For medical students in the class of 2021 interested in RadOnc - away rotations and career choices

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100+ apps, 10 interviews, ghosting, 0/3 type jobs (location, practice setting, compensation). A twitter post From a PGY-5 at a very good, but not top 20 program (he fortunately landed in a good department, but the anxiety). If this isn't enough to scare away med students from radonc programs outside of top 20 and dual apply to anesthesia/diag radiology/IM (aiming for heme onc fellowship), then nothing will. Especially in light of covid, it's even easier to dual apply as multiple away rotations for everything are down.

Over a hundred applications for 10 interviews? Oh my God! I wonder if he's counting in-person only or also ASTRO interviews? I desperately hope it's the former because if it's the latter...that's terrifying.

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City of hope is not a ‘very good’ program in that I would tell a Med student not to go there. It’s in the bottom half of programs, I would say.
 
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View attachment 310628
100+ apps, 10 interviews, ghosting, 0/3 type jobs (location, practice setting, compensation). A twitter post From a PGY-5 at a very good, but not top 20 program (he fortunately landed in a good department, but the anxiety). If this isn't enough to scare away med students from radonc programs outside of top 20 and dual apply to anesthesia/diag radiology/IM (aiming for heme onc fellowship), then nothing will. Especially in light of covid, it's even easier to dual apply as multiple away rotations for everything are down.
In today's rad onc workforce arena, if you aren't getting ghosted by a bunch of folks, interviewing at locations that make you really depressed and fearful, and maybe getting a nice stomach ulcer along the way... you haven't applied for a job in enough places.
 
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In today's rad onc workforce arena, if you aren't getting ghosted by a bunch of folks, interviewing at locations that make you really depressed and fearful, and maybe getting a nice stomach ulcer along the way... you haven't applied for a job in enough places.

whats the deal with the ghosting? Rad onc people are big ghosters. Why talk to someone and lead then on then disappear?
 
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I don't understand why PDs are endorsing aways at this moment when they never had to in prior years? If anything, students are well aware of what rad onc is and are avoiding it because of bad job market. Individuals who say we need to increase med student awareness are so out of touch with what's going on.
 
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PDs know its a bad job market. They want to increase med student awareness so that they can get more applicants with great qualifications and make sure they fill spots so they can keep their jobs and get a raise, basically misleading people into this.
Quoting from the google spreadsheet for 2020-2021.
catch 22: program directors know over expansion occurred. program directors will never push too hard for contraction because they will not get promotion. all residents, young attendings would like to see contraction. program and department chair benefit from resident supply and government money. everyone is high achieving blah blah blah and self interested at the end of the day and the decision makers will not risk their academic careers to save some naive medical students. and the soap allows for anyone, anyone to walk into the field. the previous astro chair admitted as such saying on twitter 'take A job' not A DESIREABLE job. waving a massive red flag.
 
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Or this states it better:
Target the population of students with Step 1 scores under 210 with few options but unusually rich life experiences and maturity, and the chairs won't have to compromise. Even better, with Step 1 becoming pass/fail, many schools giving pass/fail grades, and other changes aimed at corroding the visibility of merit, programs can admit whomever and still peddle the narrative that rad onc is highly selective with our surgery and med onc colleagues.

Grading Systems Use by US Medical Schools

Clinical clerkships continue to be H/HP/P/F. It's mostly a positive, but some may feel that this will select for unusually pleasant and docile trainees.
 
Maybe you should leave moderating to @evilbooyaa and @Neuronix, just a thought. You sound better as a PD

in all honesty - what about me saying City of Hope is not a good program triggered you? for one thing, that has been on your list of programs you bring up as 'bad' for a long time (LIJ, WVU, City of hope, blah). It is not a 'very good' program as I am sure you agree. if a med student told me he or she wanted to go there I would say No. I get PMs on here often from people thinking about the field. That is not a place people should go in this market. only people at top programs have a good shot at getting a good job in a location they want. The rest will have a hard time. and a list of the people who will have a hard time grows daily.

not sure why you're upset, but happy father's day, man.
 
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PDs know its a bad job market. They want to increase med student awareness so that they can get more applicants with great qualifications and make sure they fill spots so they can keep their jobs and get a raise, basically misleading people into this.
Quoting from the google spreadsheet for 2020-2021.
catch 22: program directors know over expansion occurred. program directors will never push too hard for contraction because they will not get promotion. all residents, young attendings would like to see contraction. program and department chair benefit from resident supply and government money. everyone is high achieving blah blah blah and self interested at the end of the day and the decision makers will not risk their academic careers to save some naive medical students. and the soap allows for anyone, anyone to walk into the field. the previous astro chair admitted as such saying on twitter 'take A job' not A DESIREABLE job. waving a massive red flag.

