Rad Onc Twitter

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RickyScott said:
Wouldn’t it be a reflection of terrible judgement?
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It’s possible. It’s also possible they had to be somewhere.

At some point in the last 3 years, I think I’ve said the exact same thing. Now, after meeting/talking to so many young docs, I’m hardened into believing it’s the programs and leadership that are the problem. People already do what you’re saying - SERO ain’t hiring someone from WVU.

It’s not wrong. I just think it’s the equivalent of saying we have a debt crisis so let’s cut foreign aid. It will help with debt, but it’s a drip in the ocean and the people that are being harmed are generally not the problem.

I really don’t think punishing individual residents from individual programs will help.
 
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CurbYourExpectations said:
As someone who became interested in the field before there was discussion on oversupply. I discussed with leadership and was told that everything was okay. You think that it's possible it's just bad judgement from students and residents?
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No? Did I say that? I don’t at all.
 
CurbYourExpectations said:
It is no fault of a resident, no resident should be punished... that is like saying a child is at fault for something. This is such a complex subject that those that have put in a ton of effort to look into know that there are a huge array of complexities and no one will be completely satisfied at the end of it. Scarb has done a lot of work to show this and it is very educational and shows his passion.

I think It is not a medical student's fault for trying to go into the most interesting field, we all probably agree that Radiation Oncology is the most interesting field to us:
We treat the best patients. We utilize the most interesting and complex human thinking (physics and chemistry) and use it to treat one of the worst diseases (and the most complex disease) to ever plague man kind.

I think it is an objective truth that there is an oversupply brewing, I also think that some of it is overblown. I see the point from PP docs that have worked their asses off and see how much RadOncs should be compensated. I can see the scenario of how academics are actively trying to invade encachment areas of these doctors and funnel money to superiors who have nothing to do with medicine. This also hurts the field.

There are biases from all sides. RadOncs need to focus on whats best for the field and forget about what's best for them. Issues will not be fixed until everyone is putting their asses on the line and working together to keep RadOnc great.
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Could we stop saying the problem is overblown??? It is a f****ing crisis! Every objective data point shows that. I love this field, but it is screwed without an immediate and massive correction in supply.
 
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CurbYourExpectations said:
As someone who became interested in the field before there was discussion on oversupply. I discussed with leadership and was told that everything was okay. You think that it's possible it's just bad judgement from students and residents?
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Would you be willing to disclose who in leadership said everything “was ok”. They really shouldn’t have a problem with transparency if that is what they believe.
 
RickyScott said:
Would you be willing to disclose who in leadership said everything “was ok”. They really shouldn’t have a problem with transparency if that is what they believe.
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KO routinely states on Twitter that everything is fine. In fact, he claims that he even personally met someone with three job offers once.
 
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RealSimulD said:
Why are they less worthy than someone from Harvard, that has been on probation a lot over the years.
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Did not know that... Either way, certain programs have been established as new/unnecessary and providing suboptimal training in a specialty which is oversupplied with spots. Anyone entering in 2022+ should be well aware of this. I'm with @RickyScott here on the judgement issue
 
CurbYourExpectations said:
I think some of it is overblown. I think there needs to be things done to prevent it from creating a true crisis. I love this field too and think it's the best field in medicine. I agree changes should be immediate. I agree every objective data point shows that either supply needs to be decreased or demand needs to be increases. I am putting my real life ass on the line, hope you are too.
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I strongly agree that hyperbole would "hurt the cause", as it were, but at this point I'm unclear what is "overblown".

I guess, watching what's happening right now, I would be surprised if RadOnc unemployment (meaning: people who want full time clinical jobs but are unable to get them despite trying) ever hit 10% or greater. So, the proverbial breadlines might be overblown, but I have always interpreted the breadlines thing as tongue-in-cheek, anyway.

Why do I think unemployment will always be <10%? Because of what we're seeing right now with the current "jobs bubble". With academic health system consolidation, every satellite that used to be staffed by 1 private doc is easily turned into 2 (or 3) academic jobs at half the salary. With COVID burnout and people stepping away from clinical work or retiring outright, even if it's just a 5-15% increase, that further helps elasticity. This will buy us several extra years before the unemployment needle moves at all, and I actually expect the bubble to continue for awhile yet.

