Canaries in a Coal Mine

[Damn_Daniel]

Hahahahahahahahaha. That Columbia fellowship has to be a prank. Someone's pulling people's legs here. It's like something I would do. That's ridiculous. Hahahahahahaha. No chairman in his right mind that doesn't have a great sense of humor would put that up. I respect that level of commitment to humor. It's Andy Kauffman-esque. Bravo! Take a bow!

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[deleted18755]

Related to current conversation: the new "advanced rad onc fellowship" at Columbia. Are you kidding me? Fifty percent of it is inpatient service??? So you pay someone garbage, make them treat all (or most of) the inpatients, and call it a fellowship? Pretty genius move on that departments end IMO. Well played. Well played, indeed!

I would gladly take the job in Salema KS where I am sure there are so many under-served patients who would be so thankful for my help (and where I am sure I would be paid very well) before I took this fake non-accredited "fellowship" which is clearly just an attempt by the department to exploit the poor job market (that they helped create!) and get some poor soul to work like an attending but get paid like a senior resident to help subsidize the salary of those perched high on their ivory towers!

PS: I don't know anybody at this institution but seriously come on! At least post the "fellowship" truthfully rather than pretending like it is some type of learning opportunity that will help the unfortunate soul who is has to take the position because of family/location constraints!

 

[RadOncDoc21]

Not to mention colitis and rupture/peritonitis when it gets really bad.


QFT, DD. The best part about that York job? It's PRN!!

I remember when FL would get a smattering of listings a few years ago, now I can't remember the last time I saw a FL job post. Or cali (meaning the bay area or SoCal, not Modesto or El Centro etc.), Atlanta, Charlotte, Austin, Seattle, Portland OR, etc.

I agree, last year I did see job offers in a few of those major cities. I have no idea where a lot of these places are that are being advertised on the ASTRO site.

 

[Mr RADical]

York PA is actually pretty cool

http://www.pageturnpro.com/York-Cou...fficial-York-County-Travel-Guide/index.html#1

 

[Damn_Daniel]

"Approved PGY-6 position for scutwork at large, busy hospital in Upper Manhattan. Position entails seeing inpatients that need palliative radiation therapy that is of low billable value, and not desirable to current full time staff, as work is maximal and reward is minimal. The other ten percent of the time will be hovering over the full time staff's shoulder as they contour stereotactic radiosurgery and stereotactic body radiotherapy cases (which you will not be allowed to bill for). 'Fellow' will be allowed to sit in on didactic sessions for the PGY2-5 residents that they fellow has surely received in the past, if they completed an accredited residency. Call will be minimal, and by that the University means every 2 weeks. No subsidized housing available, but fellow will be given Zillow Premium account to help find housing. Metrocard will be (partially) subsidized. Daily $5 lunch voucher provided, usable at outdoor pupusa trucks and jerk chicken store front. Patients typically uninsured and destitute, but conversing with them falls under "Medical Spanish" component of fellowship, and fellow will only be charged $100 a week for this course. Thanks for applying."

 

[seper]

We should probably post this chairman's name here. BTW, I thought he was fired a year ago or so??

 

[medgator]

Related to current conversation: the new "advanced rad onc fellowship" at Columbia. Are you kidding me? Fifty percent of it is inpatient service??? So you pay someone garbage, make them treat all (or most of) the inpatients, and call it a fellowship? Pretty genius move on that departments end IMO. Well played. Well played, indeed!

C'mon now, it's a "palliative care" fellowship

 

[BobbyHeenan]

That fellowship looked pretty doggone similar to just a PGY-6 year to me - an extension of all the things you'd normally do in your standard residency.

Like Daniel said, they should have just said:

"Look, we'll be straight with you. We know someone somewhere out there wants to live in NYC. We know you're **** out of luck finding an attending job here, so if you want to at least continue to be a radiation oncologist*, have a job, and live here...then this is what we're offering."

 

[RadOncDoc21]

As a recent graduate not far removed from residency, I will say that the grass is very green on this side. If you find a job somewhere that is descent, take that and don't do an extra year of training, it's not worth it!

