M4 thinking strongly about applying to Rad Onc: Why is there so much dissonance between opinions real life and the internet?

[Neuronix]

Ok I think this is getting silly. Regardless of whether xrthopeful is a PD or not, they have every right to post their opinions here. I don't know who xrthopeful is, but I think we can all assume that they are a radiation oncologist. Program directors may have an agenda, but they are still radiation oncologists with a point of view as valid as everyone else's. We have had some posters on here who are program directors, and it's important for all sides to understand their thoughts since they are actually out in person making decisions and influencing more people than probably most of the rest of us.

So please let's try to focus on the issues. It's really non-productive to try to second guess the motivations of posters here. There are plenty of people out there who legitimately have good or even great jobs who have no idea what we're talking about. They may be less motivated to speak about the issues than those who are unhappy for whatever reason, but their viewpoints are just as valid.

Keep it professional, not personal.

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[scarbrtj]

With my teamfoil hat on, are PDs infiltrating SDN?

A while back there was a guy who spoke about “very good people” over at the ABR. where you at?

Ok I think this is getting silly. Regardless of whether xrthopeful is a PD or not, they have every right to post their opinions here. I don't know who xrthopeful is, but I think we can all assume that they are a radiation oncologist. Program directors may have an agenda, but they are still radiation oncologists with a point of view as valid as everyone else's. We have had some posters on here who are program directors, and it's important for all sides to understand their thoughts since they are actually out in person making decisions and influencing more people than probably most of the rest of us.

So please let's try to focus on the issues. It's really non-productive to try to second guess the motivations of posters here. There are plenty of people out there who legitimately have good or even great jobs who have no idea what we're talking about. They may be less motivated to speak about the issues than those who are unhappy for whatever reason, but their viewpoints are just as valid.

Keep it professional, not personal.

I like to hear the less negative take. Some guy comes on here and it’s his motivation to plant some positive propaganda—great. That this approach can work has tons of history on its side. Maybe positive propaganda is needed if for nothing else than a coping mechanism so we don't go full Cassandra. Need more positive propaganda with all the craziness in the world or else I’m going to have to succumb to these ads now appearing in the rad onc forum...

 

[xrthopeful]

Would like to add two points:

1) I interviewed at multiple practices where making 500-600k as partner was the path without collecting technical. My understanding is that if you’re going to be able to collect technical you surely are going to make more than 500k.

2) in a multi-specialty practice the idea that the med onc is going to make more than the rad onc (TWICE MORE?) is a laughable notion in my experience. I would love to hear from anyone else in a multi specialty practice where the med oncs are making significantly more than the rad oncs.


If you want to argue that can change in the future - then fine. That’s your right. But it’s conjecture.

But don’t gaslight these poor med students that have no way of knowing what’s what at this point. But to med students - please don’t listen to me. Please don’t listen to Medgator. Please talk to people in real life.

 

[thecarbonionangle]

I like to hear the less negative take. Some guy comes on here and it’s his motivation to plant some positive propaganda—great. That this approach can work has tons of history on its side. Maybe positive propaganda is needed if for nothing else than a coping mechanism so we don't go full Cassandra. Need more positive propaganda with all the craziness in the world or else I’m going to have to succumb to these ads now appearing in the rad onc forum...

MROGA!!!

 

[scarbrtj]

Would like to add two points:

1) I interviewed at multiple practices where making 500-600k as partner was the path without collecting technical. My understanding is that if you’re going to be able to collect technical you surely are going to make more than 500k.

2) in a multi-specialty practice the idea that the med onc is going to make more than the rad onc (TWICE MORE?) is a laughable notion in my experience. I would love to hear from anyone else in a multi specialty practice where the med oncs are making significantly more than the rad oncs.


If you want to argue that can change in the future - then fine. That’s your right. But it’s conjecture.

But don’t gaslight these poor med students that have no way of knowing what’s what at this point. But to med students - please don’t listen to me. Please don’t listen to Medgator. Please talk to people in real life.

Andrew Pippas, med onc director at sleepy little Columbus Regional made twice (more than 1.5 million a year) what the rad oncs made forever. Still probably does but you didn't hear it from me!