The issue is that the critical analysis people can unleash on Oncology trials is just completely dormant when it comes to our own careers and lives. Combine that with the weather vs climate problem, and the fact that we're in a bubble, and it's basically someone saying global warming is fake because it snowed last night.

Concrete example: I know for a fact that raw consult numbers and new starts are up in my department ~10% over the last 5 years due to an aging population. I know for a fact that other people are seeing the same.

This doesn't change the fact that this entire specialty generates reimbursement by the fraction, and fractions are significantly down.

It's actually almost a "worst case scenario", where we are seeing more patients and often even doing more work for significantly less money.

BUT, because many of us are seeing (and feeling) an increase in patient volume, the next step in the critical thought process is short-circuited. I literally had someone say this to me the other day: "I know there's a lot of anxiety about the future of the specialty, but I'm busier than ever".

Me too! But based on the FFS/RVU system in America, being "busy" in RadOnc in 2022 currently means generating significantly less reimbursement, and only serves to cloud the issues at hand.

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CurbYourExpectations said:
I think it is an objective truth that there is an oversupply brewing, I also think that some of it is overblown.
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thesauce said:
Could we stop saying the problem is overblown??? It is a f****ing crisis! Every objective data point shows that. I love this field, but it is screwed without an immediate and massive correction in supply.
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Overblown, not overblown… this is like when in the active surveillance and Enza study, they called it “well tolerated.” And trust me I know we are all on the same side. But words matter. In May and June of 1776, Congress sat around hemming and hawing over the need to declare independence from Britain and to objectively cite all the injustices King George had visited on the colonies.

Objectively, rad onc has swelled its board certified MD ranks more, relatively, than any other specialty in the US over the last twenty years. Rad onc has had the greatest year over year relative decline in salary over the last ten years than any other specialty. Rad onc grads get significantly fewer job offers than residents in any other specialty. Rad onc’s board certification process is more onerous than any other specialty. The amount Medicare gives each rad onc in part B falls every year, and more cuts via APM are on the way. Rad onc is the least competitive specialty in the match. Of all the oncological subdisciplines, rad onc has the biggest annual percent decline in utilization. Thirty years ago, the average rad onc saw 300 new patients a year… now, it’s 200. And falling.

Need I go on? Or can we go ahead and dump the tea in the harbor.
 
TheWallnerus said:
Overblown, not overblown… this is like when in the active surveillance and Enza study, they called it “well tolerated.” And trust me I know we are all on the same side. But words matter. In May and June of 1776, Congress sat around hemming and hawing over the need to declare independence from Britain and to objectively cite all the injustices King George had visited on the colonies.

Objectively, rad onc has swelled its board certified MD ranks more, relatively, than any other specialty in the US over the last twenty years. Rad onc has had the greatest year over year relative decline in salary over the last ten years than any other specialty. Rad onc grads get significantly fewer job offers than residents in any other specialty. Rad onc’s board certification process is more onerous than any other specialty. The amount Medicare gives each rad onc in part B falls every year, and more cuts via APM are on the way. Rad onc is the least competitive specialty in the match. Of all the oncological subdisciplines, rad onc has the biggest annual percent decline in utilization. Thirty years ago, the average rad onc saw 300 new patients a year… now, it’s 200. And falling.

Need I go on? Or can we go ahead and dump the tea in harbor.
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But everything is fine I don’t know what you’re talking about.

Metaphorically dumping tea in the harbor would be what?
 
TheWallnerus said:
Overblown, not overblown… this is like when in the active surveillance and Enza study, they called it “well tolerated.” And trust me I know we are all on the same side. But words matter. In May and June of 1776, Congress sat around hemming and hawing over the need to declare independence from Britain and to objectively cite all the injustices King George had visited on the colonies.

Objectively, rad onc has swelled its board certified MD ranks more, relatively, than any other specialty in the US over the last twenty years. Rad onc has had the greatest year over year relative decline in salary over the last ten years than any other specialty. Rad onc grads get significantly fewer job offers than residents in any other specialty. Rad onc’s board certification process is more onerous than any other specialty. The amount Medicare gives each rad onc in part B falls every year, and more cuts via APM are on the way. Rad onc is the least competitive specialty in the match. Of all the oncological subdisciplines, rad onc has the biggest annual percent decline in utilization. Thirty years ago, the average rad onc saw 300 new patients a year… now, it’s 200. And falling.

