RadOnc Posts >99% Match Rate for US Seniors (Highest of Any Specialty)

efle

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The new Charting Outcomes document for 2020 is out, and shows that RadOnc had the highest match rate of any specialty for US MD Seniors, with 112/113 applicants finding a match last year. The 1 individual failing to match was AOA with 250+ boards, but ranked only 5 programs.

RadOnc Match Rate.PNG
RadOncThen.PNG
From lurking this board it sounds like this comes as a surprise to nobody. But for the sake of posterity, worth capturing in the data that RadOnc went from one of the most competitive specialties in the 2000s, to having effectively a 100% match rate for any interested US MD in 2020.

I'm far from well-informed about why this happened (and happened so fast), so anyone who can succinctly summarize, I'm sure many future visitors will benefit from your recap.
 
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It's pretty simple, word finally got out to the medical students that residents are having to talk to 50-100 places throughout the country to secure 1-2 job offers.

RadOnc.jpg

What this really tells me is that 113 students think they're special and can beat the odds.
 
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StIGMA

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That's drop-off-the-cliff senior MD applicant numbers (30% decrease from 4 years ago; in context of increasing total positions offered). I didn't realize it was that severe of a decrease.
 
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scarbrtj

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The new Charting Outcomes document for 2020 is out, and shows that RadOnc had the highest match rate of any specialty for US MD Seniors, with 112/113 applicants finding a match last year. The 1 individual failing to match was AOA with 250+ boards, but ranked only 5 programs.

From lurking this board it sounds like this comes as a surprise to nobody. But for the sake of posterity, worth capturing in the data that RadOnc went from one of the most competitive specialties in the 2000s, to having effectively a 100% match rate for any interested US MD in 2020.

I'm far from well-informed about why this happened (and happened so fast), so anyone who can succinctly summarize, I'm sure many future visitors will benefit from your recap.
Rad onc: one of the smallest fields in medicine. Which means it is highly sensitive to what would be more drawn out and less tumultuous perturbative effects within the specialty, vis-à-vis supply/demand, versus that of other fields. Things began looking a little over-supplied around 2010-13. So really we have just had ~7 cycles of new rad onc residency cohorts, and new rad onc grads, in that time frame. There were ~3500 rad oncs nationally in 2010 and there are ~5000-5200 now; this growth has not been offset by rising cancer incidence/prevalence, or increase in new rad onc indications. If anything, the opposite on both counts. And, resident numbers exploded (relative to previous class sizes and the number of rad oncs in America) in that period. Also, practice patterns in rad onc substantially changed (patient treatment schedules have substantially shortened). What HAS NOT been fully "baked into the market" yet is: 1) patient treatment schedules have not maximally shortened yet and their national adoption has been weak (NB: even at academic centers)... once fully adopted this will hurt the workforce market more, 2) trend toward decreased "supervision" (historically a rad onc had to mindlessly "babysit" machines with no active oversight/effort by the MD for the treatment... regulators are beginning to see this as needless), 3) reimbursement pressures which will take the form of one lump sum payment for a diagnosis somewhat irrespective of complexity/length of treatment/mode of irradiation.

An interesting book could be written about it all IMHO.
 
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Moreover, academicians in charge of the Economy of Residents are disinclined to curb the cheap labor force they have created:

1596400043875.png

Hiding behind cries of "we can't cut spots 'cuz of antitrust laws" or "if you want to cut spots it means you hate patients".

Fortunately, it appears medical students are capable of basic math and realized a 127% increase in RadOnc residents without a 127% increase in need - or really any increase in need - is bad if they want to be employed after training.
 
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Moreover, academicians in charge of the Economy of Residents are disinclined to curb the cheap labor force they have created:

View attachment 314764

Hiding behind cries of "we can't cut spots 'cuz of antitrust laws" or "if you want to cut spots it means you hate patients".