 

[Neuronix]

1) I interviewed at multiple practices where making 500-600k as partner was the path without collecting technical. My understanding is that if you’re going to be able to collect technical you surely are going to make more than 500k.

Fair enough. I never did. $400s was as high as the discussions ever seemed to get.

Agree about technical. I know several people making around $1M/year or more as partners with technicals. I tried but was never able to get one of these jobs. They are still available to the lucky or well connected few. You could conceivably get there by opening your own center as well, with all the risk and difficulty that entails. With rad onc not really expanding in its use or indications, it seems like a difficult time to try to open a new center.

2) in a multi-specialty practice the idea that the med onc is going to make more than the rad onc (TWICE MORE?) is a laughable notion in my experience. I would love to hear from anyone else in a multi specialty practice where the med oncs are making significantly more than the rad oncs.

It's a bit complicated. Some of these practices are med onc only.

As for the rad onc side, depending on which job we're talking about the med onc and rad onc salaries at full production are not dramatically different. Except, the med onc jobs are pretty wide open (not a lot of good applicants), while the rad onc jobs are highly competitive and sought after. Also, much of the compensation in some of these jobs are based on volume. The med onc volume will be there instantly when the med onc starts, while the rad onc volume has to be fought for.

This is not always true of course. Every job is different, and I don't know every detail.

Please talk to people in real life.

I like to think that I exist in real life too. Am I a simulation?

 

[scarbrtj]

I went through 3 phases.

When I was a medical student, I read this board and got opinions from “real life.” SDN was mostly negatives. Real life, from residents/attendings was mostly positive.

When I was a resident, I saw how any negative opinions voiced by other residents were actively suppressed. Sometimes implicitly, sometimes even explicitly. People were forced to be cheerleaders.

Then I became an attending and my experience with “real life” was much closer to SDN than what I was told as a medical student.

Anonymity trumps a person with an agenda every time.

PDs were terrified last cycle, and the party line is still that this board is the only problem. It would not surprise me that some would come on here to try to “cut through the noise.” FWIW I don’t think they are being dishonest. Most are in their academic echo chamber and truly don’t believe there is a problem. Don’t understand how the math computes for them... graduates up (dramatically), fractions down (dramatically) but all is well! #radoncrocks

Never can be said enough: substitute the word “fractions” with “indications” in radiation oncology discussions for a more realistic feel of the radiation oncology landscape. I.e instead of “fractions down” it becomes “indications down.” The linear accelerator is agnostic; fractions and indications are the same thing in its eyes.

 

[medgator]

But to med students - please don’t listen to me. Please don’t listen to Medgator. Please talk to people in real life.

I tell med students the same things I post on this forum. Residency slots were double digits in the 90s and are pushing 200 now, while we are able to treat more patients per physician each year thanks to sbrt and hypofx.

No agenda, just facts

 

[xrthopeful]

Just saw this from RickyScott previously as a reply to me:

‘Fundamentally, I feel that any medstudent in the top 25% of his class w/260 usmle deerves a specialty with a stable job that pays at leat 300,000 (given debt and opportunity costs)- in the location of his choosing, or a lot more if the location, away from friends and family, sucks. Radonc can not deliver that to most medstudents right now’

This is the type of post that bothers me. You really think that most people that are graduating now can’t expect 300k in a decent location or a lot more than that if they choose to move somewhere that isn’t their ideal location? What world are you living in? This is just frankly exaggerated bad information. Not even close to the experience of everyone I know over the past 3 years that went through the job hunt. This is what gives SDN a bad rep.

 

[evilbooyaa]

Just saw this from RickyScott previously as a reply to me:

‘Fundamentally, I feel that any medstudent in the top 25% of his class w/260 usmle deerves a specialty with a stable job that pays at leat 300,000 (given debt and opportunity costs)- in the location of his choosing, or a lot more if the location, away from friends and family, sucks. Radonc can not deliver that to most medstudents right now’

This is the type of post that bothers me. You really think that most people that are graduating now can’t expect 300k in a decent location or a lot more than that if they choose to move somewhere that isn’t their ideal location? What world are you living in? This is just frankly exaggerated bad information. Not even close to the experience of everyone I know over the past 3 years that went through the job hunt. This is what gives SDN a bad rep.