Need I go on? Or can we go ahead and dump the tea in the harbor.
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I get the sentiment but the Boston Tea Party took place in 1773...

I think the way to "full employment" is to have everyone making pediatrician's salaries. As many have mentioned former PP places are being consolidated and two-three "faculty" members are replacing one busy clinician. The Chair has more faculty and is growing the practice.
 
TheWallnerus said:
Yelling “I’m mad as hell and I’m not going to take it anymore” out a window. And resigning from ASTRO.
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People need to stop downplaying this - it is a catastrophic issue that must be addressed yesterday. Even hinting that this might be somewhat less than that only throws more gas on the fire. The chairman and PDs are looking for ANY EXCUSE not to fix the problem.
 
CurbYourExpectations said:
I feel like I'm being gaslighted into talking about how it's not as bad of an oversupply as people think, even though i agree it's an oversupply.
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Maybe it's where you work (academic place with a residency program)? I have no illusions where I'm at
 
Rad onc grads get significantly fewer job offers than residents in any other specialty.
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I think this is the part where people just start to make up things because everything else is bad. I guess words matter only if they support your argument. Go talk to any peds onc fellow right now about what their job market is like (and its only gotten worse since this paper).

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I bet path and nuclear medicine is probably just as bad, but I'm not just gonna make up data about it
 

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radiation said:
I think this is the part where people just start to make up things because everything else is bad. I guess words matter only if they support your argument. Go talk to any peds onc fellow right now about what their job market is like (and its only gotten worse since this paper).

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I bet path and nuclear medicine is probably just as bad, but I'm not just gonna make up data about it
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Are you saying rad onc job offer numbers are made up? I don’t have the exact histogram in front of me, but I don’t see anything above that speaks to job offers per grad. In rad onc, the median is 2 job offers. And 25% of all grads get 1. And about 5% get zero. This is most recent ARRO data.

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medgator said:
Maybe it's where you work (academic place with a residency program)? I have no illusions where I'm at
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CurbYourExpectations said:
I feel like I'm being gaslighted into talking about how it's not as bad of an oversupply as people think, even though i agree it's an oversupply.
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On one hand, I’m sure there are people having a hard time.

On the other, there are all sorts of open jobs paying median salary. Not great, but not a pittance.

It’s going to get bad. If we say it’s “so bad” now, there are data points that make the argument weak. @medgator - how has your income been last few years ? Me? I don’t have an amazing job, but my base is the highest it’s ever been. I have friends doing a pretty well.

So, some balance in the discussion is warranted maybe ?

“If your neighbor loses their job, it’s a recession. If you lose your job, it’s a depression”
 
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RealSimulD said:
On one hand, I’m sure there are people having a hard time.

On the other, there are all sorts of open jobs paying median salary. Not great, but not a pittance.

It’s going to get bad. If we say it’s “so bad” now, there are data points that make the argument weak. @medgator - how has your income been last few years ? Me? I don’t have an amazing job, but my base is the highest it’s ever been. I have friends doing a pretty well.

So, some balance in the discussion is warranted maybe ?
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I'm doing great.... Our jobs don't exist anymore (because we took them years ago and aren't retiring for awhile). Job market definitely better this year than it has been in a few years, just like locums pay etc post covid labor shortage and all.

But this is all temporary as we know what the numbers graduating are now and going forward vs anticipated demand.

As many have stated, a decade ago, no one wanted an academic satellite job, now they are what people take and they go pretty quickly.

Not going to lie, definitely a great year to get a job (vs a few years ago or a few from now)
 
TheWallnerus said:
Are you saying rad onc job offer numbers are made up? I don’t have the exact histogram in front of me, but I don’t see anything above that speaks to job offers per grad. In rad onc, the median is 2 job offers. And 25% of all grads get 1. And about 5% get zero. This is most recent ARRO data. P
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If you look at the peds onc job market data and conclude that rad onc clearly has less job offers per graduate, then we can't have a good faith discussion here. Only 60% of peds onc fellows are getting assistant professor jobs - my best guess is they are getting on average less than 1 offer per grad


Does the rad onc market suck? Yes. Is it going to get worse? Yes. Does that mean I can make up any statement about a bad rad onc market that I think "ought" to be true? No.
 
