Heme/Onc Job Offer Discussion

[slruk]

Hi all, got an offer for the following:

Full time clinical in an academic setting in the Northeast. 4 days of clinic, 1 day admin.
430k base with productivity $60/RVU over 4600. RVU seem on target based on what I've read for academics in the area.
Call is equitable, so ~1:9.
Max 16 patients/day based on how much time they give for new and follow up visits.

Personal preference is for less busy days than productivity grinding--would rather finish up on time and head home.

---

Members don't see this ad.

 

[ONC2023]

Hi all, got an offer for the following:

Full time clinical in an academic setting in the Northeast. 4 days of clinic, 1 day admin.
430k base with productivity $60/RVU over 4600. RVU seem on target based on what I've read for academics in the area.
Call is equitable, so ~1:9.
Max 16 patients/day based on how much time they give for new and follow up visits.

Personal preference is for less busy days than productivity grinding--would rather finish up on time and head home.

Hmmm… I’m sorry to say, but not a huge fan.

1. You’re getting paid $93/RVU for your base and then it goes down to $60. $60 is bad for oncology. However, if your plan is to just hit your base and relax, then that seems ok. But - are you absolutely sure they’re not going to make you work more for $60/RVU?

--- For 16 patients a day, 4 days a week, 46 weeks a year, at 2.3 RVUs/visit = 6771 RVUs
------- If you were getting paid a reasonable $90/RVU, that would be $610000
------- If they pay you based on their model: $430000 + 2171 RVUs * $60/RVU = $560000

It's a $50K pay cut - not world-ending, but they're underpaying you for working above base. Seems backwards to me.

2. Do you have NP support? Not support as in NP sees patients independently and you supervise for no money, but someone in clinic to help with orders, etc? The deal in academics is less money for more support - or it should be. If you’re not getting that or subspecialization (if you care about that), then this seems more like a community job where they want to underpay you. (This goes back to the RVU number - $60 is ok for academics maybe, but does this place offer the true benefits of academics?)

3. 1:9 call for academics is not great. I’m getting 1:13 in community for more money, though I’m in the Midwest. I again think of academics as less money for less call.

Sorry - not trying to be negative, but I don’t see much special here unless you want to be in this location.

 

[slruk]

Hmmm… I’m sorry to say, but not a huge fan.

1. You’re getting paid $93/RVU for your base and then it goes down to $60. $60 is bad for oncology. However, if your plan is to just hit your base and relax, then that seems ok. But - are you absolutely sure they’re not going to make you work more for $60/RVU?

2. Do you have NP support? Not support as in NP sees patients independently and you supervise for no money, but someone in clinic to help with orders, etc? The deal in academics is less money for more support - or it should be. If you’re not getting that or subspecialization (if you care about that), then I’m not sure what benefit this position is giving you over community jobs that pay more. (This goes back to the RVU number - $60 is ok for academics maybe, but does this place offer the true benefits of academics?)

3. 1:9 call for academics is not great. I’m getting 1:13 in community for more money, though I’m in the Midwest. I again think of academics as less money for less call.

Sorry - not trying to be negative, but I don’t see much special here unless you want to be in this location.

Yeah that's reasonable. The people in the group weren't that concerned about RVUs so I don't anticipate them pushing. Like you said, goal was to hit base and relax, if I'm above some I'll take the bonus and that's okay. Does it change your calculus if I'm just seeing heme only? No solids, and on top of that, it's primarily benign.

Yes for NP support, kind of up to me to discuss with them what I want done, but I'm thinking inbasket support really.

I might be underestimating the call--they're also in process of hiring so by the time I start, there may be more docs onboard to split the call.

And that's okay! Location is really good for me for family reasons, so it's more polling the group to get a sense of how this ranks in the grand scheme of things.

 

[whoknows2012]

That is insanely good for academic (even if “light” or satellite) northeast. No one pays more than 60/rvu. It’s relative (to the folks outside of the northeast with community jobs) so best to compare to what the alternative would be. Also, is this 1st job out of fellowship?

I would take it no questions asked. What part of northeast if you don’t mind me asking?

 

[ONC2023]

Yeah that's reasonable. The people in the group weren't that concerned about RVUs so I don't anticipate them pushing. Like you said, goal was to hit base and relax, if I'm above some I'll take the bonus and that's okay. Does it change your calculus if I'm just seeing heme only? No solids, and on top of that, it's primarily benign.