 

[Krukenberg]

I can't think of another specialty that has a fellowship that adds nothing to what was learned in residency. Cardiology, pulmonary, ortho spine, Gyn onc, CT surgery, child psych...


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[Damn_Daniel]

I meant no offense to York. They were collateral damage. It's a cute town. More livable than Alexandria or St. Cloud, MN.

Just work hard, pick a specialty you love, and move on with the rest of your life. Don't get angry.

Like Kimmy Schmidt says "I don't get pissed off. I get pissed .. On!"

 

[mpdoc2]

As a recent graduate not far removed from residency, I will say that the grass is very green on this side. If you find a job somewhere that is descent, take that and don't do an extra year of training, it's not worth it!

Actually word on the street is that doing a fellowship might hurt your chances of getting a job later.

 

[medgator]

Actually word on the street is that doing a fellowship might hurt your chances of getting a job later.

Unless you're doing academics in a specific area or really need protons, it might be considered "making up" for substandard residency training in something (brachy, srs, etc)

 

[PhillyMed777]

Actually word on the street is that doing a fellowship might hurt your chances of getting a job later.

why's that?

 

[Damn_Daniel]

why's that?

No, I don't think that's the case, overall. You do protons at Harvard, or peds somewhere, it may help. SRS/SBRT somewhere might be good. I don't think it hurts. It's just dumb you have to do that in our field when it isn't accredited and you don't get a real certification out of it. It's perfunctory most of the time, unfortunately. Some of them, like that hilarious prank by Columbia, won't help. But they will waste your time and pay you little. I've seen training done better, but never more inefficiently.

 

[seper]

There are like 3 legit, long standing fellowship programs in our field. If you are a US residency graduate and do other ones, people will talk behind your back.

 

[mpdoc2]

There are like 3 legit, long standing fellowship programs in our field. If you are a US residency graduate and do other ones, people will talk behind your back.

And unfortunately I've heard many of those talks (from the partner/employers standpoint). And unless you do a peds fellowship at St. Judes or are doing a proton fellowship at MGH or MDACC (and are applying for a proton job which are essentially non existent now) people will talk about how you couldn't get a job out of residency. It still amazes me how many graduates do proton fellowships and subsequently apply for private practice. This kind of fellowship will not help you.

 

[radiaterMike]

I am not saying that I agree- but some PP might want to advertise having a Harvard trained doc, even if he/she trained at a 'lower tier' program.

 

[mpdoc2]

I am not saying that I agree- but some PP might want to advertise having a Harvard trained doc, even if he/she trained at a 'lower tier' program.

I would've thought the same but in reality most PPs I've met haven't cared that you were top 3 trained. Especially if you were dupped into doing a 1 year extended residency and couldn't get a job.

 

[sunealoneal]

Well, this is not something I should have read a couple months before Step 1. I'll have to resist the temptation to ignore other fields next year. How the heck does a med student assess things like job market, pay cuts, etc. when considering specialities? And what exactly is the extent of the geographic limitations in the job market?

 

[stankem]

Well, this is not something I should have read a couple months before Step 1. I'll have to resist the temptation to ignore other fields next year. How the heck does a med student assess things like job market, pay cuts, etc. when considering specialities? And what exactly is the extent of the geographic limitations in the job market?

Exactly .. you can't. There are some aspects of the field that won't change - learn what those aspects are and if that's worth the uncertainty.

 

[thecarbonionangle]

Well, this is not something I should have read a couple months before Step 1. I'll have to resist the temptation to ignore other fields next year. How the heck does a med student assess things like job market, pay cuts, etc. when considering specialities? And what exactly is the extent of the geographic limitations in the job market?

From what I gather, you have to be ok with not living in a big city with the current job market (i.e. recognize that there's a lot more to the country than the coasts). If you're one of those "gotta be in Cali/NYC" types ....you're SOOL!