There are a number of academic or academic satellite jobs offering sub 300k in many of these 'decent' locations.

You are also conflating words to some extent - RickyScott said 'a location of his CHOOSING', which is different than 'a decent location'. I will support the fact that a strong geographical preference seems to have always been an issue within the field of rad onc given how small it is and how ridiculously long people can practice before they retire.

I think most jobs will be able to fit RickyScott's definition currently. However, not all jobs are like that, and to me that's an issue. Even if at least 75% of jobs are decent that means up to 25% of them are crap. RickyScott's point is that, ideally, this is a bare minimum for people entering Rad Onc, which is not the case, even now. And that's just the job market right now, without any sort of adjustment for what will be down the road in 5 years for current medical students.

Xrt, just wanted to reiterate that you are more than welcome to your opinions here, and that having somebody be optimistic and having an open discussion without personal attacks in regards to these issues is what SDN is all about. Thank you for your contributions.

 

[xrthopeful]

I agree with you Evil that not ALL jobs are like that - meeting the criteria.

However my issue is that Ricky said that MOST people can’t get that type of job. That’s where the exaggeration comes in.

If he had said that every rad onc should be able to graduate and and be able to make 300k, then I have less of an issue. Instead he sells it to this med student and says MOST can’t get that.

 

[evilbooyaa]

He says that he feels any medstudent should be able to be offered that. I agree that rad onc can offer that to most graduating RESIDENTS right now. I disagree that rad onc can offer that to graduating med students right now given the 5-year track of ongoing uncertainty with the job market. That is how I, personally, read his post in a non-hyperbolic fashion.

This is with the caveats that I, personally, predict that the job market will continue to worsen as we hear the canaries in the coal mine, see the writing on the wall, and any other metaphor stating that something is going wrong within this field.

But, nothing is changing, and those who are meant to have the specialties best interests in the field are more inclined to throw their hands in the air and say "not my problem" rather than figuring out a solution.

 

[xrthopeful]

I just think that the only concrete thing we can talk about is what the current reality is. Everything else is conjecture. The same things were being discussed 6 years ago on this forum. We can all
Agree that we need to stop expansion of training programs and also the likely larger impact on all of us will be payment reform. But we don’t know how that will play out. That’s why I focus on what the experiences of people now are. I think anyone going to medical school now should be aware that it’s very likely they may make less than the generation prior.

 

[Neuronix]

Nobody has a crystal ball. Who knows what rad onc will look like in 5 years. Currently I think we look weak in comparison to radiology (strong market, especially IR) and med onc (strong market), but that could change in 5-10 years.

Nevertheless, I wonder sometimes if xrthopeful and I are in the same specialty. I was fantasizing about making a post redirecting them to a specialty with a good job market--Interventional Radiology--and suggesting that they might be lost. How's that for gaslighting?

I know several people in the past few years who graduated without jobs, people who are or went unemployed for awhile, and people employed in a different state, different region, or much more rural than preferred without some corresponding big increase in salary. But hey, I didn't train at or work at a "top tier" institution. I trained and work in a fairly "desirable location" and the job market is horrible here. That wasn't my choice either--I applied all over the country at both the residency and faculty level and didn't land in the region I wanted as either a resident or faculty. That written, I work my *** off and things are going well for me where I'm at. I just have to make it work regardless of whether my wife's miserable and hope my marriage holds together. What choice do I have? All of this can certainly skew one's view on things.

 

[OTN]

Would like to add two points:

1) I interviewed at multiple practices where making 500-600k as partner was the path without collecting technical. My understanding is that if you’re going to be able to collect technical you surely are going to make more than 500k.

2) in a multi-specialty practice the idea that the med onc is going to make more than the rad onc (TWICE MORE?) is a laughable notion in my experience. I would love to hear from anyone else in a multi specialty practice where the med oncs are making significantly more than the rad oncs.


If you want to argue that can change in the future - then fine. That’s your right. But it’s conjecture.