Yes for NP support, kind of up to me to discuss with them what I want done, but I'm thinking inbasket support really.

I might be underestimating the call--they're also in process of hiring so by the time I start, there may be more docs onboard to split the call.

And that's okay! Location is really good for me for family reasons, so it's more polling the group to get a sense of how this ranks in the grand scheme of things.

Yes, I think that changes things. If it’s benign heme only with good NP support in a good location and you intend to just hit the base RVU and relax, then this seems more reasonable. You’re making $93/RVU for the base, which is totally reasonable.

I personally would make sure I’m not supervising an NP who sees patients independently of me without any RVUs coming my way, but that’s just me. You may not care.

 

[slruk]

would take it no questions asked. What part of northeast if you don’t mind me asking?

North half of the Northeast, not the central part. And yes, first job.

Yes, I think that changes things. If it’s benign heme only with good NP support in a good location and you intend to just hit the base RVU and relax, then this seems more reasonable. You’re making $93/RVU for the base, which is totally reasonable.

I personally would make sure I’m not supervising an NP who sees patients independently of me without any RVUs coming my way, but that’s just me. You may not care.

Good point on the NP. It does matter and I agree about the supervision part. It seemed like if they were seeing patients, it would be completely independent. And to your earlier point, this job would offer me the subspecialization which is huge for me.

 

[ONC2023]

Good point on the NP. It does matter and I agree about the supervision part. It seemed like if they were seeing patients, it would be completely independent. And to your earlier point, this job would offer me the subspecialization which is huge for me.

Same for me in terms of subspecialization.

I had one academic place try to trick me into making me think they were doing me a favor with NP support, but it was just my supervising the NP's clinic list while seeing my own clinic patients without NP help. I also didn't get any RVUs from NP supervision. Absolutely rotten deal. I would recommend have them explain what their model is - you don't want to show up and find out your clinic list of 16 patients is supplemented by 12 patients on the NP list you supervise.

 

[Hematologynerd]

Hi guys, got an offer at a hospital based community practice (affiliated with an academic cancer center) at a highly desirable/competitive city in the South:

- $430k base with productivity $40/RVU over 4500
-$20k sign on bonus
$30k per year additional program bonus
- Call 1:12

Just like slruk who recently posted this week regarding his offer, location and quality of life are higher priority for me. And practice has very good ancillary support system.

Questions are:
- Is $40/RVU reasonable or too low?
- What about goal RVU base of 4500

Thanks!

 

[ONC2023]

Hi guys, got an offer at a hospital based community practice (affiliated with an academic cancer center) at a highly desirable/competitive city in the South:

- $430k base with productivity $40/RVU over 4500
-$20k sign on bonus
$30k per year additional program bonus
- Call 1:12

Just like slruk who recently posted this week regarding his offer, location and quality of life are higher priority for me. And practice has very good ancillary support system.

Questions are:
- Is $40/RVU reasonable or too low?
- What about goal RVU base of 4500

Thanks!

The 430K for 4500 RVU is $95/RVU - very, very reasonable.

4500 RVUs, at a conservative average of 2.2 RVUs per visit 5 days a week for 46 weeks a year, is 9 patients a day.

$40/RVU above the target is, I think, the worst RVU conversion I have ever seen in oncology. Not sure if this low is typical for academics, but it's absurdly bad by community standards. Sorry to be a downer.

The only way I would take this job is if I just wanted to hit my target and relax. If you intend on working a very full clinical schedule, you will be grossly underpaid.

 

[Hematologynerd]

The 430K for 4500 RVU is $95/RVU - very, very reasonable.

4500 RVUs, at a conservative average of 2.2 RVUs per visit 5 days a week for 46 weeks a year, is 9 patients a day.

$40/RVU above the target is, I think, the worst RVU conversion I have ever seen in oncology. Not sure if this low is typical for academics, but it's absurdly bad by community standards. Sorry to be a downer.

The only way I would take this job is if I just wanted to hit my target and relax. If you intend on working a very full clinical schedule, you will be grossly underpaid.