Exactly. The current climate of Radiation Oncology is fraught with mechanisms for misleading students in real life, both unintentionally and intentionally:

1) There remains a LARGE swath of folks who are fairly ignorant to the "business" of RadOnc on a national level. How many senior attendings advising students and residents have been tucked away in their position for 10, 15, 20+ years? Did they stay at the same institution they did residency at? Are these people really going to have their finger on the pulse of the market for current and future trainees? That seems highly dubious. These advisors are not intentionally misleading students, I think they believe what they say and are being honest about their experiences. However, if you graduated residency in, like, 2002 and stayed at the same institution since them, I'm not so sure your opinion on the 2020-2025 job market is all that valuable.

2) Then there are the faculty and residents in real life who might have concerns over the state of RadOnc and/or the training provided by their department. Are they going to be honest with students? If they have any understanding of academic and social politics they will keep their mouth shut. They may not give ringing endorsements of the field, but they are unlikely to say, in real life, "stay away". If people up the food chain catch wind of that...well, you're shooting yourself in the foot. There likely won't be formal rebukes or consequences, but consideration for promotions, research collaborations, referrals, etc - there are hidden consequences. I try to be relatively honest in real life, but the last thing I want is some random student telling one of my bosses that "Elementary School said this is a dumpster fire". Yikes, no thank you.

3) And finally, as @tomballunger said, there are real-life folks whose jobs depend on this. If a PD fails to fill spots, or fills spots with "bad" applicants, they're not doing their job in the eyes of their department and chair. Their career is at stake here! They are personally incentivized to be positive and recruit. They're not bad people, not in the least - they just have their own career to consider.

This is literally why I come on SDN and post. I can freely share my opinion. My opinion and arguments must stand on their own - I won't be judged based on my pedigree or past accomplishments, and there aren't future consequences on my career.

So, student lurkers reading this thread - whenever you ask someone in real life for their opinion or advice, ask yourself - "what could be the incentive behind this person's words and actions?"
 
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in all honesty - what about me saying City of Hope is not a good program triggered you? for one thing, that has been on your list of programs you bring up as 'bad' for a long time (LIJ, WVU, City of hope, blah). It is not a 'very good' program as I am sure you agree. if a med student told me he or she wanted to go there I would say No. I get PMs on here often from people thinking about the field. That is not a place people should go in this market. only people at top programs have a good shot at getting a good job in a location they want. The rest will have a hard time. and a list of the people who will have a hard time grows daily.

not sure why you're upset, but happy father's day, man.
Patently false, HFD to you too. Maybe you should try to be accurate if you're going to be so opinionated, unless you're talking about academic satellites or something

In this market, it's a crap shoot, but ties to the area and As matter far more to many private jobs, way more than pedigree. Mostly midtier folks at a lot of private jobs, certainly more the case than finding Sloane or MDA grads
 
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okay, when people ask you for advice, you can continue to encourage them to be okay with going to mid-tier and lower tier programs

the advice I give is that if youre really interested, double apply and if it doesnt look like youre going to match in a good program, to cut ties with rad onc.
 
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okay, when people ask you for advice, you can continue to encourage them to be okay with going to mid-tier and lower tier programs

the advice I give is that if youre really interested, double apply and if it doesnt look like youre going to match in a good program, to cut ties with rad onc.
When the reality is that there are large private groups with Methodist and EV grads next to people that graduated from mdacc and Sloane

 
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okay, cool. nothing is different about now than in the past. 2020 is 2015 is 2010.
 
City of hope is a mediocre program no ifs ands or buts about it IMO

Nonetheless, that is a sad to hear only 10% response rate for jobs.

Same time that is a high number of applications! Who applies to 100 jobs??? That’s a shotgun approach if I’ve ever heard.

Shiz must be hitting the fan and I’m going to need to start applying to more places ha FML
 
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City of hope is a mediocre program no ifs ands or buts about it IMO

Nonetheless, that is a sad to hear only 10% response rate for jobs.

Same time that is a high number of applications! Who applies to 100 jobs??? That’s a shotgun approach if I’ve ever heard.

Shiz must be hitting the fan and I’m going to need to start applying to more places ha FML

when we applied: “apply to all programs, rank all, go to all interviews and feel lucky you get A spot ANYWHERE”

when we graduated: “apply to 100+ jobs, feel lucky you even get a A response, feel blessed you even get A job, feel lucky you even have a roof over your head”
 
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I am not sure why there is all this discussion about city of hope. It is a low-tier program. The only programs which are immune to this bad market are top programs/big name programs.

