Rad Onc vs. Heme/Onc

[uchihastan]

Hi everyone. I'm an M3 and up until last summer, I was fully decided on Heme/Onc. I shadowed RadOnc for a day and loved it and am now doing it as my elective (my first rotation). I keep hearing about concerns regarding the field i.e. job openings, compensation changes, etc. and I'd love to hear from you all about how you are navigating this/how much of a concern it really is. I am heavily considering RadOnc and doubting Heme/Onc especially because I am not sure I want to do IM residency. Sorry if this topic has already been discussed, I haven't used this forum in years. Thanks!

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[OTN]

If you have a geographic preference go with Heme/Onc.

 

[CurbYourExpectations]

Best field in medicine, I think most people here will tell you that. I don't have a crystal ball, but will try to help, at the end of the day you should do whatever makes you happiest.

The field is mostly saturated in large cities and not so large cities, with projections and discussion that it might get worse by the time you start practicing in the mid 2030s.

workforce paper:

DEFINE_ME

There is also a very strong push from some people to allow for most of the radiation care to be able to be done virtually. This will likely be very bad for young doctors if it becomes mainstream.

Some good discussions on stuff from Simul:

We Should Not Be Routinely Doing Telemed For Radiation Weekly Management

Simul was wrong. First time since '09

radiationeconomics.substack.com

Underemployment In Radiation Oncology

Business is not booming for many of us

radiationeconomics.substack.com

On the other hand there may be increases in benign treatments, however most people that want to go into an oncological field do it because they want to treat cancer patients. If you don't have any ties to locations, it might be fine. Idk what I would do in your shoes personally. You should reach out to some local RadOncs and discuss it more.

 

[Gfunk6]

Hi everyone. I'm an M3 and up until last summer, I was fully decided on Heme/Onc. I shadowed RadOnc for a day and loved it and am now doing it as my elective (my first rotation). I keep hearing about concerns regarding the field i.e. job openings, compensation changes, etc. and I'd love to hear from you all about how you are navigating this/how much of a concern it really is. I am heavily considering RadOnc and doubting Heme/Onc especially because I am not sure I want to do IM residency. Sorry if this topic has already been discussed, I haven't used this forum in years. Thanks!

It's not a concern at all, Rad Onc is great! Our esteemed professional society which is universally resepcted and revered put out a Workforce Survey recently assuring us that everything was dandy. Some of the people on this forum can get a little "Alex Jones" with their persecutorial complex.

Given how great the state of the field is and how bright the future is for all, this topic has been very rarely discussed on this forum. In fact, I had to do quite a bit of sleuthing to pull these threads for your reading pleasure.

Good luck and I look forward to welcoming you as a future colleague.

I'm doing all right

gettin' good grades

The future's so bright

I've gotta wear shades!

 

[MifflinDunder]

Depends on your priorities. Make sure not to pick heme-onc for lifestyle because it is not.

 

[StIGMA]

Heme/onc is more exciting with new therapies every year/rapid advancement of therapies. You have more availability to get involved with clinical trials if thats your thing. If you love molecular targets, omics technologies, etc, theres no comparison in how often that is used in med onc vs rad onc.

Rad onc is more like surgery where the techniques are what they are with small changes for each case, much more anatomically based. Major practice changes are very slow to implement and often involve less indications for radiation.

You will probably like intern year/medicine more than you expect since you are beginning to make some management decisions and have more competence. Dont let that be the main decision factor. Spend a lot more time with each specialty especially with people in their first 5yrs or so.

 

[Tigerstang]

If I could do it all over again I would have been a heme/onc, opened my own practice, sold to a larger company like McKesson, and retired before 40.

 

[uchihastan]

It's not a concern at all, Rad Onc is great! Our esteemed professional society which is universally resepcted and revered put out a Workforce Survey recently assuring us that everything was dandy. Some of the people on this forum can get a little "Alex Jones" with their persecutorial complex.

Given how great the state of the field is and how bright the future is for all, this topic has been very rarely discussed on this forum. In fact, I had to do quite a bit of sleuthing to pull these threads for your reading pleasure.

Good luck and I look forward to welcoming you as a future colleague.

I'm doing all right

gettin' good grades

The future's so bright

I've gotta wear shades!

Darn, I appreciate your honesty! I was chatting with a PD at my institution and they mentioned that they want to get more ppl interested in the specialty. I was hopeful that was a good sign but it appears not. I'll keep thinking about it and will factor your input into my decision. Thank you again!!

 

[uchihastan]

Depends on your priorities. Make sure not to pick heme-onc for lifestyle because it is not.

Fair! Could you please expand on the reasons why heme-onc isn't considered lifestyle? Is it due to being on call and never really "off" work in that respect or are there additional reasons? Please forgive my ignorance! Thanks so much.

 

[StIGMA]

Darn, I appreciate your sarcasm!

FTFY

 

[uchihastan]

FTFY

fair, although mine was a bit of sarcasm too😂 i can see many are frustrated with where the field seems to be heading so i don't take it personally!

 

[yesmaster]

a PD at my institution and they mentioned that they want to get more ppl interested in the specialty. I was hopeful that was a good sign

Why would this be a good sign?

I have a meme coin called $yesmaster that I’d like to sell you by the way

 

[yesmaster]

There’s ways to structure heme onc so it’s more of a lifestyle job

 

[uchihastan]

Why would this be a good sign?

I have a meme coin called $yesmaster that I’d like to sell you by the way

a good sign in the sense that they would be getting people interested in the specialty because the field is doing well as a whole. i think many of us students don't consider rad onc because we don't get much exposure to it without showing some initiative. that's one reason i didn't consider it. i didn't even know about the concerns for its future until about a month ago

 

[uchihastan]

There’s ways to structure heme onc so it’s more of a lifestyle job

i see, i'm glad that there is flexibility so thank you for saying that!

 

[CurbYourExpectations]

I think there are more applicants now than there have been in the past, whether that's a good thing, idk

 

[radiation]

As an MS3, you would not start your job search for another 7 years. Cancer drug prices are the highest they have ever been, spending on cancer drugs pricing are the highest they have ever been, and heme/onc salaries are the highest they have ever been. We also have an administration that is aggressively looking cut costs. I personally am not sure which field will have more uncertainty in 7 years

 

[MifflinDunder]

Fair! Could you please expand on the reasons why heme-onc isn't considered lifestyle? Is it due to being on call and never really "off" work in that respect or are there additional reasons? Please forgive my ignorance! Thanks so much.

All those and you’re the primary oncologist which will feel like being a pcp. You’ll be notified of every thing that happens to your patient, by the patient themselves, nurses, or other doctors. Notes and charting burden will likely also be much worse in heme-onc compared to rad onc. I’m a fellow. Many of my attendings never turn their EMR availability off and work on their notes late into the night and in the weekends.

 

[medgator]

Darn, I appreciate your honesty! I was chatting with a PD at my institution and they mentioned that they want to get more ppl interested in the specialty. I was hopeful that was a good sign but it appears not. I'll keep thinking about it and will factor your input into my decision. Thank you again!!

They didn't need to do that a decade or two ago when it was a very competitive specialty to match into

Ask yourself why that's the case now