MS4 - RadOnc vs. IM → MedOnc

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lllfeuno

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I know this topic has been debated before, but I would genuinely appreciate some updated opinions coming into this application cycle. My main questions are:
1. RadOnc residency vs. IM + HemeOnc fellowship: residency work hours, lifestyle, balance
2. RadOnc vs. MedOnc attending life: work/life balance, compensation, etc.

I'm deciding between the two and wondering how the residency/fellowship processes are like for the two (RO vs. IM). I get the sense that the RO residency is generally less intense than the IM route + fellowship, with more outpatient work and not being on call. After residency, it also feels like work/life balance and compensation are still superior in RO, albeit with problems in the job market.

As someone who is interested in treating cancer patients but less enthused about the prospect of inpatient medicine, is RO still a viable alternative?
I also saw this post from 2018: FUTURE RESIDENT, DO NOT BECOME A RADIATION ONCOLOGIST!!! - assuming one is lucky enough to match into a top 5-10 program, is the job market less of a problem?
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lllfeuno said:
I know this topic has been debated before, but I would genuinely appreciate some updated opinions coming into this application cycle. My main questions are:
1. RadOnc residency vs. IM + HemeOnc fellowship: residency work hours, lifestyle, balance
2. RadOnc vs. MedOnc attending life: work/life balance, compensation, etc.

I'm deciding between the two and wondering how the residency/fellowship processes are like for the two (RO vs. IM). I get the sense that the RO residency is generally less intense than the IM route + fellowship, with more outpatient work and not being on call. After residency, it also feels like work/life balance and compensation are still superior in RO, albeit with problems in the job market.

As someone who is interested in treating cancer patients but less enthused about the prospect of inpatient medicine, is RO still a viable alternative?
I also saw this post from 2018: FUTURE RESIDENT, DO NOT BECOME A RADIATION ONCOLOGIST!!! - assuming one is lucky enough to match into a top 5-10 program, is the job market less of a problem?
Click to expand...

If you are actually serious about treating cancer patients, then you have to be a medical oncologist full stop no discussion. It represents the future and will pay dividends in job security and allow you to be on the cutting edge. Every other cancer field pales in comparison.

You would be a real short sighted fool to pick one over the other because you think one is less intense.
 
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In general, the RadOnc residency experience has fewer in-hospital hours and is one year shorter (intern year + 4 residency years).

However, what med students don't see are the out-of-hospital hours spent studying for the ridiculous board exam process (4 total exams; one in Medical Physics, one in Radiation Biology, one in Clinical RadOnc, and an oral clinical exam - these are done over at least three years and cannot be completed as a resident).

I could write a dissertation and we could spawn a 17-page thread debating which residency experience is more difficult and why. Ultimately it doesn't matter.

Why doesn't matter? Because it's a small blip in the course of an entire career. If you're planning on practicing for 30 years after residency...who cares if it appears that one training experience is "easier" than the other???

If you value any level of flexibility at all for the bulk of your career, there is absolutely no question. You should do MedOnc.

I am an attending physician in Radiation Oncology. I have an objectively impressive CV and a door-opening pedigree. I have been, and continue to be, offered opportunities and privileges that my colleagues with less-shiny CVs are not offered.

My lifestyle is worse than Medical Oncologists I personally know. I cannot change jobs/practices without moving to a new geography. I make less money than Medical Oncologists I personally know.

Is the actual practice of RadOnc awesome? Yes, definitely. It's very rewarding. I wish I had done MedOnc.
 
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elementaryschooleconomics said:
In general, the RadOnc residency experience has fewer in-hospital hours and is one year shorter (intern year + 4 residency years).

However, what med students don't see are the out-of-hospital hours spent studying for the ridiculous board exam process (4 total exams; one in Medical Physics, one in Radiation Biology, one in Clinical RadOnc, and an oral clinical exam - these are done over at least three years and cannot be completed as a resident).

I could write a dissertation and we could spawn a 17-page thread debating which residency experience is more difficult and why. Ultimately it doesn't matter.

Why doesn't matter? Because it's a small blip in the course of an entire career. If you're planning on practicing for 30 years after residency...who cares if it appears that one training experience is "easier" than the other???

