For all the people who are saying rad onc market is improving

[radoncftw]

We do okay but in general, we probably underestimate how much other professions make, and also underestimate the variety of folks that make as much or more than us.

Humbling, for example, that a 28 yo Youtuber makes $1m pretax and $0.5m after tax. You got to wonder what you’ll do when AI takes your job.

physicians just don't make that much anymore. i will probably get flamed. i love my job. i make good money. but look at physician salaries now vs. 20 years ago. they are probably less now. other high income professionals salaries have increased considerably in that time.
my mom is an engineer and gets a 5% raise every year. she makes more than my wife who is pediatrician with 5 yr experience.
my dad works in medical sales. he makes more than me.
they also both take considerably more naps in the middle of the day than i do and are able to work remotely almost entirely.

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[IonsAreOurFuture]

Just wait until FLASH ruins us for good.

The biggest proponent of FLASH was Varian, specifically for protons. Now that they have quietly quit selling proton systems, I don't think we'll see it in the marketplace for a while.

A lot of the cats with nasal tumors that responded so well to 30 Gray or more with electron flash now have ORN of the facial bones, so there is no free lunch, even with FLASH. A 40% discount on 30 Gy is still 18 Gy x1. There's going to be late effects.

 

[JustAdocInBox]

physicians just don't make that much anymore. i will probably get flamed. i love my job. i make good money. but look at physician salaries now vs. 20 years ago. they are probably less now. other high income professionals salaries have increased considerably in that time.
my mom is an engineer and gets a 5% raise every year. she makes more than my wife who is pediatrician with 5 yr experience.
my dad works in medical sales. he makes more than me.
they also both take considerably more naps in the middle of the day than i do and are able to work remotely almost entirely.

Yep and physician salaries will continue to drop relative to other professionals. In the next decade or two we will see mid career engineers make more than specialist physicians.

 

[CaesarRO]

Yep and physician salaries will continue to drop relative to other professionals. In the next decade or two we will see mid career engineers make more than specialist physicians.

At least until GPT-4 makes them and us obsolete

 

[Neuronix]

physicians just don't make that much anymore.

I guess it's all relative. My mom lives in elderly section 8 and my dad lives in the middle of nowhere. What I made last year might be more than they make in their whole lives.

Meanwhile I'm here here in urban, academic rad onc...

I finally got a promotion and a raise in mid 2022. It only took 6 years of being an attending to get a promotion, and to get a raise I had to get a real job offer with significantly higher pay at another practice (my first after years of looking).

Great! I can finally buy a house for my family and get out of our cramped little condo. Except... No.

Houses here now start at $1,000/sq ft, and even at that price point there are serious issues. It's more like $1,500/sq ft for a nice place or new construction with a decent commute and good schools. Even a lot is $2 million now.

The lesson I've learned is that everyone else clearly has more money than we do as a dual physician household. I never thought we'd have any issues with money. Work hard, do the best, beam on, and everything else will sort itself out. It hasn't exactly worked out that way.

 

[Fpg1245]

I guess it's all relative. My mom lives in elderly section 8 and my dad lives in the middle of nowhere. What I made last year might be more than they make in their whole lives.

Meanwhile I'm here here in urban, academic rad onc...

I finally got a promotion and a raise in mid 2022. It only took 6 years of being an attending to get a promotion, and to get a raise I had to get a real job offer at another practice (my first after years of looking).

Great! I can finally buy a house for my family and get out of our cramped little condo. Except... No.

Houses here now start at $1,000/sq ft, and even at that price point there are serious issues. It's more like $1,500/sq ft for a nice place or new construction with a decent commute and good schools. Even a lot is $2 million now.

The lesson I've learned is that everyone else clearly has more money than we do as a dual physician household. I never thought we'd have any issues with money. Work hard, do the best, beam on, and everything else will sort itself out. It hasn't exactly worked out that way.

Seems like we have similar problems. It’s seems like every situation where things could go poorly it has. Things just don’t every break my way ever. House? Sorry unaffordable? Job? Probably won’t have one? Good schools? Better hope remote learning becomes a thing? It’s a joke and if I think about it too much it make me want to kill myself.

