Lifestyle benefits (good money/fewer hours) + continuity with patients= popular specialty. For those not interested in continuity, and simply want the lifestyle benefits, anesthesiology and rads are probably better matches. Medical specialties and ophthal. may be more comparable to RadOnc as far as continuity is concerned...?
I believe the following are some reasons why Rad Onc has gotten so popular:
1. Medical students are finding out about the specialty earlier in their career. Rad Onc used to be a "hidden gem" among medical specialties that you did not hear about in medical school. Very few medical students did rotations in Rad Onc because they did not know about the field. Two of the 6 residents at my medical school's Rad Onc program are board certified internal medicine physicians. They did not find out about all the great things about Rad Onc until they had finished their residencys. After working a few years as internists they both went back to do a Rad Onc residency. One the academic radiation oncologists I have worked with completed an internal medicine residency, a medical oncology fellowship, and then did a Rad Onc residency after finding out about the field. During my surgery rotation in medical school I met a PGY6 general surgery resident who said that Rad Onc is a field that you don't find out about in medical school, its a field you find out about well into your residency training, and by this time it is often too late for people to switch. This particular resident wished he had gone into Rad Onc, but he simply did not know about it when he was in medical school. Now, more and more medical students and tons of MudPhuds are finding out about Rad Onc, doing a rotation in the specialty, and falling in love with Rad Onc. As the specialty continues to be very popular/competitive, there will be more of a "buzz" about it in medical schools, more medical students will find out about it, and this feed forward situation should in turn make the specialty even more competitive. In my opinion, this is what has happened over the last 5 or so years. However, many medical students are not aware of the specialty. Some of my classmates say "Rad Onc, is that a fellowship you do after a residency in diagnostic radiology?" As more and more medical students find out about the specialty in the future, I believe the specialty may become even more competitive.
2. Medical students today are very concerned about lifestyle. Rad Onc is a lucrative field that offers a great lifestyle.
3. Some of the recent advances in Rad Onc, like IMRT, has radiation oncologists extremely excited. The future looks very bright as technology continues to advance. Every single private practice radiation oncologist I have met is extremely happy about going into Rad Onc, many saying it is clearly the best specialty out there. More medical students are seeing this and are becoming excited about the field too.
4. The field is extremely rewarding, in that 60% of patients in Rad Onc are treated for cure. The other 40% are treated palliatively, but this treatment has a huge positive impact on their lives. Most of us went to medical school to help others. Rad Onc really allows us to do that, have a great lifestyle, and not "sell out" by going into other specialties with good lifestyles like dermatology.