Rad onc vs. Heme/onc

[sallyhasanidea]

I'm a current phd student debating between applying into IM--> heme/onc, and rad onc. I've seen all of the talk about the job market, but I really enjoy working with cancer patients, and was wondering if it truly will be a mistake to go into rad onc. What would you do if you could go back and apply; IM or rad onc?

What worries me is the job market + whether or not there will even be jobs available when I graduate. I've seen posts saying recent grads are finding jobs in the 200k +-25k in rad onc in smaller US cities; 200k to me is a lot of money, and I wouldn't scoff at it, but I'll probably be around 450k in debt after residency. How does heme/onc salary compare to rad onc salary?

If needed to know, 250+ step1, 20+ publications, 4/5 clinical honors, no AOA, mid tier USMD. I would want to aim for a top program, but I am essentially screened out of all top tier IM programs because of my lack of AOA, so was also leaning towards rad onc because I think lower tier IM programs would prohibit me from going to a good fellowship.

What do you all think about the opportunity for private practice or to own a small group practice in heme/onc in the future. Will this still be possible, or will there be a lot of corporate ownership of heme onc practices and infusion centers?

One of the things that pushes me away from IM is that I wouldn't be able to do hospital medicine because I want to be my own boss, and would like to own a private practice at some point. Yes, I am aware of business headaches, but would much prefer that to having a boss.

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[Neuronix]

In my state the salaries for newly graduating med oncs are double the salaries for newly graduating rad oncs. They will also have numerous job offers within our state. Heck, the med oncs start getting recruiting calls when they start fellowship. Rad oncs will battle to even get one job offer in the whole state. I'm not exaggerating. This is the current reality. In 5 years I really fear what's going to happen.

 

[OTN]

If I had to choose it all over again, I would choose radonc, because my choice was made 15 years ago. If I were choosing NOW, I would choose Heme/Onc in a heartbeat over radonc. No doubt. Radonc is cooler, sure, but the job market is going to be complete trash for graduating residents for a loooooooong time.

 

[scarbrtj]

One of the hottest things in medicine right now is telemedicine's growing role. Can this horse (a supervision saddle is on its back) be put back in the rad onc barn? I can't see anything but a big cratering if not. And that's just one thing I'm thinking of right this sec. What I'm saying is, if you were truly cognizant of all the many headwinds rad onc is facing, there's no way you could consider rad onc and have a board score of ~250. You're smart but information deficient.

 

[Chartreuse Wombat]

I'm a current fourth year debating between applying into IM--> heme/onc, and rad onc. I've seen all of the talk about the job market, but I really enjoy working with cancer patients, and was wondering if it truly will be a mistake to go into rad onc. What would you do if you could go back and apply; IM or rad onc?

What worries me is the job market + whether or not there will even be jobs available when I graduate. I've seen posts saying recent grads are finding jobs in the 200k +-25k in rad onc in smaller US cities; 200k to me is a lot of money, and I wouldn't scoff at it, but I'll probably be around 450k in debt after residency. How does heme/onc salary compare to rad onc salary?

If needed to know, 250+ step1, 20+ publications, 4/5 clinical honors, no AOA, mid tier USMD. I would want to aim for a top program, but I am essentially screened out of all top tier IM programs because of my lack of AOA, so was also leaning towards rad onc because I think lower tier IM programs would prohibit me from going to a good fellowship.

I think you may be underselling yourself for IM. If the "top" programs screen-out non-AOA then go to a good program and excel. Fellowships with your pubs should be easy to achieve. I don't know how important "elite" IM training and fellowships are for academic MedOnc but if you intend to work in the community then where you trained is hardly important for a specialty as large as MedOnc. I am in a "top ten" academic center and the best MedOncs I know trained at "non-elite" programs.

I completely agree with OTN. In 2020 RadOnc is a great field but the job market is not good and will only get worse.