The work hard and all your dreams will come true was just a way to keep you on the wheel.

 

[Mandelin Rain]

I guess it's all relative. My mom lives in elderly section 8 and my dad lives in the middle of nowhere. What I made last year might be more than they make in their whole lives.

Meanwhile I'm here here in urban, academic rad onc...

I finally got a promotion and a raise in mid 2022. It only took 6 years of being an attending to get a promotion, and to get a raise I had to get a real job offer at another practice (my first after years of looking).

Great! I can finally buy a house for my family and get out of our cramped little condo. Except... No.

Houses here now start at $1,000/sq ft, and even at that price point there are serious issues. It's more like $1,500/sq ft for a nice place or new construction with a decent commute and good schools. Even a lot is $2 million now.

The lesson I've learned is that everyone else clearly has more money than we do as a dual physician household. I never thought we'd have any issues with money. Work hard, do the best, beam on, and everything else will sort itself out. It hasn't exactly worked out that way.

This has been my experience as well. I make a nice living, drive a 10 year old Honda, and take a family trip once a year. My neighbors are off doing month long European vacations, driving new Lexus, and remodeling everything. When they are working, they work from home most days doing business type stuff that I don't really understand the value of.

I just don't know where the money is coming from. Like, they're either leveraged to the eyeballs or they're making at least twice what I am. I'm fairly sure it's the latter.

 

[Mandelin Rain]

Seems like we have similar problems. It’s seems like every situation where things could go poorly it has. Things just don’t every break my way ever. House? Sorry unaffordable? Job? Probably won’t have one? Good schools? Better hope remote learning becomes a thing? It’s a joke and if I think about it too much it make me want to kill myself.

The work hard and all your dreams will come true was just a way to keep you on the wheel.

Brother/Sister, we are here for you, but if you are actually having those thoughts, please see someone now.

 

[BobbyHeenan]

This has been my experience as well. I make a nice living, drive a 10 year old Honda, and take a family trip once a year. My neighbors are off doing month long European vacations, driving new Lexus, and remodeling everything. When they are working, they work from home most days doing business type stuff that I don't really understand the value of.

I just don't know where the money is coming from. Like, they're either leveraged to the eyeballs or they're making at least twice what I am. I'm fairly sure it's the latter.

I think some (but not all) of this is the fantasy land of a zero interest rate environment. Companies did not have to be cash flow positive as debt was so cheap.

 

[Neuronix]

Seems like we have similar problems. It’s seems like every situation where things could go poorly it has. Things just don’t every break my way ever. House? Sorry unaffordable? Job? Probably won’t have one? Good schools? Better hope remote learning becomes a thing? It’s a joke and if I think about it too much it make me want to kill myself.

The work hard and all your dreams will come true was just a way to keep you on the wheel.

This is taking it to the extreme. Don't kill yourself. Seek help.

I don't know many unemployed rad oncs, and they're not unemployed permanently as long as they move somewhere else or work for Evilcore. If you're a resident, you will find a job.

There is still value in what we do. We still make more than most people. Keep some perspective.

 

[OTN]

We do okay but in general, we probably underestimate how much other professions make, and also underestimate the variety of folks that make as much or more than us.

Humbling, for example, that a 28 yo Youtuber makes $1m pretax and $0.5m after tax. You got to wonder what you’ll do when AI takes your job.

There aren't that many YouTubers pulling in this kind of money, and the Venn Diagram between "radiation oncologists" and "people who could be super successful YouTubers" does not contain overlapping circles...with the possible exception of Simul

 

[OTN]

This has been my experience as well. I make a nice living, drive a 10 year old Honda, and take a family trip once a year. My neighbors are off doing month long European vacations, driving new Lexus, and remodeling everything. When they are working, they work from home most days doing business type stuff that I don't really understand the value of.

I just don't know where the money is coming from. Like, they're either leveraged to the eyeballs or they're making at least twice what I am. I'm fairly sure it's the latter.

Leveraged. Lots of zombie companies out there that are going to collapse in the new high interest rate environment. Lots of my private equity friends who were, just last year, closing tons of deals and doing well are now wandering around in the desert with no deals getting done. It's feast or famine for those guys, and since 2008 it's been all feast. The current/upcoming famine is going to be brutal, and if the dollar does indeed lose its status as the world reserve currency, it's all over for them for good. Additionally, those in commercial real estate are in the process of getting wrecked due to the remote work trend you referenced. At least in radonc once you have a job you'll likely keep that job.