But don’t gaslight these poor med students that have no way of knowing what’s what at this point. But to med students - please don’t listen to me. Please don’t listen to Medgator. Please talk to people in real life.

1. You're correct: With technical collections, income > $500k would be expected.
2. I'm in a very large multi-specialty practice. On average our radoncs make more than our medoncs, though the variance is pretty wide. There are several superstar medoncs with enormous practices who make more than the vast majority of our radoncs, however. They're working very, very hard, though: rounding in the hospitals, seeing tons of patients in clinic each day, needing 2 nurses/2 MAs, and 1-2 NPs each, etc.

 

[scarbrtj]

anyone going to medical school now should be aware that it’s very likely they may make less than the generation prior.

1. Not "very likely they may make less." Will make less.
2. The people who really make less are the people unemployed or underemployed. There are more of these people.

Nobody has a crystal ball. Who knows what rad onc will look like in 5 years.

Knowing what it will look like (hazy outlook) can be inferred from what it will not look like (sharper outlook):
1) No chance of more fractions/treatments on average per patient
2) No chance of no APM model implementation
3) No chance of increased reimbursement rates
4) External beam via X-ray nearing end of its innovation life cycle: the most common (by far) radiation oncology therapy will not show any substantial survival improvement for any cancer currently being treated curative intent

 

[xrthopeful]

Also evilbooya since you’re a respected voice around here and are also going through the job hunt this year, will be interesting to hear your take after it’s all said and done, without naming specifics of course.

Seems like it was a decent job board day - postings in Boston, Dallas, Miami, and DC.

 

[Doctorer]

Maybe I shouldn't speak for everyone, but I imagine even the realists among us in academics with a less-than-stellar view of the job market would come off as at least somewhat guarded if asked by a medical student interested in the field. I'm very curious to see what the match is like this year. For the sake of the field's future, I hope it's finally a wake-up call.

 

[01001000]

Also evilbooya since you’re a respected voice around here and are also going through the job hunt this year, will be interesting to hear your take after it’s all said and done, without naming specifics of course.

Seems like it was a decent job board day - postings in Boston, Dallas, Miami, and DC.

The Boston job is at Harvard (good luck to the average new grad). The Miami and DC jobs are academic jobs that were also hiring not long ago, indicating high faculty turnover and poor job satisfaction. The Dallas job is actually in Plano, a suburb, and wants a board certified rad onc, preferably with 2-5 yrs of experience. Also mentioned earlier was a metro St Louis job, which is actually in O'Fallon, a suburb (in Illinois not even Missouri), and that place wants 3-5 yrs of experience as well. Job experience is becoming a more frequent requirement listed in the pp job postings. With the market in their favor, why risk hiring a new grad? And with more new grads settling for jobs they don't want with a plan to re-enter the job market in 3-5 years, it becomes that much more difficult for a new grad to land anything remotely desirable.

Just throwing out the names of these cities where jobs are posted is very misleading, as it certainly doesn't mean these are good jobs or jobs that are even attainable for the average new grad.

For the med students: I am a recent graduate who will be starting a new job next month, 2 hours from a major metro, in an area I certainly never thought I'd end up. It was the only decent job I was offered.

 

[medgator]

Job experience is becoming a more frequent requirement listed in the pp job postings. With the market in their favor, why risk hiring a new grad?

Truth. I was hired as a newish grad with a year of experience after a bad first job.

Our next hire will be someone with 3-5 years of experience. It's the state of the job market.

 

[Pointless]

Perhaps I'm in the minority here, but I know that myself and many of the people that I know in the field have great jobs that pay the kind of salaries that are being thrown around on here as essentially imaginary.... and these aren't Harvard people. Now, I also don't know anyone who works in LA or NYC or whatever the kids these days think is cool, but still. Are we really trying to tell med students that the best they can hope for in rad onc is 300-400k?? I can tell you that that most certainly does not reflect current reality.

Project as you want about the future of our specialty but right now... it's a pretty sweet gig.

 

[thecarbonionangle]

Truth. I was hired as a new grad. Our next hire will be someone with 3-5 years of experience. It's the state of the job market.

Thanks for contributing to the solution!!

