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ERAS Stats- RadOnc Uptrending
- Thread starter CurbYourExpectations
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Look at how the composition of who is applying is changing. There are less US grads applying than spots in the match...
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deleted1111261
Headline misleading!
Proportion of US MDs probably a nice indicator to track, but I think we’d benefit from more FMGs
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deleted1111261
I hear ya
I like the idea of having the talent pool be worldwide rather than just national.
Lot of smart people out there. Rather than someone who couldn’t get into ENT, how about someone who was top of their game in another country.
Just a thought.
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Normally would agree but this hasn't been the first time we've been here. When RO was very uncompetitive in the 70s and 90s these programs were filling with FMGs/IMGs as well, even if there was a dichotomy of the kinds of grads that were matching in.
It just lends credence to the idea that many of these "hellpits" are simply looking to match warm bodies rather than try to match demand with supply
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Let's put some numbers around that. Say 2.3 billion people in the world aged 20-39. Subtract out the similar folks in the US in that age range (330 mil * 0.38), and left with 2.1 billion or so.
Smart people -- let's say IQ of 130+? Assume average of 100 and SD of 15. So ~2.3% on the appropriate tail.
~49 million smart people.
Say only a 1/4 of these really smart people would be interested in medicine (hand waving here), learn english, etc etc. And of these ~0.7% (number of rad onc slots/overall number of residency slots -- an approximation of interest in rad onc) ready to push photons.
Another 86k+ global people gunning for rad onc residency slots and ultimately jobs? Would they do it for way less than we are currently paid?
For sure an overestimate, but bottom line these are large numbers (ie global population) so even once you whittle things down potential to overwhelm if floodgates opened.
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Ah yes...I think an "applicant bounce" happens in 30-40% of garbage specialties 16-18 months after they crater, right?
Corny jokes aside, this was definitely going to happen this year. We're such a small sliver of the total applicant pool, and 20-30 people is actually "huge" in RadOnc but 1/4 of my intern year IM class size.
Humans are bad at thinking big picture/long term, especially when it pertains to abstract topics. Especially when they barely understand that topic.
If you're a medical student, and RadOnc is on your radar, you've probably found a way to talk/interact with people in the field. You come on SDN and read some threads. What do you see right now?
Well, for the past 6ish months we've seen a huge surge in job churn/availability. We even talk about it on SDN. I've seen it myself.
I am still firmly in "Camp Oversupply", as strong as ever. But just like people go outside in a snowstorm and say climate change is fake because they don't understand the science behind chemistry, ecosystems, economics, etc - no med student is going to easily understand the argument about hypofrac and CON and "on beam" and UroRads etc etc.
Mostly because A LOT of the practicing attendings don't understand it either.
While med students might be "canaries in a coalmine", we can't forget that a canary cannot understand the concept of mining for coal or how the coal is processed and utilized or how the coal poses a threat to them or...
Corny jokes aside, this was definitely going to happen this year. We're such a small sliver of the total applicant pool, and 20-30 people is actually "huge" in RadOnc but 1/4 of my intern year IM class size.
Humans are bad at thinking big picture/long term, especially when it pertains to abstract topics. Especially when they barely understand that topic.
If you're a medical student, and RadOnc is on your radar, you've probably found a way to talk/interact with people in the field. You come on SDN and read some threads. What do you see right now?
Well, for the past 6ish months we've seen a huge surge in job churn/availability. We even talk about it on SDN. I've seen it myself.
I am still firmly in "Camp Oversupply", as strong as ever. But just like people go outside in a snowstorm and say climate change is fake because they don't understand the science behind chemistry, ecosystems, economics, etc - no med student is going to easily understand the argument about hypofrac and CON and "on beam" and UroRads etc etc.
Mostly because A LOT of the practicing attendings don't understand it either.
While med students might be "canaries in a coalmine", we can't forget that a canary cannot understand the concept of mining for coal or how the coal is processed and utilized or how the coal poses a threat to them or...
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The narrative is back to business as usual in academics. “Leaders” tout a “robust” job market this year and uptick in warm body applications. Things just haven’t been this good in a while. Everyone is saying it. Hellpits are salivating frothing at the mouth like old mastiffs. Nothing to see here folks. Best of times ahead!
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Then you get my analogy,brotha!