I do feel for those of you in South Florida/Miami, because that's where a lot of my tech acquaintances with tons of money headed to eventually. Can't blame remote workers for wanting to work in Vegas On the Beach, but it doesn't make it easy for everyone else.

 

[RickyScott]

Leveraged. Lots of zombie companies out there that are going to collapse in the new high interest rate environment. Lots of my private equity friends who were, just last year, closing tons of deals and doing well are now wandering around in the desert with no deals getting done. It's feast or famine for those guys, and since 2008 it's been all feast. The current/upcoming famine is going to be brutal, and if the dollar does indeed lose its status as the world reserve currency, it's all over for them for good. Additionally, those in commercial real estate are in the process of getting wrecked due to the remote work trend you referenced. At least in radonc once you have a job you'll likely keep that job.

I do feel for those of you in South Florida/Miami, because that's where a lot of my tech acquaintances with tons of money headed to eventually. Can't blame remote workers for wanting to work in Vegas On the Beach, but it doesn't make it easy for everyone else.

I am not an econ guy, but dollar post covid is even better than pre-covid. (china in much worse position with declining population, less business/investment friendly environment, dictator who makes a lot of unforced errors - most manufacturers are hedging on china and investing more in vietnam and india etc.)

 

[communitydoc13]

It’s a joke and if I think about it too much it make me want to kill myself.

Reach out to someone. You are trying to do something real. That is enough. It is not only more than the vast majority of folks who have made the Faustian bargain of going into finance; it is the most any of us can do.

There are many social workers who are happier than many private equity types.

Among the group that is trying to do real things, we are still doing OK. But, we do need to advocate for ourselves. I do believe that non-physician admins continue to believe that we are overpaid....and they are wrong. We do not sit in meetings all day. We do things. Sometimes, we cure cancer.

 

[sirspamalot]

You have to make compromises to be able to max out earnings in radonc. Getting a job in a major metro area, unless you were grandfathered in or have an inherited center coming your way, is near unicorn type stuff now.. and even if you can, the pay is miserable.

I know, I'm a unicorn, but I really think more docs should "unlock" geography by learning to fly.

 

[Mandelin Rain]

I know, I'm a unicorn, but I really think more docs should "unlock" geography by learning to fly.

Better yet, docs should unlock COL pay increases through organizing.

 

[Lamount]

Yep and physician salaries will continue to drop relative to other professionals. In the next decade or two we will see mid career engineers make more than specialist physicians.

Median Rad Onc salary is top 1-2% US median household income... so, personally, I am not crying in my beer

 

[medgator]

I do feel for those of you in South Florida/Miami, because that's where a lot of my tech acquaintances with tons of money headed to eventually. Can't blame remote workers for wanting to work in Vegas On the Beach, but it doesn't make it easy for everyone else.

This. FL has become the hottest RE market coming out of the pandemic and we aren't seeing corrections in prices like is starting to happen in the rest of the country (Boise, idaho is the poster children of the correction with fed rate hikes)

Honestly if you didn't own a house/th/condo pre pandemic, it's basically 50-100%+ more expensive on average to buy one now in FL. And with many cash deals still happening and still low inventory, i don't see price corrections happening anytime soon

These 124 housing markets are weathering the home price correction (so far) in 1981 fashion

Among the nation's 400 largest housing markets tracked by Zillow, 124 markets remain at their peak.

fortune.com

 

[Bequerel]

Median Rad Onc salary is top 1-2% US median household income... so, personally, I am not crying in my beer

This is exactly the problem! We would all rather cry into our 18 year old single malt scotch.

 

[RadOncDoc21]

This is exactly the problem! We would all rather cry into our 18 year old single malt scotch.

Right, the hospital CEO exec would actually kill himself if he made rad onc money.

I’m not saying we’re suffering but I wouldn’t mind making more money.

