you will typically get 25-35 days of PTO in your contract then technically you can tell admin I will be gone for 3 weeks in a row these days, I'm not asking, I'm telling you -- It's your problem to deal with it now and find someone to fill in for me and if you don't you are in breach of contract. So far, I have not been able to do this in good conscience. For two main reasons: (1) I care about my patients, and (2) I don't have full faith that the hospital will fail to staff it and blow up my vacation plans at the last minute.

My experience also has been that these employed positions have huge volumes full of policies and they will pull out some policy or argument against whatever you want to do, and then what do you do? Leave? Sue? Sue for what? It's just a difficult hill to die on.

The only thing you can do if 2 week breaks are important to you is try to find a job that will be ok with this, and be very upfront about it. A lot of places won't, and it could be quite limiting in an already difficult job market. Hospitalist or other shift-work style specialties within medicine are much more accommodating to several week breaks.

 

[medgator]

I've done it, but it's tough. I find that being able to continue treatment planning while on vacation helps a ton, so I always bring my laptop to contour/plan remotely. Having a partner who is willing and able to cover your practice while you're gone is also super important, naturally.

Exactly how I've handled it. Locums to do OTVs, stereo coverage etc and maybe basic emergency consults and palliative cases, I handle stuff before or after (and during with a laptop and Aria cloud access in a pinch). Very easy to take a week off though in my experience or even every other week off (had to do that recently with a family issue).

 

[Palex80]

I am obliged to take at least 2 consecutive weeks off per year, by law.

 

[taserlaser]

View attachment 405227

I am obliged to take at least 2 consecutive weeks off per year, by law.

Yeah, I’m not mandated but nice thing about a big group practice is I am very comfortable having my colleagues cover while I’m away 2-3 weeks. Just needs to be set up in advance.

 

[alwaysbeIMRTing]

Maybe there's nothing to worry about. With ROCR we will all be giving 5 fractions or less to everything and babysitting the linac in one week shifts. Three week vacations will become the norm due to oversupply and lack of shifts to go around. Getting to know your patients on OTVs will become a story told by the campfire on corporate diversity retreats. Congrats ASTRO, you've made Rad Onc the new EM.

 

[TheWallnerus]

Here’s an interesting fun fact… maybe facts plural.

By patient load/Medicare beneficiary number, the top two radiation oncologists for 77427 in America practice two weeks on/two weeks off. So two weeks “vacation” is definitely possible.

 

[alwaysbeIMRTing]

Here’s an interesting fun fact… maybe facts plural.

By patient load/Medicare beneficiary number, the top two radiation oncologists for 77427 in America practice two weeks on/two weeks off. So two weeks “vacation” is definitely possible.

If I'm looking this up correctly, which I'm sure I'm not, the top 2 MDs in terms of 77427 count:

1. Private practice rad onc in Naples, FL (lol)
2. An ENT fresh out of training who is running an image guided SRT clinic (wtf but also lol)

Looking up G6001 on the second one is fun. 7,768 charges in 2023 with average payment amount of $130.80 = $1,016,054.40

 

[yesmaster]

Billionaires getting excellent care in Naples, FL

 

[alwaysbeIMRTing]

Billionaires getting excellent care in Naples, FL

330 77263s submitted to medicare in one year. Guy has got to be seeing over 1k new patients a year. And doing that all in 26 weeks a year? Excellent care indeed.

 

[TheWallnerus]

If I'm looking this up correctly, which I'm sure I'm not, the top 2 MDs in terms of 77427 count:

1. Private practice rad onc in Naples, FL (lol)
2. An ENT fresh out of training who is running an image guided SRT clinic (wtf but also lol)

Looking up G6001 on the second one is fun. 7,768 charges in 2023 with average payment amount of $130.80 = $1,016,054.40

I don’t want to give the MD names but it’s 77427 by number of beneficiaries, not by units of 77427s. But you’re very close.

 

[ramsesthenice]

I moved to the USA from overseas. Was thinking of doing rad onc. Is it possible to take 2 week vacation every year as an attending to visit family? Or can you only really take 1 week vacations at a time?