If you value any level of flexibility at all for the bulk of your career, there is absolutely no question. You should do MedOnc.

I am an attending physician in Radiation Oncology. I have an objectively impressive CV and a door-opening pedigree. I have been, and continue to be, offered opportunities and privileges that my colleagues with less-shiny CVs are not offered.

My lifestyle is worse than Medical Oncologists I personally know. I cannot change jobs/practices without moving to a new geography. I make less money than Medical Oncologists I personally know.

Is the actual practice of RadOnc awesome? Yes, definitely. It's very rewarding. I wish I had done MedOnc.
Click to expand...
This is immensely helpful perspective, thank you!
Could you elaborate on what the work/life balance looks like for a fully practicing RadOnc vs. MedOnc? From my own conversations it seemed that MedOncs tended to have extremely busy clinics but with compensation still lower than their counterparts.
 
I understand what people are saying with "work/life balance," but I also don't. I could easily die of a heart attack at work, and I wake up thinking about patients semi regularly. There's no pause button. Radonc and medonc share patients, but these are fundamentally different specialties. By asking this question, you've already answered it. Start with Im with plans for medonc, and switch to another fellowship or become a gp if that's ultimately where your interests lie.
 
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lllfeuno said:
This is immensely helpful perspective, thank you!
Could you elaborate on what the work/life balance looks like for a fully practicing RadOnc vs. MedOnc? From my own conversations it seemed that MedOncs tended to have extremely busy clinics but with compensation still lower than their counterparts.
Click to expand...
It took a long time for me to understand this, but the "specialty zeitgeist" that makes its way to students lags behind reality by several years.

That is a very outdated point-of-view for MedOnc and stems from the time before immunotherapy, targeted agents, and mid-levels as far as the eye can see.

First, I think the current level of reimbursement for MedOnc can't last forever. That being said, immunotherapy (Keytruda etc) has only been on the scene for the last decade or so and has changed the landscape drastically. I have a friend who just signed a contract for essentially twice the salary per-patient as a RadOnc at the same institution. At one of the hospitals I currently cover, a MedOnc retired over a year ago and we haven't been able to fill the position because MedOncs are in such high demand.

Second, mid-levels (PAs and NPs) have been utilized much, MUCH better in MedOnc than RadOnc, simply because MedOnc has a much more "traditional medicine" structure. So while yes, the clinic schedule per day per MedOnc at my hospital is busier than my schedule, they have several mid-levels handling a lot (most?) of it.

I have zero mid-levels, just me, myself, and I.

Don't get me wrong, it's not like I think the docs over in MedOnc are sitting on beaches working 2-hours per day or anything. It all sucks, for all of us. My hospital feels like it's teetering on the brink. I have a text thread with one of the MD/NP teams from yesterday trying to keep track of our inpatients and the phrase "this feels like quicksand" was used several times.

My real advice, for future lurkers reading this thread, is to take the same amount of money you would have spent on med school loans and buy a franchise business instead, something like a Jiffy Lube. You'll work less and earn more.

Barring that, DO NOT EVER pick a specialty based on perception of residency lifestyle.
 
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elementaryschooleconomics said:
My real advice, for future lurkers reading this thread, is to take the same amount of money you would have spent on med school loans and buy a franchise business instead, something like a Jiffy Lube. You'll work less and earn more.
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Not even sure a JL would be safe with coming vehicular electrification. Chipotle? Chick-fil-A? Starbucks? Smoothie king?
 
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medgator said:
Not even sure a JL would be safe with coming vehicular electrification. Chipotle? Chick-fil-A? Starbucks? Smoothie king?
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Chick-fil-a is a license to print money, but I probably can't get a franchise being as I've rolled at least one joint with a page from the Bible. Otherwise, my preference would be Jimmy John's, as the free sandwiches Id take would be enough to offset the cost.
 
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Ray D. Ayshun said:
Chick-fil-a is a license to print money, but I probably can't get a franchise being as I've rolled at least one joint with a page from the Bible. Otherwise, my preference would be Jimmy John's, as the free sandwiches Id take would be enough to offset the cost.
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Former CEO is a real MF though not sure it's as relevant now as iirc he did sell the company. My biggest issue is they have the crappiest sandwiches outside of subway.

