Hem/Onc Lifestyle/Salary/Satisfaction

Discussion in 'Hematology / Oncology' started by mdeast, Feb 23, 2011.

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  1. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    Your numbers are wrong. The Research Pathway (call it this because it is in no way fast) is 2y of IM, then 4y of Onc (if single boarding) or 4.5y if double boarding. So in the end it's the same or more time than the standard pathway.

    That said, skipping my IM3 year was the best decision I could have possibly made.
     
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  3. Pewl

    Pewl The Dude Abides 10+ Year Member

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    I noticed that in the above graphs, there was no mention of radiation oncologists in the groupings, only "oncologists." This makes me wonder if they are lumping rad onc and med onc into one category. Based on the numbers I've seen, rad onc salaries tend to raise the aggregate "oncology" salaries in these groupings. I won't lie, median private practice rad onc salaries are kinda ridiculous. But, either way I think you'll be able to earn a reasonable income. :)
     
  4. asprin81

    asprin81 5+ Year Member

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    Rad Onc is always lumped with radoilogy, not with oncology
     
  5. DrVanNostran

    DrVanNostran 10+ Year Member

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    Thanks for the response, I was wondering if you could expand on this? Are new docs leaving the larger markets because they can't get enough patients? Difficult to make partner?

    Also, does anyone know how the chicago market is? I would like to end up in burbs of Chicago eventually :) Thanks.
     
  6. LennonMcCartney

    LennonMcCartney

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    It is supply and demand. The bigger cities while having larger populations to draw patients from also have an over saturation of physicians per 'paying' patient.
     
  7. shaggy alfresco

    shaggy alfresco 2+ Year Member

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    I find that the practice of Heme/Onc (outpatient) is very different from general IM (am I fair in saying this?).

    Are there any people who feel the same way? If so, how do you decide to do IM knowing you may not get a fellowship (do you have to only apply to 'high tier' university programs to 'guarantee' yourself a spot somewhere? I know it's more about how you perform in your residency as well)?
     
  8. KarmaDoc

    KarmaDoc

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    Why would rad oncs get lumped with radiologists? Rad oncs have the most years of pure oncology training compared to any other specialty. They also were treating cancer patients long before med oncs were even around.

    I have a feeling that the "wide variation in oncology salaries" are due to the fact that rad oncs are indeed being lumped with med oncs in those graphs.
     
  9. gojonn

    gojonn Member 7+ Year Member

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    KarmaDoc, after reading multiple comments by GutOnc, one of our best resources, I have to disagree with you. I highly doubt rad onc get's lumped in with med oncs causing a broad range in salaries. The large discrepencies is purely related to practice types, locations, and preferences (as in I prefer to see a lot of patients and make a lot more money).
     
  10. Pewl

    Pewl The Dude Abides 10+ Year Member

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    I think gojonn is correct. radiation oncology tends to get lumped in with radiology probably because we fall under the ABR (American Board of Radiology). All of our board exams/certifications etc are all through the ABR.

    Hell, our salary stats probably raise the aggregate radiology numbers as well. =P
     
  11. DrVanNostran

    DrVanNostran 10+ Year Member

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    Any thoughts on the future landscape with the upcoming election?
     
  12. DocIM

    DocIM

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    Getting a job in Hem/Onc has become increasingly difficult right now. I know 2 people from 2nd tier hem/Onc programs having trouble finding suitable positions, they already gave up looking in mid-big size cities.

    Apparently, hospitals are cutting down on hiring hem/Onc docs due to uncertainty resulting from the impending implementation of obamacare. So the next few years could be rough for hem/Onc grads.
     
  13. asprin81

    asprin81 5+ Year Member

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    This year I interviewed at 12 places, got 10 offers from NYC/NJ to LA/SF.... Jobs are everywhere...I don't know whats wrong with your friends CV or their expectations.....After Obamacare need for oncologist will go up, not down
     
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  14. DocIM

    DocIM

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    Did you graduate from a top tier program? They have a lot of research background and went to mid-tier med schools. They do have offers, not great, but from not so desirable places in the middle of nowhere. Apparently, that is what many hospitals have told them. It is due to uncertainty of how implementation will occur and funding for obamacare that GOP will try to cut-off. So although it is law, implementation of obamacare depends on some federal funding. Yes, it will add many new patients but no one is sure about the implementation. Businesses don't like uncertainty and act accordingly when it comes to business decisions.
     
  15. tallash

    tallash 7+ Year Member

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    From "second tier" fellowship programs, keep in mind. I have no idea what that means to you, but the most desirable markets are always going to be competitive no matter the field and with/without Obamacare.

    FWIW, I'm hearing positive things from recent grads in my institution's program and there's generally an optimistic attitude re: the effects of Obamacare and HONC.
     
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  16. Darkside

    Darkside Junior Member 7+ Year Member

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    I am a third year heme/onc fellow who lives in a major city in the US. It definitely has become more difficult to find a job in hematology/oncology. A lot of practices are not hiring because of the uncertainity of Obama care. Everyone is panicking a little and groups are being bought left and right. It will be a frustrating time for the graduates of heme/onc fellowship for the next several years.
     