 

[IonsAreOurFuture]

At least until GPT-4 makes them and us obsolete

I actually view AI as a good reason to be in Rad Onc, or at least in a sub-niche of Rad Onc. Prostate or GYN brachy? Or good at doing SpaceOAR (I know, not everyone likes SpaceOAR), there's not going to be an algorithm taking that job anytime soon. The more complex and multifaceted, the better.

Doing cutting edge research or creating something that doesn't exist? AI isn't going to steal the results of your randomized trial, (unless it's non-inferiority).

 

[RickyScott]

after hearing some podcasts abt basics of gpt/llm, impact seems to be overblown. they are just predicting which word/token follows another. there is no generalized intelligence here.

 

[thecarbonionangle]

Googling current doc listed there brings up a mugshot on image search 🤷‍♂️

Fleck Ronda, MD | Find a Doctor | Carlsbad Medical Center | Carlsbad, NM

www.carlsbadmedicalcenter.com

This is the future at many of these hellpit places. Mugshot? Everyone makes mistakes. Can you write a note and draw a circle? Sign on the dotted line. You’re hired as a resident or attending!

 

[DebtRising]

Medicine is getting worse with more stress and less autonomy and pay. So all that “compassion” we get groomed for goes into longer hours away from family and friends and less of our own life for a selfless notion which is harvested by industry for their profit over ours. And we are less and less respected after the ACA political wars, whatever side you may be on. But only our compassion is judged when we question these things.

Rad Onc is a specific microcosm of this trend with the added bonus of our own field leaders caring not but two thoughts of the health of the field or future of young physicians. We have giants in our field who have cured and treated thousands of patients but who treat younger physicians as a means to the end of their golden parachute retirement. It’s weird.

It’s all going to get worse and perspective is important - we see a lot of worse off people and we make good salaries compared to the average household. If you ever feel it’s too much definitely speak up and seek help. But relative to other professionals, this was a losing bet by a long shot, not just in dollars but more importantly time. I’m good at what I do and passionate - I would never do this again.

 

[RickyScott]

Medicine is getting worse with more stress and less autonomy and pay. So all that “compassion” we get groomed for goes into longer hours away from family and friends and less of our own life for a selfless notion which is harvested by industry for their profit over ours. And we are less and less respected after the ACA political wars, whatever side you may be on. But only our compassion is judged when we question these things.

Rad Onc is a specific microcosm of this trend with the added bonus of our own field leaders caring not but two thoughts of the health of the field or future of young physicians. We have giants in our field who have cured and treated thousands of patients but who treat younger physicians as a means to the end of their golden parachute retirement. It’s weird.

It’s all going to get worse and perspective is important - we see a lot of worse off people and we make good salaries compared to the average household. If you ever feel it’s too much definitely speak up and seek help. But relative to other professionals, this was a losing bet by a long shot, not just in dollars but more importantly time. I’m good at what I do and passionate - I would never do this again.

Part of the issue with comparing salaries to national averages is the delay and the debt. I have friends who left college as high school teachers who were able to afford homes at the time in locations that I couldn’t many years later at 4x salary + a lot of debt.

 

[Fpg1245]

Medicine is getting worse with more stress and less autonomy and pay. So all that “compassion” we get groomed for goes into longer hours away from family and friends and less of our own life for a selfless notion which is harvested by industry for their profit over ours. And we are less and less respected after the ACA political wars, whatever side you may be on. But only our compassion is judged when we question these things.

Rad Onc is a specific microcosm of this trend with the added bonus of our own field leaders caring not but two thoughts of the health of the field or future of young physicians. We have giants in our field who have cured and treated thousands of patients but who treat younger physicians as a means to the end of their golden parachute retirement. It’s weird.

It’s all going to get worse and perspective is important - we see a lot of worse off people and we make good salaries compared to the average household. If you ever feel it’s too much definitely speak up and seek help. But relative to other professionals, this was a losing bet by a long shot, not just in dollars but more importantly time. I’m good at what I do and passionate - I would never do this again.

