I know its impossible to predict the job market in 6 years but is anyone having doubts about entering the field based on the current job prospects? I've talked to a lot of people, who have told me that finding a job in a big city is very, very difficult. What are people's thoughts on this?
Risky to go into Rads?
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What is your definition of risk?
If dropping your income from 300K to 250K is considered risk, if working longer hours or working nights is considered risk, yes it is BIG TIME risk.
On the other hand, if making 250K as a life time intern (called hospitalist) is considered a win situation, go for it and don't risk your life doing radiology.
If dropping your income from 300K to 250K is considered risk, if working longer hours or working nights is considered risk, yes it is BIG TIME risk.
On the other hand, if making 250K as a life time intern (called hospitalist) is considered a win situation, go for it and don't risk your life doing radiology.
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Having read the AM and SDN forums for the last couple years and talking to local groups at my TY recently, I've heard both extremes - from unemployed radiologists all the way to fellows at programs getting jobs in the cities they want (some with multiple offers). I'm not claiming to be an expert by any means and I myself am 4-5 years away from looking for a job, but obviously the market is pretty damn tight currently. However I know of several places that are hiring, albeit they are in academics. Seems like we're moving on the path toward hospital employment like cardiology.
As far as I know the the residents and fellows at my future program (NE academic) haven't had any trouble, but I'm curious to know the specifics of their job hunts.
Anyway, I would still do rads over almost every other medical specialty. And I think as long as you stay realistic and manage your expectations for location and salary, you'll be fine.
As far as I know the the residents and fellows at my future program (NE academic) haven't had any trouble, but I'm curious to know the specifics of their job hunts.
Anyway, I would still do rads over almost every other medical specialty. And I think as long as you stay realistic and manage your expectations for location and salary, you'll be fine.
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Current medical students thinking about radiology won't be looking for jobs until they're fellows, which will be the 2019-20 academic year (current MS4s having already chosen). That's seven years from now. Think about what the job market looked like seven years ago as compared to now. Very few people saw this coming. So, if you're good enough to know what will happen in seven years, then you've picked the wrong field and your talents are wasted in medicine. You need to be working on Wall Street or playing the lottery. You'll end up chasing your tail if you make a choice based on the current market.
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cowme
While true you can't predict 6 years away, it has been nearly 5 years of a job market crisis. I agree that it's most likely a bad blip on the normal ebbs and flows of job markets, but there is a small chance that this is simply the new norm, similar to what we are seeing in the vastly oversaturated law market.
Currently we are at a transition point. Currently the traditional pp radiology is providing the major service. It is hardly struggling not to become hospital employee.
The current pp model is the best gig for senior partners and is horrible deal for junior ones. Practically the junior people are working their ass off with low pay, while senior partners are working 9-5 and maintaining their 500K+ income. In fact, senior partners are the only ones who are fighting against hospital employee position.
The experience with radiology itself and also other groups like cardiology or nephrology, proves that this is a lost battle. If we become hospital employees, we will see a dramatic change in market from all its aspect. Overall, It provides a better (much better) deal for junior people, esp those who will enter the market after the new model is implemented.
In the employment model, the ultimate pay will not be any way near what senior partners are making now, at least for the amount of work and time they put into it. However, it will result in more even distribution of income and work. My best guess is senior partners will retire because of dramatic drop in their salary and also change in their work hours (nights, weekends, ...). For junior ones, it will be better deal. There will be more jobs available as the number of studies you read per day will decrease and you get paid more per study. You will not see the high six figures anymore, but the starting salary will be higher.
The main reason we see tight job market comes from the way pp works. Hiring a newbie to read 200 studies a day and pay him only 30% of what he makes. Or Hiring a newbie to cover the nights and pay him a fraction of what he makes. At the same time the senior partners can crank though normal brain MR in the outpatient imaging center and maintain their 500K+ income without taking any call or doing after hours.
As a person who is in pp, I recommend you not to listen what they say in auntminnie. A lot of them are senior partners who are still enjoying 500K+ income with a relatively cush lifestyle. Going to the employment model which seems inevitable, is a killer for them as it will drop their income. But more importantly they will be in the same position as the juniors (read their slaves). For most of them it is equal to the end of their career. On the other hand, a lot of senior partners do not have any problem advertising bad job market as unintentionally they can convince themselves (and others) that they are even doing a favor to that new guy they hired recently.