I’ve been at a couple of academic centers and it’s usually doable. I have a partner who does it every year. That said…

It’s not a guarantee. I know if places where it’s a hard no. Don’t ask admin or a chair when interviewing. If they want/need you, everything will be “possible” during interviews. Ask the other faculty.

In the absolute best case, this will need to be planned out at least 3 (more like 6) months in advance. Last minute changes are difficult to accommodate. And since things like deaths are not planned in advance, you can still end up struggling to accommodate emergent oversees trips for more than a few days.

This 100% depends on buy in from your colleagues as the strain it adds to them if you are busy is not trivial. Be a team player and get them behind you. If they don’t care, admin usually won’t either as their concern is making money. Who generates said revenue is of little importance to them.

When looking for jobs, look for potential traps. If they are understaffed for the volume, it’s going to be hard. Also, look out for SINGLE doc satellites. Those can wreak havoc and rain s*** on faculty schedules if the expectation is main campus docs will cover them as needed. I can’t stress the word SINGLE enough. Where I trained had multiple satellites but several had 3+ docs and they held fort for all of the other satellites. Our faculty essentially didn’t feel their existence day to day. My job post residency, different story. All single doc sites and they were generally fine for periodic coverage. But eventually, one of the docs would quit and it would fall to us to cover them for the 9-18 months it took to recruit someone to a rural Midwest clinic. That’s when vacation rationing would kick in. Longer requests were still possible, but had to be coordinated with your other faculty. These issues get compounded when you start adding technologies and procedures like GamnaKnife, brachytherapy, theranostics, and adaptive MR IGRT. If only 1-2 faculty can cover those things, the pool of people to kick in and buy you longer stretches can shrink rapidly.

I just rambled. In my mind, the key is to get a sense of how happy the faculty actually are at a potential job. If you get a consistent message that everyone supports each other, it will probably be fine.

 

[Haybrant]

I'm same volume as you and same mindset.

I want to clarify to the OP: If your goal is a single 2 week vacation back home a year, that's a reasonable goal. You can do it, but it's hard. There are a few practices where this basically won't be possible (I worked for one where basically nobody took vacation, they wouldn't pay for locums, and having a partner cover for you was frowned upon). Multiple trips >2 weeks each per year, this probably isn't a great field for you.

If you are a hospital employee, you will typically get 25-35 days of PTO in your contract then technically you can tell admin I will be gone for 3 weeks in a row these days, I'm not asking, I'm telling you -- It's your problem to deal with it now and find someone to fill in for me and if you don't you are in breach of contract. So far, I have not been able to do this in good conscience. For two main reasons: (1) I care about my patients, and (2) I don't have full faith that the hospital will fail to staff it and blow up my vacation plans at the last minute.

The other option is to work part-time/locums. I don't know how old you are, but if you don't need a full-time income and benefits, you can do short term locums positions for a few months at a time and set your own schedule. There are also practices where you can split the assignment (a few months at a time, typically in pretty remote locations). But unless you really love rad onc, why? Just do radiology or anesthesia.

"a partner cover for you was frowned upon" <--- This is crazy. what is wrong with those people. Tell them to sack up.

 

[alwaysbeIMRTing]

"a partner cover for you was frowned upon" <--- This is crazy. what is wrong with those people. Tell them to sack up.

What is wrong with them is that they were crazy. And greedy.

This was one of those "you can take as much vacation as you want" practices. As long as that number was zero apparently. Vacation? Like on a plane? Why would you ever want to leave <insert shi77y state consistently in the bottom ranking for everything only beloved by people born there and never left>?

Pretty much hit all the red flag interview statements:
1. You can take as much vacation as you want. We cover for each other so we don't have to pay locums.
2. Don't ask the partners about money/salary because they will think you are only interested in private practice for money and not for patient care
3. We never advertise for jobs and only hire through connections
4. The buy-in is so big, no bank will give you a loan for it, but you will get some form of ownership, just trust us.
5. If you try to negotiate the initial offer, the CEO will be offended and tear it up.

And so on. Different forms of saying, "we are looking for someone who is stuck in the area who we can work to the bone, control through vague promises of partnership that might materialize through especially good behavior (that you better never try and ask about formally, how rude), and pay the bare minimum for as long as possible so we can pocket the rest."