Match 2025

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DrProtonX

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Eras 2025 preliminary data shows 277 people have applied for radiation oncology, an increase from 255 last year.
Breakdown:
MD: 153 —> 160
DO: 26 —> 28
IMG: 76 —> 89
While IMGs take the bigger portion of the increase, MD/DO applicants number have increased as well. Looks like Rad Onc competitiveness continues the upward trend likely due to imroving job market.

Source: ERAS® Statistics

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Pathology, rad onc, emergency medicine

Something about taking pride is being the tallest midget
I wasn’t taking pride in anything. Just presenting data and giving a possible explanation for it.

P.S. why is everyone here so against mentioning anything even remotely positive about the field? Just because there are many issues, doesn’t mean we should appreciate good thing no matter how small they are.
 
Just because there are many issues, doesn’t mean we should appreciate good thing no matter how small they are.
I do believe that the job market is improved relative to a few years ago.

I also believe that some fraction of graduating senior residents at this point are marginal (have a peculiar career trajectory or demonstrated difficulty performing in a prior opportunity).

A little boost in competitiveness is not a bad thing. However, it should not be the product of concerted outreach campaigns. It should reflect the quality of the opportunities that the field provides (understanding that this is difficult to measure).
 
Good things for the field would be new indications or at least not losing indications like esophageal adenoCa, and practice changing or at least hypothesis generating findings from Astro.

I didn’t go but partiqol was a big waste of resources to tell big proton centers what they still don’t want to hear. Any community rad onc has been telling patients protons don’t do **** for years. I can tell you now any proton phase 3 trial vs best vmat plan, ENI, risk category, hypofrac whatever angle will be negative.

Anyways I digress. A few more marginal med students isn’t indicator of job market getting better
 
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Good things for the field would be new indications or at least not losing indications like esophageal adenoCa, and practice changing or at least hypothesis generating findings from Astro.

I didn’t go but partiqol was a big waste of resources to tell big proton centers what they still don’t want to hear. Any community rad onc has been telling patients protons don’t do **** for years. I can tell you now any proton phase 3 trial vs best vmat plan, ENI, risk category, hypofrac whatever angle will be negative.

Anyways I digress. A few more marginal med students isn’t indicator of job market getting better
Emperor still needs to know he has no clothes. And now we have RCTs to prove it to payors and CMS at large
 
When will the Breast trial present results?
Radcomp breast cancer regional nodal RT trial has closed to accrual with 1200+ women enrolled and will probably report short term toxicity data in 2 to 3 years.

Longer term cardiac toxicity and 5 year PFS and OS I suspect a couple years after that
 
Looking at the Reddit spreadsheet, which itself references Discord, there were a total of 5 positions that went unfilled with Brooklyn Methodist, Thomas Jefferson and Stony Brook participating in the SOAP. All Soap position were filled before today.
 
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Rad Onc competitiveness continues the upward trend likely due to imroving job market.
*citations needed

“The job market is improving.”

“But the job quality is weak.”

Youre Weak Alec Baldwin GIF
 


This made me laugh out loud, hes a great follow on Twitter and apparently a great mentor for his rotating students.

At this point, I really have to wonder if our "dip" was from the 2018 ABR debacle. Certainly I would be discouraged about applying to this field with the way the ABR leadership treated trainees at the time. ABR has had a great turnaround, but potentially speaks to the importance of good leadership for attracting trainees.

The job market uncertainty has been the same and this class particularly will be graduating right at the end of ASTROs model period. Whatever you think about that model, this class is in a data free zone.
 
Does anyone know the unfilled programs? Did they participate in soap?
 
This made me laugh out loud, hes a great follow on Twitter and apparently a great mentor for his rotating students.

At this point, I really have to wonder if our "dip" was from the 2018 ABR debacle. Certainly I would be discouraged about applying to this field with the way the ABR leadership treated trainees at the time. ABR has had a great turnaround, but potentially speaks to the importance of good leadership for attracting trainees.

The job market uncertainty has been the same and this class particularly will be graduating right at the end of ASTROs model period. Whatever you think about that model, this class is in a data free zone.
I've spoken to a lot of medical students who are hesitant about the field specifically because of SDN, because SDN is one of the only way medical students can look online at sentiment, and many go into it because their real life conversations tell them discordant things than they hear here.
 