 

[medgator]

It's not the Fox News presentation, unfortunately. Not being able to find partnership track jobs, not being to have autonomy at freestanding centers, academic jobs being more or less private practice jobs with less pay, consistently dropping reimbursements (refer to the last 3 years of MGMA salary surveys) - this is the new normal. I'm not saying that the field is not worthwhile to go into, has lost any of it's cerebral nature, or that it's on the outs in terms of oncology. It's just that the pecuniary advantages are diminishing, compared to other fields.

Look at the latest 10 jobs on ASTRO, in order:

1. Tulsa - Hope you like steak and rodeo
2. UPMC - NW - Erie? If the best thing about your city is that it's 2 hours from Buffalo and Cleveland, you've got problems
3. College Station, TX - see #2, but replace with Austin and Houston
4. Alexandria, MN - over 2 hours from Twin Cities; the average high temperature in January is 19 degrees (F)
5. Greater Phoenix - sucker job with someone that will never make you partner
6. Modesto, CA - if you love Grapes of Wrath, you'll love living in Modesto!!
7. Syracuse - probably the worst city in NY State, but still better than most on the list.
8. St. Cloud, MN - 1.5h from Twin Cities. You could go ice fishing with the guy that takes the Alexandria job
9. Salina, KS - 1.5h from Wichita. And Wichita's major claim to fame is it's less than 3h from Kansas City
10. Fox Cities, WI - 40 minutes from Green Bay

So, basically, out the ten jobs listed (in order), the best location is ... Phoenix, if you don't mind being an indentured servant.

Next up, balmy Rochester N.Y.!

http://careers.astro.org/jobs/8120257/radiation-oncologist

 

[Gfunk6]

Next up, balmy Rochester N.Y.!

http://careers.astro.org/jobs/8120257/radiation-oncologist

Correction, Rochester satellite

 

[Krukenberg]

I just wanted to point out that the publicly advertised dermatology jobs don't seem THAT much better. https://www.healthecareers.com/aad/search-jobs/?specialty=*&keyword=physician

Same goes for urology http://careercenter.auanet.org/jobs/?sort=&keywords=&type=full-time&level=entry-level&page=2




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[RadOncDoc21]

I just wanted to point out that the publicly advertised dermatology jobs don't seem THAT much better. https://www.healthecareers.com/aad/search-jobs/?specialty=*&keyword=physician

Same goes for urology http://careercenter.auanet.org/jobs/?sort=&keywords=&type=full-time&level=entry-level&page=2




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I peeped out the derm jobs, there are more options across the country both academic and private. It's actually disheartening when you see the limited advertised jobs out there for rad onc.

 

[seper]

I have derm friends and their job market is an order of magnitude better.

 

[medgator]

Derm cares about their specialty and their graduates. They would never unilaterally act to increase residency spots by 50% in a decade without a clear reason to do so

 

[Phantom1]

I think part of the reason to increase residency slots was to capture the significant interest and influx of some of the smartest people in medicine that wanted to go into Rad Onc. Overall I think it is great for the field to have such an influx of talent... but as usual when the pendulum swings its hard to stop it just at the right spot... There really should be a moratorium on residency expansions for 2-3 years to analyze current supply and demand..

 

[medgator]

I think part of the reason to increase residency slots was to capture the significant interest and influx of some of the smartest people in medicine that wanted to go into Rad Onc. Overall I think it is great for the field to have such an influx of talent... but as usual when the pendulum swings its hard to stop it just at the right spot... There really should be a moratorium on residency expansions for 2-3 years to analyze current supply and demand..

I disagree. If you look the ratio of applicants/spots recently, it is much closer to 1:1 now, and the job market woes are/will have a chilling effect on new talent entering the field, something lost upon our "leaders" and specialty societies within the field

 

[mpdoc2]

I think part of the reason to increase residency slots was to capture the significant interest and influx of some of the smartest people in medicine that wanted to go into Rad Onc. Overall I think it is great for the field to have such an influx of talent... but as usual when the pendulum swings its hard to stop it just at the right spot... There really should be a moratorium on residency expansions for 2-3 years to analyze current supply and demand..