  17. sanj238

    sanj238 2+ Year Member

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    Can you please elaborate on your comments about difficulty finding jobs? What does mid level or top tier mean?

    Is it hard to get a heme onc fellowship? What if I am a DO and go to a state level IM residency (not really ranked)?

    When people say undesirable what does that mean? I don't mind not living in the city but if you mean North Dakota thats an issue...(No offense to North Dakota)
     
  18. drknchkn

    drknchkn

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    Going rural may not be a bad idea. I heard of a new grad getting paid 400,000 starting at a rural state up north. That would never be possible in larger cities.
     
  19. johnsmith130077

    johnsmith130077

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    how are heme oncology salaries compared to average GI salaries?
     
  20. visari

    visari 2+ Year Member

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    real estate will make you more money than either of them ..go for it
     
  21. johnsmith130077

    johnsmith130077

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    i know... but i wanna choose between the 2- gi or heme onc?
     
  22. FiveRivers

    FiveRivers 2+ Year Member

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    Have the fellows that will be graduating this year started looking for jobs? Are most of you staying in the area you completed your fellowship? Or did you find a recruiter and find a job in a different part of the country? How's the job search coming along? Thank you for any input.
     
  23. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    My group has signed 3 contracts for new fellows starting July 1. None came from recruiters. One is local, 2 are from across the country.

    The fellows in my old program have all signed contracts already. None used recruiters.
     
  24. FiveRivers

    FiveRivers 2+ Year Member

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    Wow. That's amazing. Since you have experience with heme onc and job hunting in heme onc, maybe you can help me out. If I am doing my heme onc fellowship, say in the midwest or east coast, and I wish to work say, in Phoenix. Without using a recruiter, do fellows basically google hospitals in Phoenix and apply there? How did the fellows from across the country find out about the openings that your group had? I'm aware of websites that post physician job openings, but it just seems like there have to be more than just those.
     
  25. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    Some jobs are advertised. Ours were put on our website under "opportunities" but weren't advertised beyond that. Some jobs use recruiters but the popular wisdom is that, if you need to use a recruiter, there's something wrong with the job. Not always true of course, but something to think about. Most of the ads in JCO and Blood are for academic spots but free journals often have PP job ads in them. But yeah, mostly you Google "Phoenix Oncology" and go to the websites of the groups that pop up in your search. Either they will have a listing if they're looking for someone, or they'll say who the medical director is and you send that person an email/letter of interest and your CV.
     
  26. FiveRivers

    FiveRivers 2+ Year Member

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    That's great insight and information. Thanks a lot, appreciate it.
     
  27. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    It's not really "insight" as much as it is "how to find a job 101". If you're actually a med student, chances are high that you've never actually had to do this in your life. But many of us have. It's not hard.
     
  28. EMDO2018

    EMDO2018 Banned Banned

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    Looked at the Medscape compensation survey, hem onc median was 300k in 2010, for 2013 it was 278k. One of the few fields declining in compensation every year. what is happening?
     
  29. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    See this post for a pretty good explanation of at least a few of the factors. It's also impossible to know who responded to the survey. For instance, I work PT and I answered the survey last year. So my response skewed it downward. A guy I know who's well into his career and sees on the order of 40-50 patients a day (and as a result has a baseline salary of well over $500K) was probably too damn busy to respond to it.
     
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  30. llessac15

    llessac15 Junior Member 10+ Year Member

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    I am a practicing Oncologist in a small town in the South. We are a private group with 5 partners. Our incomes range from ~$350k-$950k. The format is based on production. If we were to hire someone new, he/she would come in making about a base of $240k but would likely be around $500k by year 3. Our $350k guy still practices like he is in the 1980's or his income would be higher.

    About reimbursement, it has been most recently hit by sequestration. Sequestration has cost me about $100k over the last 12 months. Oncologists are definitely making less than just 5 years ago. But, we didn't need to make as much as we were. ObamaCare hasn't helped any. Some uninsured people may have gained insurance (a horrible one though), but many people that had good insurance lost it. Overall, it's a overall negative from a reimbursement standpoint. My predictions is that an average, hard-working Oncologist in my region will likely make around $500k in the future. That's pretty dang good. But, we'll be at the mercy of whomever is paying our salary. The workload is busy, but not near as bad a Cards, Pulm, or Surgery. Hope that helps.
     
  31. bronx43

    bronx43 Word. 10+ Year Member

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    Do you have any information about the large cities in the South? I don't think anyone would be surprised about making $500k+ as heme/onc in a small Southern city.
     
  32. DrVanNostran

    DrVanNostran 10+ Year Member

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  33. llessac15

    llessac15 Junior Member 10+ Year Member

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    I don't have any info on major Southern cities. Just smaller ones. The biggest town that I had contact with was Jackson, MS. Your peak salary was around the ranges I quoted above, but it would take about 5-8 years to get there and you work twice as hard. Small towns are definitely the way to go. You can easily travel to the bigger cities on your off weekends. Where I practice, many of the physicians live in completely other states. One Cardiologist actually flies his personal plane home to Florida every weekend he's not on call.
     