<<< Firehouse, Jersey Mike's
 
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medgator said:
Former CEO is a real MF though not sure it's as relevant now as iirc he did sell the company. My biggest issue is they have the crappiest sandwiches outside of subway.

<<< Firehouse, Jersey Mike's
Click to expand...
Firehouse and Jersey Mike's are sometimes okay. Firehouse is good when I'm feeling in the mood for a meal that would suit someone with an IQ at least one standard deviation below average or if there's a kid present, and Jersey Mike's would be amazing again of they'd actually add salt to things (specifically their roast beef), but it seems like they stopped doing that 20 years ago. Which which generally tastes good when I eat it, but something about their sandwiches turns the rest of my day into a colonoscopy prep. In any case, I'm squarely in the JJ corner.
 
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lllfeuno said:
I know this topic has been debated before, but I would genuinely appreciate some updated opinions coming into this application cycle. My main questions are:
1. RadOnc residency vs. IM + HemeOnc fellowship: residency work hours, lifestyle, balance
2. RadOnc vs. MedOnc attending life: work/life balance, compensation, etc.

I'm deciding between the two and wondering how the residency/fellowship processes are like for the two (RO vs. IM). I get the sense that the RO residency is generally less intense than the IM route + fellowship, with more outpatient work and not being on call. After residency, it also feels like work/life balance and compensation are still superior in RO, albeit with problems in the job market.

As someone who is interested in treating cancer patients but less enthused about the prospect of inpatient medicine, is RO still a viable alternative?
I also saw this post from 2018: FUTURE RESIDENT, DO NOT BECOME A RADIATION ONCOLOGIST!!! - assuming one is lucky enough to match into a top 5-10 program, is the job market less of a problem?
Click to expand...
Not sure compensation superior in RO. Re work/life balance, 4 day work week still less common in RO vs MO too.
 
elementaryschooleconomics said:
It took a long time for me to understand this, but the "specialty zeitgeist" that makes its way to students lags behind reality by several years.

That is a very outdated point-of-view for MedOnc and stems from the time before immunotherapy, targeted agents, and mid-levels as far as the eye can see.

First, I think the current level of reimbursement for MedOnc can't last forever. That being said, immunotherapy (Keytruda etc) has only been on the scene for the last decade or so and has changed the landscape drastically. I have a friend who just signed a contract for essentially twice the salary per-patient as a RadOnc at the same institution. At one of the hospitals I currently cover, a MedOnc retired over a year ago and we haven't been able to fill the position because MedOncs are in such high demand.

Second, mid-levels (PAs and NPs) have been utilized much, MUCH better in MedOnc than RadOnc, simply because MedOnc has a much more "traditional medicine" structure. So while yes, the clinic schedule per day per MedOnc at my hospital is busier than my schedule, they have several mid-levels handling a lot (most?) of it.

I have zero mid-levels, just me, myself, and I.

Don't get me wrong, it's not like I think the docs over in MedOnc are sitting on beaches working 2-hours per day or anything. It all sucks, for all of us. My hospital feels like it's teetering on the brink. I have a text thread with one of the MD/NP teams from yesterday trying to keep track of our inpatients and the phrase "this feels like quicksand" was used several times.

My real advice, for future lurkers reading this thread, is to take the same amount of money you would have spent on med school loans and buy a franchise business instead, something like a Jiffy Lube. You'll work less and earn more.

Barring that, DO NOT EVER pick a specialty based on perception of residency lifestyle.
Click to expand...
Early 1990s, and before, med oncs were KILLING IT vs rad onc in terms of compensation. This had to do with how med oncs could make money from chemo back then. However, both in rad onc (for sure) and med onc too probably, what is old is new again (in terms of many things, compensation being one).
 
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I don’t eat beef but undersalting is a f*cking crime
 
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I went to med school late and absolutely chose radonc in part because of lack of inpatient call, overnight shifts, etc. The residency was overwhelmingly easier to manage in terms of time than my spouse's IM residency. It made for a much better family lifestyle during those 4 years.