The other reason you hear relatively contradictory stories is relatively huge discrepancies between different local job markets. In a lot of big coastal cities the graduates of local academic centers can eventually find a job, but breaking into this market for non local people or those from smaller programs is very very difficult. So, those who left their desirable home towns like Boston or LA for the midwest programs with the hope of coming back after finishing residency, it is a disaster. They have to do 1-2 fellowships in the area to find a job or ...Also the change in market has been so fast that the expectations and facts are not met at all. The market in ophtho is as bad or even worse than us, but those guys had the same market since 90s. We went from a great market to a tight just in 3-4 years.
Bottom line: I would definitely do it again if I were the medical student now. If I were in college, likely I would not do medicine. The pay may be great, but I lost most of my 20s taking tests or staying in hospital. Right now, I make a good money without having enough time to spend it.
The current pp model is the best gig for senior partners and is horrible deal for junior ones. Practically the junior people are working their ass off with low pay, while senior partners are working 9-5 and maintaining their 500K+ income. In fact, senior partners are the only ones who are fighting against hospital employee position.
The experience with radiology itself and also other groups like cardiology or nephrology, proves that this is a lost battle. If we become hospital employees, we will see a dramatic change in market from all its aspect. Overall, It provides a better (much better) deal for junior people, esp those who will enter the market after the new model is implemented.
In the employment model, the ultimate pay will not be any way near what senior partners are making now, at least for the amount of work and time they put into it. However, it will result in more even distribution of income and work. My best guess is senior partners will retire because of dramatic drop in their salary and also change in their work hours (nights, weekends, ...). For junior ones, it will be better deal. There will be more jobs available as the number of studies you read per day will decrease and you get paid more per study. You will not see the high six figures anymore, but the starting salary will be higher.
The main reason we see tight job market comes from the way pp works. Hiring a newbie to read 200 studies a day and pay him only 30% of what he makes. Or Hiring a newbie to cover the nights and pay him a fraction of what he makes. At the same time the senior partners can crank though normal brain MR in the outpatient imaging center and maintain their 500K+ income without taking any call or doing after hours.
As a person who is in pp, I recommend you not to listen what they say in auntminnie. A lot of them are senior partners who are still enjoying 500K+ income with a relatively cush lifestyle. Going to the employment model which seems inevitable, is a killer for them as it will drop their income. But more importantly they will be in the same position as the juniors (read their slaves). For most of them it is equal to the end of their career. On the other hand, a lot of senior partners do not have any problem advertising bad job market as unintentionally they can convince themselves (and others) that they are even doing a favor to that new guy they hired recently.
The other reason you hear relatively contradictory stories is relatively huge discrepancies between different local job markets. In a lot of big coastal cities the graduates of local academic centers can eventually find a job, but breaking into this market for non local people or those from smaller programs is very very difficult. So, those who left their desirable home towns like Boston or LA for the midwest programs with the hope of coming back after finishing residency, it is a disaster. They have to do 1-2 fellowships in the area to find a job or ...Also the change in market has been so fast that the expectations and facts are not met at all. The market in ophtho is as bad or even worse than us, but those guys had the same market since 90s. We went from a great market to a tight just in 3-4 years.
Bottom line: I would definitely do it again if I were the medical student now. If I were in college, likely I would not do medicine. The pay may be great, but I lost most of my 20s taking tests or staying in hospital. Right now, I make a good money without having enough time to spend it.
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Yes, but a lot of that is due to older radiologists delaying retirement because they took such a large hit. I'm venturing to guess that a lot of the people who decided to work into their 70s will eventually want to enjoy retirement at some point. 5 years really isn't that long considering we were on the verge of an economic collapse. Many estimates had recovery being somewhat back to normal by 2018ish anyway.
Regardless, if not living in a major city is considered so detrimental to your life that you would rather be a hospitalist, then have at it. I like big cities, but I much rather live in a 50,000 person town a few hours out and not have to be a hospitalist, which would be sheer misery for me every day of my life at work. The possibility is always there, but the possibility for a lot of specialities getting hosed is there too. I could see midlevels doing a big chunk of a lot of the jobs and decreasing the demands for physicians in multiple areas.