CurbYourExpectations said:
I feel like I'm being gaslighted into talking about how it's not as bad of an oversupply as people think, even though i agree it's an oversupply.
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I think you're being completely reasonable, and I hope if people are hearing specific things which sound ridiculous, they're spelled out so we know what's floating around the gossip universe.

RealSimulD said:
On one hand, I’m sure there are people having a hard time.

On the other, there are all sorts of open jobs paying median salary. Not great, but not a pittance.

It’s going to get bad. If we say it’s “so bad” now, there are data points that make the argument weak. @medgator - how has your income been last few years ? Me? I don’t have an amazing job, but my base is the highest it’s ever been. I have friends doing a pretty well.

So, some balance in the discussion is warranted maybe ?
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I think this is spot on, which is why I find it so discouraging, just thinking about human nature.

Again returning to my personal/local data. Unless you're working in an amazingly forward-thinking department, I imagine most of us are still being tracked by our "on beam" aka "treatments delivered" metric. This is tightly correlated to fractions.

What is currently happening to me: there is a steady upward trend in our new consults/new start number. I know the case mix for my department (because...it's mostly me), and I know we follow "Choosing Wisely" pretty well. Consequently, the MD/Dosi/Physics workload is as high as ever, probably higher with complicated SBRT and SRS treatments my hospital didn't do 10 years ago.

But we get the same message from C-suite: you're "behind" budget expectations. They're right, of course: the only metric that's down is "treatments delivered", aka "fractions delivered".

Now, I have been aggressively highlighting this to admin, and they have actually responded in ways which assures me they understand the issue. The bottleneck now is continuing to convince people up the chain, which is difficult.

It is very hard, just, as a person, to feel busy, to run the numbers and know for a fact you're busier than anyone has ever been in your department, yet the bean counters tell you that you're not generating enough reimbursement.

Then, nationally, I think the message has been received by med students loud and clear: stay away.

But the bodies keep coming. Canaries are found under rocks. The needle hasn't moved, the pipeline remains wide open.

So then we're all watching formerly independent practices and hospitals get absorbed by large systems, academic or otherwise, but mostly academic. There's a proliferation of "2-for-1" deals, where docs staff "new" academic satellites, and the salary that used to go to one doc is split in half. Because RadOnc had a relatively high salary compared to other specialties to begin with, it's a VERY hard argument to make, saying you're "only" making $300k which is still better than many PCPs. Lost in this is the fact that while the absolute number is still relatively "high", it's a huge relative decrease, and the range between floor and ceiling is tight. Sure, starting PCP salary for employed docs can be relatively low, but if someone has a certain mindset and drive, I have watched Family Med docs build practices and generate revenue far surpassing RadOnc.

We just can't do that, which is also very hard for morale. So if you're a smart, hard-working, enterprising young doc: RadOnc is where dreams go to die.

Then, in terms of just, general respect by the enterprise of Medicine: everyone watched us gobble up some of the most exceptional students for 20 years. What have we done with that talent? Not much. Then we crashed overnight and became the least desirable specialty among students.

It combines together to just feel like we're cattle being led to the slaughterhouse. What's worse, I think there's a growing recognition and agreement that we can all see we're heading in that direction. By "slaughterhouse", I mean a very geographically-limiting technician-esque profession where the "price of admission" is a $300k+ student loan debt, ~9 years of training after undergrad, the most grueling and pedantic board certification in all of American medicine, for...what? Covering 2-3 satellites over a large academic health network for $300-$500k/year with limited opportunity to "do more"?

Don't get me wrong, I know MANY people would kill to make $300k for a 30-40 hour workweek. I know I would. But that's not what we have, is it? Even for those of you who have that job (heck, maybe it's $500k for a 30 hour workweek): your institution/hospital has hung a 400 ton weight of liability around your neck and can replace you with a phone call.

