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Those are total applicants. Not the same residency positions. And what the heck is a PGY-2 (reserved) spot?
SOAP 2023
- Thread starter Baws
- Start date
Those are total applicants. Not the same residency positions. And what the heck is a PGY-2 (reserved) spot?
If there’s no upside (technical), then I wouldn’t exactly call it generosity for an employer to start us at a higher base.
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Hospitals were never paying people technical to begin with (at least not directly, unless via market adjustment etc)
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Sounds like at least 20%.
if number of applicants is increasing but soap numbers stable or increasing, what does that say abt the overall average desirability of the applicants.
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Hmm, well I certainly don't mean to sound hyperbolic.
I could definitely be engaging in some "recall bias" where the contract pulls from 2020 and the hiring freezes in 2020-2021 are coloring my memory.
However, my statement is more about churn as well. I don't recall seeing or hearing about this level of movement before, particularly in early-to-mid career physicians. There's a lot going into that, of course, and maybe it just seems like a "better" market now because people are more willing to quit?
Also to be clear: I don't think the jobs themselves are better by any stretch of the imagination. I'm more talking about my observation that it seems people have been much more apt to say "screw this, I'm out" and make a lateral move.
So: the odds are good, but the goods are odd.
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Here is what has been posted on the reddit spread sheet for 2023 unfilled programs, so info is only as good as what has been posted there.
People are saying,
16 PGY2 advanced programs for 24 unfilled spots.
2 PGY1 categorical programs for 3 unfilled spots.
2 "reserved" programs for 2 unfilled spots.
So that would put the total of 20 programs having something unfilled for a total of 29 spots. Its unclear if all of these will be offered up in the SOAP and what a "reserved" spot is.
Program unfilled spots/spots total.
Kaiser 1/2.
UC Irvine 1/1.
Georgetown 2/2.
Mayo Jacksonville 1/1 categorical.
U of Florida 1/2.
U of Miami 2/2.
U of Chicago 2/3.
U of Indiana 2/2.
U of Kentucky 2/2.
U of Louisville 1/1.
U of Minnesota 2/2.
Beaumont 2/3 categorical.
Einstein 1/1.
Case Western 2/3.
Fox Chase 2/3.
U of Pittsburgh 2/2.
U of South Carolina 1/1.
U of West Virginia 1/1.
U of Wisconsin 1/2.
People are saying,
16 PGY2 advanced programs for 24 unfilled spots.
2 PGY1 categorical programs for 3 unfilled spots.
2 "reserved" programs for 2 unfilled spots.
So that would put the total of 20 programs having something unfilled for a total of 29 spots. Its unclear if all of these will be offered up in the SOAP and what a "reserved" spot is.
Program unfilled spots/spots total.
Kaiser 1/2.
UC Irvine 1/1.
Georgetown 2/2.
Mayo Jacksonville 1/1 categorical.
U of Florida 1/2.
U of Miami 2/2.
U of Chicago 2/3.
U of Indiana 2/2.
U of Kentucky 2/2.
U of Louisville 1/1.
U of Minnesota 2/2.
Beaumont 2/3 categorical.
Einstein 1/1.
Case Western 2/3.
Fox Chase 2/3.
U of Pittsburgh 2/2.
U of South Carolina 1/1.
U of West Virginia 1/1.
U of Wisconsin 1/2.
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Anecdotally, I keep on hearing of a lot of churn in pretty big/high powered departments. I think people are just more willing to quit and are seeing through the hypocrisy of hospitals/departments, but curious if others have thoughts.
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It's a great question, I wish there was data. Anecdotally, I agree with you. Is it more churn than usual or is it just that old adage "everyone changes jobs at 3-5 years"? An adage for a very beautiful and very healthy specialty job market, by the way.
If churn is more than usual, I wonder about the selection pressure for "academically" accomplished people and the changing realities of academic $$$ radiation $$$ oncology $$$.