A few thoughts since being out of training

1. Being a good doctor is not valued. Connections, charm, and luck have far more weight than anything else.
2. Fellow ROs aren’t your friends even the ones who essentially feel the same way you do
3. All the college seniors and med studs who were so proud of who they voted for in ‘08 and could wait to shout down any dissonance over the ACA are now living and working in the system
4. You’re basically trapped like a rat on a sinking ship. You think pharma will take you in guess again…there’s a recession coming and the govt hates pharma as much as they hate doctors.
5. The system be it PP, hosp employed, academic is designed to **** you. It cannot function unless it’s doing that.

 

[JustAdocInBox]

Part of the issue with comparing salaries to national averages is the delay and the debt. I have friends who left college as high school teachers who were able to afford homes at the time in locations that I couldn’t many years later at 4x salary + a lot of debt.

Yep, several of my friends took jobs straight out of undergrad in tech and business, started funding their 401ks in their 20s, purchased homes, job hopped to improve their salaries. In the meantime I offset my compensation for a decade and took on debt. By the time I was ready to enter the job market the academic hospital in my home town bought up more than half the community hospitals and private practices and drove down compensation by paying all docs on an academic pay scale. The rest of the practices sold to other health systems that pay better but all have aggressive non competes with zero leverage for the docs.

 

[radoncftw]

Medicine is getting worse with more stress and less autonomy and pay. So all that “compassion” we get groomed for goes into longer hours away from family and friends and less of our own life for a selfless notion which is harvested by industry for their profit over ours. And we are less and less respected after the ACA political wars, whatever side you may be on. But only our compassion is judged when we question these things.

Rad Onc is a specific microcosm of this trend with the added bonus of our own field leaders caring not but two thoughts of the health of the field or future of young physicians. We have giants in our field who have cured and treated thousands of patients but who treat younger physicians as a means to the end of their golden parachute retirement. It’s weird.

It’s all going to get worse and perspective is important - we see a lot of worse off people and we make good salaries compared to the average household. If you ever feel it’s too much definitely speak up and seek help. But relative to other professionals, this was a losing bet by a long shot, not just in dollars but more importantly time. I’m good at what I do and passionate - I would never do this again.

i think the key to happiness in medicine is finding a job with good QOL.
QOL can mean alot of different things to a different people.
One thing I have really tried to do since I became an attending was work at work and thats its. no notes, contouring, etc. from home. i spend my free time on everything else that makes life worth living.
if you can achieve this balance in our field, we really have it good.
part of why residency sucked for me was because i spent so much time outside of work working. it was really hard coming home to my wife and saying "sorry hun, the chair of our dept expects me to have all the contours/notes done before tmrw" or spending my sundays pre-charting the week.
if i was in academia (i.e. writing DEI papers in my spare time or writing ppts to give at a educaitonal conf or whatever) or in a busy busy practice seeing 20 consults a week no way this would have been possible.

 

[radoncle]

A few thoughts since being out of training

1. Being a good doctor is not valued. Connections, charm, and luck have far more weight than anything else.
2. Fellow ROs aren’t your friends even the ones who essentially feel the same way you do
3. All the college seniors and med studs who were so proud of who they voted for in ‘08 and could wait to shout down any dissonance over the ACA are now living and working in the system
4. You’re basically trapped like a rat on a sinking ship. You think pharma will take you in guess again…there’s a recession coming and the govt hates pharma as much as they hate doctors.
5. The system be it PP, hosp employed, academic is designed to **** you. It cannot function unless it’s doing that.

The first point about being a good doctor is not valued really resonates. They would much rather have a sh** doc who doesn’t rock the boat or is a company man than a good doc who speaks up and tries to make improvements. And that’s in all practice settings.

 

[theradiator]

i think the key to happiness in medicine is finding a job with good QOL.
QOL can mean alot of different things to a different people.
One thing I have really tried to do since I became an attending was work at work and thats its. no notes, contouring, etc. from home. i spend my free time on everything else that makes life worth living.
if you can achieve this balance in our field, we really have it good.
part of why residency sucked for me was because i spent so much time outside of work working. it was really hard coming home to my wife and saying "sorry hun, the chair of our dept expects me to have all the contours/notes done before tmrw" or spending my sundays pre-charting the week.
if i was in academia (i.e. writing DEI papers in my spare time or writing ppts to give at a educaitonal conf or whatever) or in a busy busy practice seeing 20 consults a week no way this would have been possible.

