Radiation therapy research as a clinical physicist vs. RadOnc

[jsydc]

Hi,

I'm currently a M.Sc. student in Medical Physics who is applying as an MD-PhD this year. My master's program was very heavily based in clinical work in radiation oncology physics, and most of my graduating peers have successfully obtained either clinical physics residencies or junior physicist positions, or are continuing on to a PhD prior to planning a similar course.

The general consensus from clinical physicists I speak with is that I'm crazy to go into medicine as I can already achieve a good balance of research and clinical work as a physicist, without subjecting myself to many additional years of slave labor. Based on average wages in Canada I won't break even on the whole MD-PhD route vs. clinical physics route until the age of 42.

From a radonc's perspective, if you want to have a strong research focus, is it better to take the Physics route or Medicine route? Do you feel more interesting research is coming out of your Physics Department or from the oncologists in your hospital? (Obviously it's not completely separate, but I assume you have some perspective of who's more involved in some aspects than others.)

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[3dtp]

Hi,

I'm currently a M.Sc. student in Medical Physics who is applying as an MD-PhD this year. My master's program was very heavily based in clinical work in radiation oncology physics, and most of my graduating peers have successfully obtained either clinical physics residencies or junior physicist positions, or are continuing on to a PhD prior to planning a similar course.

The general consensus from clinical physicists I speak with is that I'm crazy to go into medicine as I can already achieve a good balance of research and clinical work as a physicist, without subjecting myself to many additional years of slave labor. Based on average wages in Canada I won't break even on the whole MD-PhD route vs. clinical physics route until the age of 42.

From a radonc's perspective, if you want to have a strong research focus, is it better to take the Physics route or Medicine route? Do you feel more interesting research is coming out of your Physics Department or from the oncologists in your hospital? (Obviously it's not completely separate, but I assume you have some perspective of who's more involved in some aspects than others.)

In the right environment you can do this from either position. I come to the field as a medical physicist and did a lot of early dosimetry research and particle research in medical physics. On the clinical side, there is also abundant opportunities to do research as well, both in laboratory and in clinical applications. Whether the research is driven by physics or clinical medicine is highly dependent on the institution. Michigan, for example, had a highly integrated clinical/physics research program for a long time. MDACC is much more clinical trials/outcomes oriented. Depends on the institution and where you want to hang your hat.

But, if you go the MD route, make sure you are fully aware that it is a very long and at times arduous process for which you will be underpaid, underappreciated and occasionally overwhelmed. Not to discourage you, but you should go into this with your eyes wide open. To be really successful in clinical radiation oncology, you have to have a passion for the field, and for the patients who will depend on you.

The physicists are right. You have to be crazy, but then, being crazy has its own rewards.

 

[stephew]

I think you have to ask yourself what you want to do. Do you want to be a doctor? If you aren't thinking along the lines of seeing patients-and frankly you didnt mention that fundamental facet of being an MD (even with a research bent)- then perhaps you shouldnt be spending the time and money to do that. Would you be happier as a PhD of one flavor or another?

 

[jsydc]

I think you have to ask yourself what you want to do. Do you want to be a doctor? If you aren't thinking along the lines of seeing patients-and frankly you didnt mention that fundamental facet of being an MD (even with a research bent)- then perhaps you shouldnt be spending the time and money to do that. Would you be happier as a PhD of one flavor or another?

I'm very dedicated to being involved in patient care and having a career with a strong degree of patient contact, which I think is the major aspect that is missing in clinical medical physics for me as a career. Still, as I only applied to one MD-PhD program this year, and am awaiting the results of my interviews which should come next week, I'm contemplating taking more time to explore a medical physics career before making a broader application in future years should I not get in. Especially as it would give me more financial flexibility to get through further education. Before doing this, I thought I'd see what radoncs thought about research opportunities in one career vs. the other, and how satisfied they are with the research component of their work.

 

[stephew]

I'm very dedicated to being involved in patient care and having a career with a strong degree of patient contact, which I think is the major aspect that is missing in clinical medical physics for me as a career. Still, as I only applied to one MD-PhD program this year, and am awaiting the results of my interviews which should come next week, I'm contemplating taking more time to explore a medical physics career before making a broader application in future years should I not get in. Especially as it would give me more financial flexibility to get through further education. Before doing this, I thought I'd see what radoncs thought about research opportunities in one career vs. the other, and how satisfied they are with the research component of their work.