I completely disagree. This was purely an interest of greedy departments, wanting cheap labor, and therefore expanding their residency programs without even an after-thought that these same residents will have trouble finding jobs in the future.

 

[DebtRising]

The most depressing thing, and which is borderline 'disgusting' (I know I say some strong things online, not always the most elegant) is that the same people (re: Chairs and PDs) who supported this expansion are now turning around and looking to capitalize on the people who cannot find adequate employment. How? The unbridled expansion of 'fellowships', both the licensed/formalized ones and the not-fellowship-in-name-only 60-90K 'job' offers. There are maybe 3 fellowships that were worth doing... there are a heck of a lot more than 3 fellowships now and they seem to continue to grow.

Not only did the whole field, ACGME, SCAROP, WashU (my favorite), PDs and Chairs fail to make any meaningful geographic targeting effort (ie scouting people from smaller areas, dedicating a residency slot, setting up a community or ASTRO based funding system or initiative to truly help places where radiation oncology is undeserved, to attract people who want to live in those regions- you know, like any of the interventions that family medicine or internal medicine tried over the last ~15 years), they allowed a large, generalized labor expansion so that there are more cheap hands to pump out notes, kept them as captive labor for another year (or longer at these 'satellite only' positions!), and were happy enough to keep their budgets looking better / senior physicians' salaries untouched.

It's basically 'eating your young', only twice.

 

[RadOncDoc21]

I am sure those departments are very thankful for all the publications they got out of the residents, especially with all the md/phd's that went into the field over the past 10-15 years.

 

[thecarbonionangle]

Overall this is a problem in our profession (medicine) as a whole. Residencies are now "cheap labour" for hospitals camouflaged under the guise of an "education." I don't know if they were ever anything different, or maybe things are just getting worst. I can tell you that my experience in Internal Medicine has not been that much different of a note monkey. Now with hospital systems expanding and taking over cities and becoming a "brand", things will just continue to get worst.

 

[Fpg1245]

Time for a dedicated "flee radiation oncology now!" Thread? MS3 and 4's should take note now. The rash of retirements that were supposed to free up jobs isn't going to come. The dinosaurs in the field will stay as long as they have a pulse. It was lazy thinking on the part of our professional organizations who don't give a crap about residents. The leaders have no interest in even remotely relating to the problems of today's residents. They won't outright lie to you but they'll mislead you into thinking they care or hide behind "antitrust" or educational value. Rad onc Residents that are still early in the training process (i.e 2 or even 3). I think need to seriously reconsider their options and medical students should be given fair warning now to best look elsewhere. Unless of course you love the uncertainty of employment, constant paycuts, larger workloads, indifferent professional organizations, and exploitative academic positions then of course we are the specialty for you. Honestly, I don't see this turning around in a timely fashion. New grads will face the prospect of a 15-20yr drought on professional and financial advancement. Seriously get out while you can.

 

[xrthopeful]

Trollllololol

 

[firewicket]

Time for a dedicated "flee radiation oncology now!" Thread? MS3 and 4's should take note now. The rash of retirements that were supposed to free up jobs isn't going to come. The dinosaurs in the field will stay as long as they have a pulse. It was lazy thinking on the part of our professional organizations who don't give a crap about residents. The leaders have no interest in even remotely relating to the problems of today's residents. They won't outright lie to you but they'll mislead you into thinking they care or hide behind "antitrust" or educational value. Rad onc Residents that are still early in the training process (i.e 2 or even 3). I think need to seriously reconsider their options and medical students should be given fair warning now to best look elsewhere. Unless of course you love the uncertainty of employment, constant paycuts, larger workloads, indifferent professional organizations, and exploitative academic positions then of course we are the specialty for you. Honestly, I don't see this turning around in a timely fashion. New grads will face the prospect of a 15-20yr drought on professional and financial advancement. Seriously get out while you can.

If any resident reading this hasn't emailed ARRO yet to advocate for cessation in residency expansion... I'd recommend you do. Nobody can expect a change without doing anything to implement a change. Unfortunately talking about it here is educational, but does little to solve the problem.