I've spoken to a lot of medical students who are hesitant about the field specifically because of SDN, because SDN is one of the only way medical students can look online at sentiment, and many go into it because their real life conversations tell them discordant things than they hear here.

Im glad they are reading SDN. The goal should be to help medical students find the field that is right for them, not "recruit" them to become radiation oncologists.

SDN remains the only place for public balanced discussion about this field, and in my opinion that is more true than ever. Every medical student is smart enough to realize it is an anonymous internet forum and apply the relevant caveats to what they read.

I think if people are only talking with their local academic attending who has had 1 job where they trained and reading Twitter or ASTRO newsletters, they are getting a very biased view of the field.

One edit to add: I did a podcast with Laura Flores last year about the perception of the field. It seems like SDN is no longer THE popular place for people to get information about different fields. Im sure it is still checked, but now days it may be more Reddit or Discord (also both anonymous). I know its popular to blame SDN for all of Rad Onc's problems, but that just doesn't really make sense or jive with what I hear out there. Its also lazy.

If interested, the podcast is here: "Fallen Out of Favor": The Rad Onc Match with Laura - The Accelerators Podcast
 
I've spoken to a lot of medical students who are hesitant about the field specifically because of SDN, because SDN is one of the only way medical students can look online at sentiment, and many go into it because their real life conversations tell them discordant things than they hear here.

I'm happy to tell anyone in real life whatever I say on here.

However, my department tries to keep me away from students because they know I'm honest about my feelings and experiences.

That's not to say that I'm overly pessimistic. Some students I've worked with have gone into rad onc, others have decided to go into other specialties.

But, there is a tremendous pressure here and at many academic institutions on their faculty to only say positive things to students in efforts to fill their residency positions.
 
I've spoken to a lot of medical students who are hesitant about the field specifically because of SDN, because SDN is one of the only way medical students can look online at sentiment, and many go into it because their real life conversations tell them discordant things than they hear here.
One Of Us GIF


Welcome new residents to the best field in medicine!
 
Agreed. Should be true of any field but feels like oncology esp

I think a lot of people don't realize that we now know programs really abused the SOAP during our dip. It was presented in that ASTRO workforce session that the vast majority of people who SOAP'd in did not originally apply to Rad Onc. I suspect this embarrassing fact is a big driver of why ASTRO deleted that workforce session and buried any discussion.

Now we have low SOAPs but a much higher percentage of FMG matches than in the past. The stories of DO and FMG discrimination in hiring in this field are rampant, so hopefully that starts to change as well.

FMGs face a lot of barriers getting US residency positions and there is a lot of discussion online about strategy to get a spot. I worry about Rad Onc as a strategy because it is so challenging to pivot if a career in Rad Onc doesnt work out. Not true for IM or FM. I certainly understand the upside of RO over FM, but the field seems to agree that these upsides are NOT guaranteed into the future.

I wonder if any PDs are discussing these demographic changes in our field and the implications for their graduates.
 
I matched in the peak of competitiveness with most of my co-residents being MD/PhD, Ivy League type grads and I look at the current residents at my old program and just laugh and a part of me loves the fact that the same d-bag, stuffy snooty faculty that slummed it and had to hold their nose when they matched a state school grad with only a single publication now has to kiss the ass of Caribbean and DO grads with average scores to get them to match! This field is no where near as competitive as it was 10-15 years ago..not even same ballpark.
 
some fmgs would happily match even if it meant that they became permanent fellows and why match is not a gauge of supply and demand. Btw, anyone notice that university of Miami took 5 residents?

Yea to be clear Im not questioning their motivations at all and anyone who has a genuine interest in this field should be welcome to join it. Im really just speaking about PD considerations for job placement after training and the culture of our field.

Every single place Ive worked, academic and community, a person in a decision making position to hire has made comments to me about pedigree or place of training. Some obviously worse than others.
 
In principle, I don’t have a problem with
Yea to be clear Im not questioning their motivations at all and anyone who has a genuine interest in this field should be welcome to join it. Im really just speaking about PD considerations for job placement after training and the culture of our field.

