How much $$$ and time off would it take you off your perfect location?

[deleted950463]

I am not an RO but I have became exposed to enough residents and attending to realize how important locations are to people.

Say you’ve been fortunate enough to offer an RO job with the perfect location for you, let’s say Manhattan. How much more money/time off would it take to peel you off this job to go to a different job an hour and half away? Three hours away? One hour by plane away?

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[Neuronix]

You're assuming that:

1. You could ever find a permanent position at all in Manhattan if that was your desire.

2. The job several hours hours away would pay significantly different or provide different benefits than the one in the city.

3. You would be fortunate enough to be able to choose between those two options.

None of this is guaranteed in rad onc. Rad oncs apply broadly and see what sticks.

 

[elementaryschooleconomics]

I am not an RO but I have became exposed to enough residents and attending to realize how important locations are to people.

Say you’ve been fortunate enough to offer an RO job with the perfect location for you, let’s say Manhattan. How much more money/time off would it take to peel you off this job to go to a different job an hour and half away? Three hours away? One hour by plane away?

This is an interesting but probably impossible question to answer. I say this based on my own evolution from a bright-eyed MSTP student in my early 20s to a burned-out senior resident in my mid-30s with a spouse, kids, and extended family spread all over the country.

My wife and I have 2 main geographic regions where our families are based, and an additional 1-2 we would consider based on affinity/experience etc.

This is actually a question I ask myself constantly. Say I beat the odds and am offered a position in my #1 choice region. Say I am somehow even luckier to get offered a second job in a region I'm not really interested in but the pay is significantly more. How much money would it take for me to turn down my preferred geography for money?

The rate limiting step is really my wife and spawn. If I was single, would I go work in ultra-rural Wyoming for $500k? You bet your sweet butt I would, I love wide open spaces and hate cities. However, Wyoming is A LONG LONG way away from my family. Will my wife tolerate this even for $750k? More? She might initially agree but then come to hate the fact that trees are her only friends. What about my miniature genetic vessels? What are the school options like?

You'll come to find that it will NEVER be as simple as "money vs geography". Especially in RadOnc in 2020 and beyond. At this point, my only option might be a rural Wyoming position for $200k, and I'll be happy to take it because children require food.

 

[PhotonBomb]

You must really think something is wrong with yourself if you think a rural Wyoming position paying 200k is the best you think you can get

 

[elementaryschooleconomics]

You must really think something is wrong with yourself if you think a rural Wyoming position paying 200k is the best you think you can get

Ha, that's my analogy for "I'm willing to go all in on this sunk cost fallacy".

To be honest, I wish I had family near or in Wyoming. I would love to go to Wyoming. I am so tired of traffic. I'm getting to the point where I would rather personally place the PEG tubes for my H&N patients over sitting in more traffic.

 

[RickyScott]

You must really think something is wrong with yourself if you think a rural Wyoming position paying 200k is the best you think you can get

You must really think something is wrong with yourself if you think a rural Wyoming position paying 200k is the best you think you can get

Very reasonable scenario 3 years from now and 600+ more residents into job market.

 

[scarbrtj]

This is an interesting but probably impossible question to answer. I say this based on my own evolution from a bright-eyed MSTP student in my early 20s to a burned-out senior resident in my mid-30s with a spouse, kids, and extended family spread all over the country.

My wife and I have 2 main geographic regions where our families are based, and an additional 1-2 we would consider based on affinity/experience etc.

This is actually a question I ask myself constantly. Say I beat the odds and am offered a position in my #1 choice region. Say I am somehow even luckier to get offered a second job in a region I'm not really interested in but the pay is significantly more. How much money would it take for me to turn down my preferred geography for money?

The rate limiting step is really my wife and spawn. If I was single, would I go work in ultra-rural Wyoming for $500k? You bet your sweet butt I would, I love wide open spaces and hate cities. However, Wyoming is A LONG LONG way away from my family. Will my wife tolerate this even for $750k? More? She might initially agree but then come to hate the fact that trees are her only friends. What about my miniature genetic vessels? What are the school options like?

You'll come to find that it will NEVER be as simple as "money vs geography". Especially in RadOnc in 2020 and beyond. At this point, my only option might be a rural Wyoming position for $200k, and I'll be happy to take it because children require food.

Love it. I’ve seen an attending move one thousand miles for an extra 25K in the past. The trees and genetic vessels... Trees can be friends. Recall that Socrates in Plato’s Phaedrus said that the first words of prophesy came from a tree at the sacred site of Zeus at Dodona. Although he went on to clarify that “today’s young people” were too sophisticated as compared to the people of old to accept the truth from a tree. Carl Sagan said the oak and human are 50% genetically similar. As males, our daughters are 50% genetically identical to us. But our sons, a little less than 50%, thus always get a little more genes from mom.

Hug the trees and feed the children. Wyoming only has enough cancer to “feed” about 4-5 rad oncs. Don’t know if Wyoming is in the cards for any of us for now

 

[deleted950463]

i am very close with an attending in another specialty that is tight but not RO tight. He had the fortune of choosing between his perfect location and different gig and he told me he would take the perfect location regardless of pay cut.

He’s a single guy and his rationale is interesting: the best financial move one can make would be to marry someone independently financially successful, and the odd of finding those women in BFE is Vastly lower than a big city.

 

[elementaryschooleconomics]

i am very close with an attending in another specialty that is tight but not RO tight. He had the fortune of choosing between his perfect location and different gig and he told me he would take the perfect location regardless of pay cut.

