So I matched...and I need to know how to get out of it.

[deleted18755]

---

Members don't see this ad.

OP: you aren't alone.

I am a MD/PhD grad that recently matched into rad onc, at a program at the bottom of my rank list. Like OP, I was aspiring to be a physician scientist (wanted to apply for the Holman pathway, run a lab some day). I don't want to openly critical of this program, but I do know that, at least locally, the program has a very poor reputation. I had multiple rad oncs in nearby places tell me they were shocked that the program was still taking applicants and they are deficient in multiple clinical sites. (Yes, I realize I may have gone unmatched if I didn't match into this program, I have no one to blame but myself, etc.) But at the program where I matched, there are unfortunately no faculty involved in basic science research and no support for residents who have those interests. I think that my match placement will hurt those goals, and ultimately my career.

So, sure, I am shocked/disappointed by my match placement, and just like OP, I hope to eventually get over this and fulfill my obligation. But even after getting over it, how badly have I hurt my career goals? After all, from reading this forum, sounds like grads from bottom-tier residencies are lucky to find a job at all, let alone find a physician scientist position at a major academic center. Does anyone graduating from a bottom-tier program have any experience applying for academic jobs? Any advice is appreciated, Thanks

Actually, does anyone from a top-tier program have any experience applying for true academic jobs? I'm being serious here. I know radiation oncology matches a very high proportion of MD/PhD's but at least the vast majority that I met (which might be a biased selection, which is why I am honestly asking) just end up going into private practice or the same clinically oriented "academic" job that their PhD-less colleagues have. Do even MD/PhD's from MSKCC, Harvard, MCACC get funding and run labs? If not then what's the point of wasting all of the time and money (student and society) on the PhD and might as well be honest?

 

[maruchan]

If you want to do bench research for a career, going into radiation oncology at all is one of the most horrible decisions you can make. The chance of a physician scientist career is miniscule even at a top 3 program, and essentially zero otherwise.

If you want to go into academics / clinical research, it's still a pretty bad decision. Academic jobs exist, but you are way more likely to make an academic career in med onc. This is not saying that academic jobs in med onc are a cakewalk to find, but compared to rad onc you will have way, way more options.

 

[deleted103644]

Think it’s a good idea to put this here (from NRMP contract):

5.1 Match Commitment

The listing of an applicant by a program on its certified rank order list or of a program by an applicant on the applicant's certified rank order list establishes a binding commitment to offer or to accept an appointment if a match results and to start training in good faith (i.e., with the intent to complete the program) on the date specified in the appointment contract.

The binding commitment shall be deemed to have been honored so long as the applicant remains in the training program through the first 45 days after the start date of the relevant appointment contract. The same binding commitment is established during the Match Week Supplemental Offer and Acceptance Program (SOAP) if a program offers a position by listing an applicant on its preference list and the applicant accepts that offer. Absent a waiver from the NRMP, failure to honor this commitment by either party shall be a breach of this Agreement and may result in penalties to the breaching program or applicant, as described in Section 8.0.

The binding commitment may be released only through the waiver procedures set forth in Sections 2.5 and 3.6 of this Agreement. Each appointment is subject to the official policies of the appointing institution in effect on the date the program submits its rank order list or its preference list and is contingent upon the matching applicant meeting all eligibility requirements imposed by those policies. Those requirements must be communicated to applicants in writing prior to the Rank Order List Certification Deadline or at the time the program interviews the applicant during SOAP. It is recommended that each program obtain a signed acknowledgement of such communication from each applicant.

An applicant who gives notice of resignation, resigns, or vacates a position within 45 days of the start date specified in the appointment contract shall be presumed to have breached this Agreement unless evidence is submitted, through the NRMP waiver process sufficient to show that the applicant entered into the program in good faith and the NRMP determines the applicant has a reasonable basis to be released from the binding commitment to the program under the procedures set forth in Section 2.5 of this Agreement.