 

[Haybrant]

Every year Rad onc gets closer to a critical threshold. That threshold once cracked will lead to a critical downward spiral in hiring demand and job availability. We can’t actually see that pressure but once the threshold is breached the cratering will be fierce and unrelenting. People will ask what the heck happened we couldn’t see it coming at all. Anyway the decision should be pretty obvious

 

[dieABRdie]

I somehow got subscribed to "Oncology Learning Network" and every day I get multiple emails about promising results of some clinical trial and every week I get several emails about a new FDA approval for some targeted agent. More indications means more possibilities for treatment which means more billable actions which means more compensation for you. Go ahead and subscribe to it so you see yourself. I think I need to unsubscribe because its like getting kicked in the nuts daily.

I somehow fell into the job of my dreams but going back if I didn't know I was going to land this position I would have gone med onc no questions asked.

 

[metview]

I will say it again. Rad onc is the best field in medicine but we have a huge problem with leadership and job expansion. When you graduate, it will be 6 years. By that time, the job market is going to be worse than it is today because even if we fix the problem TODAY, there will be a 5 year lag, and that's assuming we fix it at this moment and there is no indication that's happening.

In terms of not getting into a top IM program because of not being AOA, the ppl in my med school class who matched into the best IM programs (ie. duke, stanford, MGH, Brigham, Upenn) were not AOA. Step 1 250, > 20 pubs, and 4/5 honors (hopefully Honor in IM) will easily get you into a top 10 IM program.

If you are truly interested in oncology, then hem onc all the way. If you want a little better life style with lesser pay and severe geographic restrictions, then rad onc. If i were in your shoes, its be heme onc >>>>> rad onc.

 

[elementaryschooleconomics]

I'm a current fourth year debating between applying into IM--> heme/onc, and rad onc. I've seen all of the talk about the job market, but I really enjoy working with cancer patients, and was wondering if it truly will be a mistake to go into rad onc. What would you do if you could go back and apply; IM or rad onc?

What worries me is the job market + whether or not there will even be jobs available when I graduate. I've seen posts saying recent grads are finding jobs in the 200k +-25k in rad onc in smaller US cities; 200k to me is a lot of money, and I wouldn't scoff at it, but I'll probably be around 450k in debt after residency. How does heme/onc salary compare to rad onc salary?

If needed to know, 250+ step1, 20+ publications, 4/5 clinical honors, no AOA, mid tier USMD. I would want to aim for a top program, but I am essentially screened out of all top tier IM programs because of my lack of AOA, so was also leaning towards rad onc because I think lower tier IM programs would prohibit me from going to a good fellowship.

No question I would do IM and MedOnc. I actually loved my intern year and IM in general which I didn't expect going in. I considered trying to stay on as a categorical resident!

 

[RickyScott]

same here and that was awhile ago.

 

[radiation]

I would strongly discourage trying to predict what reimbursements will look like in 7+ years for any speciality. Currently Med Onc has high reimbursement and geographic flexibility. This is unlikely to continue in perpetuity. The cyclical nature of reimbursements suggests that Med Onc is likely to regress to the mean 7+ years from now, especially with costs of drugs becoming unsustainable. This happens in many specialties. Nonelective specialities like derm and plastics are exempt from this but do have their own ups and down with job market. Things that you cannot predict include presidential mandates, changes in cms etc.

You can make a prediction with a high degree of likelihood that in radonc that your geographical certainty will be limited. This has always been the case for radonc and is currently exacerbated by the oversupply of residents. You can also predict there is a fairly high chance you may have to do fellowship or equivalent to increase your chances for geographic certainty.

I would sit back and really try to weight what you enjoy doing the most and not put too much into getting into a “top” IM program. If you enjoy wards medicine and can see youself doing the practice of med Onc, that would certainly be a good option and your stats more than support that pathway. But I wouldnt choose that for the sole reason to make today’s salaries or higher because you will be setting yourself up for dissatisfaction

 

[goodkerma]

Apart from job aspect, I'm surprised how many say they would do med onc if they had to choose right now. No offense to medonc colleagues but there would be nothing I hate more than the algorithmic day to day of ordering chemotherapy... If you just love oncology, I would suggest a surgical subspecality that would yield more satisfaction akin to radonc (ENT, urology, etc)- and while lifestyle in residency is tough- 3 years of IM and 3 years of medonc fellowship is no picnic compared to the relatively glamorous years of radonc.