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cowme
We can only blame the hanging on old docs for so long. By now, we should have seen SOME retire and see the market improve partially (rather than get worse). I doubt that every 70+ year old radiologist is colluding to retire en masse the day obamacare goes into effect.
I see this thrown about often as a reason for the crappy market. Logically it makes some sense, but is there any proof of this, or is it based on anecdotes?
Yes, there are SOME seniors who retire, and that is the reason most newbie find a job.
If you know the structure of the pp, you will get surprised.
A lot of senior partners just crank through easy studies, and leave the tough cases for junior ones. Most of them don't cover night. Most of them don't cover evenings. Most of them SELL some of their work to junior ones with lower price. Many of them pick what they want to read. Many only cover outpatient (easier study, most of them MR, most of them normal).
Many groups are hiring the newbies as nighthawk. Many give evening shifts only to new people.
If Obamacare goes into effect, there will not be any reason that a senior partner can do all of these. Oh, you want to work here, you have to cover nights. Oh, you want to work, you have to read the same modalities as others.
If you see the pp, only senior people are against employee model because they can not abuse the newer ones.
A typical pp radiology is where a senior partner makes 2 times what he works for and the junior makes half of what he works for. And forget about discrepancy in work distribution (easier hours, easier modalities, high end modalities, ...)
And the market seems better this year than last year, at least in my area.
Shark, are you an attending? And what region are you in? Big city/small city?
Junior attending in one of the big coastal cities. I make almost half of what partners make and read about 20% more studies, RVU wise. If you consider the complexity of the studies, the modalities (Xray vs US vs Mammo vs MR vs CT), study setting (inpatient vs outpatient, post-op vs outpatient), time spent over phone, running tumor boards, talking with the referring doctors, procedures and ESPECIALLY working hours (nights, evening, weekends), I get paid almost 30% of them per unit work.
For example one of our senior partners reads exclusively MRs. Junior people reads all the X-rays. The most ridiculous thing is when there is a hip arthrogram. Even if the senior guy reads the study, I have to do the arthrogram part which is the time consuming part (talking with the patient, prep, drep, put needle in, inject the contrast and also listen to patient's complaint) and all the RVU goes to the senior person.
Other juniors and I are sent to all the tumor boards and educational meeting with referring docs because they think we are fresh. So we have to make the powerpoint and spend time without getting paid. I understand that this is the critical part of establishing the practice, but traditionally groups considered it as a working time. Unfortunately these days, they just measure RVUs every now and then.
I bet, if we become the hospital employee, these people can not survive. Also the income of juniors will go up with less work and the income of seniors will get a huge cut. In that setting , I will never ever do a hip arthrogram to be read by other person, unless the time spent it is counted as working hours.
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cowme
Shark, aren't you in your first year though? Hasn't this model been the case for first year attendings forever?
Yes and no.
It becomes much better after you become a partner. But even if you become a partner, the story is the same. There are people who are more partner. Partnership track is long these days, sometime 4-5 years.
My point is, the whole partnership system has screwed up the salaries. This is also nothing specific to radiology. But in radiology it has also screwed up the job market. This is also the case in cardiology partnership system. The senior people read all the echos and stress tests, while the newbies has to do all the inpatient work.
Anyway, my point is, if the Obamacare is implemented or even if things just go the way they are going, in the next 2-3 years you may see even tighter market (though this year it is better than last year) but 5-6 years from now, the whole dynamics of pp will change. It will be overall better (much better) deal for newbies. You may not see the high 6 figure incomes in your life, but you will have more jobs available with good pay, more security, less stress and overall a FAIR game.
It becomes much better after you become a partner. But even if you become a partner, the story is the same. There are people who are more partner. Partnership track is long these days, sometime 4-5 years.
My point is, the whole partnership system has screwed up the salaries. This is also nothing specific to radiology. But in radiology it has also screwed up the job market. This is also the case in cardiology partnership system. The senior people read all the echos and stress tests, while the newbies has to do all the inpatient work.
Anyway, my point is, if the Obamacare is implemented or even if things just go the way they are going, in the next 2-3 years you may see even tighter market (though this year it is better than last year) but 5-6 years from now, the whole dynamics of pp will change. It will be overall better (much better) deal for newbies. You may not see the high 6 figure incomes in your life, but you will have more jobs available with good pay, more security, less stress and overall a FAIR game.