Thank you so much, this was very helpful. They are not willing to budge on the $40/RVU. But in 2 years, they will renegotiate base pay if I hit RVU target.
I really love everything else about this practice

 

[Red Rooster]

Thank you so much, this was very helpful. They are not willing to budge on the $40/RVU. But in 2 years, they will renegotiate base pay if I hit RVU target.
I really love everything else about this practice

Stay away from Houston Methodist. They are a revolving door.

 

[MifflinDunder]

Stay away from Houston Methodist. They are a revolving door.

Any particular reason why?

 

[Red Rooster]

Any particular reason why?

They pay their community docs academic salaries. RVU was 30 dollars a few years ago.

I personally know or have heard of 5 docs that have left over the past 2 years.

It can be cush if you hit your RVU goals and not much more.

Last I remember they had a 20 mile non compete.

40 dollar RVU gave it away, the only place in the south paying that pathetic RVU rate

 

[MD46]

If not getting 90$ plus per rvu in this day and age for non academic onc. Not a good deal at all!

 

[RainerMaria]

Depends where you are. If in a highly dense and populated area (like Philly for example) you're lucky if you're getting 50-65. Though I think a lot of folks have left for industry around there as it is a meat-grinder.

Which makes you question if satellite docs could ever leave and hang their own shingle ever again. I think the laws favoring big hospital and big pharma, and shutting out docs, have made it impossible for docs to hang their shingle ever again, unless they want to become concierge primary care (which may not be that bad of a lifestyle)

 

[Red Rooster]

Any particular reason why?

And your boss is a suit, and your bosses boss is a suit. Your clinical concerns run through and MBA admin etc, Methodist is a brand oncologists are plug and play (from what a former oncologist told me)

Again want to hit 5000 RVUs, be home with your family or Netflix and chill on the weekends, then it is a great job.

 

[Pickles360]

Hi everyone, I wanted your opinion on a contract offer I received this month. Its from a group backed by OneOncology in the Northeast, 425k base with a 100k signing bonus, $35 per wRVU above 5760 for 4 days a week with plan for an advancement position with a 75k base raise after year 2 and consideration for partnership after year 4. The contract lists 1:4 call and states that the term length is for 3 years initial term and then auto-renews for one year terms. From what I can tell, the practice is in a desirable area however the providers (physicians and APPs) work hard and typically exceed their base RVU statistics. I spoke to one partner who states that he works very hard but brings home over 1 mil. She said that she made roughly 700k at the 3 year mark after accounting for bonuses and was able to get APP support about 2 years in

 

[gutonc]

Hi everyone, I wanted your opinion on a contract offer I received this month. Its from a group backed by OneOncology in the Northeast, 425k base with a 100k signing bonus, $35 per wRVU above 5760 for 4 days a week with plan for an advancement position with a 75k base raise after year 2 and consideration for partnership after year 4. The contract lists 1:4 call and states that the term length is for 3 years initial term and then auto-renews for one year terms. From what I can tell, the practice is in a desirable area however the providers (physicians and APPs) work hard and typically exceed their base RVU statistics.

1. What does partnership look like? Buy-in? Real estate? Infusion drug income? Comp structure for partners? Current median for partners? 4 years is a long time to wait for that.
2. That may be the absolute most atrocious productivity payment I've ever seen. I mean, the base sucks pretty hard (that's <$75/wRVU for the base) but then they cut it by more than half when you get more productive? Pardon my French, but f*** that.

 

[Pickles360]

1. What does partnership look like? Buy-in? Real estate? Infusion drug income? Comp structure for partners? Current median for partners? 4 years is a long time to wait for that.
2. That may be the absolute most atrocious productivity payment I've ever seen. I mean, the base sucks pretty hard (that's <$75/wRVU for the base) but then they cut it by more than half when you get more productive? Pardon my French, but f*** that.

Can I ask how you calculated the wRVU for the base? I’m very new to this stuff and this thread has been eye-opening to me so far

1. No buy-in. Sounds like they used to do one until they were bought out by OneOncology. The partner told me that in her third year she was given a 100k raise from 450k to 550k base and with her wRVU bonus, was making 715k pretax so I'd be working backwards to do the math that way. Now as a partner, she makes 750k as a salary with roughly 800k in bonuses, so a significant step up. I've heard that the partners make that bonus from a lieu of different investments the company is making, but don't know enough to tell you specifically where its coming from.