 

[RickyScott]

I would strongly discourage trying to predict what reimbursements will look like in 7+ years for any speciality. Currently Med Onc has high reimbursement and geographic flexibility. This is unlikely to continue in perpetuity. The cyclical nature of reimbursements suggests that Med Onc is likely to regress to the mean 7+ years from now, especially with costs of drugs becoming unsustainable. This happens in many specialties. Nonelective specialities like derm and plastics are exempt from this but do have their own ups and down with job market. Things that you cannot predict include presidential mandates, changes in cms etc.

You can make a prediction with a high degree of likelihood that in radonc that your geographical certainty will be limited. This has always been the case for radonc and is currently exacerbated by the oversupply of residents. You can also predict there is a fairly high chance you may have to do fellowship or equivalent to increase your chances for geographic certainty.

I would sit back and really try to weight what you enjoy doing the most and not put too much into getting into a “top” IM program. If you enjoy wards medicine and can see youself doing the practice of med Onc, that would certainly be a good option and your stats more than support that pathway. But I wouldnt choose that for the sole reason to make today’s salaries or higher because you will be setting yourself up for dissatisfaction

I agree with you about trying to predict reimbursements. Fundamental difference here is that I strongly (would love to bet money on it) believe that you could have a very difficult time securing employment in radonc in 5 years. Whatever happens to medonc and other specialties, you will have a job- very likely in favorable geography , maybe not optimal pay, and at very worst you would have to devote some of your practice to im.

 

[fiji128]

I'm a current fourth year debating between applying into IM--> heme/onc, and rad onc. I've seen all of the talk about the job market, but I really enjoy working with cancer patients, and was wondering if it truly will be a mistake to go into rad onc. What would you do if you could go back and apply; IM or rad onc?

What worries me is the job market + whether or not there will even be jobs available when I graduate. I've seen posts saying recent grads are finding jobs in the 200k +-25k in rad onc in smaller US cities; 200k to me is a lot of money, and I wouldn't scoff at it, but I'll probably be around 450k in debt after residency. How does heme/onc salary compare to rad onc salary?

If needed to know, 250+ step1, 20+ publications, 4/5 clinical honors, no AOA, mid tier USMD. I would want to aim for a top program, but I am essentially screened out of all top tier IM programs because of my lack of AOA, so was also leaning towards rad onc because I think lower tier IM programs would prohibit me from going to a good fellowship.

Financially I was/am in kinda of the same position as you out of residency due to private med school debt. You don't want to be cavalier about the salary stuff just because 200K is 4x what your residency salary will be. If you'll have 450K in total debt and if you are aiming to pay it back within 10 years or so that will probably work out to be somewhere in the $5,000 a month range. If you are making $250,000/year your net take home pay each month will be about $13,000 so. After the loan payment you will be at $8,000 a month, which will only be about double your monthly net income during residency but your quality of life expectations including car/family/home ect will probably be way beyond what it was in residency. At the end of the day rad onc is probably not a viable specialty for you with that kind of debt unless you want to be making payments for the next 30 years. A general rule of thumb is you don't want your debt to be greater then your yearly salary as it gets to be very hard to pay off the debt in a reasonable time frame.


Also, with that kinda of debt no mater what you go into make sure you consolidate everything and do income based repayments while in residency, just in case you end up qualify for public forgiveness in the future, you'll want that 5 to 6 years of payment credit behind you while the payments are super low.

 

[scarbrtj]

As an aside it’s completely tragic people are coming out of med school 400+K in debt. This is basically producing indentured servants. Take rad onc out of the equation. That society can “charge” young people this high of a rate of entry for the right to be an MD, basically being predatory on their desire to be an MD, is a great wrong IMHO. Versus 20-30y ago, MDs are now getting saddled with 2-3x the debt at pay levels in real dollars that are less than that time frame? Crazy. Who can afford ... financially, emotionally, liability wise, hoop jumping wise... to be a doctor anymore?