What does Silicon Valley call jobs like that? "Golden handcuffs"?
 
CurbYourExpectations said:
Larry David lets no one win. Let's not pretend that great PP jobs are not going to sell themselves away eventually. Let's focus on helping residents.
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I think relative oversupply means there is near full employment, without it being necessarily good employment.

Breadline gross oversupply would be literally a substantial portion of us not working in radiation oncology even if we wanted to. I don’t believe the data suggests we are there yet.

Getting >$500k for 40 hours is still happening. And there are open jobs available.

Don’t think of me saying that things are fine. They are not. There are a few open jobs in SE Michigan. Y’all don’t want to work here for whatever reason. But, if you get let go wherever you are, I can guide you to one of those jobs.

I think that’s why “breadline hysteria” is going to cause eye rolls by many.
 
RealSimulD said:
I think relative oversupply means there is near full employment, without it being necessarily good employment.

Breadline gross oversupply would be literally a substantial portion of us not working in radiation oncology even if we wanted to. I don’t believe the data suggests we are there yet.

Getting >$500k for 40 hours is still happening. And there are open jobs available.

Don’t think of me saying that things are fine. They are not. There are a few open jobs in SE Michigan. Y’all don’t want to work here for whatever reason. But, if you get let go wherever you are, I can guide you to one of those jobs.

I think that’s why “breadline hysteria” is going to cause eye rolls by many.
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Is anyone making $500k+ BE out of training? Seems rare. All of those jobs afaik require BC with some experience.

Nothing would suggest that situation would be the same for someone entering residency training this month and entering practice in 2026. Those same academic satellite jobs less than a decade ago were staffed by private docs making more
 
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medgator said:
Is anyone making $500k+ BE out of training? Seems rare. All of those jobs afaik require BC with some experience.

Nothing would suggest that situation would be the same for someone entering residency training this month
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Ah. Yes.

So I think we're all generally aware of the sentiment that there are certain jobs where someone who is board certified/with experience is preferred over a new grad. At least on SDN, we kind of abstractly talk about it.

The "problem" (not really a problem, just, reality I guess) is there historically has been very little discussion or understanding about various "job market subdivisions".

As a new grad, your job market is limited mostly by your training program, as in, its reputation and its network. We can pretend your research year projects matter (kidding, occasionally they might) but we all know that certain jobs are only really available if you come out of the right school. Even so, I think this is the most generalized and equitable market, and what I think we're all usually referring to.

After that...well, it depends on the job you took out of residency. Again, using personal experience as anecdote, how I've been received feeling out jobs post-certification with a certain type of experience is VASTLY different than how I was received as a new grad.

Then, getting into mid-career, the market changes again. If you were an academic breast specialist for 15 years, it's probably going to be difficult to get a "good" community generalist gig, if you wanted. Alternatively, you might find yourself completely walled out of academics if you've been in the community for 15 years and want to move to a different city but there's only "academic" jobs available.

We (myself included) are pretty ham-fisted when talking about "the job market" as if it's a monolith.

I am still half-convinced there will always be almost zero unemployment simply because the predatory/exploitative jobs will always been an option, like a sausage grinding carousel.
 
elementaryschooleconomics said:
Ah. Yes.

So I think we're all generally aware of the sentiment that there are certain jobs where someone who is board certified/with experience is preferred over a new grad. At least on SDN, we kind of abstractly talk about it.

The "problem" (not really a problem, just, reality I guess) is there historically has been very little discussion or understanding about various "job market subdivisions".

As a new grad, your job market is limited mostly by your training program, as in, its reputation and its network. We can pretend your research year projects matter (kidding, occasionally they might) but we all know that certain jobs are only really available if you come out of the right school. Even so, I think this is the most generalized and equitable market, and what I think we're all usually referring to.

After that...well, it depends on the job you took out of residency. Again, using personal experience as anecdote, how I've been received feeling out jobs post-certification with a certain type of experience is VASTLY different than how I was received as a new grad.

Then, getting into mid-career, the market changes again. If you were an academic breast specialist for 15 years, it's probably going to be difficult to get a "good" community generalist gig, if you wanted. Alternatively, you might find yourself completely walled out of academics if you've been in the community for 15 years and want to move to a different city but there's only "academic" jobs available.