So i think that is the crux of it- or at least the first question. Do you want a career that seriously involves patient care? If yes, then you go onto the next part of the question- is it worth it to really make this big step in the big picture for you personally.

Having said that, radonc has a pretty healthy research base if that's your buzz. Ill let others chime in on more specifics that might be pertinant to you.

 

[radonc]

i agree with steph...the first thing you need to determine is if you want to care for patients...

also, if you have an interest in physics, you do not need to pursue a phd if you are going to medical school...with your interest, MSc and your MD you will have a strong background in radiation physics...and put you ahead of a lot of other MD's...and it will shave at least 3 years off the length of time...you can also try to pursue the Holman pathway, which allows for 21 months of dedicated research time to pursue your research interests...

that being said, being an MD/PhD may put you at a distinct advantage over those with just MD's or PhD's in terms of funding / academic concerns...

 

[MacGyver]

physicists I speak with is that I'm crazy to go into medicine as I can already achieve a good balance of research and clinical work as a physicist, without subjecting myself to many additional years of slave labor.

WTF? Are you telling me that physicists can bill Medicare and insurance companies for radiation therapies just like a rad onc MD can?

 

[radiaterMike]

WTF? Are you telling me that physicists can bill Medicare and insurance companies for radiation therapies just like a rad onc MD can?

Ummm- first of all, the poster never mentioned billing. Secondly, there is no Medicare and not many health insurance companies in Canada. Thirdly, there are physics components to treatment billing.

 

[MacGyver]

Ummm- first of all, the poster never mentioned billing. Secondly, there is no Medicare and not many health insurance companies in Canada. Thirdly, there are physics components to treatment billing.

Please forgive me. When somebody uses the term "clinical work" I take that to mean formulating radiation treatment plans, treating patients, and being reimbursed appropriately. Silly me.

 

[radonc]

for a physicist, thats as clinical as it comes...

 

[120300]

i agree with steph...the first thing you need to determine is if you want to care for patients...

also, if you have an interest in physics, you do not need to pursue a phd if you are going to medical school...with your interest, MSc and your MD you will have a strong background in radiation physics...and put you ahead of a lot of other MD's...and it will shave at least 3 years off the length of time...you can also try to pursue the Holman pathway, which allows for 21 months of dedicated research time to pursue your research interests...

that being said, being an MD/PhD may put you at a distinct advantage over those with just MD's or PhD's in terms of funding / academic concerns...

I agree with above. And I would say skip the Ph.D.

I went to medical school straight out of a MS program in medical physics (after working for several years before that). I have my own reasons for becoming a physician and not staying a physicist, some more important than others. I did not like the feeling of being there for the physician or for the equipment, and not for the patient. I understand that that this sentiment may be too narrow-minded, because the physicist's work ultimately benefits the patient, but that was my feeling nonetheless.

If you do end up deciding to go to med school for the express purpose of becoming a radiation oncologist that's fine. But in my opinion, one of the greatest things about becoming a physician is that you have a wide range of careers at your disposal. If you want to be a surgeon, pediatrician, radiologist, ophthalmologist, pathologist, etc. it is all there for you once you start med school. Don't fly through med school without exploring this flexibility. (kinda preachy, but so what)

 

[jsydc]

cbay

Thanks for the post. a lot of your sentiments reflect many of my concerns about working as a physicist. Although this isn't the place where I'll get strong counterarguments from a physicists perspective.
I'm far from 100% set on radonc, and part of my motivation for the PhD component is that I have an amazing project lined up with my current lab that speaks to a lot of my interests. While I'm not sure what balance I want to strike between academic research and medicine, I know radonc is a fascinating field that appeals to me both in it's technical challenges and the nature of the patient interaction. I'm also interested in maintaining a research component in medical practice, and I wanted to see how radonc's feel about their opportunities to do so. I guess coming in with physics training already opens a lot of doors for this.

Kind of a convoluted question to ask, but at least it's reassuring to know that other people have taken this route before, and are positive about the options. I'll probably get more out of talking with some radoncs I know locally to get a better perspective, as it's a somewhat different game in Canada vs. the US, and I'd prefer to stay here if I can.