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Going into rad onc right now is a $54.20/share Twitter stock purchase
Desperation of FMG and IMGs and greedy boomers make a hell of a combination
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deleted1116990
The open "job market" sucks. I've been in it for a year trying to work something out. Getting interviews is hard, and when you finally think you have put together something halfway decent you either realize it's a bait and switch scam or the whole thing falls apart. Leverage is non-existent and take-it-or-leave-it terms still prevail, to the extreme that you are expected to interview without knowing the details of an offer and before an offer is handed to you it comes with a mini-lecture of "if you attempt to negotiate any of this, we will pull it back immediately." I have had offers literally come to me and say "we need you to hurry up and sign this because we have a new grad we interviewed after you and we need to offer to her if you're not going to take it." Locums rates are 50% of full-time pay whereas other fields they are 150-200% of full-time pay. So that's not even a worst-case backup option.
Oh, and I also want to add that I am searching with literally zero geographic restrictions. From Hawaii to Maine from cowtown to downtown Manhattan. I can't imagine trying to throw even a slight geographic restriction in the mix.
I am sick of academics gaslighting about how it's a lie that there is a problem with the "job market." They are not in it. They are in their bubble. Oh, the job market is great because you are hiring people for 400k to be pseudo-academic cogs with no say in anything to staff a different satellite every day of the week? Yeah, maybe it's my fault because my standards are too high after a decade of training for this and jumping through all the stupid board exam hoops I suppose.
Compare this to literally any other field of medicine at the moment. Why are people still applying to this? Yeah, I get it that as a med student you are used to having no stability and certainty about your future and living out of a suitcase as you do rotations. That's ok when you are 25 years old. Trust me, you don't want zero stability and constantly moving around and permanently interviewing when you are in your late 30s. Residency was the best time of my life in medicine because I knew, no matter what, what I was going to be doing and where I was going to be for the next 4 years and it wasn't going to suddenly change up on me. Think ahead and do something else.
Oh, and I also want to add that I am searching with literally zero geographic restrictions. From Hawaii to Maine from cowtown to downtown Manhattan. I can't imagine trying to throw even a slight geographic restriction in the mix.
I am sick of academics gaslighting about how it's a lie that there is a problem with the "job market." They are not in it. They are in their bubble. Oh, the job market is great because you are hiring people for 400k to be pseudo-academic cogs with no say in anything to staff a different satellite every day of the week? Yeah, maybe it's my fault because my standards are too high after a decade of training for this and jumping through all the stupid board exam hoops I suppose.
Compare this to literally any other field of medicine at the moment. Why are people still applying to this? Yeah, I get it that as a med student you are used to having no stability and certainty about your future and living out of a suitcase as you do rotations. That's ok when you are 25 years old. Trust me, you don't want zero stability and constantly moving around and permanently interviewing when you are in your late 30s. Residency was the best time of my life in medicine because I knew, no matter what, what I was going to be doing and where I was going to be for the next 4 years and it wasn't going to suddenly change up on me. Think ahead and do something else.
A huge victory for the academic spin machine. >1.00 applicant per spot. Good job everybody!
I, for one, am looking forward to an ASTRO with less hand-wringing about jobs and more talks on protons and the non-inferiority of less radiation therapy.
I, for one, am looking forward to an ASTRO with less hand-wringing about jobs and more talks on protons and the non-inferiority of less radiation therapy.
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Right now, the rad onc job market is probably as strong as any time during the past 5 years (just like with everything else in the current economy). However, it is still among the very worst in all of medicine. If this doesn't concern you as a med student, send in those applications!
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Does anybody know if other fields have the same dynamic of being expected to waste time and interview without knowing the details of the job and pay etc? It seems like such a waste of time only to find out the job sucks after you take days off to fly somewhere to interview.
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Yep.... Lots of employed hospital and academic gigs. Very little private out there, but yes as geographically open as it has been in several years
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deleted1116990
No. You have to play this stupid game of acting like you don't care about pay, time off, or clinic schedule/operations to even get a foot in the door. You're in it because deep down you as a Floridian really want to live in Clinton, Iowa and serve the patients in the community for whatever they are gracious enough to pay you. Suggest anything otherwise upfront and you can forget about being flown out for an interview.
Oh and it's not all peachy in the PP world either. Come and talk to me after you've been involved with a fake partnership track. It's not a small club.
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I want to know how the job market feels specifically for new grads. I've heard of a lot of jobs hiring, but also a lot are not new grads (sometimes understandable).
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From my experience a lot of satellites for new grads. Private groups and established practices are looking for more experience but not as many are coming up which is not surprising.
