Match rate 2026
Started by allseasons
Below psychiatry. Was a different story a decade+ ago
Eh, recovery has to start somewhere. Have a strong feeling it's going to dip a decent amount again this year.
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I don't take too much stock into match rate as it only tells you how many applied and not the quality of applicants. If we had a 95% match rate but our applicants are top tier, that's better than a lower match rate. Still, it does seem like the job market has been relatively good the past few years but I only have my own program's experience to compare.
We have students come through, for some reason our private group is one of the main sites for the local med school. Maybe b/c of the legacy names in our group / LORs. They end up spending a fair amount of time with me, because I enjoy it. I've had 6 in the last year and a half that were applying radonc. 3 were outstanding, absolute studs. One matched at Duke, the other two will apply soon. One was pretty good and they matched. One was leaving the specialty they were in and didn't spend much time with them.
But, the ones that were good - I was very impressed. Great people, great scores/research. They picked things up fast, dictations were more than passable. They are doing research in our practice, I think one or more had abstracts accepted.
Small "n" but I am optimistic about med students. I have same worries others do about AI and how they are going consolidate info/learn. But, the ones I've had used it as an assistant rather than a crutch. What an interesting time to be a medical student.
But, the ones that were good - I was very impressed. Great people, great scores/research. They picked things up fast, dictations were more than passable. They are doing research in our practice, I think one or more had abstracts accepted.
Small "n" but I am optimistic about med students. I have same worries others do about AI and how they are going consolidate info/learn. But, the ones I've had used it as an assistant rather than a crutch. What an interesting time to be a medical student.
We will never be an "elite" specialty again. All it would have taken would be for ASTRO and leaders to manage expansion like optho, uro, neurosurg etc, but they chose to behave like pigs rather than responsible stewards in peer specialties. The over expansion is testament to a greed and psychopathology amongst leadership that simply is not present in desirable specialties. these are bad people that will make bad and selfish decisions w/ wide ranging damage to the specialty.
Business forum has recent thread on lack of leverage for re-negotiating unfavorable employment situations. Oversupply is a primary driver of lack of leverage. A radiologist who is reading 20% more films would absolutely be able to renegotiate a contract which is happening presently in my local.
Business forum has recent thread on lack of leverage for re-negotiating unfavorable employment situations. Oversupply is a primary driver of lack of leverage. A radiologist who is reading 20% more films would absolutely be able to renegotiate a contract which is happening presently in my local.
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187 positions total, 222 total applicants.
146 US MD senior applicants, 134 US MD seniors matched.
If you use US MD Seniors per Position as a measure of competitiveness, it's roughly in the middle of competitiveness among specialties, tied with OB/GYN ( see page 12-13 here: Charting Outcomes™: Characteristics of U.S. MD Seniors Who Matched to Their Preferred Specialty: 2026 Main Residency Match® )
I wonder how many would match today if we limited the match to only applicants who would have matched 10 years ago.
146 US MD senior applicants, 134 US MD seniors matched.
If you use US MD Seniors per Position as a measure of competitiveness, it's roughly in the middle of competitiveness among specialties, tied with OB/GYN ( see page 12-13 here: Charting Outcomes™: Characteristics of U.S. MD Seniors Who Matched to Their Preferred Specialty: 2026 Main Residency Match® )
I wonder how many would match today if we limited the match to only applicants who would have matched 10 years ago.
What exactly does ‘elite’ mean and what did it do for patients, you, or the field?
It means people who actually care about matching into rad onc rather than scrambling in to an open spot as demonstrated by interest like outside rotations, research etc
ASTRO leadership over the last 20 years entered the field when it was a bottom-of-the-barrel specialty. Do with that information what you will.
Many people in ASTRO leadership have stated they wouldn't have matched during peak rad onc. Very rarely would see fmgs matching in.
Now we are back to the status quo before the turn of the century. Psych used to match fmgs during peak rad onc now they have essentially flipped flopped
Not sure why this should bother anyone. It is what it is. It was a bubble with imrt and the field doing the right thing in the 90s and cutting spots
Now the bubble popped and no one really wants to cut spots to match reality claiming "antitrust" but it wasn't a problem to expand the last two decades on no data apparently 🤷
the people in leadership now are many of those that were part of "elite" era
didn't seem to help them very much
and also keeping in mind, it's already a medical student. the variance seems like a lot to us between students, but frankly, most med students can learn. it's not that hard.
didn't seem to help them very much
and also keeping in mind, it's already a medical student. the variance seems like a lot to us between students, but frankly, most med students can learn. it's not that hard.