Fortunately, it appears medical students are capable of basic math and realized a 127% increase in RadOnc residents without a 127% increase in need - or really any increase in need - is bad if they want to be employed after training.
"Focuses on the life of the doctor, not the patient?" Why does this dumb motherf<cker think one is independent of the other?
 
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The good news is that about 50% of med students know enough to stay away from this dumpster fire. Good for them.

Guess that explains why there has been so much out reach from the academic folks on twitter ect... to try and rush up applicants lately.
 
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"Focuses on the life of the doctor, not the patient?" Why does this dumb motherf<cker think one is independent of the other?

I honestly wish I could understand why he thinks this way. It's intellectually cheap and dishonest. A doctor is going to perform their best when they've been well trained, feel supported, and are not concerned that the rug is going to be pulled out from under them in terms of their ability to practice. An unhealthy RadOnc job market/labor force puts everyone at risk - especially in states without a Certificate of Need, s/p APM implementation when people are going to fight tooth and nail to have enough patients on-beam to break even. If you flood the market and drive away talented medical students, eventually you're left with a glut of folks who were unable to Match elsewhere - oh wait, sorry, per KO - a glut of "compassionate folks who love Radiation Oncology".
 
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View attachment 314764

Hiding behind cries of "we can't cut spots 'cuz of antitrust laws" or "if you want to cut spots it means you hate patients".

Fortunately, it appears medical students are capable of basic math and realized a 127% increase in RadOnc residents without a 127% increase in need - or really any increase in need - is bad if they want to be employed after training.
[/QUOTE]

The guy is such an academic stooge. Goldilocks number, I mean really.
 
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Would it be possible to put a consortium of practices that don’t need to hire people in the next 4 years? We can’t control the number of spots but if enough people realize “hey almost everyone in this specialty doesn’t need me” then maybe it would further deter the over expansion of the specialty. Obviously there is no guarantee there would not be some unexpected hiring however I would definitely be willing to put up money betting our practice does not need a new physician. Our specialty is small enough that we could easily track each other. Thoughts?

All of the “anti-trust” lies seems to have quieted down as some of the leaders have now openly contracted their programs. This may be a way to strengthen the momentum for places to contract.
 
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efle

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Will a lack of US MD seniors cause some reduction in residency slots? Or will the number of spots remain and just have increasing IMG matches to make up for the difference?
 
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GapCalc

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Will a lack of US MD seniors cause some reduction in residency slots? Or will the number of spots remain and just have increasing IMG matches to make up for the difference?

That's the big question. I believe most on this discussion board will predict that the majority of programs do not close/contract in a permanent fashion. We'll become Pathology, or maybe we already have...
 
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medgator

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The way US MD seniors will know the dumpster fire known as the specialty of radiation oncology is safe to match into again is when we see spots back down to 80-120 or so. Lot of ground to catch up and PDs are finally starting to come around post covid given what they are likely seeing with their graduating seniors this year
 
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That's the big question. I believe most on this discussion board will predict that the majority of programs do not close/contract in a permanent fashion. We'll become Pathology, or maybe we already have...
Believe we will have some token closings but this is not just about residency overexpansion but decreased utlization, and I doubt there is much we can do about that. After the apm is instituted, there will be a true disaster.
 
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efle

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The way US MD seniors will know the dumpster fire known as the specialty of radiation oncology is safe to match into again is when we see spots back down to 80-120 or so. Lot of ground to catch up and PDs are finally starting to come around post covid given what they are likely seeing with their graduating seniors this year
Was radonc hit hard by COVID? Would have thought their patients/treatments would be mostly non-elective
 
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I honestly wish I could understand why he thinks this way. It's intellectually cheap and dishonest. A doctor is going to perform their best when they've been well trained, feel supported, and are not concerned that the rug is going to be pulled out from under them in terms of their ability to practice. An unhealthy RadOnc job market/labor force puts everyone at risk - especially in states without a Certificate of Need, s/p APM implementation when people are going to fight tooth and nail to have enough patients on-beam to break even. If you flood the market and drive away talented medical students, eventually you're left with a glut of folks who were unable to Match elsewhere - oh wait, sorry, per KO - a glut of "compassionate folks who love Radiation Oncology".