MDA, MSK, MGH, Penn, Hopkins, Duke, WashU, UMich, Mayo, UCSF, Stanford, Yale
 
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I don't really understand this discussion about City of Hope either.

10% interview rate to applications seems about right to me.

I had a similar experience applying to jobs as a senior resident.
 
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When the reality is that there are large private groups with Methodist and EV grads next to people that graduated from mdacc and Sloane

I am not sure why there is all this discussion about city of hope. It is a low-tier program. The only programs which are immune to this bad market are top programs/big name programs.

MDA, MSK, MGH, Penn, Hopkins, Duke, WashU, UMich, Mayo, UCSF, Stanford, Yale
I wouldnt say they are immune- it is a matter of perspective. Many of the grads from these programs are taking jobs that I wouldnt have touched ten years ago when I was coming out from a not so big name program, and they are often not getting their first choice geographic metro.
 
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I am not sure why there is all this discussion about city of hope. It is a low-tier program. The only programs which are immune to this bad market are top programs/big name programs.

MDA, MSK, MGH, Penn, Hopkins, Duke, WashU, UMich, Mayo, UCSF, Stanford, Yale
CCF, Wisconsin, UF, UNC, Emory etc all have decent placement as well and likely will continue to do so. Personally I'd rather hire someone from one of those with the 3As over a top 5 place
 
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CCF, Wisconsin, UF, UNC, Emory etc all have decent placement as well and likely will continue to do so. Personally I'd rather hire someone from one of those with the 3As over a top 5 place

i think there are about 20-25 programs, including all of these, that I would tell a student to feel comfortable that they will end up okay out of. not really a high endorsement of the field when there are 80 programs plus.

no one graduating from a US med school who has choices should go into many of the the bottom 60 programs.
 
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CCF, Wisconsin, UF, UNC, Emory etc all have decent placement as well and likely will continue to do so. Personally I'd rather hire someone from one of those with the 3As over a top 5 place

But how often do you hire?

For our academic satellite clinical positions we interviewed almost exclusively top 5 residency program grads this year.

This is the future for most new grads, as long as new jobs even continue to exist for them.
 
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i think there are about 20-25 programs, including all of these, that I would tell a student to feel comfortable that they will end up okay out of. not really a high endorsement of the field when there are 80 programs plus.

no one graduating from a US med school who has choices should go into many of the the bottom 60 programs.
I think you will get a job somewhere in the country. Next year, it would not surprise me if 20% of graduating residents are unemployed in the form of fellows or locums.
 
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I am not sure why there is all this discussion about city of hope. It is a low-tier program. The only programs which are immune to this bad market are top programs/big name programs.

MDA, MSK, MGH, Penn, Hopkins, Duke, WashU, UMich, Mayo, UCSF, Stanford, Yale

The eternal debate!

RadOnc is now like law school. You should go to a "top tier" place to get a job. What is a top tier place? Old, big, Brand Name programs with large alumni networks who can help you secure a job. Places with names the general public recognizes so their referring docs can say "I'm sending you to Dr X - she trained at Harvard, she's great". In an age with TheMedNet, eContour, RadOncQuestions, great textbooks, regional courses - the only limit on learning how to be a safe and competent Radiation Oncologist is yourself. Your program gives you the intangibles - you can't learn pedigree.

Well, let me clarify when I say "you should go to a top tier place". You should - just not in RadOnc. Unless you want to figure out how to collect unemployment.
 
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there are some programs that have historically gotten interest like university of miami based on location alone.

med students are wising up though. no one should go to miami to train. I have talked to multiple recent grads, and it's a bad program with bad education and lack of supportive faculty. would add most of the new york programs too.
 
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But how often do you hire?

For our academic satellite clinical positions we interviewed almost exclusively top 5 residency program grads this year.

This is the future for most new grads, as long as new jobs even continue to exist for them.
It's a fair point. The jobs are trending towards employed and academic satellites... If you can be location agnostic though, they are much less likely to care about pedigree outside of that

 
there are some programs that have historically gotten interest like university of miami based on location alone.

med students are wising up though. no one should go to miami to train. I have talked to multiple recent grads, and it's a bad program with bad education and lack of supportive faculty. would add most of the new york programs too.

i agree with this. The majority of recent residents have ended up in rural middle of nowhere places. Some have been recently under-employed. Reports have been of lots of scut, bad education and very little support in job search. Pay attention folks!
 
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there are some programs that have historically gotten interest like university of miami based on location alone.

med students are wising up though. no one should go to miami to train. I have talked to multiple recent grads, and it's a bad program with bad education and lack of supportive faculty. would add most of the new york programs too.