 

[taserlaser]

As an aside it’s completely tragic people are coming out of med school 400+K in debt. This is basically producing indentured servants. Take rad onc out of the equation. That society can “charge” young people this high of a rate of entry for the right to be an MD, basically being predatory on their desire to be an MD, is a great wrong IMHO. Versus 20-30y ago, MDs are now getting saddled with 2-3x the debt at pay levels in real dollars that are less than that time frame? Crazy. Who can afford ... financially, emotionally, liability wise, hoop jumping wise... to be a doctor anymore?

Canadians come out of med school with debt, but my tuition (one of the cheaper schools) came to about 15k CAD / year x 3 years, and I got a stipend of 5k during clerkship. I would consider my quality of education to have been quite excellent. What US schools charge is absolute criminal. I'm less than one year out of residency, have paid off my line of credit, and already have savings.

 

[evilbooyaa]

As an aside it’s completely tragic people are coming out of med school 400+K in debt. This is basically producing indentured servants. Take rad onc out of the equation. That society can “charge” young people this high of a rate of entry for the right to be an MD, basically being predatory on their desire to be an MD, is a great wrong IMHO. Versus 20-30y ago, MDs are now getting saddled with 2-3x the debt at pay levels in real dollars that are less than that time frame? Crazy. Who can afford ... financially, emotionally, liability wise, hoop jumping wise... to be a doctor anymore?

Agreed.. They charge this because that's the price, with student loans, that folks are able and willing to bear.

 

[sallyhasanidea]

I agree with you about trying to predict reimbursements. Fundamental difference here is that I strongly (would love to bet money on it) believe that you could have a very difficult time securing employment in radonc in 5 years. Whatever happens to medonc and other specialties, you will have a job- very likely in favorable geography , maybe not optimal pay, and at very worst you would have to devote some of your practice to im.

What do you all think about the opportunity for private practice or to own a small group practice in heme/onc in the future. Will this still be possible, or will there be a lot of corporate ownership of heme onc practices and infusion centers?

One of the things that pushes me away from IM is that I wouldn't be able to do hospital medicine because I want to be my own boss, and would like to own a private practice at some point. Yes, I am aware of business headaches, but would much prefer that to having a boss.

 

[ramsesthenice]

Apart from job aspect, I'm surprised how many say they would do med onc if they had to choose right now. No offense to medonc colleagues but there would be nothing I hate more than the algorithmic day to day of ordering chemotherapy... If you just love oncology, I would suggest a surgical subspecality that would yield more satisfaction akin to radonc (ENT, urology, etc)- and while lifestyle in residency is tough- 3 years of IM and 3 years of medonc fellowship is no picnic compared to the relatively glamorous years of radonc.

This has always been my thought as well. Other than the word oncology and the fact we treat mostly similar populations, rad onc and med onc have very little in common day to day. I never personally put the two side by side myself. I like the technical aspects of the job and I know I wouldn’t be happy in med onc. My mind is very task oriented. I am close with a lot of med oncs and monotony does seem to be a bit more of a complaint from them. It’s like any field...great for some, not for all. No matter what field you pick, the key is making sure you actually like the work, not just the idea of the work or some aspects of it.

 

[fiji128]

Ya it's all very predatory in a lot of ways. At least its not nearly as bad as law schools where you can leave with 250K in debt with an 90K a year job. Basically guaranteeing that you will be making payments until you retire.

 

[OTN]

What do you all think about the opportunity for private practice or to own a small group practice in heme/onc in the future. Will this still be possible, or will there be a lot of corporate ownership of heme onc practices and infusion centers?

One of the things that pushes me away from IM is that I wouldn't be able to do hospital medicine because I want to be my own boss, and would like to own a private practice at some point. Yes, I am aware of business headaches, but would much prefer that to having a boss.

Small group practice? Likely not. The cash outlays required to have infusional antineoplastic agents on-hand are very large and can be overwhelming for a small group. In addition, you would be squeezed from both payers and suppliers. Tough to make ends meet without some economies of scale.

 

[sallyhasanidea]

You have a lot of debt. You want to work in a city. You want to be your own boss. There is no way I could tell you with a straight face that rad onc is the career for you.