  34. BestDoctorEver

    BestDoctorEver Banned Banned Account on Hold 5+ Year Member

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  35. BestDoctorEver

    BestDoctorEver Banned Banned Account on Hold 5+ Year Member

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    A cardio doc with a personal plane! Does he have other incomes in addition to his physician salary?
     
  36. Lawgiver

    Lawgiver Banned Banned Account on Hold

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    what is the difference is ones that makes 500k and one that makes 300k?
     
  37. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    The answer is in the first paragraph you quoted. It's a production based system. See more patients, give more chemo, make more money. It's not a linear relationship and it's a type of practice environment that is shrinking as a result of a lot of outside factors, but does still exist.
     
  38. NilsOlav

    NilsOlav 2+ Year Member

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    Can I please ask what practice environments are currently common in hem/onc? Broadly speaking, it seems many if not most specialties are moving towards hospital-employed or mega groups. I suppose we could include academics or VA work too. Is this the case for hem/onc too? Thanks.
     
  39. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    Any and every type of practice is still out there. Solo practitioners in smaller cities/towns who share call with other similar docs, small PP groups, large single-specialty PP groups, large multi-specialty PP groups and hospital employed positions. It is true that there is a trend to employed positions with small groups and solo practitioners going under the umbrella of a hospital or large group.
     
  40. RustBeltOnc

    RustBeltOnc 2+ Year Member

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    There are profound strengths and weaknesses to the various practice options. You need to talk to someone works/has worked in each to see what type of risk/hassle you are most comfortable with. However, there are many parts of the country where private practice isn't an option for someone new, and you have to deal.
     
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  41. bashwell

    bashwell SDN Bronze Donor Bronze Donor 2+ Year Member

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  42. carrigallen

    carrigallen 16th centry dutch painter 10+ Year Member

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    I agree that insurance changes and proposed changes in Congress are going to take a huge bite out of compensation. Much of oncology income is based on services (infusion fee, nurse fee, injection fee, etc). Bundling and changes in fee structures will hurt oncology the most, especially the top earners.
    If you want to make money in the current climate, skip medicine and go to work for defense contractors - Northrop Grumann, Lockheed-Martin, etc.
     
  43. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    I think that joining a pure PP group as a new grad in the current environment is a recipe for disaster. Once these changes come along, the senior partners are going to decide they'd rather be fishing/golfing/skiing/sailing than doing the same work they did last year for half the money, so they're going to look for somebody to buy them out. The only people buying these days are hospitals, and they're not paying what a lot of those guys are used to making. The pre-partner/junior partner folks are going to get hosed.
     
    Last edited: Apr 8, 2015
  44. HO2011

    HO2011 2+ Year Member

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    Agree with gutonc. lots of PP group are selling themselves to hospitals or USoncology. And new hires are paid substantially lower in the first a few years before becoming a partner which may never happen if the practice is bought by hospitals.
     
  45. bobow98

    bobow98 Beast Mode 7+ Year Member

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    In light of these observations what are the options available to young grads these days?
     
  46. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    Like I said above (I'm too lazy to link it, you can scroll up yourself), all models are available to young grads these days. You just need to decide what works for you where. I chose my current position based on a combination of location and workload. I purposely work 3/4 time. I live in an amazing location. I get paid pretty well.

    I could make a lot more money either working more or working somewhere else. Neither of things are worth it for me.
     
  47. lilPhysician

    lilPhysician 7+ Year Member

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    The fellows at my program have already signed contracts with practices for 230k- 500k ranging from prime locations to very small towns. Given the worsening cuts to chemo I'm sure we'll be making no better than hospitalists in the future :/
     
  48. Merely

    Merely 2+ Year Member

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    Can you talk about the research pathway? Is that like a thing that only a few IM programs have that you apply to out of med school or do you apply to that during PGY1 or how does that work?
     
  49. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    Yes and yes. Both options are available depending on the program.

    But the likelihood of turning the research pathway into a research career is so low these days that it's hardly worth discussing. Do it if you want. You won't lose more than a year of your life. But be realistic about your options if you do.
     
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  50. Brahnold Bloodaxe

    Brahnold Bloodaxe

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    I'm curious: are these changes that are going to result in physician compensation being halved designed to reduce overall spending on oncology services, or keep spending more or less the same but to divert it to a favored target? Because based on everything that I've read, it doesn't seem that spending is actually being cut. It's just being taken, repackaged, and handed out to hospitals/ACOs/bureaucrats rather than physicians. Is this an accurate assessment, or are actual cuts in the amount of money spent each year the driving force behind the woes of PP oncology?
     
  51. geripalgal

    geripalgal

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    Hey gutonc - just to clarify, are you saying that 3 incoming fellows are starting their fellowship already with a signed offer for a post fellowship job?
     

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