 

[Neuronix]

I particularly enjoyed interviewing at practices where it was basically stated:

"I was hired as a new grad with a good partnership track. Our next hire won't be partnership track. It's the state of the job market."

As a marketing/hiring gimmick, plenty of places have senior partners who share technical and junior "partners" who don't.

How's that for being part of the solution .

 

[medgator]

Thanks for contributing to the solution!!

It was a group decision, but you can't argue with the logic and I wanted to validate what 01001000 said. Just being honest, something some on this forum, and in academia won't be. And I know I'm not the only one who sees it like this.

Personally, I grew more in first 2-3 years of practice than I did throughout all of residency. Studying for orals, getting BC and getting more efficient at managing larger loads of patients and referring physicians in PP is a big jump. I also had a bad first job experience out of training that, in retrospect, allowed me to cut my teeth, so to speak, in preparation for where I currently practice.

All the more reason to try and locums/moonlight at a preferred practice to become a known quantity at the time of your job search during pgy5.

Med onc would never have to do that, but imo, that's a reality in this field now for landing a coveted job these days

 

[thecarbonionangle]

It was a group decision, but you can't argue with the logic and I wanted to validate what 01001000 said. Just being honest, something some on this forum, and in academia won't be. And I know I'm not the only one who sees it like this.

Personally, I grew more in first 2-3 years of practice than I did throughout all of residency. Studying for orals, getting BC and getting more efficient at managing larger loads of patients and referring physicians in PP is a big jump. I also had a bad first job experience out of training that, in retrospect, allowed me to cut my teeth, so to speak, in preparation for where I currently practice.

All the more reason to try and locums/moonlight at a preferred practice to become a known quantity at the time of your job search during pgy5.

Med onc would never have to do that, but imo, that's a reality in this field now for landing a coveted job these days

So you post here along with others about the job market and the failure of our leadership to address it. I agree with you on that. However what i don’t get is when you’re in a position to help someone, a new grad, your group, including you, throw your collective arms up saying nothing to do about it, it is the way it is, the new normal. How about you be the change you want to see? Your partners don’t agree? Change their mind. It frustrates me that people in power to change things do nothing, because they benefit from it!

 

[medgator]

So you post here along with others about the job market and the failure of our leadership to address it. I agree with you on that. However what i don’t get is when you’re in a position to help someone, a new grad, your group, including you, throw your collective arms up saying nothing to do about it, it is the way it is, the new normal. How about you be the change you want to see? Your partners don’t agree? Change their mind. It frustrates me that people in power to change things do nothing, because they benefit from it!

You'd rather just have me lie about it?

You may have heard this one before:

Don't hate the player, hate the game, one that is slowly getting even more tilted away by the powers at be that can actually fix things.... I've already offered what I think is the current solution to the problem if you're a new grad in that same post....

 

[thecarbonionangle]

You'd rather just have me lie about it?

You may have heard this one before:

Don't hate the player, hate the game, one that is slowly getting even more tilted away by the powers at be that can actually fix things.... I've already offered what I think is the current solution to the problem if you're a new grad in that same post....

I mean im not sure what credit you want for being “honest”. Sure you get that, as many def will not admit it, but i do take issue with the group appearing to not want to be a force for change. It seems you would rather a new grad go somewhere they hate for 3 years to rot then apply to your group in a presumably “desirable” area now jaded and bitter, will you offer a good contract or also take advantage of market forces to beat that poor person down further? You wouldnt rather them come fresh, happy, greatful wanting to be like you and look up to you, etc? Its not personal, i just deeply believe that people need to be the force for change. Such a problem with our field!

 

[medgator]

I mean im not sure what credit you want for being “honest”. Sure you get that, as many def will not admit it, but i do take issue with the group appearing to not want to be a force for change. It seems you would rather a new grad go somewhere they hate for 3 years to rot then apply to your group in a presumably “desirable” area now jaded and bitter, will you offer a good contract or also take advantage of market forces to beat that poor person down further? You wouldnt rather them come fresh, happy, greatful wanting to be like you and look up to you, etc? Its not personal, i just deeply believe that people need to be the force for change. Such a problem with our field!