He’s a single guy and his rationale is interesting: the best financial move one can make would be to marry someone independently financially successful, and the odd of finding those women in BFE is Vastly lower than a big city.

Uh...yeah I guess that's one way you can live your life...

 

[deleted573262]

i am very close with an attending in another specialty that is tight but not RO tight. He had the fortune of choosing between his perfect location and different gig and he told me he would take the perfect location regardless of pay cut.

He’s a single guy and his rationale is interesting: the best financial move one can make would be to marry someone independently financially successful, and the odd of finding those women in BFE is Vastly lower than a big city.

Every physician should be able to find a balance between lifestyle and salary without depending on someone who is financially successful. Even so, money does not bring happiness, a fact visible on this forum.

 

[dieABRdie]

Even so, money does not bring happiness....

But it sure can rent it

 

[Burt Radnolds]

Even if you are making great money, you better save it for when you get undercut by some starving new grad and are out of a job.

 

[deleted18755]

[QUOTE
Hug the trees and feed the children. Wyoming only has enough cancer to “feed” about 4-5 rad oncs. Don’t know if Wyoming is in the cards for any of us for now
[/QUOTE]
This actually really made me think for a moment and put things in perspective.

Since the 90’s people have been saying “you could always go to Wyoming/North Dakota, Mississippi, etc and easily find a job that pays a fortune” but when you really think about it and look at the population and distribution it is actually true that Wyoming can only support a handful of rad oncs and even relatively populated “undesirable” states with full blown metropolitan areas (definitions may vary) like Alabama don’t have a half dozen openings per year, every year so it’s not like a size able proportion of the 200 graduates per year can rely on using these types of jobs and places as backups forever. Once they are full they are full and that’s that...

 

[randomname2018]

While this does seem like a reasonable question it isnt grounded in reality. Even less so in the years to come.

At the moment I am in my desired geographic location. I have been offered opportunities to leave that have exceeded my current compensation and benefits which I have turned down. I believe we are headed for a significant downturn in the next several years and remain bearish on potential opportunities. New hires would be the first to go, particularly ones that have heavy financial contracts.

The only way I'd consider a cash grab opportunity now is if I was within 5 years of retirement.

 

[RickyScott]

While this does seem like a reasonable question it isnt grounded in reality. Even less so in the years to come.

At the moment I am in my desired geographic location. I have been offered opportunities to leave that have exceeded my current compensation and benefits which I have turned down. I believe we are headed for a significant downturn in the next several years and remain bearish on potential opportunities. New hires would be the first to go, particularly ones that have heavy financial contracts.

The only way I'd consider a cash grab opportunity now is if I was within 5 years of retirement.

Ironically, some of us dont intend to "retire" and late 70s and

[QUOTE
Hug the trees and feed the children. Wyoming only has enough cancer to “feed” about 4-5 rad oncs. Don’t know if Wyoming is in the cards for any of us for now

This actually really made me think for a moment and put things in perspective.

Since the 90’s people have been saying “you could always go to Wyoming/North Dakota, Mississippi, etc and easily find a job that pays a fortune” but when you really think about it and look at the population and distribution it is actually true that Wyoming can only support a handful of rad oncs and even relatively populated “undesirable” states with full blown metropolitan areas (definitions may vary) like Alabama don’t have a half dozen openings per year, every year so it’s not like a size able proportion of the 200 graduates per year can rely on using these types of jobs and places as backups forever. Once they are full they are full and that’s that...
[/QUOTE]
Another myth: The Rural Safety Net: rural places are rural because not many people live there by definition and dont need a lot of radoncs to fill those regions.

 

[PleaseRemainCalm]

i am very close with an attending in another specialty that is tight but not RO tight. He had the fortune of choosing between his perfect location and different gig and he told me he would take the perfect location regardless of pay cut.

He’s a single guy and his rationale is interesting: the best financial move one can make would be to marry someone independently financially successful, and the odd of finding those women in BFE is Vastly lower than a big city.

Yes this is a real argument I have made...not too many single high rollers in BFE as everyone else's salary is LOWER for living there.

 

[TheIllusionist]

I'm still a student, but I guess I was raised old school. The whole "I want to be in a big city because there are more rich professional women there who could match my salary" isn't all that appealing to me. I thought a big freedom of becoming a doctor was being able to not worry about the finances of your future partner, barring something really bad like no job and hundreds of thousands in loans.

 

[deleted1002574]

It’s not that there just professional women in big cities. There are just more women in general. For example, DC and NUC are way skewed with more women and also a significant gay population, so straight men make out like bandits.

Smaller towns the ratios are worse - more men, less women, and that makes things competitive. Male Docs that used to be residents that used to be Med students that used to be chemistry majors that used to be mathletes in high school don’t have .. how do you say it ... game. You’d think though if you have that sweet, sweet KHE money, game wouldn’t be necessary ...

I'm still a student, but I guess I was raised old school. The whole "I want to be in a big city because there are more rich professional women there who could match my salary" isn't all that appealing to me. I thought a big freedom of becoming a doctor was being able to not worry about the finances of your future partner, barring something really bad like no job and hundreds of thousands in loans.

 

[TheIllusionist]

It’s not that there just professional women in big cities. There are just more women in general. For example, DC and NUC are way skewed with more women and also a significant gay population, so straight men make out like bandits.

Smaller towns the ratios are worse - more men, less women, and that makes things competitive. Male Docs that used to be residents that used to be Med students that used to be chemistry majors that used to be mathletes in high school don’t have .. how do you say it ... game. You’d think though if you have that sweet, sweet KHE money, game wouldn’t be necessary ...

you would think they would try and learn after working so hard at other things in life