Actually, writing DEI papers is almost certainly a life hack because presumably these papers have a higher acceptance rate in 'woke' journals while requiring less work than something that would actually advance the field.

 

[finalpsychyear]

i think the key to happiness in medicine is finding a job with good QOL.
QOL can mean alot of different things to a different people.
One thing I have really tried to do since I became an attending was work at work and thats its. no notes, contouring, etc. from home. i spend my free time on everything else that makes life worth living.
if you can achieve this balance in our field, we really have it good.
part of why residency sucked for me was because i spent so much time outside of work working. it was really hard coming home to my wife and saying "sorry hun, the chair of our dept expects me to have all the contours/notes done before tmrw" or spending my sundays pre-charting the week.
if i was in academia (i.e. writing DEI papers in my spare time or writing ppts to give at a educaitonal conf or whatever) or in a busy busy practice seeing 20 consults a week no way this would have been possible.

Nowadays, the goal for all docs should be to reach FI as quickly as possible. Hit it hard when young and taper as you get older. Later on, settle for QOL hours or work PT. Starting with QOL, at the start of your career is a risky move. No one knows where things will be in 10 years. Medicine has fundamentally changed to just a cog in the wheel at the mercy of the masters.

I am extremely bearish on the future in most fields and that was before mid levels encroachment. Mid levels will be the new way medicine functions. Again, it is insanity that this is the case but we have left in charge the people who will push this forward. Its all about $$ and cost savings in the way medicine functions here. We have arguably the unhealthiest people on the planet yet spend the most on healthcare. Make your money while you still can and get the hell out.

 

[CaesarRO]

A few thoughts since being out of training

1. Being a good doctor is not valued. Connections, charm, and luck have far more weight than anything else.
2. Fellow ROs aren’t your friends even the ones who essentially feel the same way you do
3. All the college seniors and med studs who were so proud of who they voted for in ‘08 and could wait to shout down any dissonance over the ACA are now living and working in the system
4. You’re basically trapped like a rat on a sinking ship. You think pharma will take you in guess again…there’s a recession coming and the govt hates pharma as much as they hate doctors.
5. The system be it PP, hosp employed, academic is designed to **** you. It cannot function unless it’s doing that.

I'm sorry that #2 has been your experiecne.

I have great relationships with my coworkers, including Rad Oncs in competing systems in a fairly saturated part of the country.

 

[Lamount]

Medicine is getting worse with more stress and less autonomy and pay. So all that “compassion” we get groomed for goes into longer hours away from family and friends and less of our own life for a selfless notion which is harvested by industry for their profit over ours. And we are less and less respected after the ACA political wars, whatever side you may be on. But only our compassion is judged when we question these things.

Rad Onc is a specific microcosm of this trend with the added bonus of our own field leaders caring not but two thoughts of the health of the field or future of young physicians. We have giants in our field who have cured and treated thousands of patients but who treat younger physicians as a means to the end of their golden parachute retirement. It’s weird.

It’s all going to get worse and perspective is important - we see a lot of worse off people and we make good salaries compared to the average household. If you ever feel it’s too much definitely speak up and seek help. But relative to other professionals, this was a losing bet by a long shot, not just in dollars but more importantly time. I’m good at what I do and passionate - I would never do this again.

If you could do it over again, which field would you have gone into?

Banking/Finance, CS, Engineering?

Looking around, it is hard to think about another job that actually checks all of my boxes: enjoyable, lucrative, and fulfilling. Clearly, this is a very individual sort of assessment... and being a banker may check those boxes for some here, but I don't think I would like it.

 

[Neuronix]

I'm sorry that #2 has been your experiecne.

I have great relationships with my coworkers, including Rad Oncs in competing systems in a fairly saturated part of the country.

I also have a good working relationship with every rad onc I encounter. I try to give every rad onc the benefit of the doubt for all the reasons we discuss on this site. I do my best to support junior rad oncs here or elsewhere in their own careers.

But any rad onc practice owner or rad onc department manager/chair that I've worked under seems to be in the position of trying to get as much out of us as possible while disempowering their physicians and paying as little as possible.

That's how I read #2 anyway.