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It's really strange. I heard the Anderson has a good balance of decent salaries and reasonable workload which i certainly don't hear about in the NCI designated big names places in the northeast (**** salaries considering col and workload)
A made-up story about technical and churn
Characters:
Big rad onc - Bro
Rad onc student applicant - Rosa
2009
Bro: Ever since IMRT was developed, the private practice guys have been raking in those technical fees. Rural hospitals, urorads, those guys couldn’t even contour a bladder!
Rosa: Doesn’t our academic hospital get technical fees too?
Bro: Yes but we also want their technical fees. You have to think big, imagine how much we could do with more resources.
Rosa: Like what?
Bro: Research! Curing cancer! We could push the field forward that much faster.
Rosa: Isn’t that what NIH funding is for?
Bro: Ugh, I don’t like writing grants. But I have many, many great ideas.
Rosa: Wow, I like the sound of that. I can’t wait to be just like you.
2023
Bro: Remember when we talked about growing our clinical enterprise? It worked! We are 200% bigger, with many satellites and many residents.
Rosa: That’s great! Did all your research ideas get funded?
Bro: What research ideas? Oh, I forgot to update you. The technical fees were so profitable for us, that we’ve just been focusing on growing as much as possible, expanding our residency program and acquiring satellites.
Rosa: I thought you wanted to grow your clinical enterprise to support your research ideas.
Bro: Hmm, yes, I suppose that’s what I told the private practice doctors. Such a negative, nasty crowd, by the way. Anyways, to be honest, it’s been a mixed bag, we lost some indications with stomach cancer and lymphoma, but we gained some indications with early-stage lung cancer and oligomets.
Rosa: I see. Do you have any faculty openings?
Bro: Of course! Lots of satellite positions. You wouldn’t have your own lab, or startup funds, but you could enroll onto clinical trials.
Rosa: I can do that at a community hospital too?
Bro: Well, if you work for us, you’ll be contributing to research! Curing cancer! Pushing the field forward!
Rosa: But you just said that even after taking over all those private practices, you haven’t made significant gains in new therapies or indications. That’s not what I signed up for.
Bro: Look kid, do you want the job or not?
Rosa: Sorry, Bro.
END
Characters:
Big rad onc - Bro
Rad onc student applicant - Rosa
2009
Bro: Ever since IMRT was developed, the private practice guys have been raking in those technical fees. Rural hospitals, urorads, those guys couldn’t even contour a bladder!
Rosa: Doesn’t our academic hospital get technical fees too?
Bro: Yes but we also want their technical fees. You have to think big, imagine how much we could do with more resources.
Rosa: Like what?
Bro: Research! Curing cancer! We could push the field forward that much faster.
Rosa: Isn’t that what NIH funding is for?
Bro: Ugh, I don’t like writing grants. But I have many, many great ideas.
Rosa: Wow, I like the sound of that. I can’t wait to be just like you.
2023
Bro: Remember when we talked about growing our clinical enterprise? It worked! We are 200% bigger, with many satellites and many residents.
Rosa: That’s great! Did all your research ideas get funded?
Bro: What research ideas? Oh, I forgot to update you. The technical fees were so profitable for us, that we’ve just been focusing on growing as much as possible, expanding our residency program and acquiring satellites.
Rosa: I thought you wanted to grow your clinical enterprise to support your research ideas.
Bro: Hmm, yes, I suppose that’s what I told the private practice doctors. Such a negative, nasty crowd, by the way. Anyways, to be honest, it’s been a mixed bag, we lost some indications with stomach cancer and lymphoma, but we gained some indications with early-stage lung cancer and oligomets.
Rosa: I see. Do you have any faculty openings?
Bro: Of course! Lots of satellite positions. You wouldn’t have your own lab, or startup funds, but you could enroll onto clinical trials.
Rosa: I can do that at a community hospital too?
Bro: Well, if you work for us, you’ll be contributing to research! Curing cancer! Pushing the field forward!