Actually I don't mind living in some ****ty part of the country

 

[Lamount]

I'm a current fourth year debating between applying into IM--> heme/onc, and rad onc. I've seen all of the talk about the job market, but I really enjoy working with cancer patients, and was wondering if it truly will be a mistake to go into rad onc. What would you do if you could go back and apply; IM or rad onc?

What worries me is the job market + whether or not there will even be jobs available when I graduate. I've seen posts saying recent grads are finding jobs in the 200k +-25k in rad onc in smaller US cities; 200k to me is a lot of money, and I wouldn't scoff at it, but I'll probably be around 450k in debt after residency. How does heme/onc salary compare to rad onc salary?

If needed to know, 250+ step1, 20+ publications, 4/5 clinical honors, no AOA, mid tier USMD. I would want to aim for a top program, but I am essentially screened out of all top tier IM programs because of my lack of AOA, so was also leaning towards rad onc because I think lower tier IM programs would prohibit me from going to a good fellowship.

What do you all think about the opportunity for private practice or to own a small group practice in heme/onc in the future. Will this still be possible, or will there be a lot of corporate ownership of heme onc practices and infusion centers?

One of the things that pushes me away from IM is that I wouldn't be able to do hospital medicine because I want to be my own boss, and would like to own a private practice at some point. Yes, I am aware of business headaches, but would much prefer that to having a boss.

If I were a med student today, even with the miserable job market, I would still choose rad onc over med/onc (as I earn the ire of half of the posters here)... but that's because I think the field is awesome. You become an expert in cancer biology like a med/onc and an expert in anatomy like a surgeon... which is a really cool combination. I was also (almost) a physicist before med school, so rad onc is a natural fit for me.

That being said, when I got into the field... it wasn't JUST that I thought the field was cool, it was also lauded for its high compensation, excellent lifestyle, and elite pedigree. I would be lying if I said that those factors didn't contribute to my excitement. I was fortunate and got a job that checked (most) of my boxes, but I think that much of this might have having the good fortune to meet the right people at the right time...

If you love the field for what it is, go for it! I would just anticipate facing stormy seas looking for a job... If, on the other hand, you are looking for a bit of certainty after a long life of applications and interviews, med/onc is a very reasonable choice in the current environment.

 

[elementaryschooleconomics]

If I were a med student today, even with the miserable job market, I would still choose rad onc over med/onc (as I earn the ire of half of the posters here)... but that's because I think the field is awesome. You become an expert in cancer biology like a med/onc and an expert in anatomy like a surgeon... which is a really cool combination. I was also (almost) a physicist before med school, so rad onc is a natural fit for me.

I know for me - and I assume for most of us here - this is what drives me up a wall about the mismanagement of RadOnc in terms of market forces. The field is incredible, you're harnessing the power of the atom to cure cancer.

Unfortunately, harnessing the power of the atom has high overhead costs and there is an oversupply of Bruce Banners...

 

[Radonc90]

Some 30 years ago, I considered medonc/hemonc, I matched into internal medicine but finally decided against medonc simple bc in the 1990s, the chemo Tx was toxic. Patients were sick like a dog bc medonc used DTIC, IL-2 for melanoma. MAID chemo for sarcoma.

Now is the opposite, the advances made in medonc/hemonc regarding immunotherapy, immuno-oncology is amazing.
If I am practicing medonc/hemonc now, I will be happy.
The bottom line is: you must like cancer patients, otherwise, don't go into the oncology fields (surgonc, gynonc, medonc, radonc etc.).
Cancer patients require a significant commitment, ethics, skills, compassion, creativity that non-oncology MDs do not understand us in the field of oncology.

And yes, go into medonc/hemonc. I say this even I have mentored a ton of med students and radonc residents...
The job market is bad for radonc, no doubt about it.
No need for radonc job market data (which is very very difficult to obtain accurately), you can smell it in the air...

 

[RickyScott]

If I were a med student today, even with the miserable job market, I would still choose rad onc over med/onc (as I earn the ire of half of the posters here)... but that's because I think the field is awesome. You become an expert in cancer biology like a med/onc and an expert in anatomy like a surgeon... which is a really cool combination. I was also (almost) a physicist before med school, so rad onc is a natural fit for me.