Can any residents/fellows comment on the current job market status? Are fellows getting jobs in cities these days? From everything I'm reading on the internet and AM, it seems like jobs are only available in rural areas (i.e. Montana, etc)
There are 1000 graduates every year. If they don't find the job, we should have 4000 thousand jobless people now.
There are still good jobs in big cities. There are groups that are hiring. There are a lot of jobs within 2 hours of big cities. However, most of good jobs go to the graduates of local medical center. For example Boston jobs, at least good ones go to the graduates of local programs. So if someone is trained in DC or NY, he will find it difficult to find a good job in Boston. He should either do 2 fellowships or should take the so called bad jobs.
The definition of good and bad is relative. These people entered market when you could find a day job in Boston without night shift without fellowship even if you were trained in Arizona. Now the same people have to do a a fellowship and also cover nights and evenings for 20% less money. So it looks crappy to them.
The rule of thumb: Most people can find a reasonable job within 80-100 miles of where they live. Everybody can find a job within 1 hour drive if he is willing to work exclusively nights or take less pay or do IR. probably NY is the only exception.
The job market is bad, but no way near what people say. You have to choose two of three among location, hours and money (and type of modality like mammo and IR). So if you want to work in Chicago you can, but you have to take less pay or work more nights.
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How would the job market forecast be if I was interested in living abroad and covering USA nightshifts? I think I read somewhere that Beth Israel has a telemedicine group covering their nightshift (from Israel.....Ex patriots w US MD licenses)...... Any idea if this is a viable option? Or needle in a haystack type of job.
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Right now you can not charge medicare if you read a study outside US territory. As a nighthawk oversees, you can only give a prelim read.
But, more importantly, the way things are going, nighthawk is going to be history in a few year. Even Teleradiology from inside US, despite what people say, did not expand even close to what people expected.
1- More and more groups are doing internal night coverage. At least in big markets, most groups are covering their nights themselves.
2- Night volume is high these days to the point that financially justifies having a radiologist in house. Traditionally there were for example 3 CTs every night. It was not financially reasonable to have in house radiologist. Also consider that traditionally overnight prelims were re-reported in AM. With high volume it is not doable.
3- More and more clinicians are asking for final report in a shorter time. For example a lot of hospitals have turn around time for ED studies (like immediate to half an hour) and inpatients (a few hours like 2-3 hours). One outpatient clinic that we are covering, even asked for the same day read for outpatient studies.
4- There are many clinicians who prefer to know the reporting radiologist. The truth is teleradiology, is a commodity. The radiologist does not care about quality. It is just volume. This has resulted in many problems for clinicians. If you do radiology right, after an even short time you will see a very rewarding nice mutual relationship with most referring doctors. For sure, there are always exceptions and pathologic personalities.
5- In summary, I think oversees telerad is almost obsolete even now. Teleradiology inside US is still surviving, but in the long run it may go away.
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Really? My sister in laws large radiology group has sought out huge telerads contracts and it's one of the few growth parts of the field (according to her). She sees things going to much smaller employed groups of rads for procedures and breast imaging and most everything else sent to corporate imaging centers that do high volume remote reads.
As an outsider, I think you'll see more democracy of salaries between radiologists (as you suggest) but MUCH,MUCH lower salaries overall. Radiology, like pathology, is something that is being reduced to a commodity where it's going to be a race to the bottom for fees and salary unless you are one of the few shareholders who will own the group of employed MD's. The salaries of many people in the field right now have only been maintained through unreproducible productivity gains. Medicare/CMS is on the record that they feel radiology services are overvalued (hint:more cuts on the way) and they've already nipped the loophole for technical services/depreciation of equipment charges that made up a fair share of reimbursement.
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Ultimately, we're all talking about anecdotes here, but mine much more closely mesh with shark2000's than with your sister's.
My impression is that the commoditization pendulum has started to swing back the other way, as evidenced by "take back the night" movements across the country. Medical imaging remains a pillar of healthcare delivery, and - for the foreseeable future - radiologists remain the experts in its acquisition and interpretation. And, unlike most of pathology, our input can and does have a near-real time effect on patient care, and that impact is greatly enhanced by a personal - and even local - relationship between the radiologist and ordering provider. Practices are starting to understand this, even if they are being nudged in that direction by reimbursement cuts.