To add to this, typically the non partners see up to 20 patients per day. As partners, she said they can see from 30-40 per day with APP support.

 

[ONC2023]

Hi everyone, I wanted your opinion on a contract offer I received this month. Its from a group backed by OneOncology in the Northeast, 425k base with a 100k signing bonus, $35 per wRVU above 5760 for 4 days a week with plan for an advancement position with a 75k base raise after year 2 and consideration for partnership after year 4. The contract lists 1:4 call and states that the term length is for 3 years initial term and then auto-renews for one year terms. From what I can tell, the practice is in a desirable area however the providers (physicians and APPs) work hard and typically exceed their base RVU statistics. I spoke to one partner who states that he works very hard but brings home over 1 mil. She said that she made roughly 700k at the 3 year mark after accounting for bonuses and was able to get APP support about 2 years in

Hey. This offer has some mediocre aspects and some red flag aspects.

1) Mediocre: Your base is 425 K for 5760 RVUs, which equals $74 per RVU ($425000/5760). That's overall low for oncology, but if you're in private practice, it might be a bit more justifiable if the partnership equity makes it up longer term. The signing bonus is very good.
2) Red Flag: The $35/RVU above 5760 is highway robbery. The harder you work, the less you will make.
3) Mediocre: 4 year partnership is long. Whether it's worth it depends on their track record of making new hires partners. If they fire you at the end of year 3, that's a lot of sweat equity you've lost. Has anyone failed to make partner?
4) Mediocre: 1:4 call is pretty bad, at least for me. How busy will you be on weekends? How many hospitals to cover?

It sounds like partnership equity is quite valuable from what you say, so I think you have to decide how unhappy you'd be being paid $35/RVU above your base for 4 years and how much you trust that partnership will materialize.

Just to provide some context, my PP offer in upper Midwest is:
- 400K for 4400 RVU base
- $90/RVU above base
- 1:10 call
- partnership at end of 5 years (no buy in, all sweat equity) - this is a very long partnership, but since I'm being paid fairly for my RVUs, I'm ok with it

You're in the Northeast, so not surprising the offer is less generous.

 

[Pickles360]

Hey. This offer has some mediocre aspects and some red flag aspects.

1) Mediocre: Your base is 425 K for 5760 RVUs, which equals $74 per RVU ($425000/5760). That's overall low for oncology, but if you're in private practice, it might be a bit more justifiable if the partnership equity makes it up longer term. The signing bonus is very good.
2) Red Flag: The $35/RVU above 5760 is highway robbery. The harder you work, the less you will make.
3) Mediocre: 4 year partnership is long. Whether it's worth it depends on their track record of making new hires partners. If they fire you at the end of year 3, that's a lot of sweat equity you've lost. Has anyone failed to make partner?
4) Mediocre: 1:4 call is pretty bad, at least for me. How busy will you be on weekends? How many hospitals to cover?

It sounds like partnership equity is quite valuable from what you say, so I think you have to decide how unhappy you'd be being paid $35/RVU above your base for 4 years and how much you trust that partnership will materialize.

Just to provide some context, my PP offer in upper Midwest is:
- 400K for 4400 RVU base
- $90/RVU above base
- 1:10 call
- partnership at end of 5 years (no buy in, all sweat equity) - this is a very long partnership, but since I'm being paid fairly for my RVUs, I'm ok with it

You're in the Northeast, so not surprising the offer is less generous.

Thank you so much for breaking things down like this! I really appreciate it

 

[IM_to_ortho_hopeful]

Hi everyone, I wanted your opinion on a contract offer I received this month. Its from a group backed by OneOncology in the Northeast, 425k base with a 100k signing bonus, $35 per wRVU above 5760 for 4 days a week with plan for an advancement position with a 75k base raise after year 2 and consideration for partnership after year 4. The contract lists 1:4 call and states that the term length is for 3 years initial term and then auto-renews for one year terms. From what I can tell, the practice is in a desirable area however the providers (physicians and APPs) work hard and typically exceed their base RVU statistics. I spoke to one partner who states that he works very hard but brings home over 1 mil. She said that she made roughly 700k at the 3 year mark after accounting for bonuses and was able to get APP support about 2 years in

At $35/RVU the reason why the parter you spoke to is making $1M is because she’s eating the professional fees of her associates haha interesting way to structure a buy in. But would be wary to see if there is a revolving door of associates that feed the partners for a year or two

 

[gutonc]

Can I ask how you calculated the wRVU for the base? I’m very new to this stuff and this thread has been eye-opening to me so far

@ONC2023 showed my work for me.