A program that terminates a resident within 45 days of the start date specified in the appointment contract shall be presumed to have breached this Agreement unless evidence is submitted through the NRMP waiver process sufficient to show that the program entered into the contract in good faith and the NRMP determines the program has a reasonable basis to be released from the binding commitment to the applicant under the procedures set forth in Section 3.6 of this Agreement.

At the conclusion of Match Week, each program shall forward letters of appointment to all applicants who have matched with or have accepted a position through SOAP in that program. Applicants are expected to return one copy of the letter of acceptance to the program before the deadline stated in the letter.

You need to go to the first 45 days minimum of your PGY2 year unless you can get a waiver (you won’t).

If you do not, you have violated your match agreement and will be screwed out of most positions in most specialties.

Best plan is to stay the course for now and if necessary, start looking for spots to switch after starting at your assigned program. Personally, I would probably aim for doing a fellowship rather than switching, but I dont know how common/useful those are to people in your specialty.

 

[Haybrant]

Actually I was referring to my Rad Onc co-applicants here...and you'd be surprised, this year we had fewer people applying to primary care specialties from my school than many allopathic schools. It's not just the MD kids that don't see the value in going into primary care anymore (and the debt burden for us is often higher, making it even less of a feasible pursuit).

wait what? so all the DO applicants got their first choice and you didn't? This should speak volumes

To neuronix's point I also thought research was what everyone wanted to hear. I still remember sitting across from a big name chair (who is well known for research) during an interview discussing how I thought the work I was doing was going to make a big difference in translational research one day and him pushing me to explain how I would see that fruition. As I reflected on that later I understood how over my head I was in that conversation and my current self would be 100% embarassed. The guy must have thought I was an idiot to be honest, or at least that I haven't fully explored what I was talking about which is probably the case for 90% of non-Phds. Still got in but definitely not bc of that conversation

 

[kristofer]

To neuronix's point I also thought research was what everyone wanted to hear. I still remember sitting across from a big name chair (who is well known for research) during an interview discussing how I thought the work I was doing was going to make a big difference in translational research one day and him pushing me to explain how I would see that fruition. As I reflected on that later I understood how over my head I was in that conversation. The guy must have thought I was an idiot to be honest, or at least that I haven't fully explored what I was talking about which is probably the case for 90% of non-Phds. Still got in but definitely not bc of that conversation

I have seen many applicants, not just MDs but often MD/PhDs, get dinged significantly during post-interview discussions for saying they want a translational research academic career and not being able to back it up. I think applicants are conditioned to think that saying this, whether true or not, will give them a boost in rankings. Lying and saying you want to do research is apparently what's expected (and sadly what usually happens), so why not go for the gold? The reality is that if you say this, expect to be grilled extensively and have your academic background carefully scrutinized to determine if you have any idea what you're talking about and solid realistically achievable goals. Nobody's really going to question you if you say you want to be involved in retrospective studies and clinical trials throughout your mostly clinical career working as faculty for a large university health system (the "correct" answer to the research question, if there is one), but if you start talking about basic science and translational research, you will raise eyebrows. Failing to back it up is probably worse than saying you hate research and want to bail into private practice asap.

 

[RadOncThrowaway]

wait what? so all the DO applicants got their first choice and you didn't? This should speak volumes

To neuronix's point I also thought research was what everyone wanted to hear. I still remember sitting across from a big name chair (who is well known for research) during an interview discussing how I thought the work I was doing was going to make a big difference in translational research one day and him pushing me to explain how I would see that fruition. As I reflected on that later I understood how over my head I was in that conversation. The guy must have thought I was an idiot to be honest, or at least that I haven't fully explored what I was talking about which is probably the case for 90% of non-Phds. Still got in but definitely not bc of that conversation

No, what I meant was, my MD Rad Onc Co-applicants. I am not personally aware of who and how many other DOs applied to RO this cycle, and where those individuals matched on their lists.

I've never made any hope or claim that I would "make a big difference in translational research" - My goal is for a research focused academic career, and I am more interested in translational over clinical, based on my prior experience and training. I stated somewhere else in this thread, I'm not divulging any additional personal details, but I have the research training and experience that would not make a translational-focused career an unreasonable goal. And, I've been doing it long enough to know not to have any level of overly lofty expectations or grandiose dreams of a big discovery.