Believe all the posters here about jobs. I still believe that radonc has better day to day QOL. But, you have no no leverage and very little lateral mobility. National job search is mandatory. US med school grads in medonc often have to turn down opportunities at their home institution. Locums market is a joke in RO, which is a very good indicator of demand.

Most importantly, a career is long. It is nice to be part of the action as the standard of care changes, to have new and meaningful (we have lots of new tech that is of marginal clinical importance) tools. To believe that your field is the one driving the improving patient outcomes. To be excited when you open up your trade journal and realize that you are going to be treating nearly every disease site differently and better in the near future.

Choose medonc. Don't franchise.

JM great but when you get it Mike's way, must be eaten within 15 minutes.
 
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communitydoc13 said:
I went to med school late and absolutely chose radonc in part because of lack of inpatient call, overnight shifts, etc. The residency was overwhelmingly easier to manage in terms of time than my spouse's IM residency. It made for a much better family lifestyle during those 4 years.

Believe all the posters here about jobs. I still believe that radonc has better day to day QOL. But, you have no no leverage and very little lateral mobility. National job search is mandatory. US med school grads often have to turn down opportunities at their home institution. Locums market is a joke in RO, which is a very good indicator of demand.

Most importantly, a career is long. It is nice to be part of the action as the standard of care changes, to have new and meaningful (we have lots of new tech that is of marginal clinical importance) tools. To believe that your field is the one driving the improving patient outcomes. To be excited when you open up your trade journal and realize that you are going to be treating nearly every disease site differently and better in the near future.

Choose medonc. Don't franchise.

JM great but when you get it Mike's way, must be eaten within 15 minutes.
Click to expand...
Locums market appears to be strengthening based on number of texts I'm receiving and the rate seems to be at $2000 a day for most centers. This is just a matter of retirements and supervision requirements, not strong job market. I wouldn't take it as good or bad, at the moment.

RO residency has reflected my real life, too. But, I've never been super busy except for one short lived job. I've always lived around 5-10 consults a week, 10-20 on beam. That is where most of my friends are at and they are not working very late. But, we certainly earn less. It is an easy trade off for me. I'm happy with lower volumes at this stage in life.

From what I see in my environments, medoncs seem to earn more for less work. But, I have very few data points.

I love radiation oncology, but I would choose medical oncology for flexibility - geography, type of practice, hours/days a week, etc. Too difficult in terms of living where you want to live.
 
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communitydoc13 said:
I went to med school late and absolutely chose radonc in part because of lack of inpatient call, overnight shifts, etc. The residency was overwhelmingly easier to manage in terms of time than my spouse's IM residency. It made for a much better family lifestyle during those 4 years.

Believe all the posters here about jobs. I still believe that radonc has better day to day QOL. But, you have no no leverage and very little lateral mobility. National job search is mandatory. US med school grads often have to turn down opportunities at their home institution. Locums market is a joke in RO, which is a very good indicator of demand.

Most importantly, a career is long. It is nice to be part of the action as the standard of care changes, to have new and meaningful (we have lots of new tech that is of marginal clinical importance) tools. To believe that your field is the one driving the improving patient outcomes. To be excited when you open up your trade journal and realize that you are going to be treating nearly every disease site differently and better in the near future.

Choose medonc. Don't franchise.

JM great but when you get it Mike's way, must be eaten within 15 minutes.
Click to expand...
Rad onc was an incredibly savvy choice for lifestyle. I think I partly chose rad onc because the physics aspect fascinated me. Photons, protons, electrons… plus the math. I remember in pathology in medical school the pathology professor talking about how cool it was that total skin electrons could treat mycosis fungoides. I thought these things would be important and could be leveraged in new and interesting ways until the end of time. Turns out, we’ve taken photons as far as they can go in terms of their efficacy. Protons operate at the fringes of medical beneficiality, and perhaps outside the fringe, but the proton users deny this to our specialty’s shame. Maybe one to ten patients in America this year will get total skin electrons, and I might be overestimating. And what about new things? Heavy ions? Ha. FLASH is not building on previous work in incremental and logical fashion; it’s a “shot in the dark” that even the FLASH people say that if it works they have no idea how it works.
 