Rosa: But you just said that even after taking over all those private practices, you haven’t made significant gains in new therapies or indications. That’s not what I signed up for.
Bro: Look kid, do you want the job or not?
Rosa: Sorry, Bro.
END
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People will either feel this stabbing their soul with hilarious truth,
or not understand it at all.
There is no in between.
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Using gyngyn's numbers in this thread, radiation oncology did not fill 44 of 206 positions available (~21%).
Before anyone goes declaring victory of a course correction, please remember that 29 of the 44 spots are actively trying to SOAP, and positions with a "no SOAP pledge" often fill outside the match.
This is only including programs participating in SOAP to my knowledge. I know of a few other positions not listed there that did not fill that will try to fill after SOAP.
Before anyone goes declaring victory of a course correction, please remember that 29 of the 44 spots are actively trying to SOAP, and positions with a "no SOAP pledge" often fill outside the match.
This is only including programs participating in SOAP to my knowledge. I know of a few other positions not listed there that did not fill that will try to fill after SOAP.
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Which means if all SOAP spots fill there will be at least 191 new rad oncs in 5 years. Ugh.
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And even more with filling outside of the SOAP. I know Kentucky has filled 2 positions this way in recent years. I imagine there are more.
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I believe that most positions that do not fill in SOAP and from "no SOAP pledge" institutions eventually do fill outside the match. Sometimes this is with med school seniors, other times with long-term fellows going through alternative pathway.
I have many examples through academic network of friends.
This is an issue that ARRO and the manuscripts written about this topic have essentially ignored.
Can't name names on this one due to semi-anonymous nature of SDN.
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Can independently confirm this sadness
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There are several programs that are chronic soap fillers over the past several years. This is well documented in other threads. You need a complete list of all unmatched programs and the spots to keep an eye on and document this stuff though crossing this with the acgme enrollment data.
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There will never be a fix regarding residency positions until academic departments close, and there will be no closure of academic departments unless they become unprofitable.
Middle and lower tier programs are now the repository for the desperate...and there are a lot of desperate people out there.
I actually don't think more conversation needs to be had. This is us. Unless the powers that be redefine what it means to be a radiation oncologist, this is probably where we should be. No established academic radiation oncologist is suffering because their department finds a way to staff their residency program, and almost no communities with serious doctor shortages are pining for a radiation oncologist.
This is our unhappy equilibrium. A marginal, niche field with some lifestyle upside when you can find a job. This is always what we were.
Anecdotally... I have heard of several "academic" departments pulling their people aside to tell them they need to increase their production by X percent. I saw that writing on the wall as a PGY3.
You need to publish, get grants, and teach residents to get promoted. Now they're expecting you to get out there and hustle too.
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Chicago, FL, Wisconsin damn son
Yup. Curious if COVID just delayed things or if there's a real uptick in churn.
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Must be nice to pontificate from your well feathered perch and job for lyfe in a major metro area.
D
deleted1111261
DH: It’s just we lost a lot of really good men out there.
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Why in these tough times even the admin have to suffer. Well, sort of. They'll just get reshuffled. But you? You just have to work harder. Lol.
www.beckershospitalreview.com
Penn Medicine eliminates administrative jobs in cost-cutting move
Penn Medicine is eliminating some administrative jobs.
Hellpits like WV…no surprise
Must be noted that multiple hellpits did not make this list due to ranking every single applicant
Kaiser and UCI…desirable location but medical students want to be educated
Chicago and Wisconsin: the days of being malignant, cross/triple covering, AND also desirable are over (Wisconsin has had a steep fall after multiple cases of outright nepotism that has caused department turmoil. I would no longer consider it elite after what has happened over the past few years. UChicago, I think we all know)
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How the mighty have fallen..
Some of us weren't even lucky to sniff interviews at these places let alone match at them in the heyday
I loved how Uchicago made a point of saying that they promote based on merit like over and over during the tour.