Jeez o man. When I started this thread, my intention was honestly to get advice on this unexpected, disappointing, and potentially career altering situation (that yes, I got myself into), and to ask if any of you all, who have obviously have been through the match before, and who obviously know much more about the field than I do, had been in this situation before and could recommend a course of action. I didn't realize it was going to become such a hyper-critical debate. I guess I could have phrased some things a bit less provocatively. Learned my lesson.

 

[MDACCRules]

No, what I meant was, my MD Rad Onc Co-applicants. I am not personally aware of who and how many other DOs applied to RO this cycle, and where those individuals matched on their lists.

Re sounding over my head thinking I'll "make a big difference in translational research" - I stated somewhere else in this thread, I'm not divulging any additional personal details, but I have the research training and experience that would not make a translational research-focused career an unreasonable goal. And, I've been doing it long enough to know not to have any level of overly lofty expectations or grandiose dreams of a big discovery.

Jeez o man. When I started this thread, my intention was honestly to get advice on this unexpected, disappointing, and potentially career altering situation (that yes, I got myself into), and to ask if any of you all, who have obviously have been through the match before, and who obviously know much more about the field than I do, had been in this situation before and could recommend a course of action. I didn't realize it was going to become such a hyper-critical debate. I guess I could have phrased some things a bit less provocatively. Learned my lesson.

When you made your rank list and looked at the bottom of the list, what did you suppose would happen when you matched there? I'm really not saying this to provoke anything - I'm just curious. You're a DO in a competitive field. You had to know it was possible.

Comparing you to a millennial may seem harsh, but you literally interviewed at this program, knew it was rubbish, ranked it, and signed a contract stating that if you landed there, you would go there (i.e. - "The Match"). None of this was 'sneaky' on the part of the program or Big Medicine. I'm just having a hard time comprehending it.

This is just the stuff you were told about and knew about. Imagine all the stuff out there about the field that people aren't telling you about. You're in for a rude awakening. Tragically, if you don't get the research job you won't, you'll have to toil for 35-50 hours a week, Monday to Friday, making $400k-1 mill / annually, have the respect of your neighbors, friends, family, and community. You'll cure people, help them live with less pain, and be supportive of them as a person. It brutal out here. Would not wish horrible life upon my arch-nemesis UConnRICH from the pizza making forums. I CANNOT WAIT TIL MY MISERY ENDS!!

 

[DrfluffyMD]

Actually I was referring to my Rad Onc co-applicants here...and you'd be surprised, this year we had fewer people applying to primary care specialties from my school than many allopathic schools. It's not just the MD kids that don't see the value in going into primary care anymore (and the debt burden for us is often higher, making it even less of a feasible pursuit).

I am guessing the guy who pmed me and this OP went to the same school by this admission. 2 radonc DOs from the same school...making the OP imminently identifiable.

 

[thecarbonionangle]

I am guessing the guy who pmed me and this OP went to the same school by this admission. 2 radonc DOs from the same school...making the OP imminently identifiable.

The number of DOs every year is minimal. For example, This year it appears Rutgers, San Antonio and Jefferson matched DOs. There may be more. I wish them the best and good for them. I'm sure any of the unmatched applicants would have loved any of those spots. I personally don't care for the DO vs. MD debate at all. I wish there was just one degree and we could get over all this snobbery and elitism. I've worked with DOs in multiple settings; they were fine. I honestly never thought about it unless I looked at their white coats during rounds. However, DO applicants must recognize that they have an uphill path when applying to this field due to prejudice. Do people even match derm, ENT, Plastics, ortho, urology as DOs? At least our field has some level of DO friendliness. As already mentioned, Merchant is a DO PhD and has been successful. I doubt a similarly competitive field has even one to two success stories, if any, of DOs.

 

[thecarbonionangle]

OP: you aren't alone.