1. No buy-in. Sounds like they used to do one until they were bought out by OneOncology. The partner told me that in her third year she was given a 100k raise from 450k to 550k base and with her wRVU bonus, was making 715k pretax so I'd be working backwards to do the math that way. Now as a partner, she makes 750k as a salary with roughly 800k in bonuses, so a significant step up. I've heard that the partners make that bonus from a lieu of different investments the company is making, but don't know enough to tell you specifically where its coming from.

Doubling your income from passive sources as a partner is a pretty good gig if true.

To add to this, typically the non partners see up to 20 patients per day. As partners, she said they can see from 30-40 per day with APP support.

What does this actually look like? Do you actually see the patient or just get credit for the APP's work? A little back of the envelope math shows me that if I did that at my current job, my gross would be ~$1.5M. I would never because that's way too much work for me thank you. But if that's the amount of work you're doing, that's what you should be getting paid.

 

[Pickles360]

@ONC2023 showed my work for me.

Doubling your income from passive sources as a partner is a pretty good gig if true.

What does this actually look like? Do you actually see the patient or just get credit for the APP's work? A little back of the envelope math shows me that if I did that at my current job, my gross would be ~$1.5M. I would never because that's way too much work for me thank you. But if that's the amount of work you're doing, that's what you should be getting paid.

Yeah I definitely dont think the passive income is leading to the entire bonus but parts of it for sure. It may be like the previous poster mentioned where the associates are "buying in" by supplementing the partners' income until they become partners themselves.

It seems like the partners have 30-40 patients on the schedule and the APP is capped at 20 per day total. She doesn't have to reinforce the visit by seeing the patients the APP sees unless she wants/deems it necessary to, but does have to sign off on the note/plan and have an idea of whats going on in general.

 

[vipmak]

I got an offer from one of the USON PP groups in mid-atlantic area. I would like to get your thoughts as I am exclusively looking for PP.

The position is for a satellite office with general heme-onc panel. They have 1 physician at that location and trying to add another. 4 day work week. 1:8 call. Office is super busy and expected to see 20-25 patients. Current partner at that location is seeing 30-35 patients with APP. Office is next to a community hospital. Daily hospital rounding with 6-8 consults on the list. Base is $400 with 2 year partnership track. Sweat equity for first 2 years. No buy in. Partner compensation is 80% profit sharing, 10% productivity and 10% quality/leadership incentives. I am being told that compensation will be 2-3x of the base after becoming partner. No ancillary revenue stream or real estate state ownership. Work commute for me would be 40 mins.

 

[MifflinDunder]

Curious as a fellow. Are these USON PP groups like typical PP where half your patients are benign heme? I can't imagine seeing 30-35 solid tumor patients a day.

 

[MD46]

I got an offer from one of the USON PP groups in mid-atlantic area. I would like to get your thoughts as I am exclusively looking for PP.

The position is for a satellite office with general heme-onc panel. They have 1 physician at that location and trying to add another. 4 day work week. 1:8 call. Office is super busy and expected to see 20-25 patients. Current partner at that location is seeing 30-35 patients with APP. Office is next to a community hospital. Daily hospital rounding with 6-8 consults on the list. Base is $400 with 2 year partnership track. Sweat equity for first 2 years. No buy in. Partner compensation is 80% profit sharing, 10% productivity and 10% quality/leadership incentives. I am being told that compensation will be 2-3x of the base after becoming partner. No ancillary revenue stream or real estate state ownership. Work commute for me would be 40 mins.

Once partner 35 patients a day strictly RVU for 4 days a week approx , that would be 13,500 rvus if 4 weeks vacation. 1.35 mil if $100 / rvu

10% pro and 10% other incentives so around 1.5 mil?

 

[Pickles360]

I know the inside deets of pretty much every practice in the mid Atlantic. If you want to DM me which practice this is, I'm happy to share what I know.