How far out are you in training? Have you actually even gotten out of training and taken a bad job fresh out of residency while trying to get board certified, like many of us, including myself, have?

Honest question.

 

[Neuronix]

Last warning about personal attacks. This back and forth bickering is not appreciated. Take it to PMs or use the ignore feature.

(Offending posts were deleted)

 

[thecarbonionangle]

How far out are you in training? Have you actually even gotten out of training and taken a bad job fresh out of residency while trying to get board certified, like many of us, including myself, have?

Honest question.

I dont think the fact that i have not taken a “bad job” in middle of nowhere midwest and “paid my dues” then gotten a highly coveted job disqualifies what i am saying. My point still holds.
I am interviewing everywhere, middle of nowhere places, academics, pp.

 

[medgator]

I dont think the fact that i have not taken a “bad job” in middle of nowhere midwest and “paid my dues” then gotten a highly coveted job disqualifies what i am saying. My point still holds.
I am interviewing everywhere, middle of nowhere places, academics, pp.

Look forward to seeing your experience in a few years. Give back to the forum that helped you get into this awesome specialty

 

[RickyScott]

He says that he feels any medstudent should be able to be offered that. I agree that rad onc can offer that to most graduating RESIDENTS right now. I disagree that rad onc can offer that to graduating med students right now given the 5-year track of ongoing uncertainty with the job market. That is how I, personally, read his post in a non-hyperbolic fashion.

This is with the caveats that I, personally, predict that the job market will continue to worsen as we hear the canaries in the coal mine, see the writing on the wall, and any other metaphor stating that something is going wrong within this field.

But, nothing is changing, and those who are meant to have the specialties best interests in the field are more inclined to throw their hands in the air and say "not my problem" rather than figuring out a solution.

that is exactly my point. I feel that based on the quality of medstudents who have been going into this field that 90+% should at a bare minimum obtain a 300,000 k (mid career) in their choice location, and obviously more if they have to compromise. Many other equally rewarding/interesting specialties can deliver it. I also need to reiterate that the job market today will be very different than 5 years from now. This whole discussion reminds me of the active debate about smoking causing cancer in the early 90s when I was in colleg. You still had scientists, statisticians, and executives who wouldnt admit this in front of congress/in public- would argue about statistical methodologies and correlation...
15 years ago, we had half the number of residency positions and still used conventional fractionation, and finding a decent job was not that easy.

 

[RickyScott]

I mean im not sure what credit you want for being “honest”. Sure you get that, as many def will not admit it, but i do take issue with the group appearing to not want to be a force for change. It seems you would rather a new grad go somewhere they hate for 3 years to rot then apply to your group in a presumably “desirable” area now jaded and bitter, will you offer a good contract or also take advantage of market forces to beat that poor person down further? You wouldnt rather them come fresh, happy, greatful wanting to be like you and look up to you, etc? Its not personal, i just deeply believe that people need to be the force for change. Such a problem with our field!

I dont see the problem here. Example- new grad vs someone chafing in academic satellite for several years. Why is contributing to the problem to go with the junior faculty?

 

[xrthopeful]

Just to post my experience since I know people are always posting about academic satellites like they are bottom of the heap trashpads:

I took a PP partnership job but I definitely strongly considered an academic satellite. 350k for a stable job with only 10-15 patients on treat in a good location with a large guaranteed support system as well as a built in patient population?

Many many people want that job, and it beats what you can get I many other specialties. Different strokes for different folks, you know? Not everyone wants to hustle or build a practice or work hard. I want to see more patients and have the ability to have a higher income potential, but not everyone does. Stop demeaning things that you don’t understand.

Biggest problem with this place is people that post in broad brushes. Academics this and satellites that. That’s just as bad as someone in academics demeaning the community practice.

 

[RickyScott]

Just to post my experience since I know people are always posting about academic satellites like they are bottom of the heap trashpads:

I took a PP partnership job but I definitely strongly considered an academic satellite. 350k for a stable job with only 10-15 patients on treat in a good location with a large guaranteed support system as well as a built in patient population?

Many many people want that job, and it beats what you can get I many other specialties. Different strokes for different folks, you know? Not everyone wants to hustle or build a practice or work hard. I want to see more patients and have the ability to have a higher income potential, but not everyone does. Stop demeaning things that you don’t understand.