We (myself included) are pretty ham-fisted when talking about "the job market" as if it's a monolith.

I am still half-convinced there will always be almost zero unemployment simply because the predatory/exploitative jobs will always been an option, like a sausage grinding carousel.
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This is right!
 
radiation said:
If you look at the peds onc job market data and conclude that rad onc clearly has less job offers per graduate, then we can't have a good faith discussion here. Only 60% of peds onc fellows are getting assistant professor jobs - my best guess is they are getting on average less than 1 offer per grad


Does the rad onc market suck? Yes. Is it going to get worse? Yes. Does that mean I can make up any statement about a bad rad onc market that I think "ought" to be true? No.
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Are we arguing? Over what? Tell me how 60% of a graduating class getting asst prof jobs leads to proof positive that the average total offers per grad is 1. You are offering, as you admit, your “best guess” of this based on a paper from 2017. First, things may have changed since then, and second, I was quoting the most contemporaneous data available. Is it true that there could be a specialty whose grads get less than a *median* of 2 offers. Sure… I am not the repository of all graduating class workforce data from all specialties. I have not seen that data however, but I do know that 2 is close to zero and that job offers have to be a positive integer or zero. I read through the link you provided; it did not touch on this point at all.
 
medgator said:
Anyone want to corroborate that this actually is happening anywhere else (even mayo??)

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In my speciality, I can confirm it is true for Mayo. They also rotate division chiefs because the thought is one makes better decisions when you will have to feel the effects down the line.

If only they'd post a job at the Mayo campus I could convince the spouse to move to...
 
TheWallnerus said:
Are we arguing? Over what? Tell me how 60% of a graduating class getting asst prof jobs leads to proof positive that the average total offers per grad is 1. You are offering, as you admit, your “best guess” of this based on a paper from 2017. First, things may have changed since then, and second, I was quoting the most contemporaneous data available. Is it true that there could be a specialty whose grads get less than a *median* of 2 offers. Sure… I am not the repository of all graduating class workforce data from all specialties. I have not seen that data however, but I do know that 2 is close to zero and that job offers have to be a positive integer or zero. I read through the link you provided; it did not touch on this point at all.
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this is hilarious - you are doing your best rad onc chairman impression - "oh but the data doesn't explicitly contradict what I am saying so I will just go against all common sense and use classic the data is out of date excuse"
 
radiation said:
this is hilarious - you are doing your best rad onc chairman impression - "oh but the data doesn't explicitly contradict what I am saying so I will just go against all common sense and use classic the data is out of date excuse"
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Huh? I said rad onc grads get the fewest job offers per grad. Which is that 50% of rad onc grads get 2 offers or less (the median is 2), based on 2021 data. You said your "best guess" is that peds onc grads have an average of 1 job offer... from a 2017 paper that has zero data about job offers per grad. You seem to be countering the below objective observations
TheWallnerus said:
Objectively, rad onc has swelled its board certified MD ranks more, relatively, than any other specialty in the US over the last twenty years. Rad onc has had the greatest year over year relative decline in salary over the last ten years than any other specialty. Rad onc grads get significantly fewer job offers than residents in any other specialty. Rad onc’s board certification process is more onerous than any other specialty. The amount Medicare gives each rad onc in part B falls every year, and more cuts via APM are on the way. Rad onc is the least competitive specialty in the match. Of all the oncological subdisciplines, rad onc has the biggest annual percent decline in utilization. Thirty years ago, the average rad onc saw 300 new patients a year… now, it’s 200. And falling.
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with a "best guess" that ped onc grads get an average of 1 job offer per grad. But there is zero pertinent data to back up this guess, yes?

I am very confused if you're being picky or obtuse or if we met one time and I made a joke about your socks.

EDIT: You were making very... interesting... comments on this subject last year. Peds onc is your idee fixe. OK! Look, how's this:
TheWallnerus said:
Rad onc grads get significantly fewer job offers than residents in any other specialty (except maybe peds onc, data TBD).
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Mayo...peds-onc comparisons.