It would fix the job market; there are AMAZING applicants out there (they are about 50 in number)
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I assume that fox chase and uf just upheld basic standards and couldn’t match anyone. Only a total ***** would choose Columbia, LIJ, stony brook, arkansas over these programs.
RTOGsaveRadonc
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Imagine a lot of scut, toxicity at those places as alluded to above by others. Which program has the most scut/cross—attending coverage? Hopefully this will inspire change, medical students aren’t stupid they do their research. They’re going to see through the smiles and BS.
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This is reason number 236 why rad onc oversupply is bad. More rad oncs cost society more money. Rad oncs feel pressure to increase their productivity as their RVUs thin due to supply rising (workforce dilution, too many rad oncs) and stable to slightly falling demand (both utilization and fractionation). So every rad onc in America ups their RVUs by 500 per year (more fractions, more followups, more IMRT, more protons). And now rad onc costs society $100 to $200M more a year. Just because our leaders couldn’t manage our workforce.
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Oh they managed it alright. Managed it so they themselves had to do as LITTLE WORK AS POSSIBLE in their lifetime job, like a VA physician. The only thing they could get was 'free help' so the gorged on it and as a result, could pontificate even more at chart rounds.
Nah, those socratic sessions didn't leave a mark, now did they..
Nah, those socratic sessions didn't leave a mark, now did they..
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My best guess is that fox chase and UF didn't interview the people that ended up matching at Columbia, LIJ, Stony Brook, Arkansas.
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When you can't get into Emergency Medicine (20% unfilled), just know, there is always a place by a warm linac in an academic radonc department (21% unfilled).
And just like the fringe right, once you're 'born' out of residency, they won't give even ONE about you. You can suck it down (with your lunchables) in misery, just like those poor forced children.
And just like the fringe right, once you're 'born' out of residency, they won't give even ONE about you. You can suck it down (with your lunchables) in misery, just like those poor forced children.
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Bingo. Bob Amdur has scruples that are sorely lacking at many programs these days
No, because even if some programs don't participate in the SOAP, the majority appear to be doing so. You could argue that perhaps the current classes of radoncs may have trouble finding jobs in a few years, but in reality I think it will just serve to undercut currently practicing radoncs.
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No. See:
SOAP 2023
It’s more than last year. “Rebounding” is not the word I’d hope to be associated with rad onc spots Those are total applicants. Not the same residency positions. And what the heck is a PGY-2 (reserved) spot?
forums.studentdoctor.net
SOAP 2023
It’s more than last year. “Rebounding” is not the word I’d hope to be associated with rad onc spots Those are total applicants. Not the same residency positions. And what the heck is a PGY-2 (reserved) spot?
forums.studentdoctor.net
No. As long as the people that control the supply chain continue to benefit from an oversupply, nothing will change. Radiation oncology is not rocket science. You don't need an MD/PhD in radiation biology or medical physics to do it. You can be a DO. You can be an IMG/FMG, a neurosurgery resident, or someone who SOAPed into it from some other specialty without having a clue what it even is. Medical school is competitive and the vast majority of people coming out of medical school have the capacity to be competent radiation oncologists.
There are no consequences to a program failing to match other than a bruise to their ego. Even the ego check has become a thing of the past because now it is all too easy to say things like "well, there are more spots than applicants, obviously some programs are going to go unfilled" or "radiation oncology suffers from a PR problem perpetuated by trolls on the internet." There are no consequences for a program that is forced to participate in the SOAP, but their are certainly consequences for not participating. That program doesn't get to lock in a physician for 4 years who, after ~1 year of radonc training, can competently do ~90% of the work the specialty requires for 25% of the cost.
In the context of medical training as a whole, the SOAP is a good thing for programs and medical students. However, it is positively toxic for the field of radiation oncology. It prevents our oversupply issues from self-correcting because, come July 1st, graduating medical students need a job and programs need a body, and that's a match made in West Virginia heaven. In the absence of some external force limiting radonc programs from participating in the SOAP, bad training programs will to continue to exist, will continue to be bad, and will continue to exploit unmatched medical students at what is perhaps the lowest point in their lives. There are no consequences for SOAPing, there are only consequences for not filling.