That being said, when I got into the field... it wasn't JUST that I thought the field was cool, it was also lauded for its high compensation, excellent lifestyle, and elite pedigree. I would be lying if I said that those factors didn't contribute to my excitement. I was fortunate and got a job that checked (most) of my boxes, but I think that much of this might have having the good fortune to meet the right people at the right time...

If you love the field for what it is, go for it! I would just anticipate facing stormy seas looking for a job... If, on the other hand, you are looking for a bit of certainty after a long life of applications and interviews, med/onc is a very reasonable choice in the current environment.

I totally agree with your reasoning, except in the vast majority of cases, there is a spouse with her own career who may have geographic limitations, and if she doesn’t have a well remunerating job, than you require even more certainty of employment.

 

[medgator]

If I were a med student today, even with the miserable job market, I would still choose rad onc over med/onc (as I earn the ire of half of the posters here)... but that's because I think the field is awesome. You become an expert in cancer biology like a med/onc and an expert in anatomy like a surgeon... which is a really cool combination. I was also (almost) a physicist before med school, so rad onc is a natural fit for me.

That being said, when I got into the field... it wasn't JUST that I thought the field was cool, it was also lauded for its high compensation, excellent lifestyle, and elite pedigree. I would be lying if I said that those factors didn't contribute to my excitement. I was fortunate and got a job that checked (most) of my boxes, but I think that much of this might have having the good fortune to meet the right people at the right time...

If you love the field for what it is, go for it! I would just anticipate facing stormy seas looking for a job... If, on the other hand, you are looking for a bit of certainty after a long life of applications and interviews, med/onc is a very reasonable choice in the current environment.

I totally agree with your reasoning, except in the vast majority of cases, there is a spouse with her own career who may have geographic limitations, and if she doesn’t have a well remunerating job, than you require even more certainty of employment.

Bingo @RickyScott geography overrides pretty much everything else for many which is why Cali can get away with paying a fraction of what you will earn in the Midwest, despite there being way more jobs available there

 

[Reaganite]

Maybe I'm in the minority, but I think med onc sucks major (insert derogatory term here). You couldn't pay me any amount of money to do that work. That being said, I would discourage anyone from going into RadOnc right now, and I personally stand to benefit substantially from wage suppression. I consider myself a reasonably fair employer, but even I'm tempted by the sub-200k salary I can probably offer a new associate these days. I'd probably pick a surgical subspeciality if I had to. Do cool surgeries and let your NP do the postop stuff.

 

[sallyhasanidea]

Maybe I'm in the minority, but I think med onc sucks major (insert derogatory term here). You couldn't pay me any amount of money to do that work. That being said, I would discourage anyone from going into RadOnc right now, and I personally stand to benefit substantially from wage suppression. I consider myself a reasonably fair employer, but even I'm tempted by the sub-200k salary I can probably offer a new associate these days. I'd probably pick a surgical subspeciality if I had to. Do cool surgeries and let your NP do the postop stuff.

Could you expand more on why you think med onc sucks, what specifically do you dislike about it?

 

[RadRadRad]

I think it will be extremely hard to be your own boss in medonc
Seems like the trend is hospital employment especially if hospital has 340b drug discount or you join a mega group large enough to get chemo rebates/discounts. There are some smaller groups that still do well often because of imaging or Linac ownership.

 

[thecarbonionangle]

Could you expand more on why you think med onc sucks, what specifically do you dislike about it?

