Timeline from interview to offer

[bronchogenic]

Could anyone share some insights on what the typical timeframe is from an on site interview to being offered a RadOnc job? What sorts of deliberations happen after the interview and how long do these usually take? Thank you.

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[BobbyHeenan]

this is incredibly variable.

in my practice it all depends on how many interviews we have lined up. If we have three lined up spaced over a few months, unless we're absolutely smitten with interviewee number one or two, we wait until all are interviewed if they all on paper look like great candidates.

If you have a sense that you are the only person interviewing for whatever reason and it's been over a month since interview and not heard back....probably not a good sign.

 

[TheWallnerus]

Could anyone share some insights on what the typical timeframe is from an on site interview to being offered a RadOnc job? What sorts of deliberations happen after the interview and how long do these usually take? Thank you.

My first real interview… it was about three days from interview to offer. Remember what Ben Franklin said… fish, and visitors, and offer delays, smell after three days.

 

[elementaryschooleconomics]

This will have no standard answer. I've experienced wildly different things personally and witnessed my friends experience wildly different things.

That's just my first-hand experience, I won't even get into hearsay.

I agree with @BobbyHeenan above - if you think you're the only one and haven't heard for a month, bad.

If you're the only one but it's a hospital employed job, or any setting where there's more than one decision maker (i.e. they have to vote on it), a couple days of quiet is normal like @TheWallnerus said.

My first job with a private practice was this weird dance where I had to say that if I was offered the job I would definitely take it, so then they offered me the job (paraphrasing, and all of life is a weird dance).

My current weird academic job (not a true "satellite" but not main campus), I was driving back from my on-site interview and my Chair called my cell before I had made it home to offer me the job.

Conversely, I've watched my friends strung along for a month or two, almost always when it's a large SCAROP institution.

Fun, right?

 

[RSAOaky]

Everyone does it differently. Some like to bring all potential candidates on site before sending out an official offer. Others will extend an official offer for the first candidate they like enough. Sometimes even when there is an offer out there, interviewing continues because you don't know if that person will take the offer. Sometimes, you are not the first choice and you are waiting for those in front of you to either accept or refuse an offer. It just all depends. Much like you continue to interview until you have a signed offer in hand, jobs continue to interview until a candidate has signed an offer.

 

[yesmaster]

Generally if it takes longer than 1-2 weeks after on-site, it’s a bad sign that no offer is forthcoming.

 

[drowsy12]

Generally if it takes longer than 1-2 weeks after on-site, it’s a bad sign that no offer is forthcoming.

I don’t agree. Have had multiple jobs that break this rule, including my current one.

It’s highly dependent on the situation. In fact you should expect it to take a while but you should also continue to follow up.

More than the time it takes, if you’re getting blown off, you’ll know by the nature of what you are hearing back.

 

[medgator]

I don’t agree. Have had multiple jobs that break this rule, including my current one.

It’s highly dependent on the situation. In fact you should expect it to take a while but you should also continue to follow up.

More than the time it takes, if you’re getting blown off, you’ll know by the nature of what you are hearing back.

Yep. What happens when they decide to open a new center, or someone unexpectedly leaves or retires mid cycle and they need someone ASAP to fill it? I started my current job in January off cycle where they were looking for someone BC with experience

 

[ramsesthenice]

I don’t agree. Have had multiple jobs that break this rule, including my current one.

It’s highly dependent on the situation. In fact you should expect it to take a while but you should also continue to follow up.

More than the time it takes, if you’re getting blown off, you’ll know by the nature of what you are hearing back.

Agree and I can say first hand where I trained wanted to interview everyone before extending an offer. To each their own, but I I feel like after some time, you know the caliber of people out there and I don’t understand letting someone really good potentially take a different job because you need to talk to everyone before making a choice. It worked out for me. If they had made me an offer right away, I would have stayed and I think it would have held me back a bit. Instead, they told me in July that they wouldn’t make any decisions until October. Some places just take their time.

 

[drowsy12]

One thing I’ve heard for new grads specifically is that the timeline for the hunt has shifted. Back in my day I had my first visits with people at ASTRO during my PGY5 year, that’s where I did the speed dating rounds with folks.