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List of programs not matching since 2019:
2019
Buffalo 1
Case Western 2
Columbia 1
Jefferson 2
Kansas 1
Utah 1
UPMC 1
SUNY Downstate 2
Dartmouth 1
Georgetown 1
Montifiore 2
Arizona 1
Louisville 1.
Minnesota 2
Oklahoma 1
Arkansas 1
UC Davis 1
Tennessee 1
Rochester 3
2020
Buffalo 1
Case Western 1
Jefferson 2
Kansas 1
SUNY Downstate 2
Arizona 2
Oklahoma 1
Arkansas 1
UC Davis 1
Tennessee 1
Rochester 2
Beaumont 1
City of Hope 2
Indiana 1
Stony Brook 1
Brooklyn Methodist 2
Tufts 1
Virginia 2
Virginia Commonwealth 2
West Virginia 1
2021 (Can't find the numbers but 35 total spots).
Arkansas
Kaiser
UC Irvine
Georgetown
Iowa
Louisville
Tufts
Henry Ford
Minnesota
Nebraska
Dartmouth
Stony Brook
Buffalo
SUNY Downstate
SUNY Upstate
Case Western
South Carolina
Vanderbilt
UT San Antonio
Virginia 1
West Virginia
Medical College of Wisconsin
Emory 3
VCU 2
North Carolina
2022
UAB 1
Mayo Arizona 1
Arkansas 1
Kaiser 2
UC Irvine 1
Georgetown 1
Henry Ford 2
Minnesota 1
Dartmouth 1
Rutgers 1
SUNY Downstate 2
SUNY Upstate 1
Stony Brook 1
U Rochester 2
Northwell LIJ 1
Allegheny 1
Thomas Jefferson 1
MUSC 2
Baylor 2
UT San Antonio 2
UT Galveston 1
U Miami 1
West Virginia 1
2023
Kaiser 1
UC Irvine 1
Georgetown 2
Mayo Jacksonville 1
U of Florida 1
U of Miami 2
U of Chicago 2
U of Indiana 2
U of Kentucky 2
U of Louisville 1
U of Minnesota 2
Beaumont 2
Montifiore 1
Case Western 2
Fox Chase 2
U of Pittsburgh 2
U of South Carolina 1
U of West Virginia 1
U of Wisconsin 1
West Virginia was first accredited in 2016. They first entered the match in 2017. They subsequently failed to match in 2017, 2020, 2021, 2022 and 2023.
2019
Buffalo 1
Case Western 2
Columbia 1
Jefferson 2
Kansas 1
Utah 1
UPMC 1
SUNY Downstate 2
Dartmouth 1
Georgetown 1
Montifiore 2
Arizona 1
Louisville 1.
Minnesota 2
Oklahoma 1
Arkansas 1
UC Davis 1
Tennessee 1
Rochester 3
2020
Buffalo 1
Case Western 1
Jefferson 2
Kansas 1
SUNY Downstate 2
Arizona 2
Oklahoma 1
Arkansas 1
UC Davis 1
Tennessee 1
Rochester 2
Beaumont 1
City of Hope 2
Indiana 1
Stony Brook 1
Brooklyn Methodist 2
Tufts 1
Virginia 2
Virginia Commonwealth 2
West Virginia 1
2021 (Can't find the numbers but 35 total spots).