Generally speaking (not familiar with his reasons), some people who went into RO, did not enjoy rounding and like inpatient medicine. They did not like dealing with chronic issues. Theres a lot of self selection. Specifically in the most recent competitive years, we attracted a lot of applicants wanting prestige and lifestyle. This is why some are so offended by the declining standing because they have a lot of their identity and self worth wrapped around this prestige. I actually really enjoyed many aspects of medicine and miss it at times. Not everyone does. Multiple of my coresidents were quite vocal about hating dealing with medical issues. It would be cool if we had a path in RO to give some chemo and work our way back inpatient for some who want. If neurologist can do it, we should.
It may go a long way in lifting our specialty. Services always love it when they see me walking around the hospital. Like man what a sight to see the RO attending! and im pretty good looking croc too, beautiful smile, so that probably helps a bit

 

[RickyScott]

Generally speaking (not familiar with his reasons), some people who went into RO, did not enjoy rounding and like inpatient medicine. They did not like dealing with chronic issues. Theres a lot of self selection. Specifically in the most recent competitive years, we attracted a lot of applicants wanting prestige and lifestyle. This is why some are so offended by the declining standing because they have a lot of their identity and self worth wrapped around this prestige. I actually really enjoyed many aspects of medicine and miss it at times. Not everyone does. Multiple of my coresidents were quite vocal about hating dealing with medical issues. It would be cool if we had a path in RO to give some chemo and work our way back inpatient for some who want. If neurologist can do it, we should.
It may go a long way in lifting our specialty. Services always love it when they see me walking around the hospital. Like man what a sight to see the RO attending! and im pretty good looking croc too, beautiful smile, so that probably helps a bit

Excellent post

 

[MegaVoltagePhoton]

Some 30 years ago, I considered medonc/hemonc, I matched into internal medicine but finally decided against medonc simple bc in the 1990s, the chemo Tx was toxic. Patients were sick like a dog bc medonc used DTIC, IL-2 for melanoma. MAID chemo for sarcoma.

Now is the opposite, the advances made in medonc/hemonc regarding immunotherapy, immuno-oncology is amazing.
If I am practicing medonc/hemonc now, I will be happy.
The bottom line is: you must like cancer patients, otherwise, don't go into the oncology fields (surgonc, gynonc, medonc, radonc etc.).
Cancer patients require a significant commitment, ethics, skills, compassion, creativity that non-oncology MDs do not understand us in the field of oncology.

And yes, go into medonc/hemonc. I say this even I have mentored a ton of med students and radonc residents...
The job market is bad for radonc, no doubt about it.
No need for radonc job market data (which is very very difficult to obtain accurately), you can smell it in the air...

agreed on job

Some 30 years ago, I considered medonc/hemonc, I matched into internal medicine but finally decided against medonc simple bc in the 1990s, the chemo Tx was toxic. Patients were sick like a dog bc medonc used DTIC, IL-2 for melanoma. MAID chemo for sarcoma.

Now is the opposite, the advances made in medonc/hemonc regarding immunotherapy, immuno-oncology is amazing.
If I am practicing medonc/hemonc now, I will be happy.
The bottom line is: you must like cancer patients, otherwise, don't go into the oncology fields (surgonc, gynonc, medonc, radonc etc.).
Cancer patients require a significant commitment, ethics, skills, compassion, creativity that non-oncology MDs do not understand us in the field of oncology.

And yes, go into medonc/hemonc. I say this even I have mentored a ton of med students and radonc residents...
The job market is bad for radonc, no doubt about it.
No need for radonc job market data (which is very very difficult to obtain accurately), you can smell it in the air...

You can’t be implying that chemo toxicity (and immuno toxicity) doesn’t exist?

I mean I agree with avoiding rad onc right now but one of the reasons Is not less side effects with chemo

 

[90sportsfan]

One of the hottest things in medicine right now is telemedicine's growing role. Can this horse (a supervision saddle is on its back) be put back in the rad onc barn? I can't see anything but a big cratering if not. And that's just one thing I'm thinking of right this sec. What I'm saying is, if you were truly cognizant of all the many headwinds rad onc is facing, there's no way you could consider rad onc and have a board score of ~250. You're smart but information deficient.

I was thinking the same thing. He/she also claiming to have 20+ pubs, mostly all honors, and saying they will be screened out of "all" top IM programs was a little odd too. Something about the original post isn't adding up......

 

[RickyScott]

..., if you were truly cognizant of all the many headwinds rad onc is facing, there's no way you could consider rad onc and have a board score of ~250. You're smart but information deficient.

Very true.