Insights into private practice

[ONCRAD]

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Currently a medical student on the interview trail.

All the applicants I've talked to have said they want to do academics in the future and I am part of that bunch. However, you talk to residents and many will say they were like that at one point, but end up changing their minds and wanting to do private practice. Apparently, 80% of the jobs are in private practice.

From my understanding, to secure a job at a prestigious academic program you should be, above all, productive in research as a resident, but also train preferably at a top-tier program and have the right connections.

I know nothing of private practice and was hoping someone could shed some light on this mysterious side of radiation oncology.

-Is there such a thing as a "top-tier" private practice gig?
--If so, what makes them highly sought after? Location? Salary/benefits? Good management?
-What do they look for in applicant?
--Training program prestige? Board scores? Connections? Research? Affability?

 

[Gfunk6]

99% of residents entering (including me) were gung-ho about academics when applying. Upon graduation only ~40% of residents go into academics. So, as you stated, people obviously change their minds (or wise up 😉).

To answer your specific questions:

-Is there such a thing as a "top-tier" private practice gig?
--If so, what makes them highly sought after? Location? Salary/benefits? Good management?

Yes, there are absolutely top tier private practice groups. There are many features which distinguish them:

1. Long history of successful practice which is mark of the ability to weather changes in a frequently changing and scary health care environment
2. Treating their associates (non-partners) fairly
3. A mix of physicians with varying strengths in marketing, clinical Rad Onc, and administrative skills (E Pluribus Unum).
4. Strong ties to academia - they may rotate residents, enroll on national trials, or have adjunct/volunteer faculty on staff
5. Generous revenue/benefits for partners
6. Smooth operations (with competent executive and middle management) & workflow

-What do they look for in applicant?

As always, the three A's. Affability, availability, and ability - in that order. 🙂

--Training program prestige? Board scores? Connections? Research? Affability?

Training program prestige can range in importance from middling to critical (the latter is true for practices who historically recruit from one program, usually Harvard or MSKCC). At most training will be necessary but it is never sufficient. Most of the time, training program is a relative non-factor.

There are a great many training programs (97%) in my view, that provide outstanding training in clinical Rad Onc which is one of the critical prerequisites for private practice success. Whether your program is an 'academic powerhouse' is of relatively low importance. It may serve as 'icing on the cake' but pedigree can absolutely NOT substitute for the three A's above.

Nobody cares about your board scores (assuming you passed).

Connections are critical as many top jobs are not publicly advertised. Also, Rad Onc is a small field and people will talk to their 'buddies' from an applicant's residency program to get the 'real scoop.'

Research is of middling importance in most cases.