Elite means highly selective. It doesn’t follow that those selected are any way “better” than those in the “average” specialty. Overexpansion, however, is unique to radonc among “elite” specialties, and reflects poor stewardship and leadership who make poor and selfish decisions ie ROCR etc.
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Is ROCR really even that bad? Isn't the whole point that it will lead to more stability as hypofractionation takes over?
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I don’t believe reimbursement matters much vs supply and demand in a market where 90% radomcs are employed. With extreme hypofracionation under rocr, many departments would close early and jobs wouo be eliminated. We have satellite that that supports one doc. Under rocr w/5 fraction breast prostate and single fraction Mets, it would be probably be open for 2-3 hours day.
Rocr also provides consolidation pressure: competitive advantage to proton and pps exempt centers- buy up neighboring practices and expand.
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People are still going into this dumpster fire of a specialty?
IMO decoupling from fractionation has to happen because hypofrac is a train that can’t be stopped. Frankly I would look forward to a system where I’m not punished for prescribing a shorter course.
Site-neutral bundled payments were advocated for over a decade ago by the freestanding community while ASTRO was busy trying to prevent rad oncs and other docs from owning linacs
Now with rocr they finally came around but quite honestly it's too little too late
It turns out that not all rad onc jobs are terrible, just the ones in Florida.
Kidding, sort of. The northeast can be pretty bad too.
If you're out in the midwest you may have no idea that there's a problem with the specialty.
You can see some egregious radiation treatments, and yet referring docs and patients have no idea and are unlikely to find out. Possibly the quality of rad onc entrant has some correlation with practice patterns long term - curiosity, lifelong learning, intellectual honesty. If there’s some breakthrough in flash, maybe someone with baseline higher IQ would adapt and others would draw big circles.
Low match rate and high selectivity also helps rad onc’s in obvious ways. Astro and Dennis Hallahan’s may cry over patient wait times, rural care but these are paper tigers and they know it. In practice a flood of rad onc labor depresses wages, limits linac ownership and negotiating power, and ensures patients are being treated by physicians with less lifetime case load experience. If you see 3 new consults a week, you are more likely to follow clinical cookie cutter pathways, probably written by academics with similar low case load experience or evicore carelon evolent AI guideline makers, we lose nuance and we call that progress.
The heat death of the rad onc specialty is a flood of 200+ residents per year, a proliferation of mega academic and hospital owned nonprofit corporations, and because of the lack of negotiating power, no rad onc under half a century of age will own the machines, and we’ll have our specialty, its investments, research, clinical practice dictated by admin, c suites or MSO’s or other vehicles of control of the boomers.
Low match rate and high selectivity also helps rad onc’s in obvious ways. Astro and Dennis Hallahan’s may cry over patient wait times, rural care but these are paper tigers and they know it. In practice a flood of rad onc labor depresses wages, limits linac ownership and negotiating power, and ensures patients are being treated by physicians with less lifetime case load experience. If you see 3 new consults a week, you are more likely to follow clinical cookie cutter pathways, probably written by academics with similar low case load experience or evicore carelon evolent AI guideline makers, we lose nuance and we call that progress.
The heat death of the rad onc specialty is a flood of 200+ residents per year, a proliferation of mega academic and hospital owned nonprofit corporations, and because of the lack of negotiating power, no rad onc under half a century of age will own the machines, and we’ll have our specialty, its investments, research, clinical practice dictated by admin, c suites or MSO’s or other vehicles of control of the boomers.
With the new codes nobody would be stupid enough to own. People are barely generating median hospital incomes. Margins were tight before - it’s not as great as people think - and now unmanageable. If there isn’t drastic change in reimbursement, there will be no owners.
You would be punished. more raodoncs would be looking for jobs which would depress salaries and $/rvu would drop. Excessive fractionation helps support the surplus radoncs that Astro pumped out.
Unfortunately this is economic reality.
The blended rate will be less than what most people actually get paid. Omission will pretty much never happen. People will use minimal number of fractions and tolerate more toxicity. They aren’t going to have 6 extra visits with a patient when it could be just 1.
The only thing that will matter is volume (since the rate is basically fixed to the ICD code) and throughput (minimizes labor cost). Why do the bells and whistles when you can do a “good enough” job without having to spend time or money on tech.
When incentives change, behavior will adjust to maximize recovery of revenue loss.
This may be cynical, but it’s what will happen. Because if the assumption is correct that people that currently do more fractions than the norm are only doing it for the money, then why wouldn’t they do the opposite ?