It seems like an admission from a pd that this discussion about the health of our specialty isn't actually important.
 

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It seems like an admission from a pd that this discussion about the health of our specialty isn't actually important.
who knows what sort of cognitive dissonance is raging in his mind. Don’t pts also deserve well trained competent primary care docs? Removing someone from that pool and giving them 4+years of training in an oversupplied specialty?
 
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medgator

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Was radonc hit hard by COVID? Would have thought their patients/treatments would be mostly non-elective
Elective surgeries/colonoscopies/mammo/screenings were though. Plus many are adopting more hypo-fractionated courses of treatment during the Pandemic to get patients finished quicker, which allows existing docs to treat more patients, thereby reducing demand if numbers remain static.

Edit: hiring freezes by many hospitals also where more and more of the rad onc jobs are located.

Think of getting a good job in rad onc right now in a tolerable location as being analogous to winning the hunger games as it was never an easy proposition in the best of times a decade ago
 
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Was radonc hit hard by COVID? Would have thought their patients/treatments would be mostly non-elective

In brief, RadOnc has always been a tight job market, made exponentially worse over the last decade by unchecked oversupply.

Obviously, with COVID, many institutions and departments lost revenue, and went into hiring freezes. This has essentially locked up the academic job market for us at this time. We're being told things may open back up in the Fall/Winter, but...COVID obviously isn't under control, and no one can really say what will happen. Other hospitals/multi-specialty groups can and will choose to limp along with the staff they have if they can get away with it.

Really, we were/are on a razor's edge for jobs for new grads - a global pandemic was the push we didn't need, even though patient volumes weren't hit as hard as say, Optho. In a tight market with less elasticity, this means that 2021 grads forced into positions they don't want will likely cut into the job market for 2022 new grads - except now they'll have a year of attending experience and be board certified. Practices will be able to get these folks at a similar price with less risk. This will just snowball and repeat year after year, especially since we have 1,000 more shiny new Radiation Oncologists currently in the training pipeline.

So...hopefully less than 113 US MD Seniors apply this year...or maybe some people just want to waste their life training for a job they can't get?
 
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Gfunk6

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It’s only one person's experience, but I have had at least triple the usual number of unsolicited inquires from senior residents about a job this year. Plus the requests are coming in much earlier than usual, at the very start of PGY-5 (e.g. one year in advance of graduation). I'm curious if others in positions to hire have noticed the same?
 
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medgator

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It’s only one person's experience, but I have had at least triple the usual number of unsolicited inquires from senior residents about a job this year. Plus the requests are coming in much earlier than usual, at the very start of PGY-5 (e.g. one year in advance of graduation). I'm curious if others in positions to hire have noticed the same?
Ditto. More frequent the last 2-3 years
 
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I'm curious if others in positions to hire have noticed the same?

I'm not in charge of hiring, but my practice has had a ton of interest much, much earlier than usual.... like end of PGY4 interest. We're fortunate to have excellent candidates applying. I can't help but feel like it's musical chairs with fewer spots and more applicants. When the music stops... well, you can always retrain in IM if you did PGY1 as a prelim medicine intern, right?

I also had a chance to look at the NRMP Charting Outcomes document and aside from feeling like a chump for working so hard to get this job I love, I can't help but feel bad for the guy/gal who didn't match. With n=1, this document is really calling someone out hard.

5 ranks, 3 specialties, AOA, Step 1 256, Step 2 260, AOA... yikes.
 
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It’s only one person's experience, but I have had at least triple the usual number of unsolicited inquires from senior residents about a job this year. Plus the requests are coming in much earlier than usual, at the very start of PGY-5 (e.g. one year in advance of graduation). I'm curious if others in positions to hire have noticed the same?

Yep for sure, getting people of all years 2-5 really.
 