Damn haven't seen the banhammer used on here in a while. Must have missed something good!

But how often do you hire?

For our academic satellite clinical positions we interviewed almost exclusively top 5 residency program grads this year.

This is the future for most new grads, as long as new jobs even continue to exist for them.

That's sad. Sorry that this big-coastal-elitist program thing isn't just made up in Wallner's (DO) head.
 
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Damn haven't seen the banhammer used on here in a while. Must have missed something good!



That's sad. Sorry that this big-coastal-elitist program thing isn't just made up in Wallner's (DO) head.

you came when the biryani was already gone. Don’t worry we can order more!
 
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I’m going to bring up avoid programs again from prior thread I started.

Slightly edited since I’ve learned more. Let’s see the opinions this time around


Not worth it IMO (criteria is some combo of new program + avg program + below avg city + reputation)

Oklahoma, Cedars Sinai, LIJ, Georgetown, Indiana, Beaumont, Buffalo, UMDNJ, Univ Rochester, Mayo Jacksonville

LOWEST TIER (some combo of new program + bad reputation + below below avg location + job prospect?)

NYP Methodist, UT Galveston, Dartmouth, Univ Tennessee, West Virginia, Arkansas, City of Hope, Nebraska, Stony Brook, Mississippi, Kansas, SUNY Downstate, Minnesota, Wayne State, Oklahoma, Kaiser, UC Irvine, Loma Linda, NCI, Allegheny, UT SA, Texas AM, Iowa, Kentucky, SUNY Upstate, Louisville, Case Western, Baylor, Wake Forest, MUSC, UC Davis, Univ Arizona
 
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That's half the programs in the country. Sounds about right.
 
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It really is quite sad how many bad places there are. You have no excuse to go to one of these places. You have been warned.
 
I’m going to bring up avoid programs again from prior thread I started.

Slightly edited since I’ve learned more. Let’s see the opinions this time around


Not worth it IMO (criteria is some combo of new program + avg program + below avg city + reputation)

Oklahoma, Cedars Sinai, LIJ, Kaiser, Georgetown, Indiana, Beaumont, Buffalo, UMDNJ, Univ Rochester, Univ Arizona

LOWEST TIER (some combo of new program + bad reputation + below below avg location + job prospect?)

NYP Methodist, UT Galveston, Dartmouth, Univ Tennessee, West Virginia, Arkansas, City of Hope, Nebraska, Stony Brook, Mississippi, Kansas, SUNY Downstate, Minnesota, Wayne State, Mayo Clinic Jacksonville, UC Irvine, Loma Linda, NCI, Allegheny, UT SA, Texas AM, Iowa, Kentucky, SUNY Upstate, Louisville, Case Western, Baylor, Wake Forest, MUSC, UC Davis
I would also add decent programs that are historically malignant: Jefferson and Maryland?
 
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I’m going to bring up avoid programs again from prior thread I started.

Slightly edited since I’ve learned more. Let’s see the opinions this time around


Not worth it IMO (criteria is some combo of new program + avg program + below avg city + reputation)

Oklahoma, Cedars Sinai, LIJ, Kaiser, Georgetown, Indiana, Beaumont, Buffalo, UMDNJ, Univ Rochester, Univ Arizona

LOWEST TIER (some combo of new program + bad reputation + below below avg location + job prospect?)

NYP Methodist, UT Galveston, Dartmouth, Univ Tennessee, West Virginia, Arkansas, City of Hope, Nebraska, Stony Brook, Mississippi, Kansas, SUNY Downstate, Minnesota, Wayne State, Mayo Clinic Jacksonville, UC Irvine, Loma Linda, NCI, Allegheny, UT SA, Texas AM, Iowa, Kentucky, SUNY Upstate, Louisville, Case Western, Baylor, Wake Forest, MUSC, UC Davis

Not this again...

Somebody goes to UPMC lol (and has no idea about midwestern progams -- for instance multiple in the lowest tier list are totally fine and one on the tier above list is possibly the most malignant program in the entire country).

Anyways...

If a med student is ranking a rad onc residency program based on desirable location he/she is doing it wrong.
 
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I would remove wake forest. They are a solid middle program with good job placement. I would add Miami and UPMC, both places which appear to be pretty decent on paper but when you lift the lid, it really stinks up the room, like the trash you keep delaying to take out.

also oklahoma belongs in bottom pile

beaumont is historically a very good place

rochester and buffalo are decent places just in a tundra

kaiser and cedars grads have ended up in very solid jobs.
 