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deleted1111261
Mayo AZ wants experienced or internal of fresh grad, is what I’ve heard
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Lot of the employed hospital gigs in my neck of the woods are trying to find experienced/BC first and then going with new grad if they can't find that
Here’s the info for Big 3 program grads (your best possible scenario):
MDACC:
MDACC
MDACC Satellite
MDACC Satellite
PP Upstate NY
PP Kentucky
PP Florida
PP Texas
MSKCC:
PP Tennessee
MSKCC
Duke University
UT Southwestern
UNC
Rockefeller University (post doc)?
HROP:
MDACC
MGH
MGH
BWH
BWH Satellite
Just from this years results, looks like if you want PP go to MDACC, if you want academic go to HROP or MSKCC. MSKCC has the most diverse exit options it looks like.
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deleted1116990
Exactly what I recently experienced. During attempted negotiation I was reminded frequently they had a new grad on the hook they could offer it for much less to, and ultimately, I think they decided screw it lets go with the cheaper option.
Reality of rad onc: If you want to (or worse, have to) leave your job for any reason, you will be competing with a glut of new grads. Decent chance you will have to go back to entry level terms and start all over if you want to move despite your 5+years and BC. Awesome career!
Spending a decade and a half of my adult life training for a profession... then getting ghosted by Laredo, TX = true misery
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This is the part that people don't really talk about and where "did you get a job" is not a good metric for the health of the market.
My experience and talking to friends this year, people have had upward mobility leaving their first job, so I disagree there. But the lack of ability to negotiate rings true. This is a huge problem in a field with questionable behavior of some leaders (so many stories from all types of practices, academic and otherwise).
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deleted1116990
We should start a ghosting thread. I got ghosted by Spencer, IA after I gently questioned their plan to have a random NP cover the clinic because I wasn't sure we were the same level of "provider." But hey at least they returned my call initially. Kearney, NE (literally the middle of nowhere) completely ignored me. NGL, that one hurt. At least Laredo is warm. I talked with them years ago and their clinic sounded like an absolute nightmare. I'm surprised it's still open.
As long as they make money it will remain open.
This was the most frustrating thing for me.
EVERY time I led with what I expected for compensation / clinic autonomy... everything ground to a complete halt.
Most important advice to new grads I can give:
1) Do everything to absolutely exude enthusiasm. Don't express criticism for the way they operate. Do not even mention compensation. Agree to whatever they are asking.
2) Just expect to take a job you might not want... if you are going to hold out; be sure to have 3 - 6 months of funds to cover you as you try to piece together some garbage locums assignments.
3) If you ultimately decide you are holding out... and you can't accept their offer. I recommend doing everything you can to waste their time. Learn how to actually ENJOY wasting their time. Drag out minor contract issues... etc. Its really the only thing that made me feel better.
Yep... in discussions with Arkansas; the moment I questioned their use of NPs in supervising radiation therapy. Silence.
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Ha, I got ghosted by them too!
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deleted1116990
In my most recent failed attempt to negotiate a fair deal, it was really the clinic autonomy thing, not just the compensation that killed it. I made the insane ask of wanting them to promise me control of the schedule and that I wouldn't be forced to sit there if no patients are being treated. They could not deal with not having carte blanche control over the physician. They'll pay you a little more (maybe), but they will never let go of the contractural freedom to make you do whatever they want or change the terms whenever they want. If they get a whiff during the recruiting process that you aren't a total pushover, they will ghost you. Above all else, they want a doctor that will let admin control everything and be totally happy about it.
Again, this is only possible because of the supply and demand imbalance in the job market. In a healthy/fair environment, you would be able to negotiate a contract with a penalty if they choose to break their contractural promises (for instance, if they want to get rid of you 2 years into a 3 year contract they have to buy you out of it and pay you the full salary as severance). Instead everything is in their favor and they can fire you with 90 days notice or present you with an entirely different contract after you have already moved and settled. Why even have a contract? It's a scam to protect the hospital's interests upon your exit and harm yours, not to guarantee a salary upfront. Salaries and bonuses in contracts are all smoke and mirrors. They can change them whenever they want with a 90 day heads up.
As always, important to remember that increasing resident complement in order to decrease radiation oncologists' marketplace power was the specific intent, as delineated by Dr. Dennis Hallahan so eloquently in the Red Journal.
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I have been ghosted in Wyoming
I have been ghosted in Texas
I have been ghosted in Tennessee
I have been ghosted in Georgia
If you haven’t been job ghosted are you even #radonc
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deleted1116990
Isn't there a song about this?