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elementaryschooleconomics said:
It took a long time for me to understand this, but the "specialty zeitgeist" that makes its way to students lags behind reality by several years.

That is a very outdated point-of-view for MedOnc and stems from the time before immunotherapy, targeted agents, and mid-levels as far as the eye can see.

First, I think the current level of reimbursement for MedOnc can't last forever. That being said, immunotherapy (Keytruda etc) has only been on the scene for the last decade or so and has changed the landscape drastically. I have a friend who just signed a contract for essentially twice the salary per-patient as a RadOnc at the same institution. At one of the hospitals I currently cover, a MedOnc retired over a year ago and we haven't been able to fill the position because MedOncs are in such high demand.

Second, mid-levels (PAs and NPs) have been utilized much, MUCH better in MedOnc than RadOnc, simply because MedOnc has a much more "traditional medicine" structure. So while yes, the clinic schedule per day per MedOnc at my hospital is busier than my schedule, they have several mid-levels handling a lot (most?) of it.

I have zero mid-levels, just me, myself, and I.

Don't get me wrong, it's not like I think the docs over in MedOnc are sitting on beaches working 2-hours per day or anything. It all sucks, for all of us. My hospital feels like it's teetering on the brink. I have a text thread with one of the MD/NP teams from yesterday trying to keep track of our inpatients and the phrase "this feels like quicksand" was used several times.

My real advice, for future lurkers reading this thread, is to take the same amount of money you would have spent on med school loans and buy a franchise business instead, something like a Jiffy Lube. You'll work less and earn more.

Barring that, DO NOT EVER pick a specialty based on perception of residency lifestyle.
Click to expand...
This certainly piqued my interest. From word of mouth, the net profit margin for a typical fast food franchise is ~$50,000 per store. Is that accurate? Does anyone have updated numbers as minimum wages have increased in certain states? What would the profitability of a Jiffy Lube or Chik-fil-A be?
 
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lllfeuno said:
As someone who is interested in treating cancer patients but less enthused about the prospect of inpatient medicine, is RO still a viable alternative?
Click to expand...

Yes, but there are a number of important caveats. Rad oncs are fully employed with well above average income compared to other physicians right now. However, geographic limitation is severe and lateral movement is difficult. If you're not happy with your job, it's likely you may just have to deal with it for a long time, possibly the rest of your career. The most likely situation is your career will be near where you trained, so consider that. So assuming you are ok with living anywhere, far from family, particularly small towns, you have cleared the first bar which cuts prospective interest in the field by 90% probably off the bat. The second caveat is that you won't start practicing until 2030 and won't retire until about 2060. That's a long time from now, and there are multiple forces that could realistically conspire to change the fully-employed, high income, but little ability to fall up with a job change to a situation where a significant number of people who are BC in rad onc are unable to find full-time work in the field and have to do something else. This is less of a concern for people already employed with retirement < 20 years away. For someone like you, with retirement 40+ years away, it's a risk to think about. Anybody who tells you this can't happen (chairs and PDs) is lying. It happened in Canada. It very well can happen here.

There is the famous saying "don't put all your eggs in one basket." Rad onc has, for all intents and purposes, one basket. Photon irradiation for tumors and tumor beds. If podiatrists are allowed to start training to do THAs (for the sake of argument) and their number of THAs is cut in half, orthopedic surgeons aren't going to be unemployed because of it. Or even a bigger stretch, Americans stop being fat and needing hips replaced. They have other things besides THAs. Many other things. We have one thing.

lllfeuno said:
I'm deciding between the two and wondering how the residency/fellowship processes are like for the two (RO vs. IM). I get the sense that the RO residency is generally less intense than the IM route + fellowship, with more outpatient work and not being on call.
Click to expand...

Residency is far less intense because you only have to do one year of IM instead of 3, and after the IM training there is no inpatient side of oncology and call to deal with for rad oncs. To be honest, I had a great life in residency. Got to live in a fun place with a lot of fun people. Never sleep deprived. After residency has been terrible. Working in small towns by myself in small departments. That's doing it backwards. Do not choose your medical specialty based on the intensity of training. Even neurosurgeons, who have a grueling residency, can have really good lifestyles after residency and can name their own price at any hospital in America.

lllfeuno said:
assuming one is lucky enough to match into a top 5-10 program, is the job market less of a problem?
Click to expand...