These days, from what I hear through grape vine from my old program, people are a lot more aggressive with starting earlier during PGY4 Year due to concerns with the job market and some people already have jobs by the time Astro comes around, especially if they have specific geographic needs

 

[DrProtonX]

One thing I’ve heard for new grads specifically is that the timeline for the hunt has shifted. Back in my day I had my first visits with people at ASTRO during my PGY5 year, that’s where I did the speed dating rounds with folks.

These days, from what I hear through grape vine from my old program, people are a lot more aggressive with starting earlier during PGY4 Year due to concerns with the job market and some people already have jobs by the time Astro comes around, especially if they have specific geographic needs

How early in residency is it acceptable to reach out? Is it worth to sign a contract early on if they have residency stipend?

 

[randomname2018]

How early in residency is it acceptable to reach out? Is it worth to sign a contract early on if they have residency stipend?

If you have geographic constraints, I would strongly encourage you to reach out early and follow up. Historically, early contracts were rare and will become even more rare. Personally, if an employer was offering an early contract with a stipend that would be a red flag.

 

[DrProtonX]

If you have geographic constraints, I would strongly encourage you to reach out early and follow up. Historically, early contracts were rare and will become even more rare. Personally, if an employer was offering an early contract with a stipend that would be a red flag.

They’re not offering, they have ‘loan repayment assistant’ but i’m doing PSLF so i’m trying to ask if they can turn that into residency stipend. My biggest concern is if I sign early, I might miss out on the possible salary increase that might happen later on

 

[deleted1180461]

if an employer was offering an early contract with a stipend that would be a red flag.

BTDT. Beware the 6 figure check some particularly evil places will dangle at PGY-4s. There is a catch.

 

[DrProtonX]

BTDT. Beware the 6 figure check some particularly evil places will dangle at PGY-4s. There is a catch.

What’s the catch?

 

[ramsesthenice]

They’re not offering, they have ‘loan repayment assistant’ but i’m doing PSLF so i’m trying to ask if they can turn that into residency stipend. My biggest concern is if I sign early, I might miss out on the possible salary increase that might happen later on

Back up a second. How badly do you want this particular job? If it checks off multiple must haves and strong preferences, don’t overthink it. Most new grads in this market will be lucky to get more than a couple formal offers. You know what’s worse than potentially leaving some money on the table? Having to take a job you only sort of like in a place you don’t want to be because you passed up a really good fit.

The flip side is also true. If you already have an offer, that’s a good sign and I don’t think you need to settle for something if it’s not right or you have another specific opportunity in mind you would like to pursue.

 

[radoncftw]

I signed late into my PGY-4 year. I think its more common now. I agree with the above posts. For me it was the location and the main decent job that would be available in that location.
I think the tough thing in hindsight is that your perspective changes for what a good job is when you are a PGY5 making 60k.
Unfortunately we do not have the ease of lateral job changes like other specialities.

 

[NotMattSpraker]

What’s the catch?

In general, this is a lump sum payment to someone with relatively little money, so insidiously unfair to the applicant. As you know single lump sum is often way less expensive than many other things like a better salary or comp structure or benefits, but residents would do a lot of things for $100,000 check.

Ive never heard of it coming free and clear except one time that I think is a bizarre exception.

The most common thing is you have to pay it back if you leave before some fixed time. This 100% locks staff in jobs, see it all the time. It doesnt really need to be a lock in at a physician salary though. My advice is just plan for the cost, various ways to do that.

They’re not offering, they have ‘loan repayment assistant’ but i’m doing PSLF so i’m trying to ask if they can turn that into residency stipend. My biggest concern is if I sign early, I might miss out on the possible salary increase that might happen later on

Im confused by this post. If you are able to negotiate on salary, Id do that now. I cant believe anyone would raise their salary right now due to lack of applicants.

Im doing PSLF and had to pay loans for a while while working. The loan assistants can still help you potentially. I have paid wayyyy more out of pocket since graduating residency that Ive ever seen offered in loan assistance.

If you've done the math and converting the loan assist to some other benefit that helps you more, thats a really good negotiation proposal IMO.