The fact that there were 2 prior employees who did not make partner is a full on red flag. No need to look any further than that and whatever reason they give you is baloney.

Would I be able to reach out to you to speak about the mid Atlantic practices in general?

 

[Pickles360]

Also, I see a few people mentioned that US Oncology is a better private equity group to become a part of than OneOncology in regard to them offering partner tracks after 2 years. Does anyone have experience with either group? Sorry to blow up the chat!

 

[HemeOncHopeful19]

Also, I see a few people mentioned that US Oncology is a better private equity group to become a part of than OneOncology in regard to them offering partner tracks after 2 years. Does anyone have experience with either group? Sorry to blow up the chat!

I have heard better things about USON than other groups but that may have more to do with the region I live in being more USON heavy. I’m not sure I would consider USON private equity as it is a “partnership” with McKesson which is one of the largest companies on the planet and is publicly listed.

I have known people who are happy with USON but I have also met people who left USON or were not pleased there, usually the complaint I have heard (keep in mind people can be biased) is that they treat Texas Onc and Rocky Mtn Cancer as their golden children compared to the other groups.

 

[gutonc]

I have heard better things about USON than other groups but that may have more to do with the region I live in being more USON heavy. I’m not sure I would consider USON private equity as it is a “partnership” with McKesson which is one of the largest companies on the planet and is publicly listed.

I have known people who are happy with USON but I have also met people who left USON or were not pleased there, usually the complaint I have heard (keep in mind people can be biased) is that they treat Texas Onc and Rocky Mtn Cancer as their golden children compared to the other groups.

I have heard similar from docs I know in a USON group. To be clear, none of them have left, it's just an issue they have brought up.

 

[usmrpas]

1st year fellow starting to think about job prospects. Leaning towards hybrid practice - hopefully somewhere I can focus on 2-3 tumor groups rather than being a generalist. My main question is how common is it to find jobs that are less than full time (e.g., 0.6-0.8 FTE)?

More or less likely in academia, hybrid, private?

 

[HemeOncHopeful19]

1st year fellow starting to think about job prospects. Leaning towards hybrid practice - hopefully somewhere I can focus on 2-3 tumor groups rather than being a generalist. My main question is how common is it to find jobs that are less than full time (e.g., 0.6-0.8 FTE)?

More or less likely in academia, hybrid, private?

Not too common starting out, I feel like this is more of a long play where you get in with a group and after a few years of proving yourself to be reliable you can try to negotiate a part time gig but many places may not offer it since they want you to work work work

 

[gutonc]

Not too common starting out, I feel like this is more of a long play where you get in with a group and after a few years of proving yourself to be reliable you can try to negotiate a part time gig but many places may not offer it since they want you to work work work

I agree. Highly unlikely to find this in a PP group. They're going to want you to move the meat all day every day. You might find it in an academ-ish setting, but that will vary widely. Academics might be an option, but not in a big name place, some smaller institution where they need FT clinicians.

 

[ONC2023]

1st year fellow starting to think about job prospects. Leaning towards hybrid practice - hopefully somewhere I can focus on 2-3 tumor groups rather than being a generalist. My main question is how common is it to find jobs that are less than full time (e.g., 0.6-0.8 FTE)?

More or less likely in academia, hybrid, private?

Hey - final year fellow here who spent the past 12 months looking for a non-academic somewhat subspecialized job. I want to parse this out into two separate questions.

1) Can you find a subspecialized non-academic job? Yes, these jobs exist but are quite a bit rarer than pure specialized academic or pure general community heme-onc. The good news is that heme-onc is in such high demand that even "rarer" jobs are not that rare. If you're willing to get paid less, you can move to an academic-ish satellite of a northeast cancer center. If you want to make more, you can move to the midwest or south. And there's always something like Kaiser on the West coast.

2) 0.6 FTE? I personally did not find a single 0.6 FTE job outside of academics in my job search. But there are definitely 0.8 FTE/4 days a week hospital-employed jobs. Private practice is usually going to be 1.0 FTE, I think.

You're asking the right questions at the start of fellowship that I wish I thought of earlier. My best advice is to (a) get the broadest clinical training to start and (b) start your job search early so you can focus on your weaker clinical areas if a job you like wants you to see a tumor type you're uncomfortable with.