Biggest problem with this place is people that post in broad brushes. Academics this and satellites that. That’s just as bad as someone in academics demeaning the community practice.

I am not demeaning academic satellites and certainly some may find them a good fit. As you said "different strokes for different folks." The problem in this field is that they are dominating the job market, so certainly some docs who would rather not be there are forced into them, Also regarding hustle, a community hospital systems will often provide you with catchment. I have personally not taken out a referring doc to dinner. The issue with satellites is often how they dictate patient treatments, and take away much of the decision making. Loss of control will make many miserable.

 

[fiji128]

The above is just a function of the job market as it currently exist. If radiation oncologist were in high demand relative to their supply then this type of employment strategy would not work and solid private practices would not mind mentoring and developing a fresh new grade for a few years.

Also when reading through this thread and the salary numbers that are being thrown out with various surveys keep in mind that the only relvenet numbers are those of recent grads for the audicience here. Otherwise you get a lot of established MDs in those figures with deals/situations that are likely not to ever be available to the future/current crop of residents.

 

[xrthopeful]

Look - that ship has sailed. No matter what field you go into now, Medicine has been taken over by MBAs who are going to take your billing and hire you.


No point in being mad about it. It’s a reality of medicine in 2019.

 

[RickyScott]

Look - that ship has sailed. No matter what field you go into now, Medicine has been taken over by MBAs who are going to take your billing and hire you.


No point in being mad about it. It’s a reality of medicine in 2019.

So you are basically pointing out that most medstudents will be employed.. Yes- (although in most fields this will be a community hospital, not a spoke and wheel satellite system which I will argue is worse.) and therefore everything comes down to supply and demand, which is where this field is failing miserabl

 

[xrthopeful]

Hold on hold on - any academic satellite (which are former smaller community hospitals that have gotten bought out) that is hiring rad oncs is also hiring urologists, breast surgeons, etc etc etc. it affects everyone. This isn’t unique to rad onc, there’s nothing special about us.

The supply/demand point I will never argue with.

 

[OTN]

Look - that ship has sailed. No matter what field you go into now, Medicine has been taken over by MBAs who are going to take your billing and hire you.


No point in being mad about it. It’s a reality of medicine in 2019.

Why can't we be mad about it?

 

[xrthopeful]

Why can't we be mad about it?

Haha you can. It’s just so cliche to me. I feel like it’s all anyone who went to medical school in like the last decade plus has heard from older docs. ‘I would never go into medicine now! I would never let my kids go into medicine. You guys should have done business, that’s where the real money is’ etc etc etc

It’s tired to me. But yes it’s human nature to gripe so go ahead.

 

[evilbooyaa]

I mean im not sure what credit you want for being “honest”. Sure you get that, as many def will not admit it, but i do take issue with the group appearing to not want to be a force for change. It seems you would rather a new grad go somewhere they hate for 3 years to rot then apply to your group in a presumably “desirable” area now jaded and bitter, will you offer a good contract or also take advantage of market forces to beat that poor person down further? You wouldnt rather them come fresh, happy, greatful wanting to be like you and look up to you, etc? Its not personal, i just deeply believe that people need to be the force for change. Such a problem with our field!

Medgator is simply providing his experience that the job market is reacting to the residency oversupply by being more picky about who they hire. It's simple supply and demand economics. If they can be picky and still get great candidates why wouldn't they? Getting an attending job now is as competitive as getting into residency was back in the day where people complained about Step 1 cut-offs at higher tier programs.

It is what it is, and one practice keeping their hiring practices stagnant to appease SDN is not going to change that.

 

[RickyScott]

Hold on hold on - any academic satellite (which are former smaller community hospitals that have gotten bought out) that is hiring rad oncs is also hiring urologists, breast surgeons, etc etc etc. it affects everyone. This isn’t unique to rad onc, there’s nothing special about us.

The supply/demand point I will never argue with.