 

[DrProtonX]

In general, this is a lump sum payment to someone with relatively little money, so insidiously unfair to the applicant. As you know single lump sum is often way less expensive than many other things like a better salary or comp structure or benefits, but residents would do a lot of things for $100,000 check.

Ive never heard of it coming free and clear except one time that I think is a bizarre exception.

The most common thing is you have to pay it back if you leave before some fixed time. This 100% locks staff in jobs, see it all the time. It doesnt really need to be a lock in at a physician salary though. My advice is just plan for the cost, various ways to do that.



Im confused by this post. If you are able to negotiate on salary, Id do that now. I cant believe anyone would raise their salary right now due to lack of applicants.

Im doing PSLF and had to pay loans for a while while working. The loan assistants can still help you potentially. I have paid wayyyy more out of pocket since graduating residency that Ive ever seen offered in loan assistance.

If you've done the math and converting the loan assist to some other benefit that helps you more, thats a really good negotiation proposal IMO.

So my situation is a bit unique. Location is ideal and the employer is pretty good based on previous experiences. I’m fairly early in my training that’s why i’m hesitant if I should contact them or not, I don’t wanna come off as desperate.

Since the location is very ideal, if they offered me a 6 figure paycheck for a let’s say 3-5 year contract, I would sign in a heartbeat!

 

[TheWallnerus]

So my situation is a bit unique. Location is ideal and the employer is pretty good based on previous experiences. I’m fairly early in my training that’s why i’m hesitant if I should contact them or not, I don’t wanna come off as desperate.

Since the location is very ideal, if they offered me a 6 figure paycheck for a let’s say 3-5 year contract, I would sign in a heartbeat!

6 figures is rather imprecise 🙂

 

[DrProtonX]

6 figures is rather imprecise 🙂

It was more of a figure of speech. What I mean is I would absolutely sign with this place. I just don’t know when and how I should approach them. Is there such a thing as “too early”?

 

[Burt Radnolds]

It was more of a figure of speech. What I mean is I would absolutely sign with this place. I just don’t know when and how I should approach them. Is there such a thing as “too early”?

I have ran recruitment on many new hires from the physician side. It is never too early in my opinion. If they aren't in hiring mode yet set a reminder to check in every 6 months. If they switch to hiring mode and are ready to lock you in ahead of time, and the job checks all the boxes for you, take it or you might miss the boat.

There is nothing to lose from early contact. It shows strong interest and hints towards long term fit / stability. Very very important for practices. It also gives them, and you, an extended time to get to know each other.

You seem afraid of this in between scenario where you have indicated interest but aren't quite sure and they decide to move forward. If they like you and are reasonable people, you can politely explain you aren't ready to fully commit several years out. Yeah they might go and hire someone else but they were going to do that anyways and it's on you for not being ready, not them, and it's highly unlikely your early contact motivated them to go hire someone else.

Don't outplay yourself here.

 

[deleted1180461]

What’s the catch?

NMS pretty much nailed it above.
The bean counters have done the math and determined that it's better to cut you a $100-$150k check (always structured as a loan that is forgiven over many years) upfront than let you have the equivalent amount as salary with no strings attached. They seek to lock someone early career in who can't afford to pay it back because it's a very bad job where you will be treated poorly and completely owned by them.

This is the equivalent of finding your wife on 90 day fiancé. She's beautiful and woos you at first sight, but then 100 days in you come home and she has set your car on fire and filled the house with 40 cats.

 

[yesmaster]

I had one of these upfront packages at low six figures at a prior job and I didn’t pay back one cent. I also lived like a resident so I could’ve paid it back anytime. I don’t think it’s a red flag or a trap.

 

[DrProtonX]

NMS pretty much nailed it above.
The bean counters have done the math and determined that it's better to cut you a $100-$150k check (always structured as a loan that is forgiven over many years) upfront than let you have the equivalent amount as salary with no strings attached. They seek to lock someone early career in who can't afford to pay it back because it's a very bad job where you will be treated poorly and completely owned by them.