Every single place Ive worked, academic and community, a person in a decision making position to hire has made comments to me about pedigree or place of training. Some obviously worse than others.
I am not sure how important motivations are. If I had soaped into anesthesia, or half a dozen other fields, I have no doubt I would be invested, and engaged and as or more competent than colleagues.

The essence of a “proffesion” dating back to middle age guilds is to wield a monopoly over a field and provide its practitioners with good income and work in return for certain standards/quality. Astro and scarop are basically breaking this social contract for cheap labor. Almost by definition, radonc has the worst culture in medicine because it expanded more than any other specialty.
 
I matched in the peak of competitiveness with most of my co-residents being MD/PhD, Ivy League type grads and I look at the current residents at my old program and just laugh and a part of me loves the fact that the same d-bag, stuffy snooty faculty that slummed it and had to hold their nose when they matched a state school grad with only a single publication now has to kiss the ass of Caribbean and DO grads with average scores to get them to match! This field is no where near as competitive as it was 10-15 years ago..not even same ballpark.

Yea to be clear Im not questioning their motivations at all and anyone who has a genuine interest in this field should be welcome to join it. Im really just speaking about PD considerations for job placement after training and the culture of our field.

Every single place Ive worked, academic and community, a person in a decision making position to hire has made comments to me about pedigree or place of training. Some obviously worse than others.
worst, most self-serving academic leadership in all of medicine. Continues to be proven year in, year out

Wouldn't go into rad onc just on that alone
 
In principle, I don’t have a problem with

I am not sure how important motivations are. If I had soaped into anesthesia, or half a dozen other fields, I have no doubt I would be invested, and engaged and as or more competent than colleagues.

The essence of a “proffesion” dating back to middle age guilds is to wield a monopoly over a field and provide its practitioners with good income and work in return for certain standards/quality. Astro and scarop are basically breaking this social contract for cheap labor. Almost by definition, radonc has the worst culture in medicine because it expanded more than any other specialty.

This is a good point. The trainees are not necessarily "abused" despite the motivations of programs participating in SOAP. Id guess its common that those that SOAP in with no prior interest ultimately become competent and engaged radiation oncologists.
 
i wouldnt say the job market has improved at all and has actually gotten quite a bit worse. its like the housing market. are there houses on the market, yes lots of them. but when you get into the nitty gritty you all know that there are major fatal flaws with alot of those houses despite them being 50% more expensive than 7 years ago.
 
i wouldnt say the job market has improved at all and has actually gotten quite a bit worse. its like the housing market. are there houses on the market, yes lots of them. but when you get into the nitty gritty you all know that there are major fatal flaws with alot of those houses despite them being 50% more expensive than 7 years ago.
Way harder to lateral out of a bad job, way less independent/PP opportunity out there as a PSA model becomes less appealing and the deck is stacked against physician ownership/entrepreneurship

So it's basically dealing with large hospital/academic employers and veritable monopolies/duopolies when it comes time to job hunt in the context of too many grads coming out
 
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So it's basically dealing with large hospital/academic employers and veritable monopolies/duopolies when it comes time to job hunt in the context of too many grads coming out
Yes indeed. Employers have all of the leverage in most cases (not all, but most). This trend will only worsen as consolidation continues the race to the bottom.
 
Yes indeed. Employers have all of the leverage in most cases (not all, but most). This trend will only worsen as consolidation continues the race to the bottom.
If there’s one thing I wanted as medical student it was to spend a decade plus* of training and accumulate huge loan debt so I could choose a specialty where someone had “all the leverage” over me.




*counting my proton fellowship
 
If there’s one thing I wanted as medical student it was to spend a decade plus* of training and accumulate huge loan debt so I could choose a specialty where someone had “all the leverage” over me.




*counting my proton fellowship


If leverage is a goal of a medical student right now, they should look elsewhere.

Medicine is not what it was when you went to medical school, to say the least.
 