 

[deleted18755]

I forwarded this thread to 5 attendings at the mid-sized residency program (located in a well populated but "undesirable" location in the rust belt where most graduates have no problem finding great jobs this or other "undesirable" locations) and I've heard from 4 who were shocked and had no idea that the job market was falling through the floor.

I wonder if our colleagues outside of major cities are clueless that there is a problem since everybody around them has no problem finding jobs (and honestly most people from small programs seek jobs in smaller places ... the only reason I know about this problem is from my interactions with recent graduates who have tried to venture out) while those in big cities
and big programs couldn't care less since they benefit as noted as in multiple post.

Regardless as fire notes nothing will change by just discussing this on this forum.

 

[Reaganite]

I forwarded this thread to 5 attendings at the mid-sized residency program (located in a well populated but "undesirable" location in the rust belt where most graduates have no problem finding great jobs this or other "undesirable" locations) and I've heard from 4 who were shocked and had no idea that the job market was falling through the floor.

I wonder if our colleagues outside of major cities are clueless that there is a problem since everybody around them has no problem finding jobs (and honestly most people from small programs seek jobs in smaller places ... the only reason I know about this problem is from my interactions with recent graduates who have tried to venture out) while those in big cities
and big programs couldn't care less since they benefit as noted as in multiple post.

Regardless as fire notes nothing will change by just discussing this on this forum.

There are plenty of jobs in desirable locations. I know several california spots that have filled in the last few years. Yeah, the pay sucks (250k-ish), but they are still relatively stable positions. Big Problem: they are never advertised. They fill with other california graduates. No point taking a chance on an unknown commodity when you can hire someone you know and trust. I recently hired 2 people myself, and both were local guys with average pedigrees. For PP, I am much more interested in a known commodity than your pedigree.

 

[Sheldor]

There are plenty of jobs in desirable locations. I know several california spots that have filled in the last few years. Yeah, the pay sucks (250k-ish), but they are still relatively stable positions. Big Problem: they are never advertised. They fill with other california graduates. No point taking a chance on an unknown commodity when you can hire someone you know and trust. I recently hired 2 people myself, and both were local guys with average pedigrees. For PP, I am much more interested in a known commodity than your pedigree.

I think this is a pretty good point, since I first came onto these boards asking about jobs when I was a medical student the common refrain was "the best jobs aren't advertised." After networking for the last few years I often hear about great jobs but then never see them come through on the ASTRO job board. Also, I was told back in 2009 when I first started coming here as an excited medical student interested in Rad Onc, "You'll be able to get a job! Often times it won't be on a coast or in a big city, but you'll get one." Honestly, are things really that much worse, now 7 years later? I hear about jobs all the time and I am a novice networker.

Remember, medicine, and especially Rad Onc are the opposite of nearly every field we are accustomed too. Job opportunities and pay go DOWN as you head towards high cost of living "desirable" areas. (This still baffles people when I tell them because we are indoctrinated in our pre-medicine life to think that there are MORE jobs available in big cities with higher pay.)

 

[mpdoc2]

...

 

[Mandelin Rain]

Part of the problem is managing expectations. When you're a life long academic super star at the top of your med school class, have aced your boards, published 10 papers, and trained at a highly ranked cancer center, you may expect to be able to write your own ticket.

That's not the way this works, and (almost) no one in private practice cares about (almost) any of that when the job hunt commences. On the opposite end of the spectrum, there are (almost) no research dollars available and (almost) no 80:20 scientist jobs with chair support out there.

It certainly doesn't help that residents are flooding out in ever increasing numbers, but everyone entering the field needs to realize that they are not going to get everything they want on the back end. Hell, you probably will not get most of what you want. Very few in any medical specialty do these days. It's a crappy moment in history to be a physician. You will, however, still get a field with low acuity levels, minimal after hours disturbances, high pay-to-difficulty ratio, and (most importantly) affords you the opportunity to help cancer patients. You will live better than 99.9% of people, whether it's in New York or York.