I'm not saying that teleradiology is dead...just that I think we've reached a plateau. And part of this is a generational issue. For one, I believe newer radiologists will have more realistic expectations of 1) reimbursement and therefore salary as well as 2) the importance of relationships with providers. Secondly, subspecialty training is the new norm. That will put some downward pressure on teleradiology, which currently benefits from offering subspecialty reads in lieu of the local general radiologists.
I can very much see a consolidation of radiology practices, resulting in regional dominance for the sake of 24/7 coverage and subspecialty reads, but the service will still be essentially local in its nature.
Going into radiology is risky with all the information we have right now.
The salaries are falling and will continue for the foreseeable future. There is no floor to how low salaries can go. No one at CMS cares about our how low our salaries are or that spots may not fill for residency.
The job market will remain bad for years to come as we are producing way too many radiologists for the number of available positions and slowing growth of the field. Not to mention all the young attending rads itching to jump into more desirable positions.
The hours and workload increasing as groups try to desperately maintain income. Productivity demands increasing. Litigation risk increasing as a result.
Move away from private practice models. Corporation are taking over more and more private practices. Death of many independent outpatient centers because of drastic government cuts. Hungry young rads joining telerad and corporate outfits because not many private groups are hiring.
Bundling and other obamacare initiatives could cause all radiologists to become totally dependent on the hospital with drastically falling salaries and working conditions.
Radiology is still the same wonderful/interesting field it was 5-10 years ago. But there are many trends in radiology that are very troubling to say the least. It is unlikely that these trends will reverse.
The salaries are falling and will continue for the foreseeable future. There is no floor to how low salaries can go. No one at CMS cares about our how low our salaries are or that spots may not fill for residency.
The job market will remain bad for years to come as we are producing way too many radiologists for the number of available positions and slowing growth of the field. Not to mention all the young attending rads itching to jump into more desirable positions.
The hours and workload increasing as groups try to desperately maintain income. Productivity demands increasing. Litigation risk increasing as a result.
Move away from private practice models. Corporation are taking over more and more private practices. Death of many independent outpatient centers because of drastic government cuts. Hungry young rads joining telerad and corporate outfits because not many private groups are hiring.
Bundling and other obamacare initiatives could cause all radiologists to become totally dependent on the hospital with drastically falling salaries and working conditions.
Radiology is still the same wonderful/interesting field it was 5-10 years ago. But there are many trends in radiology that are very troubling to say the least. It is unlikely that these trends will reverse.
Who let a plastic surgeon in? Go and change the size of boobs and *****es.
Radiology is different form changing the size of people fat distribution. It is about life and death decisions, it is about diagnosing cancer versus FNH in liver, it is about dominating the trauma service when all the trauma surgeons are looking at the small liver laceration and you tell them "hay guys, you did not see the spinal cord transection, that is more important " and they rush into the phone to call NS.
I'd rather work as a cab driver than dealing with body dysmorphic disorder patients day and night.Though I don't care about pathology, but next time that your mom gets a breast biopsy, think in your mind whether radiology or pathology are commodity or not.
When a plastic surgery attending is reading the radiology forum and then jumps in with great excitement feeling happy that a radiology group lost its contrast or the salaries are going down, I am confident that he made a mistake in choosing specialty 10 years ago.
Though it is not easy, you can always switch and do a second residency. You can do 5 years of radiology and be happy the rest of your life rather than hating your job, reading radiology forums the rest of your life and envy the position of radiology as it is becoming more and more central to the patient care.
Thanks god that our salaries are a bit down, so all these jealous people from surgery to medicine to Gyn who are miserable in their jobs, at least feel a little relieved.
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Technologically advanced, objective diagnosis is the future of medicine... I. E. A scan that tells the doctor what is wrong with the patient. Treatment is easy, so to speak, if you know the problem... The physical exam is dying. Are primary care docs and NPs/PAs even taught the physical exam anymore? It Is too subjective most of the time. Hopefully, Radiologists can continue to provide value and continue to play their role as gate keepers of this objective diagnosis.