This is the equivalent of finding your wife on 90 day fiancé. She's beautiful and woos you at first sight, but then 100 days in you come home and she has set your car on fire and filled the house with 40 cats.

I see how it could be a red flag if they reached out to me and offered that, especially in today’s market. However, they haven’t reached out to me, i’m the one who’s considering reaching out to them due to the ideal location and see if I could get a 6-figure paycheck (or preferably monthly stipend for remainder of residency if possible) if I sign with them early.

 

[deleted1180461]

I had one of these upfront packages at low six figures at a prior job and I didn’t pay back one cent. I also lived like a resident so I could’ve paid it back anytime. I don’t think it’s a red flag or a trap.

There are always going to be N=1 unicorn cases where someone randomly stumbles into a job with a 4 day workweek with a 200k signing bonus out of residency, 10 weeks of PTO, and tech buy-in after 2 years in a desirable warm coastal city making 1.5M/yr now and looks around and says why is everyone complaining, rad onc is great!

 

[DrProtonX]

There are always going to be N=1 unicorn cases where someone randomly stumbles into a job with a 4 day workweek with a 200k signing bonus out of residency, 10 weeks of PTO, and tech buy-in after 2 years in a desirable warm coastal city making 1.5M/yr now and looks around and says why is everyone complaining, rad onc is great!

I get the sarcasm in your comment. But honestly if I can find a job with 4-day work week, $50-100k signing bonus out of residency, 6-8 weeks PTO and making $700-800k in a decent location (desirable location for me isn’t NYC, LA, SanFran)… I would forever say rad onc is great!

 

[deleted1180461]

I get the sarcasm in your comment. But honestly if I can find a job with 4-day work week, $50-100k signing bonus out of residency, 6-8 weeks PTO and making $700-800k in a decent location (desirable location for me isn’t NYC, LA, SanFran)… I would forever say rad onc is great!

I had a job similar to this but bad location.

125k sign on with 5 year lock in.
5 day week but 16 weeks PTO (and I took every last day)
650k salary.

Sounds amazing right?

It was a complete nightmare. I blew up everything I had built in my life to that point to work for psychopaths who committed outright emotional abuse and threats.

All for a stupid $125k check I took as a pgy-4. That I put in a CD earning 2.25% like an idiot (the bonus I mean loan accrued interest at a rate WAY higher than this). I’ll never forget the sense of something being wrong when they handed it to me.

I was seriously contemplating retraining in radiology.

Be careful.

 

[drowsy12]

Have you ever had a job that wasn’t a nightmare? Seems like you say that a lot

 

[deleted1180461]

Have you ever had a job that wasn’t a nightmare? Seems like you say that a lot

My current one is awesome.

It is ridiculous that I had to go through 3 jobs to get here, but I think this needs to be expected if you’re going to train in this field at this point.

I mean you get so beat down your standards become:

1. Don’t lie to me.
2. Don’t gaslight me.
3. Don’t threaten me.

Edit: forgot don’t steal from me. That one especially sucks.

And that’s like basically the bar to have an acceptable job in rad onc in 2024.

 

[DrProtonX]

I had a job similar to this but bad location.

125k sign on with 5 year lock in.
5 day week but 16 weeks PTO (and I took every last day)
650k salary.

Sounds amazing right?

It was a complete nightmare. I blew up everything I had built in my life to that point to work for psychopaths who committed outright emotional abuse and threats.

All for a stupid $125k check I took as a pgy-4. That I put in a CD earning 2.25% like an idiot (the bonus I mean loan accrued interest at a rate WAY higher than this). I’ll never forget the sense of something being wrong when they handed it to me.

I was seriously contemplating retraining in radiology.

Be careful.

That does sound awful but with $650k salary, why didn’t you save up and pay back the $125k after a year to get out?

 

[CurbYourExpectations]

Things have to be taken in context with that the radonc job market has not always been healthy and there are waxes and wanes. I think the job market at this time is fairly good. I know of many people in recent years who have signed early and people with good lateral mobility. At the current state of the job market it is reasonable to reach out to people and sign early if it's a good fit for you. I think that people hiring should be trying to hire people early if you like the person. It is almost a normalized job market. Is it as good as other medical specialties? Probably not, but it's good for radonc.