I am a MD/PhD grad that recently matched into rad onc, at a program at the bottom of my rank list. Like OP, I was aspiring to be a physician scientist (wanted to apply for the Holman pathway, run a lab some day). I don't want to openly critical of this program, but I do know that, at least locally, the program has a very poor reputation. I had multiple rad oncs in nearby places tell me they were shocked that the program was still taking applicants and they are deficient in multiple clinical sites. (Yes, I realize I may have gone unmatched if I didn't match into this program, I have no one to blame but myself, etc.) But at the program where I matched, there are unfortunately no faculty involved in basic science research and no support for residents who have those interests. I think that my match placement will hurt those goals, and ultimately my career.

So, sure, I am shocked/disappointed by my match placement, and just like OP, I hope to eventually get over this and fulfill my obligation. But even after getting over it, how badly have I hurt my career goals? After all, from reading this forum, sounds like grads from bottom-tier residencies are lucky to find a job at all, let alone find a physician scientist position at a major academic center. Does anyone graduating from a bottom-tier program have any experience applying for academic jobs? Any advice is appreciated, Thanks

what did you think was going to happen when you stared at your rank list? I tell every medical student I work not to assume anything. you can end up anywhere on your list. MD/PHD or not, nothing was guaranteed for you. Move forward graciously and make the best of it. Pouting about it at this point is not going to help you. Multiple people have already answered your question with the same advice to the original poster which applies to you as well.

 

[seper]

Honestly, for many years there has been no difference in teaching between mid-tier US MD schools and DO schools. I know tons of great DO's physicians personally and professionally. I'd venture to say that DO schools are better than Caribbean MD schools.

The number of DOs every year is minimal. For example, This year it appears Rutgers, San Antonio and Jefferson matched DOs. There may be more. I wish them
the best and good for them. I'm sure any of the unmatched applicants would have loved any of those spots. I personally don't care for the DO vs. MD debate at all. I wish there was just one degree and we could get over all this snobbery and elitism. I've worked with DOs in multiple settings; they were fine. I honestly never thought about it unless I looked at their white coats during rounds. However, DO applicants must recognize that they have an uphill path when applying to this field due to prejudice. Do people even match derm, ENT, Plastics, ortho, urology as DOs? At least our field has some level of DO friendliness. As already mentioned, Merchant is a DO PhD and has been successful. I doubt a similarly competitive field has even one to two success stories, if any, of DOs.

 

[DrfluffyMD]

Honestly, for many years there has been no difference in teaching between mid-tier US MD schools and DO schools. I know tons of great DO's physicians personally and professionally. I'd venture to say that DO schools are better than Caribbean MD schools.

That statement is wrong. Google clinical education of DO schools. Many DO schools lack teaching hospitals and some DO students don’t even know how to round when they start their fourth year. There is definitely an educational difference between them and midtier USMD schools, who usually have multiple clinical sites including teritary centers complete with residencies.

I wish more premed would come to understand that DO education is often the inferior option due to overexpansion and lack of good clinical sites.

 

[evilbooyaa]

Honestly, for many years there has been no difference in teaching between mid-tier US MD schools and DO schools. I know tons of great DO's physicians personally and professionally. I'd venture to say that DO schools are better than Caribbean MD schools.

Disagree with your first line. Agree with your second. Agree with your 3rd. US MD has more access, generally speaking, to academic/teaching hospitals than DO. There will always be exceptions, but averages are averages.

Think about how many DO medical schools are affiliated with a Rad Onc residency, versus how many MD schools are affiliated.

 

[Mandelin Rain]

My goal is for a research focused academic career, and I am more interested in translational over clinical, based on my prior experience and training.

It's a tough pill to swallow, but if you wanted a bench research focused career (over practicing clinical medicine) you should have gotten a PhD, done a post doc in the best lab that would take you, and written grant after grant after grant application to bring funding for your own salary to your final landing spot.

Instead, you presumably have some extensive research background (perhaps a PhD?), but then went and got a DO, and applied to radiation oncology where there are next to no non-clinical research positions in existence and very few industry sponsored avenues to secure funding.