Yes, absolutely. There is debate what these programs are, but go to the program with the best reputation in the area you want to live in. When I went into rad onc, I was lucky to get in anywhere and now I am pigeon holed in a part of the country far from where I grew up.
 
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I'm having trouble with the number of Jersey Mike's fan in here. What is this, #radonctwitter? I thought we were different. The number 9 at JJ's is clearly the best sandwich. I guess I'm not making JM money yet. Those things are like $15 a piece.
 
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Ray D. Ayshun said:
I'm having trouble with the number of Jersey Mike's fan in here. What is this, #radonctwitter? I thought we were different. The number 9 at JJ's is clearly the best sandwich. I guess I'm not making JM money yet. Those things are like $15 a piece.
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It's the soft roll and McDonald's cut on the lettuce.

Lots of sub places now too bougie with Ciabatta rolls and nothing more basic than aioli, all with real italian antipasto quality meats and sharp provolone.

JM just perfectly processed and soft enough to eat even when you've lost all your teeth. Like a Big Mac or Fish Fillet. Perfect.
 
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Ray D. Ayshun said:
I'm having trouble with the number of Jersey Mike's fan in here. What is this, #radonctwitter? I thought we were different. The number 9 at JJ's is clearly the best sandwich. I guess I'm not making JM money yet. Those things are like $15 a piece.
Click to expand...
Yeah, I guess the price point is different. The “regular” is $9 and much smaller than footlong at subway. But quality very good.
 
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With respect to fast food franchises, these don't seem to make as much money as people think they do, especially subway, one of the easiest to open. To make a good living owning franchises you have to own a lot of them.

Except for Freddy's for some reason. To the point that I have encountered two separate private practices where partners had discussed buying a Freddy's as an outside business venture. Maybe it's an exception, I don't know I've never eaten at one or ever had the desire to.
 
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metallica81788 said:
Freddy's is awesome
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Where do you live? Do you want to buy a Freddy's with me? If it's successful maybe we can add on a vault and drop in an old Tomo, like a rad onc hobby side gig. Or like those combo gas station/pizza huts/liquor stores.
 
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Moonbeams said:
Where do you live? Do you want to buy a Freddy's with me? If it's successful maybe we can add on a vault and drop in an old Tomo, like a rad onc hobby side gig. Or like those combo gas station/pizza huts/liquor stores.
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not as crazy as sounds

walmart-scaled.jpg
 
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theradiator said:
This certainly piqued my interest. From word of mouth, the net profit margin for a typical fast food franchise is ~$50,000 per store. Is that accurate? Does anyone have updated numbers as minimum wages have increased in certain states? What would the profitability of a Jiffy Lube or Chik-fil-A be?
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Profit margin? PROFIT MARGIN?

Son we only talk about EBITDA 'round these parts.
 
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Moonbeams said:
With respect to fast food franchises, these don't seem to make as much money as people think they do, especially subway, one of the easiest to open. To make a good living owning franchises you have to own a lot of them.

Except for Freddy's for some reason. To the point that I have encountered two separate private practices where partners had discussed buying a Freddy's as an outside business venture. Maybe it's an exception, I don't know I've never eaten at one or ever had the desire to.
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Have always wondered how a TopGolf or its less fancy rip-off sibling drive shack does... That would be a franchise i could camp out at
 
lllfeuno said:
1. RadOnc residency vs. IM + HemeOnc fellowship: residency work hours, lifestyle, balance
2. RadOnc vs. MedOnc attending life: work/life balance, compensation, etc.

I get the sense that the RO residency is generally less intense than the IM route + fellowship, with more outpatient work and not being on call. After residency, it also feels like work/life balance and compensation are still superior in RO, albeit with problems in the job market.

As someone who is interested in treating cancer patients but less enthused about the prospect of inpatient medicine, is RO still a viable alternative?
Click to expand...