 

[NotMattSpraker]

I get the sarcasm in your comment. But honestly if I can find a job with 4-day work week, $50-100k signing bonus out of residency, 6-8 weeks PTO and making $700-800k in a decent location (desirable location for me isn’t NYC, LA, SanFran)… I would forever say rad onc is great!

I would not overthink this or put the cart ahead of the horse. I did this a ton during my search.

If you are local to them, reach out. There is basically no downside to that. Id argue its more important to see if you like the group than anything else.

Just to give you an idea: Im in I guess a lower tier "desirable city" and people reach out as early as PGY3. We are certainly not paying stipends. Also, I think you should lower your expectations a little on the finances 🙂

You have to remember a lot of RO jobs are just very corporate, so you should be gunning for a fair and vanilla contract that is tracked to median. Im sure if you go remote rural you can negotiate creatively. Make them buy you a scribe for the rest of residency!

Its always true that the absolute number of RO jobs in any city is small and there are a lot of ROs that would be happy in decent cities.

 

[NotMattSpraker]

Things have to be taken in context with that the radonc job market has not always been healthy and there are waxes and wanes. I think the job market at this time is fairly good. I know of many people in recent years who have signed early and people with good lateral mobility. At the current state of the job market it is reasonable to reach out to people and sign early if it's a good fit for you. I think that people hiring should be trying to hire people early if you like the person. It is almost a normalized job market. Is it as good as other medical specialties? Probably not, but it's good for radonc.

I have no idea what is normal anymore in any aspect of life LOL

It seems like there are a lot of jobs. But I also have a lot of friends that are changing jobs. A LOT of people with a "bad first job", that are now happy.

Im happy for those people, but it makes me wonder about whether the quality of the average RO job is eroding. Now, of course, I would never claim that in an academic journal with no supporting data or anything. Im just wondering.

 

[DrProtonX]

I would not overthink this or put the cart ahead of the horse. I did this a ton during my search.

If you are local to them, reach out. There is basically no downside to that. Id argue its more important to see if you like the group than anything else.

Just to give you an idea: Im in I guess a lower tier "desirable city" and people reach out as early as PGY3. We are certainly not paying stipends. Also, I think you should lower your expectations a little on the finances 🙂

You have to remember a lot of RO jobs are just very corporate, so you should be gunning for a fair and vanilla contract that is tracked to median. Im sure if you go remote rural you can negotiate creatively. Make them buy you a scribe for the rest of residency!

Its always true that the absolute number of RO jobs in any city is small and there are a lot of ROs that would be happy in decent cities.

I would not overthink this or put the cart ahead of the horse. I did this a ton during my search.

If you are local to them, reach out. There is basically no downside to that. Id argue its more important to see if you like the group than anything else.

Just to give you an idea: Im in I guess a lower tier "desirable city" and people reach out as early as PGY3. We are certainly not paying stipends. Also, I think you should lower your expectations a little on the finances 🙂

You have to remember a lot of RO jobs are just very corporate, so you should be gunning for a fair and vanilla contract that is tracked to median. Im sure if you go remote rural you can negotiate creatively. Make them buy you a scribe for the rest of residency!

Its always true that the absolute number of RO jobs in any city is small and there are a lot of ROs that would be happy in decent cities.

I’m not necessarily expecting those numbers, but since the location i’m considering is rural 50-100k population (that counts as rural right?) i’m hoping I can negotiate some favorable terms, especially since that would help them too knowing they won’t have to look for a replacement for me for a long time

 

[deleted1180461]

I would not overthink this or put the cart ahead of the horse. I did this a ton during my search.

If you are local to them, reach out. There is basically no downside to that. Id argue its more important to see if you like the group than anything else.

Just to give you an idea: Im in I guess a lower tier "desirable city" and people reach out as early as PGY3. We are certainly not paying stipends. Also, I think you should lower your expectations a little on the finances 🙂

You have to remember a lot of RO jobs are just very corporate, so you should be gunning for a fair and vanilla contract that is tracked to median. Im sure if you go remote rural you can negotiate creatively. Make them buy you a scribe for the rest of residency!