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I would remove wake forest. They are a solid middle program with good job placement. I would add Miami and UPMC, both places which appear to be pretty decent on paper but when you lift the lid, it really stinks up the room, like the trash you keep delaying to take out.

also oklahoma belongs in bottom pile

beaumont is historically a very good place

rochester and buffalo are decent places just in a tundra

kaiser and cedars grads have ended up in very solid jobs.

You have a good pulse on programs. Can't refute any of that.

How long before a designated UPMC spokesman shows up and requests mods censor criticism again ironically giving credence to said criticism?
Promoting a supposedly "trash" female resident throughout residency then refusing to graduate her and attempting to tank her career doesn't get you in the bottom tier for bad reputation? Pittsburgh location a redeeming quality for yinz?
 
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I would remove wake forest. They are a solid middle program with good job placement. I would add Miami and UPMC, both places which appear to be pretty decent on paper but when you lift the lid, it really stinks up the room, like the trash you keep delaying to take out.

also oklahoma belongs in bottom pile

beaumont is historically a very good place

rochester and buffalo are decent places just in a tundra

kaiser and cedars grads have ended up in very solid jobs.

I’m always for putting the bad programs in the bad list

Seems to be getting longer every day haha

Wake is such a crap location though ugh

I still remember my hotel stay for Rochester interview. Downtown was dead beyond belief

Buffalo at Least paid for hotel but GD it was cold ugh

@KHE88 oh relax this is to help ppl. Who is most malignant I’ll edit it accordingly

Also I wasn’t cool enough to even get an interview at Pitt ;)

(Though now I’m grateful).

Pitt reminds me of an ex of mine who happened to be from Pitt. Was fantastic for a little while at the time but damn she was cray. Had to leave that. But still think fondly sometimes. Maybe Stockholm syndrome?
 
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@KHE88 oh relax this is to help ppl. Who is most malignant I’ll edit it accordingly

Not gonna say it because as far as I know they haven't been outted here publically and I don't want to doxx myself or anyone else, but it should be fairly obvious.
 
@KHE88 oh r
Pitt reminds me of an ex of mine who happened to be from Pitt. Was fantastic for a little while at the time but damn she was cray. Had to leave that. But still think fondly sometimes. Maybe Stockholm syndrome?

Lmao. I think we all have that same ex. You have some good times, lots of bad memories and yet you still kinda liked the “ride” and think of them fondly even though they were nutz!
 
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I also want to say historically Kansas was “bad” as in the type of place the chiefs told you “run for your life” at the lunch and half the people failed boards. Nowadays, it is a totally different program. They have a great department with multiple fully funded physician scientists, all the modalities including protons. New chair. Nice PD. The place can only get better.

if you see a place that never gets better its a mark of stagnancy, something very wrong at the core.
 
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CCF, Wisconsin, UF, UNC, Emory etc all have decent placement as well and likely will continue to do so. Personally I'd rather hire someone from one of those with the 3As over a top 5 place

Of the 3 A's which is the least important?

Ability.

No one gives a **** if your a phenomenal doctor if you're a prick and you don't answer your phone.
 
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Of the 3 A's which is the least important?

Ability.

No one gives a **** if your a phenomenal doctor if you're a prick and you don't answer your phone.
Yup that's the joke (with truth behind it):

Availability, Affability, and.... Ability (some would say in that order)
 
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I am not sure why there is all this discussion about city of hope. It is a low-tier program. The only programs which are immune to this bad market are top programs/big name programs.

MDA, MSK, MGH, Penn, Hopkins, Duke, WashU, UMich, Mayo, UCSF, Stanford, Yale
May not be called the Yale Program much longer ;)

 
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MUSC, also a bad place to be. Must be in bottom pile list, like single sheath toilet paper that smears your hand.
 
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Yeah I don't want to be a conspiracy theorist but it certainly feels like ASTRO is allowing all these "miscellaneous" job posting to artificially boost the numbers.

Here's the raw count, 979 jobs:

View attachment 302155

If you organize by "physician/surgeon", you're down to 224 jobs:

View attachment 302156

Which include things like Heme/Onc and the Mather fellowship:

View attachment 302157

I agree with @evilbooyaa's math.

Right now I count:
~821 jobs listed on the ASTRO job wesbite...
Of these ASTRO listings, it shows there are 28 radiation oncologist jobs in the United States.
Anyone's welcome... more than welcome... to please check my tally.
Rad onc jobs are like our therapeutic x-rays: you can't see 'em, touch 'em, or smell 'em, but you have faith they're there.

EDIT: there may be ~15-20x as many medical oncology-related jobs on the ASTRO website right now than radiation oncology jobs.
 
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1592924017092.png

EDIT: Cant get gifs to work:(
 
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