On the Protection of Medical Students

[CurbYourExpectations]

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[StIGMA]

I'll give my summarized version. I think SDN is among the most forthcoming information sources for medical students- also ask talkative residents/faculty one on one about their about their experiences. Work location is restricted, similar to how a subspecialist surgeons are restricted, and you will never have the cachet that they do. It is likely you may never work where you want to. If this is a critical consideration, look into other fields. Salaries will not keep place with inflation, even less so if utilization continues to downtrend. Work-life balance and patient satisfaction are better than average. I know a lot of disgruntled med oncs, radiologists, and surgeons. You will provide key insights into patient care that they do not have. Have reasonable expectations.

 

[elementaryschooleconomics]

Uh oh.

Speaking from experience, one of us usually writes posts like this when we read/see/endure something ridiculous.

@CurbYourExpectations - what prompted this? Did I miss something that the entrenched, dogmatic elders of the field did?

But, regardless of why this thread now exists:

Dear current and future medical students, please only become a Radiation Oncologist if your soul will scream in agony if you choose ANYTHING else.

The individuals you will seek guidance from in real life - namely, faculty physicians at institutions large enough to support a RadOnc residency program - they are the minority of Radiation Oncologists in this country, and almost always have zero experience outside of their one, or perhaps two jobs within that specific Ivory Tower environment. No, having 30 years of experience doesn't really matter if all 30 of those years were spent working at the same institution you did your residency in.

Faculty physicians at institutions with residency programs recruiting medical students...they aren't really trying to recruit you because they think the workforce concerns are fake and everything is amazing and the internet is full of trolls.

They're trying to recruit you because it justifies their own life choices.

Because it's painful if a bright-eyed M1 shows up in your office and asks if they should become a Radiation Oncologist, just like you, and you have to look this kid in the face and say "well, the job market really is tight, and I'm sort of trapped here, well, at least I think I am, because I haven't really ever tried to leave, because if I try to leave and get rejected, that's proof the job market is tight, so instead, I'm not going to try to leave, I'm just going to tell myself and you and everyone else the internet is full of trolls, but actually, you probably shouldn't become a Radiation Oncologist, which means maybe I shouldn't have become one, either".

That's...not normally how the human ego protects us from ourselves.

Anyway...RadOnc: the mechanics of the day-to-day medicine is enjoyable. The geographic lock and limited options and existential threats are not enjoyable.

Choose your own adventure.

 

[CurbYourExpectations]

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[medgator]

I absolutely will benefit from an excess in RO labor as a part owner of a practice, in the future thanks to academic/big rad onc. Morally, I didn't ask to be put in a position/situation where I can exploit another human being for my own personal benefit, but I guess some chairs and PDs are 💯 ok with that when they go to bed every night.

I feel grateful to have gotten my position at a time when rad onc was uber competitive and possibilities for ownership still existed in non Podunk areas. Those opportunities simply are just aren't very common anymore even in Podunk areas as the system has favored higher cost hospital and academic centers when it comes to surviving cuts and reimbursement changes.

Academic chairs and PDs who ignore oversupply and overtraining concerns are gaslighting medical students that are interested in the field, plain and simple. And it really isn't surprising when you realize that our specialty's main professional organization has been anti private practice, anti physician ownership of linear accelerators and has turned a blind eye to this problem for several years under the strawman argument of "anti trust" when it comes to workforce concerns.

Medical students you have been warned. In 2024 and beyond, if I was a competitive US medical student, I would pick med onc, gu, ENT, or rads in a heartbeat over rad onc even though I would love being a rad onc 10000x over those other things. Because I'm not going to let a ****ty job market dictate where I live and to what level I'm exploited as a physician. Academic leadership in this specialty has at best ignored workforce issues and at worst has been a major part of the problem through unwarranted residency expansion.

 

[TheWallnerus]

Radiation oncology doesn’t even control many new expansions of radiation, nuclear medicine has just as high of a likelihood of overtaking radiopharmaceuticals.

 

[drowsy12]

if you are a current pre-med, med student, or really resident in any field - your expectation should NOT be to expect ownership in your career.

If it happens and it works out as a success - awesome. But medicine went from 30% employed to 70% employed over the past decade. The market forces that motivate this are getting stronger rather than going away.

 

[medgator]

if you are a current pre-med, med student, or really resident in any field - your expectation should NOT be to expect ownership in your career.

If it happens and it works out as a success - awesome. But medicine went from 30% employed to 70% employed over the past decade. The market forces that motivate this are getting stronger rather than going away.

We have the added downside of a high capital cost to practice our specialty unlike nearly any other except perhaps Rads which is in far better shape, job market wise

 

[medgator]

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Nuc med at the VA. Probably the only place their specialty still has a future in employment as standalone specialty outside of perhaps some larger academic places

 

[TheWallnerus]

if you are a current pre-med, med student, or really resident in any field - your expectation should NOT be to expect ownership in your career.

If it happens and it works out as a success - awesome. But medicine went from 30% employed to 70% employed over the past decade. The market forces that motivate this are getting stronger rather than going away.

True. Likely to be an (pretty well paid) employee working for a large corporate entity as a doctor. Back in college I would look at my friends getting business degrees and thought “man I would hate to go into business.” Not much different versus going into medicine, now.

 

[RickyScott]

https://x.com/5_utr/status/1789664231920750647?s=46&t=bNjInwwyz2DPnd4UFJOtbg

 

[theradiator]

Although Dr. Amini grossly mischaracterized the discussion on SDN, I have to give him credit for trying to put a positive spin on our specialty.

 

[RickyScott]

Nuc med at the VA. Probably the only place their specialty still has a future in employment as standalone specialty outside of perhaps some larger academic places

I thought nuc med as a stand alone specialty was shut down and now just a radiology fellowship? In my experience, isotopes at academic centers are administered by radiologists, who politically have more sway than radonc. If this ever becomes lucrative, they will tell astro to get lost. (Seems like They already have.)

 

[brushbeamscanning]

There are nuc only residencies but job prospective are more limited because they won't be board certified to read other cross sectional imaging.