 

[HemeOncHopeful19]

Hey - final year fellow here who spent the past 12 months looking for a non-academic somewhat subspecialized job. I want to parse this out into two separate questions.

1) Can you find a subspecialized non-academic job? Yes, these jobs exist but are quite a bit rarer than pure specialized academic or pure general community heme-onc. The good news is that heme-onc is in such high demand that even "rarer" jobs are not that rare. If you're willing to get paid less, you can move to an academic-ish satellite of a northeast cancer center. If you want to make more, you can move to the midwest or south. And there's always something like Kaiser on the West coast.

2) 0.6 FTE? I personally did not find a single 0.6 FTE job outside of academics in my job search. But there are definitely 0.8 FTE/4 days a week hospital-employed jobs. Private practice is usually going to be 1.0 FTE, I think.

You're asking the right questions at the start of fellowship that I wish I thought of earlier. My best advice is to (a) get the broadest clinical training to start and (b) start your job search early so you can focus on your weaker clinical areas if a job you like wants you to see a tumor type you're uncomfortable with.

I would add to that that in my (limited) experience there are plenty of PP jobs that do 4 or 4.5 clinic days per week, although you are expected to be available for patient/infusion/nursing needs on those off times you can often hang out at home and I would still consider that full FTE.

If you want a true “I work 4 days a week don’t even think about bothering me on Monday or Friday or whatever 5th day would be” I haven’t come across too many of those even hospital employed.

 

[Satriale]

I would add to that that in my (limited) experience there are plenty of PP jobs that do 4 or 4.5 clinic days per week, although you are expected to be available for patient/infusion/nursing needs on those off times you can often hang out at home and I would still consider that full FTE.

If you want a true “I work 4 days a week don’t even think about bothering me on Monday or Friday or whatever 5th day would be” I haven’t come across too many of those even hospital employed.

There's quite a bit of heterogeneity in terms of culture at various hospital employed practices. I've worked a couple of these jobs, and both of have had options for a true 4 day work week. The day off was truly off -- no expectation for inbox, orders, calls, etc. Of course, you never stop being a doctor, and if a surgeon calls your cell while you're out grabbing groceries, you're still going to pick up the phone and work through the case. Apart from that, the office isn't going to bother you on your day off.

All the more reason for future job seekers to probe further when looking at various positions and understand what a "day off" really means.

 

[gutonc]

Both good points above. As far as my corporate overlords go, I don't have a day off on Friday, I have an admin day. As far as my nurses and MAs go, Friday is my day off and they will only bother me for critical issues and even then will apologize profusely. I suspect this will decrease once I finally get a colleague here this fall.

 

[bobsmith]

There's quite a bit of heterogeneity in terms of culture at various hospital employed practices. I've worked a couple of these jobs, and both of have had options for a true 4 day work week. The day off was truly off -- no expectation for inbox, orders, calls, etc. Of course, you never stop being a doctor, and if a surgeon calls your cell while you're out grabbing groceries, you're still going to pick up the phone and work through the case. Apart from that, the office isn't going to bother you on your day off.

All the more reason for future job seekers to probe further when looking at various positions and understand what a "day off" really means.

The flipside of this is usually that your colleagues are also truly off when they're off, which means you're covering for them.

I personally would rather handle a handful of questions about my own patients on my admin day rather than answer a handful of questions about someone else's patients on one of my other (busier) days, but some people prefer the opposite and that's fair.

I think as long as the whole group has an understanding / agreement of what's expected, it all evens out.

 

[Satriale]

The flipside of this is usually that your colleagues are also truly off when they're off, which means you're covering for them.

I personally would rather handle a handful of questions about my own patients on my admin day rather than answer a handful of questions about someone else's patients on one of my other (busier) days, but some people prefer the opposite and that's fair.

I think as long as the whole group has an understanding / agreement of what's expected, it all evens out.

True, and you can also expect that you'll have some extra catching up to do the morning after with paperwork and calls that accumulated during your day off. A price to pay for a little extra freedom.

Your point also raises another important question to ask when looking at jobs -- how many of the triage questions are handled by APPs when the doc isn't around, and how much falls on the covering "doc of the day"? It's nice when the clinic structure has good filters built in, so that you're primarily just dealing with a few MD level issues on those days.