Just too many mistakes to overcome IMO. You don't get a re-do. Settle in and be a good rad onc, even if that's not what you saw yourself doing.

 

[seper]

I guess we can look at USMLE Step 1 stats to support/disprove your claim about the inferiority of DO education. There will probably be selection bias though, as more competitive DO's take USMLE vs. all of MD's.

Disagree with your first line. Agree with your second. Agree with your 3rd. US MD has more access, generally speaking, to academic/teaching hospitals than DO. There will always be exceptions, but averages are averages.

Think about how many DO medical schools are affiliated with a Rad Onc residency, versus how many MD schools are affiliated.

 

[DrfluffyMD]

I guess we can look at USMLE Step 1 stats to support/disprove your claim about the inferiority of DO education. There will probably be selection bias though, as more competitive DO's take USMLE vs. all of MD's.

Step 1 is not a measurement for clinical education. The inferiority of DO clinical education on the average is more than a claim, it’s a FACT. To state otherwise is simply misleading.

 

[medgator]

That statement is wrong. Google clinical education of DO schools. Many DO schools lack teaching hospitals and some DO students don’t even know how to round when they start their fourth year.

The post you responded to discussed Caribbean MD schools which afaik do have issues in some cases and the general sense I get is that DO > Caribbean MD

 

[Ray D. Ayshun]

No, what I meant was, my MD Rad Onc Co-applicants. I am not personally aware of who and how many other DOs applied to RO this cycle, and where those individuals matched on their lists.

I've never made any hope or claim that I would "make a big difference in translational research" - My goal is for a research focused academic career, and I am more interested in translational over clinical, based on my prior experience and training. I stated somewhere else in this thread, I'm not divulging any additional personal details, but I have the research training and experience that would not make a translational-focused career an unreasonable goal. And, I've been doing it long enough to know not to have any level of overly lofty expectations or grandiose dreams of a big discovery.

Jeez o man. When I started this thread, my intention was honestly to get advice on this unexpected, disappointing, and potentially career altering situation (that yes, I got myself into), and to ask if any of you all, who have obviously have been through the match before, and who obviously know much more about the field than I do, had been in this situation before and could recommend a course of action. I didn't realize it was going to become such a hyper-critical debate. I guess I could have phrased some things a bit less provocatively. Learned my lesson.

Based on what you’re saying here, it sounds to me that if you had to choose between physician and scientist, you might choose the latter. With rare exceptions in radonc, that’s the choice. Not sure how extensive your background is, especially on paper, but it sounds like you’d prefer doing a postdoc or working in pharma exclusively over being a clinician exclusively, with loan debt Pushing you towards the latter.

Fwiw, I’ve seen young attendings work semi-collaboratively on small projects with well-funded pi’s that became bigger projects. Might wanna go through residency first, though, and you just might find, as I have, that you’re more cut out for sacrificing for the greater good in the way mdaccrules mentioned a few posts back.

 

[RadTastic]

Don't put a place at the end of your rank list if you would prefer not matching at all over matching at that place. It's not that complicated.

You say that matching at this program will hurt your career goals, wouldn't not matching at all hurt your career goals more (ie not being a radiation oncologist)?

I think people need some basic education in how to make their rank list, don't med schools provide this guidance anymore? You can end up at any program you rank. It doesnt matter if you have a 280 step one, MD/PhD from Harvard. If you rank a program even if it's 20th on your list it is possible that you match there. If you'd rather not match, don't rank it.

OP: you aren't alone.

I am a MD/PhD grad that recently matched into rad onc, at a program at the bottom of my rank list. Like OP, I was aspiring to be a physician scientist (wanted to apply for the Holman pathway, run a lab some day). I don't want to openly critical of this program, but I do know that, at least locally, the program has a very poor reputation. I had multiple rad oncs in nearby places tell me they were shocked that the program was still taking applicants and they are deficient in multiple clinical sites. (Yes, I realize I may have gone unmatched if I didn't match into this program, I have no one to blame but myself, etc.) But at the program where I matched, there are unfortunately no faculty involved in basic science research and no support for residents who have those interests. I think that my match placement will hurt those goals, and ultimately my career.