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It really is amazing how far we have fallen. We went from be lucky if you match ANYWHERE to anybody with a pulse walking on. numerous new programs in the works. We are the new path. Pay attention folks!
 
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RickyScott

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It really is amazing how far we have fallen. We went from be lucky if you match ANYWHERE to anybody with a pulse walking on. numerous new programs in the works. We are the new path. Pay attention folks!
Troubling when I see tweeters discuss what to look for in a candidate: humanism, research, overcome hardship etc or all the of the above? How about a pulse and no criminal record.
 
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efle

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I also had a chance to look at the NRMP Charting Outcomes document and aside from feeling like a chump for working so hard to get this job I love, I can't help but feel bad for the guy/gal who didn't match. With n=1, this document is really calling someone out hard.

5 ranks, 3 specialties, AOA, Step 1 256, Step 2 260, AOA... yikes.
My guess is something very unique, like they were trying to match one of several specialties at a specific academic hospital or two that were the only options in the city their SO is training in.

Edit: Someone PMed me deets and yes it was a very odd situation and they weren't a traditional radonc applicant. Count this year's match rate as 112/112
 
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metallica81788

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Rad onc: one of the smallest fields in medicine. Which means it is highly sensitive to what would be more drawn out and less tumultuous perturbative effects within the specialty, vis-à-vis supply/demand, versus that of other fields. Things began looking a little over-supplied around 2010-13. So really we have just had ~7 cycles of new rad onc residency cohorts, and new rad onc grads, in that time frame. There were ~3500 rad oncs nationally in 2010 and there are ~5000-5200 now; this growth has not been offset by rising cancer incidence/prevalence, or increase in new rad onc indications. If anything, the opposite on both counts. And, resident numbers exploded (relative to previous class sizes and the number of rad oncs in America) in that period. Also, practice patterns in rad onc substantially changed (patient treatment schedules have substantially shortened). What HAS NOT been fully "baked into the market" yet is: 1) patient treatment schedules have not maximally shortened yet and their national adoption has been weak (NB: even at academic centers)... once fully adopted this will hurt the workforce market more, 2) trend toward decreased "supervision" (historically a rad onc had to mindlessly "babysit" machines with no active oversight/effort by the MD for the treatment... regulators are beginning to see this as needless), 3) reimbursement pressures which will take the form of one lump sum payment for a diagnosis somewhat irrespective of complexity/length of treatment/mode of irradiation.

An interesting book could be written about it all IMHO.

You need to take this and your previously posted graph to RadOnc Twitter and post it daily. Maybe then everyone will get the picture.
 
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Neuronix

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You need to take this and your previously posted graph to RadOnc Twitter and post it daily. Maybe then everyone will get the picture.

Do one better. Publish it. Offer it up on Twitter that you are willing to collaborate with some people in academics. I wonder who would take that on. Send it straight over to the red journal once you polish it. I am really curious who would want to work with you and what will happen.
 
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scarbrtj

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Do one better. Publish it. Offer it up on Twitter that you are willing to collaborate with some people in academics. I wonder who would take that on. Send it straight over to the red journal once you polish it. I am really curious who would want to work with you and what will happen.
I am working on it.
 
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scarbrtj

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For those keeping score at home, I count ~28 general RadOnc jobs on ASTRO right now (non-fellowship, American, non-director) out of the ~980 total jobs posted.

This felt like the right place to make that statement.
Used to be that the responses we’d get when posting observations like this were similar to the responses Galileo would get when he’d report what he’d seen in his telescope.
 
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It’s only one person's experience, but I have had at least triple the usual number of unsolicited inquires from senior residents about a job this year. Plus the requests are coming in much earlier than usual, at the very start of PGY-5 (e.g. one year in advance of graduation). I'm curious if others in positions to hire have noticed the same?

Also not in charge of the hiring; but the number of folks who are contacting us is also higher than normal. Not sure if it's tripled though.
 

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