RadOnc Job Market

[Sheldor]

These two papers jibe with my own experiences on the job trail. If you are simply interested in a job, ANY job, then you will have absolutely no problem. It is just that the finding a job in "highly populated metropolitan HSAs of the country" that is challenging.

For what it's worth, MDs and administrators in lesser populated areas of the country are DESPERATE for Radiation Oncologists. I've received some 'informal' offers that involved so much $$$ that they seriously made me consider relocation. But not for long . . .

So if I'm willing to live anywhere, I don't need to spend the next few years sweating bullets?

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[medgator]

So if I'm willing to live anywhere, I don't need to spend the next few years sweating bullets?

Correct. Especially inland, less populated areas

 

[ramsesthenice]

People like me have it nice. I really want a good academic job and I'm going to work hard for it. That being said, my family is all from the Midwest and we would be more than happy and a whole lot richer back home. I have two awsome potential futures in the field I love just ahead of me. It's certainly not all doom and gloom for everyone.

 

[ramsesthenice]

So if I'm willing to live anywhere, I don't need to spend the next few years sweating bullets?

No one should spend five years sweating bullets. You already put at least 4 years of your life on hold for med school. You don't want to put your life on hold anymore than you have to. Play hard, enjoy your training, and you will get somewhere. Likely somewhere you like. May not be your first pick and you may take a pay cut, but you will still be in great shape (unless maybe you were luckey enough to grow up super loaded and have really really high standards).

 

[revaldo]

How competitive are academic clinical appointments (not physician scientist)? I

 

[seper]

I was surprised to find that some "academic clinical" RadOnc positions actually mean straightforward community care without any reserach activity/expectations whatsover. These are usuallly low-paid, less competitive spots.

 

[Gfunk6]

I was surprised to find that some "academic clinical" RadOnc positions actually mean straightforward community care without any reserach activity/expectations whatsover. These are usuallly low-paid, less competitive spots.

Right, these types of positions can either be clinical-educator jobs or in a satellite facility. Both require mainly teaching (although the latter may have NO teaching depending on the proximity of the satellite to the 'mothership').

 

[medgator]

I was surprised to find that some "academic clinical" RadOnc positions actually mean straightforward community care without any reserach activity/expectations whatsover. These are usuallly low-paid, less competitive spots.

If they are community type academic positions (with a private practice feel), they really end up having to pay better in order to compete with the more lucrative private practice jobs

 

[OTN]

Have seen a fair number of these jobs and I'm always left kind of confused about them. They pay you somewhere between academics and private practice and the work varies. Some are essentially private practice with an academic name and none of the real perks of academia which begs the question of why would you do private practice work for an academic salary. On the flip side there are some great satellites where residents rotate out to the center, you teach, and you may even have an academic day, time at the main campus, etc. It seems like some recent grads I know have taken these positions with hopes to move the central center eventually and some comfortable to spend their days at the satellite.

Potential Positives:
- Marketing done by academic institution- easier to get patients, maintain a good service with the academic name behind the institution.
- Salary-based position: Not as much financial risk.
- Residents might be around to do the actual work.
- I'm going to put location availability here as well. In many of the larger cities academic institutions have many of the jobs.
- "Foot in the door" to move to a tenure track position if interested in the future.

Potential Negatives:
- Less pay.
- Less flexibility in treatment protocols (might have to follow departmental regimens for example)
- As with any salaried position with a large organization, less control over departmental decisions (technology, expansion, etc).

 

[Member223232]

Hot off the press....
Hope we dont turn into nuc med or radiology in 3 years....
I feel concerned about the future of rad onc residents entering now.....


http://www.redjournal.org/article/S0360-3016(13)00082-5/fulltext

National Residency Matching Program Results for Radiation Oncology: 2012 Update
Sanjay Aneja, BS, Lynn D. Wilson, MD, MPH, Bruce G. Haffty, MD, James B. Yu, MD
Received 4 January 2013; accepted 12 January 2013.

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Article Outline
National Residency Matching Program
Radiation Oncology Match: 2012
Changing Applicant Strategies
Meeting Increasing Demand for Radiation Therapy
Conclusion
References
Copyright

Radiation oncology remains one of the most competitive specialties to obtain a residency training position. Over the past decade, National Residency Matching Program (NRMP) data have shown sizeable increases in the number of applicants relative to commensurate increases in the number of positions 1, 2, 3, 4, 5, 6, 7. Recent evidence suggests that a 2-fold increase in the residency workforce is needed within 5 years to compensate for increases in demand for radiation therapy services (8). Complicating the supply gap, recent changes in healthcare reform are projected to increase the number of insured patients by almost 32 million (9). Surveillance of the residency workforce data from the NRMP is useful to project future adequacy of the workforce and the continued recruitment of the best applicants.