 

[DebtRising]

Listen, I understand, perspective is important and expectations in all of medicine need to be managed.

Those facts do not excuse senior leadership from relentlessly expanding the labor force indiscriminately. Having a generation of physicians who enjoyed better reimbursement, less debt, and probably more important than either of those a better practice environment with less paperwork / insurance hassle / bureaucratic oversight / greater research funding and autonomy oversee this expansion, hide behind every possible excuse to accept responsibility for modulating it now that the model it was based on shows there is now a projected decade long oversupply, AND THEN TAKE ADVANTAGE of the poor employment environment they created by decreasing salaries to new grads / creating more of fake fellowships / or continue to expand or create new resident programs so they get a piece of the free labor, is absolutely wrong and sadistic.

If this was about serving the needs of the population, then a geographic targeting strategy would have been implemented both for new labor and technology investments in undeserved area. This is a well known strategy that other fields had already undertaken. To my knowledge, almost no serious initiates were formed in this spirit (if so, disclose and I will happily admit my ignorance).

I don't know what the solution is. Maybe writing to ARRO will help, maybe not. Maybe I will feel better when I am finally out from under my educational debt. Maybe the field will have a crash like in the early to mid 90s and a radical change will be forced on those who are reluctant to reverse course now. That probably would be the worst option - if one thing is clear almost all of the general metrics of being a 'physician' as a job were dramatically better [save residency hours] at that time, so the blow was likely less harsh. To me this field feels awfully fragmented and disconnected - the opposite of what I thought a small field where 'everyone knows someone who knows almost everyone' would feel.

 

[radoncftw]

The most depressing thing, and which is borderline 'disgusting' (I know I say some strong things online, not always the most elegant) is that the same people (re: Chairs and PDs) who supported this expansion are now turning around and looking to capitalize on the people who cannot find adequate employment. How? The unbridled expansion of 'fellowships', both the licensed/formalized ones and the not-fellowship-in-name-only 60-90K 'job' offers. There are maybe 3 fellowships that were worth doing... there are a heck of a lot more than 3 fellowships now and they seem to continue to grow.

Not only did the whole field, ACGME, SCAROP, WashU (my favorite), PDs and Chairs fail to make any meaningful geographic targeting effort (ie scouting people from smaller areas, dedicating a residency slot, setting up a community or ASTRO based funding system or initiative to truly help places where radiation oncology is undeserved, to attract people who want to live in those regions- you know, like any of the interventions that family medicine or internal medicine tried over the last ~15 years), they allowed a large, generalized labor expansion so that there are more cheap hands to pump out notes, kept them as captive labor for another year (or longer at these 'satellite only' positions!), and were happy enough to keep their budgets looking better / senior physicians' salaries untouched.

It's basically 'eating your young', only twice.

 

[DukeNukem]

If any resident reading this hasn't emailed ARRO yet to advocate for cessation in residency expansion... I'd recommend you do. Nobody can expect a change without doing anything to implement a change. Unfortunately talking about it here is educational, but does little to solve the problem.

You're nuts if you think ARRO has the ability or desire to do anything besides the ASTRO Illuminati's bidding.

What did WashU specifically do?

See http://forums.studentdoctor.net/threads/bloodbath-in-red-journal.1014614/

 

[Dare2Dream]

Another thing we need to be doing is increase the awareness of what radiation oncology is, does, etc in the general medical community.

For example, we receive more oncological training than Heme/Onc physicians, yet they are the ones that receive consults. This is because IM residents/attendings generally don't even know about our speciality.

It is our responsibility as current/future residents to try and give a lecture during prelim year regarding the utilities and benefits of radiation in hopes that IM can potentially refer patients to us as well as med oncs if we want a seat at the table rather than letting med oncs make decisions for us in the future.

This is perhaps the most important point. However, you'd need to go one step further to change things as educating in itself is not going to change much. What does having the most oncology training translate to in clinical terms? Are Radoncs willing to manage patients the same way as Medoncs throughout treatment? If not, then it would be difficult to change the current setup with Medoncs as the gatekeepers. Perhaps it's time for a paradigm shift but that would require willingness to cover aspects of treatments that are usually relegated to Medoncs. Also the name "Radiation Oncologist" is itself quite limiting if Radoncs want to compete with Medical oncologists on equal footing.