In places like philadelphia and boston, penn and harvard employ a lot of docs at suburban community hospital cancer centers (not owned by the academic center). However, the rest of the docs at these hospitals, uro, gi anesthesisa, etc work for the community hospital. Basically, the academic center is coming in and being a middle man, syphoning off money..... The academic center is basically taking over the radiation department but not the hospital, because that is where the money is. Same is true for mdacc affiliates- the radonc will be employed by madacc, but every other doc at that hospital will be employed by the hospital.

 

[xrthopeful]

People can choose how they want to run their sphere.

There are academic programs interested in constant expansion (and get mad when ACGME doesn’t approve their expansion) and there are programs that CAN easily get approved for more spots but don’t because they don’t want to add to the problem. I’ve had experience with both.


There are private places that want to run a good fair practice and are interested in being up front and want to invest in you as a future partner. There are some practices that have no interest in you other than supplying them labor and don’t plan on making you partner. I’ve been exposed to both.

Everyone has the ability to choose what they would like to be a part of. Choose Wisely.

 

[medgator]

Hold on hold on - any academic satellite (which are former smaller community hospitals that have gotten bought out) that is hiring rad oncs is also hiring urologists, breast surgeons, etc etc etc. it affects everyone. This isn’t unique to rad onc, there’s nothing special about us.

The supply/demand point I will never argue with.

You really are going to compare our job situation to urology?

 

[xrthopeful]

Haha urology and rad onc are so different I would never attempt
To compare two widely different specialties.

My urology friends complain about how the field isn’t what it used to be because they have to be employed. They also complain about the older docs making them take all the call. Urology call sucks.

But overall they’re happy enough. Just like the rad oncs I know IRL

 

[RickyScott]

I think it’s interesting to see how ambitious, driven people who fought tooth and nail through college; med school, residency get through it all and at the end are totally okay with being exploited like this.

Yeah sure, inflate residency spots, buy up all the local practices, employ me for half of what I’m billing and siphon off the rest for MBA administrators.

It’s all getting worse from here, but sure, submit that ERAS, med students!

On twitter #radonc, there is prolific faux- virtue signalling and fake humanism from several docs I personally know to be petty, highly selfish, self promoting, backstabbers. They try to present radonc to medstudents that it is a divine honor to join the priesthood of this specialty and be ready to foresake salary and location that other specialties can provide, because nothing is as compelling and meaningful as radiation.

 

[fiji128]

On twitter #radonc, there is prolific faux- virtue signalling and fake humanism from several docs I personally know to be petty, highly selfish, self promoting, backstabbers. They try to present radonc to medstudents that it is a divine honor to join the priesthood of this specialty and be ready to foresake salary and location that other specialties can provide, because nothing is as compelling and meaningful as radiation.

Some of the posters on #radonc are ridiculous. Like whats even the point of doing rad onc if I can't use it as a platform to promote my politics.

 

[scarbrtj]

I have personally not taken out a referring doc to dinner.

I always wonder how this works...
Seinfeld voice: "Well the man supplied me with some free food and alcohol. That's not nothing. I hadn't considered his clinical skills before. But after he paid for that finely cooked steak and a couple glasses of wine... my mind is completely changed. That meal--which I didn't have to pay for mind you--made me realize the brilliant doctor that he is. He gets all my referrals from here on out! If he can pay for my dinner he can surely cure cancer no problem."

 

[medgator]

I always wonder how this works...
Seinfeld voice: "Well the man supplied me with some free food and alcohol. That's not nothing. I hadn't considered his clinical skills before. But after he paid for that finely cooked steak and a couple glasses of wine... my mind is completely changed. That meal--which I didn't have to pay for mind you--made me realize the brilliant doctor that he is. He gets all my referrals from here on out! If he can pay for my dinner he can surely cure cancer no problem."

Reminded me of this oldie.... Of course finding a pharma pen or knick knack these days is like finding a unicorn

This Promotional Pen Works So Great, Imagine How Well The Drug Must Work

Somebody just sent a box of Prilosec promotional pens to our clinic and, boy, am I impressed. It's got a big, comfortable barrel and comes in an attractive purple. And it writes smooth as can be. No globbing or streaking; just a nice, clean, blue ballpoint line. It's also got some really cool...

www.theonion.com