Hard to make a moral judgement on these models. (Now I have seen multifraction RA palliative plans to extremities from Mayo, so they do look out for their institutional bottom line). Rotating chairs and program directors are the way to go. Otherwise, pathologies of power just too great.

Peds-onc is an interesting comparison. From my distance (huge distance, I haven't interacted with a peds-onc since residency) the person who goes into peds-onc: 1. doesn't care about money, 2. is deeply committed to the academic mission of their work, 3. is an effing god within their institution and to the patients they treat.

I suspect that the inferences about the peds-onc job market are real. I also suspect that the folks who went into peds-onc already knew the realities. (They were committed to a national, academic job search from the get go. They are serious people, not like me.)

Back in my day, peds-onc was not competitive in terms of traditional metrics. (I knew some marginal med students who did peds-onc fellowships at the best places). This is fine. The traditional metrics for competitiveness were stupid (see us).

Peds-onc, more than almost any other specialty is an academic only deal. Peds-radonc has always been pretty much like this. The peds person often had to supplement with another service, brought in less clinical revenue and were expected to be fully committed to all academic mission type things (like be a part of every meaningful collaborative group you could).

True believer academic types of course have no problem viewing the ideal rad-doc as being a peds-onc type person.

They are not wrong. They also need to recruit fewer and fewer of these people into the field going forward.
 
I'm confused as to how this comparison is being made. I have a friend who did Pediatric Heme/Onc, and did several collaborative projects with them over the years.

Maybe my friend (and other acquaintances in that department) are outliers, but they view their jobs COMPLETELY differently. They know, from the outset, that if they pick that career they're locking themselves into academics and even then, only the institutions big enough to support that specialty. "I knew I would never have a community job, it just doesn't exist for us" is verbatim what I've been told.

Conversely, there doesn't appear to be much of a "job search", as @Ray D. Ayshun guessed.

I have never met anyone in niche specialties like Peds Heme/Onc who were surprised by their job market, or feel misled by leadership. There's a clear line between RadOnc/EM/Path and Peds Heme/Onc or like...Medical Genetics or whatever.
 
Mandelin Rain said:
Have we reviewed the Aerospace Medicine or Undersea and Hyperbaric Medicine job markets?

These are important data points.
Click to expand...
If I tried to publish a Phase III RCT comparing job outcomes and Arm A had RadOnc while Arm B had Peds Heme/Onc, Vinay Prasad would have a 45 minute podcast rant about the imbalance.
 
elementaryschooleconomics said:
I have never met anyone in niche specialties like Peds Heme/Onc who were surprised by their job market, or feel misled by leadership. There's a clear line between RadOnc/EM/Path and Peds Heme/Onc or like...Medical Genetics or whatever.
Click to expand...
I don't know, but these fields, just like Radonc or PhD programs ranging from physics to literary criticism are prone to the same academic forces that eventually push their trainees from having good, real, academic prospects right out of training to being the equivalent of adjunct faculty after several years of post-doc positions or instructorships.

Academia as a whole is itself an industry that eats it's young. Most kids shouldn't even be getting undergrad degrees.
 
communitydoc13 said:
I don't know, but these fields, just like Radonc or PhD programs ranging from physics to literary criticism are prone to the same academic forces that eventually push their trainees from having good, real, academic prospects right out of training to being the equivalent of adjunct faculty after several years of post-doc positions or instructorships.

Academia as a whole is itself an industry that eats it's young. Most kids shouldn't even be getting undergrad degrees.
Click to expand...
North Korea style propaganda: radoncs have it good! better than PhD academics and 100% academic ped onc. Problem comes when medstudents rotate through every other specialty where seniors are getting 10+ job offers on average.
 
RickyScott said:
North Korea style propaganda: radoncs have it good! better than PhD academics and 100% academic ped onc. Problem comes when medstudents rotate through every other specialty where seniors are getting 10+ job offers on average.
Click to expand...
Typically, in their desired geography.

Rather than 2, in "a" location.
 
TheWallnerus said:
Meet Robert

He has IIIB NSCLC

10 years ago, chemoRT is the 1st line option almost every time

Now… chemoRT, we hardly knew ye

Click to expand...

I think this is a mistake… because they transition to calling it “advanced”
 
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