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For those of you that made a jump a few years in, what was that process like? Did you end up feeling a few people out at ASTRO? Go to some on-site interviews? Take the first offer available?
Radiation Oncology for the last decade I've been following it has been known for geographic job issues. When I was entering medical school way back when the conventional wisdom was that something like 2/3 of new residents change jobs within the first few years. I have since seen that play out in my friends and ultimately my life!
Keep in touch with folks at practices where you have connections and have an interest in relocating to
This was key for me, and the people I know. The ultimate path to the dream job in Rad Onc is to make connections with your dream practice(s), then network with them from your PGY-2-PGY-5 year. Then at the beginning of PGY-5, you reach out to see what their needs will be. If they have a job, GREAT. Most likely it will be something like, "We have a partner that is retiring soon, so nothing now but maybe in the next 1-2 years." Or, "We have some expansion opportunities that we are waiting to be finalized, but maybe in the next 1-2 years." So you go about your job hunt and take the best job you can elsewhere. Then, you stay in touch! And lo and behold, in 1-2 years they say, "Guess what! We now have opening you still interested? We'd love to fly you out." Then you go out and then you face the difficult decision as to whether you uproot your life again to move. I've seen some people end up loving their first job so much they stay put, and I've seen others jump on their dream job and ride of into the sunset.
Anyway, the modern (at least the last 10 years) path for getting the dream job is the above. Hope it helps!