Arkansas
Kaiser
UC Irvine
Georgetown
Iowa
Louisville
Tufts
Henry Ford
Minnesota
Nebraska
Dartmouth
Stony Brook
Buffalo
SUNY Downstate
SUNY Upstate
Case Western
South Carolina
Vanderbilt
UT San Antonio
Virginia 1
West Virginia
Medical College of Wisconsin
Emory 3
VCU 2
North Carolina
2022
UAB 1
Mayo Arizona 1
Arkansas 1
Kaiser 2
UC Irvine 1
Georgetown 1
Henry Ford 2
Minnesota 1
Dartmouth 1
Rutgers 1
SUNY Downstate 2
SUNY Upstate 1
Stony Brook 1
U Rochester 2
Northwell LIJ 1
Allegheny 1
Thomas Jefferson 1
MUSC 2
Baylor 2
UT San Antonio 2
UT Galveston 1
U Miami 1
West Virginia 1
2023
Kaiser 1
UC Irvine 1
Georgetown 2
Mayo Jacksonville 1
U of Florida 1
U of Miami 2
U of Chicago 2
U of Indiana 2
U of Kentucky 2
U of Louisville 1
U of Minnesota 2
Beaumont 2
Montifiore 1
Case Western 2
Fox Chase 2
U of Pittsburgh 2
U of South Carolina 1
U of West Virginia 1
U of Wisconsin 1
West Virginia was first accredited in 2016. They first entered the match in 2017. They subsequently failed to match in 2017, 2020, 2021, 2022 and 2023.
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Is this list only institutions that participated in SOAP? I know one institution that I'm pretty sure didn't match spots over that time interval that is not included.
I’ve heard mixed things. Pretty sure a couple programs I’ve heard that didn’t match are not on that list for 2022/2023 so I believe it’s just programs participating in the SOAP. I’ve heard as many as 44 unfilled spots.
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Total Number of Radiation Oncology Residents
2001-2002: 468
2002-2003: 507
2003-2004: 518
2004-2005: 534
2005-2006: 540
2006-2007: 565
2007-2008: 589
2008-2009: 595
2009-2010: 615
2010-2011: 612
2011-2012: 666
2012-2013: 676
2013-2014: 705
2014-2015: 721
2015-2016: 733
2016-2017: 749
2017-2018: 767
2018-2019: 774
2019-2020: 771
2020-2021: 783
2021-2022: 762
2022-2022: 765
2001-2002: 468
2002-2003: 507
2003-2004: 518
2004-2005: 534
2005-2006: 540
2006-2007: 565
2007-2008: 589
2008-2009: 595
2009-2010: 615
2010-2011: 612
2011-2012: 666
2012-2013: 676
2013-2014: 705
2014-2015: 721
2015-2016: 733
2016-2017: 749
2017-2018: 767
2018-2019: 774
2019-2020: 771
2020-2021: 783
2021-2022: 762
2022-2022: 765
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Probably most of the drop from the peak of 783 to today 765 (net 18 loss or about 4-5 training spots per year) can likely be attributed to these closed programs; Drexel in 2019 (4), Medical College of Georgia in 2019 (4), California Pacific in 2019 (4) and Cornell 2021 (6) and those programs known to not be filling intentionally MDAAC 1 per year, Harvard 1 per year and Colorado 1 every 4 years. While these programs have increased in size at the same time Loma Linda 5 to 6, Case Western Reserve 6 to 7, Columbia 6 to 8, Northwestern 8 to 9, Thomas Jefferson 9 to 11, Duke 13 to 14.
So any talk about not filling in the SOAP or only taking people that are super interested in rad onc but somehow couldn't manage to match is not believable and the data does not support such claims.
The only way to get these numbers down year after year is through complete closures of programs.
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I’ve seen much of the same. Many/most of our faculty have exceeded their RVU goals (ie bonus caps out) by >30-40%. In response, they intermittently block consult slots. Institution did not like this and creates new metric: percent of available consult slots that are filled. Faculty obviously unhappy. Then at the end of the year, bonuses way lower than prior years (we’re talking like less than a quarter of what they normally get). Meanwhile, the hospital is building huge shiny new hospital building, opening multiple other new sites etc.
But you better keep running on that hamster wheel getting grants and publishing if you want to get promoted
As a resident I’ve seen the writing on the wall and jumped ship as soon as I could before they started breathing down my neck about staying on as faculty
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Beaumont is img heaven nowadays