 

[RickyScott]

If you could do it over again, which field would you have gone into?

Banking/Finance, CS, Engineering?

Looking around, it is hard to think about another job that actually checks all of my boxes: enjoyable, lucrative, and fulfilling. Clearly, this is a very individual sort of assessment... and being a banker may check those boxes for some here, but I don't think I would like it.

I think l would have gone into medonc, and yes the job would be a lot less enjoyable.

 

[OTN]

If you could do it over again, which field would you have gone into?

Banking/Finance, CS, Engineering?

Looking around, it is hard to think about another job that actually checks all of my boxes: enjoyable, lucrative, and fulfilling. Clearly, this is a very individual sort of assessment... and being a banker may check those boxes for some here, but I don't think I would like it.

CS for me. I have friends who graduated from college when I did with CS degrees, and the timing was perfect because of how/when the tech was developed. They're now C-level execs at well-known tech firms. Can't be too hard on myself, as hindsight is 20/20, but I wish I didn't have the medicine blinders on when I was younger and could have been more open to other opportunities.

 

[RadOncDoc21]

CS for me. I have friends who graduated from college when I did with CS degrees, and the timing was perfect because of how/when the tech was developed. They're now C-level execs at well-known tech firms. Can't be too hard on myself, as hindsight is 20/20, but I wish I didn't have the medicine blinders on when I was younger and could have been more open to other opportunities.

Social media influencer for me. Either that or likely would have started a crypto scam or both.

 

[DebtRising]

If you could do it over again, which field would you have gone into?

Banking/Finance, CS, Engineering?

Looking around, it is hard to think about another job that actually checks all of my boxes: enjoyable, lucrative, and fulfilling. Clearly, this is a very individual sort of assessment... and being a banker may check those boxes for some here, but I don't think I would like it.

Probably CS. Would miss the intrinsic value and talking with patients.

Wether I was a rank and file coder, or (failed) start up hopper, or ascended the corporate latter, or niche work in gaming I couldn’t predict. But I would have had a lot of choices, I would likely be financially more secure, and wouldn’t have to worry as much about field security. Most importantly I’d have more direction over my time, and the broader choices / geographic freedom would absolutely be happiness generators. Live and learn.

 

[yesmaster]

Product management with CS undergrad. Pay scale with YOE is more attractive than IC role, but then again, FAANG is firing its middle management so this grift is probably played out for now.

Law is not fun. Banking is not fun.

Rad onc would still be good if I could choose location or be fully remote. Alternatively, I would’ve done accelerated BS/MD and a couple other time savers. Finishing residency at age 28 and in the 2010’s would’ve helped with location. Radiology and heme/onc are good.

 

[MDbecomesMD]

When I was matching in 2013, Rad Onc was considered to be one of those specialities where, when you match, you are "set for life", never having to worry about having a lucrative job again. A lot of people went into the field with that expectation. Due to oversupply of residents and decreasing indications for radiation, this dynamic has changed. While, on a whole, we remain well compensated (far higher than the average physician) and have a relatively awesome QOL, the job market is tight and there isn't a whole lot of flexibility in terms of finding a job in a given city (i.e. you may have to live somewhere you don't want to live). We are no longer considered "elite", which bugs some folks to immensely (I am sure you will see this in others' comments).

I personally love this field and would do it again, even knowing how things have changed since I applied... but there are many others who do not feel the same way and are very frustrated about how the job market has changed. I would only go into radiation oncology if you truly love the field... I would NOT count on the lifestyle/compensation remaining as they are now. Things, of course, may improve... but I don't want to give you an overly rosy perspective.

If any other RadOncs would like to weigh in with advice for current med students who are interested in oncology, I'd love to hear your thoughts Lamount gave me lots of helpful information, but I am open to advice and thoughts from anyone willing to share. Thanks!

 

[Gfunk6]

If any other RadOncs would like to weigh in with advice for current med students who are interested in oncology, I'd love to hear your thoughts Lamount gave me lots of helpful information, but I am open to advice and thoughts from anyone willing to share. Thanks!

Do an internal medicine residency and go into Med Onc. You will still be the "primary" Oncologist and your general medicine training will keep your options open. You will be a sought after commodity after fellowship almost anywhere you go. Med Oncs do have significant call and hospital-based responsibilities however, but in my view this is an ok price to pay for the compensation and job security.