So, sure, I am shocked/disappointed by my match placement, and just like OP, I hope to eventually get over this and fulfill my obligation. But even after getting over it, how badly have I hurt my career goals? After all, from reading this forum, sounds like grads from bottom-tier residencies are lucky to find a job at all, let alone find a physician scientist position at a major academic center. Does anyone graduating from a bottom-tier program have any experience applying for academic jobs? Any advice is appreciated, Thanks

 

[RadTastic]

I would think that if someone could get an MD or even, gasp, a DO, they could figure out how a rank list / The Match works. If you'd rather not match at all don't rank the place

Don't put a place at the end of your rank list if you would prefer not matching at all over matching at that place. It's not that complicated.

You say that matching at this program will hurt your career goals, wouldn't not matching at all hurt your career goals more (ie not being a radiation oncologist)?

I think people need some basic education in how to make their rank list, don't med schools provide this guidance anymore? You can end up at any program you rank. It doesnt matter if you have a 280 step one, MD/PhD from Harvard. If you rank a program even if it's 20th on your list it is possible that you match there. If you'd rather not match, don't rank it.

 

[Dare2Dream]

I don't want to doubt the OP's story. However, the OP is an anonymous internet poster. The fact that he later went along with someone's prodding that a DO may face challenges like him doesn't make it a verified fact that he is a DO. I point that out because there are usually only a handful of DO's who match each year and it would be unfair for them to be under the cloud based on assumptions extrapolated from anonymous internet posts. I do hope regardless of all the exacts, the OP was able to get enough advice to make a decision for his specific case.

 

[Neuronix]

Tragically, if you don't get the research job you won't, you'll have to toil for 35-50 hours a week, Monday to Friday, making $400k-1 mill / annually, have the respect of your neighbors, friends, family, and community.

Adjust those salaries downward, the hours upward, and get called a radiologist pretty much every day and I'll agree with you 😉

 

[RadTastic]

Adjust those salaries downward, the hours upward, and get called a radiologist pretty much every day and I'll agree with you 😉

The MGMA median salary is ~500K.

 

[medgator]

The MGMA median salary is ~500K.

Lagging indicator

 

[Neuronix]

The MGMA median salary is ~500K.

And the post I was responding to said 400k-1mil. $500k is on the low end of that range, and unless you're in middle of absolute nowhere you aren't going to come out of residency making that.

 

[Mandelin Rain]

I can't imagine there are too many full-time mid career docs making much less than 400k. But yes, fresh out, you're probably not getting that.

 

[Neuronix]

I can't imagine there are too many full-time mid career docs making much less than 400k. But yes, fresh out, you're probably not getting that.

I'm not sure how you define mid career, but the 25th percentile AAMC total compensation for associate professor is $386,000. So that's at least 25% of "mid career" academic rad oncs making less than 400k.

There are also plenty of "mid-career" (by age/experience) assistant professors out there in academics. 50th percentile for them is $360,000.

 

[RickyScott]

In academic programs I am familiar with, no one has had their salary lowered, but good luck trying to get a raise in this job market. My sense is you have a group of mid-career/later career docs holding onto salaries in the high 3s/low 4s. Do you think the younger "academics" (babysitters of satellite clinics) starting out today will take on those salaries over the next 5 to 10 years. When I was there, the only way you could really get raises was to get another job offer... The residency over expansion doesnt just impact new grads.

 

[scarbrtj]

Adjust those salaries downward, the hours upward, and get called a radiologist pretty much every day and I'll agree with you 😉

As a side note, according to Medicare the specialty appellation “radiation oncology” doesn’t exist. We are radiologists (
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c13.pdf).

 

[medgator]

As a side note, according to Medicare the specialty appellation “radiation oncology” doesn’t exist. We are radiologists (
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c13.pdf).