191 spots in the match, up from prior year, 12 PGY-1, 179 PGY-2. 5 unfilled pre SOAP. At least 240 applicants (maybe that ranked as first choice?). 135 US MD Senior matches (~71%), 16 US DO Senior matches (~8%), 7 US IMG (carib, etc.) matches (~4%), 24 non-US IMG (~13%), 4 prior MD grads (~2%), and unfilled during primary cycle (~2%)(but ultimately filled).
9 reserved spots, 3 unfilled during official cycle.
Of 52 reserved spots in the past 5 years (spots offered to start as a PGY2 if have already completed a year elsewhere), 36 have filled during the NRMP match, and possibly some outside of the match.


Given that most spots fill in SOAP, and there being so many R spots, I am beginning to wonder if spots that were "decreased" in the initial match, are just being used as reserved spots.
Anyone with a residency program know?


-edit @medgator 2025- 191, 2024- 186, 2023- 191, 2022- 176, 2021- 188, mild fluctuations, probably from alternating number of residents per year. Approximately 187 spots per year over the last 5 years in the main match (not including R spots).
At the very least, every spot is being filled at some point, at the very most, some spots that weren't being used by programs in the match of PGY-1 or PGY-2 (but never officially closed) are being added back into R spots and we are creating more physicians than we think based on original number of spots offered in the match.

In 2024 there were 12 spots PGY 1, all filled. 175 spots PGY-2, 163 initially filled in the match and 16R Spots, 13 filled in the initial match.
During the 2024 SOAP 9 of the 12 open positions were available within the SOAP and 7 of them filled. 1 of the R spots was in the SOAP and filled. So 7 unfilled spots within the NRMP for 2024. 196 total people matched this year.

In 2023 7 of 10 PGY1 spots were filled in initial match and 147 of 181 PGY 2 spots and 8 of 13 Reserved spots.
In the SOAP 25 of the 42 spots that went unfilled filled. So 17 unfilled within the NRMP from 2023. 187 people matched this year.

In 2022 9 of 10 PGY1 spots filled in initial match and and 134 of 166 PGY 2 spots filled while 6 of 9 R spots filled.
In the SOAP 29 total spots were offered and 23 filled (1 PGY 1, 20 PGY 2 and 2 R spots). So 13 unfilled within the NRMP in 2022. 172 matched this year.

In 2021 12 of 15 PGY 1 spots filled in initial match for PGY 1 and 138 of 173 filled for PGY2 while 3 of 5 R spots filled.
In the SOAP 2 PGY 1 filled, 19 PGY 2 filled and 1 R filled. So 18 unfilled within the NRMP in 2021. 175 matched this year.

According to NRMP there were 741 spots available as advanced and categorical positions from the years 2021-2024. There were 730 people who matched into radiation oncology in the years 2021-2024. So pretty much all spots, or at least 98% of spots are virtually being filled within the NRMP (and probably the rest outside of the NRMP, maybe more?).


Edit again
If we include 2025 data. For the years 2021-2025 there were 932 spots available as categorical or advanced positions. There were 5 PGY 2 spots not filled in initial match and 3 R spots not filled in initial match. SOAP data not available yet. But if we assume 6 of those 8 spots filled.
Of the 932 spots available for application from medical school graduates (advanced and categorical) in the years 2021-2025, 928 people have matched to the field of radiation oncology through the NRMP system.

Effectively 99.5% of positions have filled within the NRMP match system over the past 5 years.


Edit again again
When going back to 2019-2020 when the matching issues started.
In 2020- 189 positions were available as categorical and advanced and 154 matched in the initial, 2 of 3 R positions filled, in the SOAP 27 positions were filled. A total of 183 matched this year.

In 2019- Of 207!!! offered positions in categorical and advanced match, 177 matched and 2 of 4 R spots. In the SOAP 19 people matched. A total of 198 people.


In the past 7 years of extreme heightened concern of oversupply there were 1328 positions offered in the NRMP match for advanced and categorial years for new graduates. 1309 people matched into radiation oncology during this time.

In the past 7 years, Approximately 99% of positions offered were filled within the NRMP match system. ENJOY YOUR SUNDAY! lol
 
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Given that most spots fill in SOAP, and there being so many R spots, I am beginning to wonder if spots that were "decreased" in the initial match, are just being used as reserved spots.
Anyone with a residency program know?
191 spots in the match, up from prior year


Huh?
 
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