'been ghosted by Reno, Chicago, Fargo, Minnesota
Buffalo, Toronto, Winslow, Sarasota
Wichita, Tulsa, Ottawa, Oklahoma
Tampa, Panama, Mattawa, La Paloma
Bangor, Baltimore, Salvador, Amarillo
Tocapillo, Baranquilla, and Perdilla, I'm a
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So true and I know colleagues from multiple specialties who thought they would be treated with honor by admins because they were told by their mom everyone will respect you when you are a doctor. NOT TRUE. The world, especially when money is involved, can be a cutthroat place. Med students and residents you’ve been warned! Read the fine print.
Didn't graduate yet, but I am signed, few friends are signed or about to sign as new grads too. Seems like one of the better job markets rad onc has had. I was able to negotiate a (in my view) competitive salary with reasonable terms. I will be in a desirable location. Friend also negotiated higher salary in an extremely competitive location. We both had multiple offers, so that was our leverage.
Not to dismiss the real problems in our field or difficulty others are going through, but I was expecting to end up in Salina Kansas.
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Let me preface this with: I want to be wrong. Everyone take note of this post, and feel free to throw garbage at me until I puke.
I am intensely interested to have you tell us about your job in July 2024. Hopefully, you'll be the happiest person on SDN and I'll be puking garbage.
But...I am unsure.
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Damn I'm behind I guess, I've been worried about my prospects. I maybe have two offers but seeing how some ASTRO meetings go.
Any reason for the extreme pessimism? Not seeking congratulations, but why throw shade? I've been on SDN for over 10 years, and was reading the rad onc forum for almost as long, I am well aware of the job market, how bad people have been burned, etc. I am very happy with my offer, and your post speaks volumes of why people don't like SDN rad onc.
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It's been bad for several years culminating in the crap that happened in 2020 with postponed contracts etc.
That being said, this is the best job market I've seen in several years as RO isn't immune to the post covid labor shortages that are present everywhere, coinciding with a stronger locums market as well.
Many of us recall getting emailed by WeatherBy and comphealth during covid asking if we needed practice coverage and offering a slate of BC rad oncs looking to offer locums services at the peak of the pandemic, now it's a complete 180
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Depends on how many 60+ year old docs get Covid?
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What a mean post. Denigrating while adding zero to the conversation. Congratulations
I'll take what I can get as far as good job market news. Glad to hear it.
It strikes me that our "output" of new residents is on a 5 year scale and our "input" for feedback on how the market is going comes in on an annual basis and seems to swing wildly year to year. At the end of the day, I still don't see any real mechanism (or willingness) to adjust the supply side of residents regardless of what we as a field think is happening on the demand side of jobs, forecast 5 yrs in the future. I eagerly await the job market analysis with Shah and company.
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Agree with this.
The issue (right now) isnt that one can’t get a job. As one becomes more experienced, the easier it is see what makes up a “good job” vs a “bad job.”
As we’ve all stated, the opportunities are becoming slim these days. My peers who came out from my institution are averaging at least 3 job changes in less then 10 years.
It’s a strong job market for new grads this year. Satellites and clinics that have run lean over the last 3 years because of uncertainties associated with APM and the pandemic are finally looking for help. Satellites that were put on hold are finally being built. Now that there’s a bit more clarity that the world will stay open, people that left medicine are finally being replaced. All this to go along with the standard cycle of retirements, perhaps even accelerated as the markets are still at a relative high and now it’s actually possible to do things in your retirement. To add to all this, the interview process has been accelerated due to zoom. It’s relatively easy to interview more candidates and, similarly, for more candidates to go on interviews. If you keep the number of jobs constant, but each job doubles the number of interviews they offer, then you give the perception that it’s a “really great year” because it seems like there are more “opportunities” for applicants. The ability to know who you want before ASTRO also moves the timeline up, and the knock on effect of places that have their **** together making decisions early, is that it puts pressure on others to do the same or to make more favorable offers to applicants.
So for a lot of reasons, this is a genuinely strong year to be a new grad. It also may artificially seem like it’s even stronger than it truly is. I’m sure the #radoncisgreat crowd is on the precipice of rebranding themselves as #radoncisback, and the gaslighting will continue. However, in the absence of a real trend with a genuine hypothesis as to why there is a sudden increased need for radonc services and why we think this need would be sustainable, I think career academics and free thinkers alike should call this what it is. An outlier.
So for a lot of reasons, this is a genuinely strong year to be a new grad. It also may artificially seem like it’s even stronger than it truly is. I’m sure the #radoncisgreat crowd is on the precipice of rebranding themselves as #radoncisback, and the gaslighting will continue. However, in the absence of a real trend with a genuine hypothesis as to why there is a sudden increased need for radonc services and why we think this need would be sustainable, I think career academics and free thinkers alike should call this what it is. An outlier.
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deleted1111261
Very, very good point
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