 

[MDbecomesMD]

Do an internal medicine residency and go into Med Onc. You will still be the "primary" Oncologist and your general medicine training will keep your options open. You will be a sought after commodity after fellowship almost anywhere you go. Med Oncs do have significant call and hospital-based responsibilities however, but in my view this is an ok price to pay for the compensation and job security.

Thanks for the reply! Are future job prospects your primary reason for recommending this route? It certainly still interests me deeply so I am not opposed in the least.

 

[medgator]

Med Oncs do have significant call and hospital-based responsibilities however, but in my view this is an ok price to pay for the compensation and job security.

Not even. The bigger, smarter groups try to get a heme/onc hospitalist to help out during the week and with a big enough group, looking at 1/6-8 weeks of weekend call

 

[Gfunk6]

Thanks for the reply! Are future job prospects your primary reason for recommending this route? It certainly still interests me deeply so I am not opposed in the least.

Well, if I had to summarize this entire argument against Rad Onc in a few bullet points:

1. We are over-training the number of residents relative to the work need. Like climate change, day-to-day things may look fine but by the time you are ready to enter clinic it will be a zombie apocalypse.
2. Apathetic leadership in the field who only care about preserving their own skins and money at any cost.
3. Reducing indications for radiation therapy and reducing fractions (treatment length) for radiation therapy. When you add this fact to #1 above, it does not yield a good outcome.

 

[MDbecomesMD]

Well, if I had to summarize this entire argument against Rad Onc in a few bullet points:

1. We are over-training the number of residents relative to the work need. Like climate change, day-to-day things may look fine but by the time you are ready to enter clinic it will be a zombie apocalypse.
2. Apathetic leadership in the field who only care about preserving their own skins and money at any cost.
3. Reducing indications for radiation therapy and reducing fractions (treatment length) for radiation therapy. When you add this fact to #1 above, it does not yield a good outcome.

Thanks for the succinct explanation! This makes total sense.

As a non-traditional student who previously worked for several years in the ER, my plan when entering medical school was to go into EM. Obviously that is not the wisest of options at the moment given the current climate of Emergency Medicine, so I want to ensure that I select a future specialty that is both gratifying and risk-averse when it comes to job security. I appreciate your insight!

 

[madchemist89]

It is difficult to predict the future of any field, but specializing in an organ system or at the beginning of the referral chain will almost always be secure.

 

[Bequerel]

I posted this a year or 2 ago. I’d do IM then oncology fellowship. That’s 5 years. Then if you still want to do rad onc then do the 4 year residency and locum during residency. Total of 9 years with potential to make 150k during last 4 years if you pick a cushy enough residency. Also, if you were dual boarded and in the perfect situation you could actually own a center and capture technical component easier then if just rad onc boarded

 

[RickyScott]

I posted this a year or 2 ago. I’d do IM then oncology fellowship. That’s 5 years. Then if you still want to do rad onc then do the 4 year residency and locum during residency. Total of 9 years with potential to make 150k during last 4 years if you pick a cushy enough residency. Also, if you were dual boarded and in the perfect situation you could actually own a center and capture technical component easier then if just rad onc boarded

That’s exactly what I would do in retrospect.

 

[Fpg1245]

I posted this a year or 2 ago. I’d do IM then oncology fellowship. That’s 5 years. Then if you still want to do rad onc then do the 4 year residency and locum during residency. Total of 9 years with potential to make 150k during last 4 years if you pick a cushy enough residency. Also, if you were dual boarded and in the perfect situation you could actually own a center and capture technical component easier then if just rad onc boarded

Can literally invent demand like a ****ing Onc God.
If the idiots in RO ever combined it with HO...They would have so many MD PhDs 270+ with a sudden interest in oncology. At least they would hold the key to something great to hold over a resident's head when they finish, as opposed to the pure dog **** they currently have.

 

[madchemist89]

I believe we should be trained as clinical oncologists. We should be able to give concurrent chemo and immuno in the nonmetastatic setting. This is our best way forward, but the med oncs will never give this part of their turf up.