Therapeutic radiologists. Considering some of us treat keloids, acoustics, Trigeminal neuralgia, heterotopic ossification etc. I've always felt that TR is a more comprehensive term than RO

 

[scarbrtj]

Therapeutic radiologists. Considering some of us treat keloids, acoustics, Trigeminal neuralgia, heterotopic ossification etc. I've always felt that TR is a more comprehensive term than RO

Sorry, gave you wrong CMS reference (which does mention "radiation oncology" but obviously still delineates it as a "radiology" service)... I meant to cite this one.

"Ordinarily, the dentist extracts the patient’s teeth, but another physician, e.g., a radiologist, administers the radiation treatments."
"The incident to provision may also be extended to include all necessary and appropriate services supplied by a radiation physicist assisting a radiologist when the physicist is in the physician’s employ and working under his or her direct supervision."

The govt. using this term is probably just a holdover from our history, like when we were therapeutic radiologists.

 

[Ray D. Ayshun]

Therapeutic radiologists. Considering some of us treat keloids, acoustics, Trigeminal neuralgia, heterotopic ossification etc. I've always felt that TR is a more comprehensive term than RO

I think we should be called physical therapists.

 

[MDACCRules]

I think we should be called physical therapists.

Ha.

My mom thinks I'm a radiologist. I don't correct her.

 

[Mandelin Rain]

I'm not sure how you define mid career, but the 25th percentile AAMC total compensation for associate professor is $386,000. So that's at least 25% of "mid career" academic rad oncs making less than 400k.

There are also plenty of "mid-career" (by age/experience) assistant professors out there in academics. 50th percentile for them is $360,000.

That sucks. My best advice would be to find a new job.

 

[kristofer]

That sucks. My best advice would be to find a new job.

And the post I was responding to said 400k-1mil. $500k is on the low end of that range, and unless you're in middle of absolute nowhere you aren't going to come out of residency making that.

It depends on what you define as middle of nowhere. I am currently looking for jobs in small Midwestern cities and towns, and the norm is starting at 50% MGMA + productivity bonus and benefits for hospital employed positions. The few partnership tracks available start at less, but promise double income after 2 years and buy-in. So if your "middle of nowhere" encompasses all of flyover country, then yeah sure. Academic jobs in major metropolitan areas on the coast are going to pay at the bottom end because they can. Very rural desperate sites in the Midwest seem to start even new grads at 75% MGMA and up. The 1 mil figure is not inaccurate for mid-career physicians in these locations. Rad onc is (for now) still a great field for someone willing to live anywhere in the Midwest. The geographic limitations of this field have been beaten to death on this forum already. Virtually everybody still wants to live in coastal metro areas. I don't see that changing anytime soon and would expect even more downward pressure on salaries in these areas.

 

[Neuronix]

You act like I didn't look for jobs in the Midwest when I finished residency. I looked all over the country and even internationally.

The academic positions in the Midwest that I looked at paid the same as the ones on the coasts, at least for starting salaries.

 

[Mandelin Rain]

What I've gathered from this board, middle of nowhere to a rad onc refers to anywhere that's not within 15 minutes of NYC, Philadelphia, Boston, Miami, San Francisco, and/or LA. Chicago, Dallas, Atlanta, Houston, and Phoenix are all borderline and may be acceptable in a pinch. Everywhere else sucks, and you'd be better off dead than living there.

 

[RickyScott]

It depends on what you define as middle of nowhere. I am currently looking for jobs in small Midwestern cities and towns, and the norm is starting at 50% MGMA + productivity bonus and benefits for hospital employed positions. The few partnership tracks available start at less, but promise double income after 2 years and buy-in. So if your "middle of nowhere" encompasses all of flyover country, then yeah sure. Academic jobs in major metropolitan areas on the coast are going to pay at the bottom end because they can. Very rural desperate sites in the Midwest seem to start even new grads at 75% MGMA and up. The 1 mil figure is not inaccurate for mid-career physicians in these locations. Rad onc is (for now) still a great field for someone willing to live anywhere in the Midwest. The geographic limitations of this field have been beaten to death on this forum already. Virtually everybody still wants to live in coastal metro areas. I don't see that changing anytime soon and would expect even more downward pressure on salaries in these areas.

been in this field a while and I dont know anyone who earns anything close to 1 mill who doesnt own part of the equipment (which often means they had to make an investement with risk)...I am a geographic snob, but for a close to a mill I would move to the middle of nowhere in a new york minute...