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National Residency Matching Program
The NRMP data for radiation oncology (2012) are based on data from the NRMP data tables (www.nrmp.org). The NRMP data were selected for this report because they are publicly available and serve as the most accurate means to evaluate and compare trends within the radiation oncology match. There are a few notable caveats to the data. (1) NRMP does not record applicants who do not participate in the NRMP match. (2) In addition to postgraduate year 2 (PGY-2) positions, NMRP classifies combined preliminary medicine and radiation oncology programs as postgraduate year (PGY-1) positions in radiation oncology. (3) The data include information for United States seniors and independent applicants. Independent applicants are defined as previous graduates of United States medical schools or students/graduates of osteopathic medical schools, Canadian medical schools, Fifth Pathway programs, or international medical schools. (4) The data include the total number of applicants who selected radiation oncology as the “only choice,” “first choice,” and “not first choice” of specialty. Moreover, the final total of applicants who participate in the NRMP is less than those who participate in the initial Electronic Residency Application Service (ERAS) process because some applicants are not invited for interviews, decide to pursue another specialty, or both.

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Radiation Oncology Match: 2012
In 1996, 117 United States and international medical graduates participated in the NRMP for radiation oncology for 99 positions at 61 programs. Comparatively, in 2012, 258 United States and international medical graduates participated in the 2012 radiation oncology match for 171 positions and 78 programs (all 78 programs offered PGY-2 positions, and 7 that offered PGY-2 positions as part of the radiation oncology residency also offered PGY-1 positions) (Table 1). There were 3 new radiation oncology programs in the past year, and there was an increase in the number of applicant participants compared with 2011. In 2012, a total of 222 candidates were United States seniors, and 30 were independent applicants. The percentage of United States seniors constituting the applicant pool has increased steadily over the past 5 years, with 86% of 2012 applicants attending a United States medical school. Despite increases in the number of programs, the number of positions remained constant at 171 over the past year. In 2012, a total of 156 positions were offered as PGY-2, and 15 were offered that included a PGY-1.

Table 1. National Residency Matching Program match data comparison
Year 2012 2011 2010 2009 2008 2007 1996
Radiation oncology programs 78 75 72 69 69 66 61
Positions offered 171 171 157 156 144 142 99
Total number of applicants (U.S./IA) 257 225 213 200 196 202 117
U.S. seniors as percentage of applicant pool (%) 86 83 82 84 84 80 60
U.S. seniors as percentage of those who matched (%) 98 94 91 87 92 93 80
Positions filled (%) 99 96 96 92 94 94 72
Ratio of applicants to positions 1.5 1.3 1.4 1.3 1.4 1.4 1.2
Abbreviations: IA = independent applicant; U.S. = United States.

Radiation oncology became markedly more competitive in 2012. Of the 15 available PGY-1 positions, 100% were filled by United States seniors. The match/fill rate for the 156 PGY-2 positions was 99%, with only 1 position left unfilled by the match. A total of 98% of the available positions were filled with United states seniors, which is the highest percentage ever. Of the applicants who designated the specialty of radiation oncology as their only choice, 27% of applicants went unmatched, representing an increase from the 20% of unmatched applicants in 2011. The 7% increase in unmatched applicants is the largest among any field in 2012. Specifically, 15% of United States seniors who only ranked radiation oncology programs were left unmatched—a figure second only to orthopedic surgery at 18%. Additionally, in 2012, programs needed to rank on average 3.3 applicants to fill each residency position, which is significantly fewer compared with the 7.1 ranked applicants required in 1996.

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Changing Applicant Strategies
Unlike previous years, in 2012, radiation oncology did not represent the only specialty choice for the majority of applicants. Radiation oncology represented the only specialty choice for 101 applicants and the first choice among multiple specialties for 146 applicants. This is starkly different from previous years, when the majority of applicants chose to rank only radiation oncology programs (Figure 1). This represents a strategic shift for applicants that may raise concerns regarding new applicants’ dedication to the field. This may represent a growing trend of medical schools recommending that students apply in a second specialty when attempting to obtain a position in radiation oncology rather than reapplying to radiation oncology during the next match cycle in the event they do not match. Radiation oncology leadership must be vigilant about this emerging trend because it may represent the loss of potentially talented applicants interested in radiation oncology.


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Fig. 1
National Residency Matching Program applicant rankings: either radiation oncology alone or multiple specialties in 2010, 2011, and 2012.

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Meeting Increasing Demand for Radiation Therapy
Evaluating the residency workforce has important implications to the future supply of radiation oncologists. Increasing the number of residency training positions serves as the most direct way to address the rising demand for radiation therapy services. According to the NRMP data for the current PGY-1 class (7) and American Board of Radiology data for PGY-2 thru PGY-5 classes (10), there are currently 838 residents in the radiation oncology resident workforce, representing almost no gain from 2011 (837 residents). Without significant increases in the number of training positions, radiation oncologists will face pressure to maintain higher patient volumes and likely rely more on physician assistants and advanced-practice registered nurses to ease the increased clinical burden.

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Conclusion
It remains very competitive to obtain a radiation oncology residency training position in the United States. United States seniors continue to be a large segment of those who apply to, and are eventually accepted by, training programs. The number of radiation oncology residency programs and positions offered has grown steadily over the past 10 years; however, despite current expansions, the supply may not meet the commensurate increases in demand for radiation therapy services. Radiation oncology remains at the forefront of competitive specialties as measured by the percentage of unmatched applicants and the ratio of applicants to positions. Increasing numbers of applicants to radiation oncology are also pursuing other specialties during the match.

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[Gfunk6]

\Recent evidence suggests that a 2-fold increase in the residency workforce is needed within 5 years to compensate for increases in demand for radiation therapy services (8).

Oh, there'll be jobs alright . . . in rural and underserved areas.