“I didn’t get into oncology to do inpatient medicine. I did it to be a badass and find balance.” -Cobra Kai
 
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lllfeuno said:
As someone who is interested in treating cancer patients but less enthused about the prospect of inpatient medicine.....
Click to expand...
I echo most of what had been said about other points... but just wanted to mention something about "inpatient medicine" in Oncology.

Make absolutely sure you shadow a real community, private medical oncologist. NOT one associated with a university or pseudo-academic organization. The real world is VERY different compared to the university. Our medical oncologists are not found in the halls of our hospital any more than the rad oncs. As a matter of fact... there are a handful I have NEVER seen at the hospital. In many communities Medical Oncology is simply not an inpatient heavy specialty. A transplant service might be different, but often those are limited to university/academic places. These days... it is all about keeping the patient "OUT" of the hospital.

Of course patients will need to be hospitalized from time to time. So then.... who "rounds" on them???

The hospitalist of course. They admit, round and discharge. Its really sad... but they just get dumped on. The med oncs just throw in a consult note (or their mid-level does it).

And make sure you also shadow that community oncologist in their "outpatient" clinic. When I did my heme/onc rotation; I remember thinking how sad it was to see all those sick people in their hospital beds. And how I could never spend my days like that. Then I was invited to the attending's clinic that morning. EVERY SINGLE PATIENT we saw that morning... no evidence of disease.

Their clinics are definitely much busier... but as mentioned they heavily utilize mid levels to facilitate getting things done. They will have more medically complex issues to handle throughout the day, which is obviously more stressful. But when I get there around 7am... none of them have pulled into the parking lot yet. When I leave around 5:30-6:30pm.... they are gone. I am routinely catching up on reviewing daily imaging or treatment planning at home. I have no doubt their hours actually in the clinic are less enjoyable than mine.... but their "lifestyle" is light years better than the academic/university rad oncs I know.

TL;DR: Community Medical Oncology ≠ Inpatient Medicine

​

 
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Thank you everyone!! This was tremendously helpful for me.

One last question - how do the day-to-day, lifestyle, and compensation differ between academic RadOncs vs. MedOncs?
 
TheWallnerus said:
not as crazy as sounds

walmart-scaled.jpg
Click to expand...
Fixed it for you
1663358054543.png


Also, to the OP, regarding work life balance between an MO and RO attending. Despite all the extremism on this forum, RO has a vastly superior lifestyle to MO. In fact, if you choose RO, you will find abundant time to indulge your passions . . .

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Medoncs in my region that work 4 day weeks still earn same or more as radoncs and are constantly being recruited. Work a few locums gigs at 5k a day and take the rest of the year off?
 
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Gfunk6 said:
Fixed it for you
View attachment 359731

Also, to the OP, regarding work life balance between an MO and RO attending. Despite all the extremism on this forum, RO has a vastly superior lifestyle to MO. In fact, if you choose RO, you will find abundant time to indulge your passions . . .

View attachment 359732
Click to expand...
Don't know about that... Modern MO nirvana is all about going strong on mid-level coverage in the outpatient setting and hiring a heme onc hospitalist to cover inpatients during the week if the group can swing it.

OP, med onc lifestyle can run the gamut of better than RO lifestyle with better pay to much worse lifestyle, possibly still with equal if not better pay.

MO locums market >>>> RO locums market

In terms of day to day work and interest, RO >>> MO. Would much rather plan RT than deal with chemo and immuno side effects while taking BS heme consults on the side
 
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medgator said:
Don't know about that... Modern MO nirvana is all about going strong on mid-level coverage in the outpatient setting and hiring a heme onc hospitalist to cover inpatients during the week if the group can swing it.

OP, med onc lifestyle can run the gamut of better than RO lifestyle with better pay to much worse lifestyle, possibly still with equal if not better pay.

MO locums market >>>> RO locums market
Click to expand...

OP.... one important point here.

1663377147468.png
 
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elementaryschooleconomics said:
Paul Wallner graduated medical school before man walked on the moon.

Wait sorry what were we talking about again?
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Most of us lived in an era without cell phones…or watching shows that have advertisements…my kids were watching a show and questioned why they have to wait for the show to come back
 
Any idea who will takeover for wallner after he retires to his recently purchased 8 million dollar island home in Miami?
 
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