The increase in Rad Onc residencies look comparable to EM, IM, anesthesia, etc based on the data below. So I’m still not sure how Rad Onc got screwed so hard
EM and IM grew out of a huge national need. The US got a D rating in EM services because there were way too few specialists running the emergency departments, very often (and still) ERs are staffed with FM or IM specialists. They really needed to do some catching up.
Additionally, since IM disproportionately specializes in “old people” diseases, they are much more likely to be hit hard with the aging boomer population.
With RadOnc you can make somewhat the same argument as IM, but it’s a pretty cush gig, and so there’s a lot of wiggle room to increase productivity if reimbursements drop. Which is what happened with radiology before. And is happening with radonc still. Lots of radonc residencies are opening up not because of a shortage or radoncs(there isn’t one) but because older faculty realize they can subsidize their salaries with trainees while reimbursements drop while selling it as a service.
Probably the single biggest reason I didn’t go into the field. When I discussed with one potential adviser about my concern regarding this, he immediately denied knowledge of the thing and was subsequently persistently rude after. I was supposed to start a research project with him, but he ghosted me thereafter (I definitely was never rude or unpleasant to him in any way). That was the end of my RadOnc pursuit. The old guard know what they’re doing, at least some of them.
The good news (or bad depending on your perspective) is the wiggle room in radiology is gone which was responsible for past job market ruts. so assuming there aren’t policy or infrastructural changes, we aren’t going to slip into a bad market again. AI may improve the rate at which lists are cleared which may reduce the need for radiologists somewhat. Additionally, reformulation of Medicare’s reimbursement structure may end up shoving radiologists out of the equation in a lot of ways, especially if hospital admins don’t see “value added” of radiologists. This latter is a much bigger threat to the future of radiology. Otherwise, given the current state of the market, the rate at which imaging is increasingly utilized, and the aging population, I sincerely doubt we will have any problems with job availability in the next 15 years.