 

[Pickles360]

Where are y'all doing the most of your job searching when looking? NEJM? Linkedin? Am I missing the best way to accrue the best offers?

 

[ONC2023]

Where are y'all doing the most of your job searching when looking? NEJM? Linkedin? Am I missing the best way to accrue the best offers?

NEJM has very high quality postings, as does the ASCO Career Center. PraceticeLink/PracticeMatch have lower quality postings but more of them.

I wonder if the difference in quality is that NEJM/ASCO are more expensive for employers to post on. Many of the PracticeLink/PracticeMatch postings tend to be smaller hospitals in perhaps less appealing geographic areas.

I used all of the above in my job search.

 

[gutonc]

NEJM has very high quality postings, as does the ASCO Career Center. PraceticeLink/PracticeMatch have lower quality postings but more of them.

I wonder if the difference in quality is that NEJM/ASCO are more expensive for employers to post on. Many of the PracticeLink/PracticeMatch postings tend to be smaller hospitals in perhaps less appealing geographic areas.

I used all of the above in my job search.

This is the way. Those listings are ridiculously expensive. And most employers are remarkably cheap. We looked into listing an open position in NEJM and JCO and we were pushing $10K for a 30 day posting.

I wound up hiring somebody who PM'd me here.

 

[HemeOncHopeful19]

Where are y'all doing the most of your job searching when looking? NEJM? Linkedin? Am I missing the best way to accrue the best offers?

I mean it really depends on what you’re looking for and what you mean by “best offer.”

A well run PP group is probably not going to be shelling out $10k to post a job on NEJM for example. A hospital that does that might mean they’re overflowing with cash and can pay you more, or it might mean they are super desperate or spend all their money on recruiting rather than paying their docs.

I’ve done everything from cold calling the front desk of an office 3 states away because my wife had a job interview there to PMing GutOnc myself lol

 

[Pickles360]

Thank you all!

 

[GrassrootMaltan]

The best way is to Google ‘city name’ + ‘cancer center / oncology’ + ‘physician recruiter’ + ‘LinkedIn’. You’ll find them lurking there. Send them a connection request, then a message, then exchange emails, and take it from there. You’ll catch a lot of non-posted opportunities this way.

 

[MotoMD]

Trying to figure out what the SoCal market is like LA/OC. Oneoncology is 350 to 400 base and 39 dollars and RVU. It’s pretty pathetic. I have heard of places like COH or memorial group doing 90 an RVU but I found a job that is 500k base, large sign on, and about 100 to 150 in bonus each year not based on how many patients you see but based on how the practice performs. You are not a partner but all this is paid as 1099. To me the last option sounded the best.

 

[HemeOncHopeful19]

Trying to figure out what the SoCal market is like LA/OC. Oneoncology is 350 to 400 base and 39 dollars and RVU. It’s pretty pathetic. I have heard of places like COH or memorial group doing 90 an RVU but I found a job that is 500k base, large sign on, and about 100 to 150 in bonus each year not based on how many patients you see but based on how the practice performs. You are not a partner but all this is paid as 1099. To me the last option sounded the best.

90/RVU should be the bare minimum.

1099 should pay 30% higher due to taxes and benefits, they are trying to take advantage of you not realizing that imo

 

[Hemeoncfellow]

Does anyone have good experience or know-how with private practices in the Northeast, specifically New York, New Jersey, Connecticut, or Pennsylvania that are hiring in the next year or two? I have seen NY Cancer and Blood and Astera Care as options but it seems that they are associated with OneOncology. Does anyone know of or work with more private groups that might be hiring? I’m currently a second year fellow

 

[HemeOncHopeful19]

Does anyone have good experience or know-how with private practices in the Northeast, specifically New York, New Jersey, Connecticut, or Pennsylvania that are hiring in the next year or two? I have seen NY Cancer and Blood and Astera Care as options but it seems that they are associated with OneOncology. Does anyone know of or work with more private groups that might be hiring? I’m currently a second year fellow

Your best bet would be to google some of the groups you are interested in and try to find any that have younger docs (so you know they might be open to hiring a new grad fellow) and cold calling their front desk in your 3rd year.

I would not be surprised if many of those groups prefer to hire someone a few years out of fellowship though and be wary if all of the docs are older these groups might all be workaholics unless that is your thing.