 

[deleted18755]

Some of you guys on here have such great ideas . . . I really wish we could select leaders for ASTRO (or at least "real world" radiation oncology) from this forum!

Here is a true story: My wife is a medical oncologist and in her final year of fellowship I stayed on at the same institution on faculty. On one -5 to -10 degree night in February at 2am I get a call from the resident about an inpatient consult and I tell him ("oh wow" oh well let med onc and thoracic surgery sort it out . . . suck to be them . . . thank God we are in radiation oncology, this field is awesome, etc etc . . . let's get in "early" at 7:30am tomorrow to get updated, meet, and discuss!). I fall back asleep and woke up to the phone ringing and started to get mad that the resident woke me up again when I realized it was my wife's phone and within five minutes she was running out the door in a brutal even by our standards upstate New York February night while 7 months pregnant. I obviously would have gone in with her just to drive her and help out as best as I could but we had another baby sleeping (until that moment it hadn't even occurred to either of us to come up with a backup childcare plan when both of us were on call since what are the chances that I would actually have to go in?).

Anyway, I get in at 7:30 am (my wife had been there since maybe 2:30am as had some surgeons and many others others) and everybody looks at me like "who are you" and a nurse says "sorry this is an urgent/emergent situation and the doctors and oncologists are very busy, who are you and how can I help you." I tell her "I'm actually a doctor, a radiation oncologist, and I'm here to see the patient." Somebody, it might have even been a resident or medical student, basically laughs at me and says "the doctors and ONCOLOGISTS have been here for hours . . . we don't need a radiologist!

It's nice to enjoy the lifestyle of a radiation oncologist vs a medical oncologist (trust me I know, I'm literally married to one and have been since medical school days) and although the above example is a bit extreme honestly who do you think the vast majority of people think of as the "real oncologists" . . . people don't care about years of training, how many papers you published etc, especially in private practice, all that matters is who took good care of the patient when they needed it.

At the very least, please, please go and see consults on the weekend, even if it is whole brain or bone met and you don't need to sim or treat until Monday morning. You can still let the patient know about RT and let them and your colleagues know that you are a "real" doctor who works and cares about patients outside of 8-4:30 M-F. For the love of God when your medical friends (MD's in other specialties, or even mid-level providers, RN's whatever) talk about their insane shifts or how hard they work don't brag about how great our lifestyle is (I've seen this happen more than a few times) . . . you might end up with more free time than you expected (unemployed!!!).

 

[medgator]

Seeing inpatients on the weekends is a good way to get into the "trenches" with referring MDs in PP. I think most good PP guys do this.

 

[BobbyHeenan]

Seeing inpatients on the weekends is a good way to get into the "trenches" with referring MDs in PP. I think most good PP guys do this.

I agree. I see every consult on same day it's called in 99% of the time, even if on Saturday or Sunday. It's not necessary in non competitive markets, but in a place where independent surgeons and med oncs have choices for rad onc referrals, it's pretty necessary.

 

[Dare2Dream]

It's nice to enjoy the lifestyle of a radiation oncologist vs a medical oncologist (trust me I know, I'm literally married to one and have been since medical school days) and although the above example is a bit extreme honestly who do you think the vast majority of people think of as the "real oncologists" . . . people don't care about years of training, how many papers you published etc, especially in private practice, all that matters is who took good care of the patient when they needed it.

That is exactly what I was getting at above. I've heard it being repeated many times that Radoncs get the most oncology training and there is a need to educate other doctors about it but what does it translate into clinically? Are Radoncs willing to be in the trenches like Medoncs in managing patients throughout their oncology treatment? If the goal is to continue to mainly stick to conventional Radonc work and not diversify, then it is difficult to address the risks to the fields with Medoncs acting as gatekeepers and making decisions on treatment that may negatively impact Radoncs over the long run.