 

[MDACCRules]

What I've gathered from this board, middle of nowhere to a rad onc refers to anywhere that's not within 15 minutes of NYC, Philadelphia, Boston, Miami, San Francisco, and/or LA. Chicago, Dallas, Atlanta, Houston, and Phoenix are all borderline and may be acceptable in a pinch. Everywhere else sucks, and you'd be better off dead than living there.

Yes. This is fact and not disputed. That's why everyone is so butt hurt on this forum. THEY WANT TO LIVE! But why mention Philadelphia? That's an odd one to put in this group of cities. That's a place where "you'd be better off dead than living there" to quote the pithy and eloquent poster above.

I stated a wide range on purpose, trying to encompass about 90% of all rad onc salaries with that range as to avoid any argument, and even that started a unnecessary row. Sheesh. I meant mid-career, I never said starting salary. When you talk about what a job pays, any normal human would assume that they meant mid career, unless they specifically said starting salary. In any case, of practicing doctors, that range of salaries represents the vast majority of practicing rad oncs.

 

[nkmiami]

Regardg

Yes. This is fact and not disputed. That's why everyone is so butt hurt on this forum. THEY WANT TO LIVE! But why mention Philadelphia? That's an odd one to put in this group of cities. That's a place where "you'd be better off dead than living there" to quote the pithy and eloquent poster above.

I stated a wide range on purpose, trying to encompass about 90% of all rad onc salaries with that range as to avoid any argument, and even that started a unnecessary row. Sheesh. I meant mid-career, I never said starting salary. When you talk about what a job pays, any normal human would assume that they meant mid career, unless they specifically said starting salary. In any case, of practicing doctors, that range of salaries represents the vast majority of practicing rad oncs.

Because Eagles fans are the best, and phillie has the best food of any city...

 

[Mandelin Rain]

Addended post should read Washington DC in place of Philadelphia.

 

[kristofer]

You act like I didn't look for jobs in the Midwest when I finished residency. I looked all over the country and even internationally.

The academic positions in the Midwest that I looked at paid the same as the ones on the coasts, at least for starting salaries.

I was not talking about academic positions. Small Midwestern cities and town typically do not have large academic centers. I specifically said hospital-employed positions and partnership-track positions.

 

[OTN]

been in this field a while and I dont know anyone who earns anything close to 1 mill who doesnt own part of the equipment (which often means they had to make an investement with risk)...I am a geographic snob, but for a close to a mill I would move to the middle of nowhere in a new york minute...

There are practices which can get one to this kind of income without substantial financial risk (there will always be some buy-in for a private practice group), but they are not common, I agree.

 

[medgator]

(there will always be some buy-in for a private practice group)

There shouldn't be if it is a professional practice (a scrupulous one, at least).

 

[RadOncThrowaway]

Welp guys, this has officially gotten weird. Someone who was bent on identifying me also managed to find out my school and my school-email address, and over the weekend sent me several odd and vaguely threatening emails, with details pertaining to this thread. This was after I found my personal information posted elsewhere on sdn. Since I cannot delete this thread, and even if I could, this individual at the least already has my information, all I can say is - seriously? I don’t understand this witch hunt, and I wonder what happened to you, that you feel the need to threaten a total stranger’s career and future livelihood because of what medical school I go to, before I’ve even graduated. It honestly scares me that I might have to work with people like you one day. It really punctuates this whole disappointing experience.

And thanks to those of you who have actually given me helpful advice and encouragement.
I didn’t expect for this thread to go in the direction it did, but it’s been...enlightening.

 

[RadOncMegatron]

Nobody's really going to question you if you say you want to be involved in retrospective studies and clinical trials throughout your mostly clinical career working...

Oh man, hits so close to home...