It’s always true that the absolute number of RO jobs in any city is small and there are a lot of ROs that would be happy in decent cities.

Finances should depend on volume.

It’s amazing how few come out of residency understanding this.

Should you make 800k?

It depends on how many patients you treat. That’s the only acceptable answer. Once you accept the salary mindset you allow someone else to exploit you.

 

[radoncftw]

Finances should depend on volume.

It’s amazing how few come out of residency understanding this.

Should you make 800k?

It depends on how many patients you treat. That’s the only acceptable answer. Once you accept the salary mindset you allow someone else to exploit you.

800k is alot for rad onc.

need the wallnerus in here, but i think there are not very many rad oncs making that kind of money.

 

[NotMattSpraker]

Let me step it back some. I think these upcoming years will be good for the Radonc job market, better than years preceding it.

Last year I saw a person walk away from an offer, I couldnt believe it. Very impressive candidate, but I agree it is a good market.

Finances should depend on volume.

It’s amazing how few come out of residency understanding this.

Should you make 800k?

It depends on how many patients you treat. That’s the only acceptable answer. Once you accept the salary mindset you allow someone else to exploit you.

Haha no, I understand. I've never been in a position to say "you are exploiting me" when I am handed an offer.

I’m not necessarily expecting those numbers, but since the location i’m considering is rural 50-100k population (that counts as rural right?) i’m hoping I can negotiate some favorable terms, especially since that would help them too knowing they won’t have to look for a replacement for me for a long time

You're rural if you need to be rural 🙂

Good luck. Im curious. I know of like 1 job similar to what your numbers, so maybe theres a handful out there? If you are "rural" hospital employed, it seems like these places aren't negotiating. This is the perma locums. And now you might have remote set ups (no I am not affiliated with one).

Just seems unlikely, but I hope it works out! If its your hometown, Id lean on that when you interview.

 

[deleted1180461]

800k is alot for rad onc.

need the wallnerus in here, but i think there are not very many rad oncs making that kind of money.

12-13k wRVU is a comfortable 30-40 hour work week in rad onc and should compensate that much.

The problem is we are over saturated and believe 7-8k wRVU is what full time 8-5 M-F rad onc should be.

 

[TheWallnerus]

800k is alot for rad onc.

need the wallnerus in here, but i think there are not very many rad oncs making that kind of money.

Isn’t MGMA telling us maybe 15% of all rad oncs now making that kind of money. That would be about 750 rad oncs nationwide. Very “Ripleys Believe It Or Not,” but if you like MGMA data, it is what it is.

 

[Bequerel]

Isn’t MGMA telling us maybe 15% of all rad oncs now making that kind of money. That would be about 750 rad oncs nationwide. Very “Ripleys Believe It Or Not,” but if you like MGMA data, it is what it is.

I think this is believable. More than 15% of the rad oncs I keep in touch make this much. If you’re in private practice (hospital based or free standing) and are not in the most desirable area of the country and you aren’t making >800k, then you’re doing something wrong.

 

[Doctorer]

Isn’t MGMA telling us maybe 15% of all rad oncs now making that kind of money. That would be about 750 rad oncs nationwide. Very “Ripleys Believe It Or Not,” but if you like MGMA data, it is what it is.

Yup. And keep in mind MGMA doesn't necessarily include the (smaller and smaller share of) radoncs in PP/ownership.

 

[radoncftw]

Yup. And keep in mind MGMA doesn't necessarily include the (smaller and smaller share of) radoncs in PP/ownership.

I guess MGMA is also total compensation as well (not necessarily salary + bonus).

 

[deleted1180461]

I guess MGMA is also total compensation as well (not necessarily salary + bonus).

Many in PP rad onc make 7 figures and don’t report to MGMA.

MGMA is a reasonable estimate for hospital employed jobs in terms of the flat wRVU rate you should negotiate. ($70 unless someone wants to convince me otherwise!)

It’s not necessarily for PP that are billing on their own especially if high volume.

That said I have met w2 docs making nearly 1.5M per year. It can happen but admin hates it cause they are scared of the big bad stark boogey man.