What to do after residency if no job offers?

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radonculous101

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What alternatives are PGY-5's thinking of for when they dont get a job for next year? Seems like alot of people will be in that boat this year, nothing seems to be available outside of quite remote cities in middle states. So just curious if people are thinking of doing fellowship, moving to remote area, moonlighting, leaving medicine, other thoughts?
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can one do an IR fellowhip from rad onc? that would be very interesting.
 
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There definitely is some selection bias out there (as expected) but all I'm getting are bunksville, ND

You would think after residency, finding an average job close to family would be a little easier and no I'm not asking for southern California, 3 days a week: 500k per year either.
 
RadOncDoc21 said:
There definitely is some selection bias out there (as expected) but all I'm getting are bunksville, ND

You would think after residency, finding an average job close to family would be a little easier and no I'm not asking for southern California, 3 days a week: 500k per year either.
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For the record, many jobs don't necessarily go through the ASTRO site. If you have your heart set on a certain location, it may be better to just cold-call, cold-email practices preferably starting in your PGY-4 year to get a sense of their needs.

Market does feel a little tighter, I will give you that, but I do know at least in FL, people are still signing contracts and getting jobs. Also in TX and the carolinas. The big metro areas along the coasts are always a tough nut to crack.

Personally, I'd look at the VA or academics if the op is looking for a certain geographic area and pp opportunities haven't been panning out.
 
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If location is important to you, radonc ain't the right field. Even in "good" years (and I have no idea if this is one or not), you're just not going to have that much geographic choice. My year, for example, not a single job was available in the entire state of Colorado, and I was pretty happy with the overall number of offers I had. If a job in a "remote city in a middle state" is available, then that's what's available. If it were me, I would take a job in a less-than-desirable location, then continue to network as hard as possible for that next job while working on passing boards.

This is the worst part of our field IMO- very, very tough to dial things in geographically.
 
I agree with OTN. You basically have a few options which I will list in decreasing order of desirability:

1. Get a good job in a crappy location. This will keep your skills sharp, keep you professionally engaged, and keep the door open for jobs in an area where you potentially want to move.
2. Do locums work in the area where you want to move. This may not pay the bills depending on the work available. Also, you may not be involved in primary patient management but only 'babysitting.'
3. Get a Urorads job or Dermrads job in the area you want to live. This may put a permanent 'black mark' on your CV, so pursue with caution.
4. Do a non-clinical job. Consulting type arrangements are great for semi-retired Rad Oncs or at least those with > 5 years experience. Not good for new grads.
 
californiaXRT said:
This is a very depressing thread.
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Then write a letter to the editor of the Red Journal asking the 'powers that be' to stop indiscriminately opening Rad Onc positions throughout the country. Somehow, I doubt the folks in the ivory towers will give a hoot.
 
Looks like he was an attending at WashU when he wrote that. He's in PP now.
 
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I have a very very deep regret for going into Radonc right now. It's like everything I've done for so many years means nothing. This is a terrible feeling
 
radonculous101 said:
I have a very very deep regret for going into Radonc right now. It's like everything I've done for so many years means nothing. This is a terrible feeling
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Cheer up mate, I can definitely relate to you but I still think the field is a great field and I'm banking on that it is still too early to tell how things will end up in regards to finding a job.

In the famous words of 2pac: "Gotta keep ya head up!"
 
Has the tightness of the job market started to trickle down to medical students?

We've taken a hit in interested med students in Radiology largely due to job market concerns. Curious if you guys are seeing this as well.
 
I've heard from multiple younger attendings that new insurance rules are expected to weed out non-board certified/non-MOC senior RadOnc's... there are a lot of those, true, but I'm skeptical.
 
seper said:
I've heard from multiple younger attendings that new insurance rules are expected to weed out non-board certified/non-MOC senior RadOnc's... there are a lot of those, true, but I'm skeptical.
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As am I. There will be lawsuits filed I am sure from those who are in fact BC but have lifetime certificates. The non-BC people will probably get weeded out.
 
seper said:
I've heard from multiple younger attendings that new insurance rules are expected to weed out non-board certified/non-MOC senior RadOnc's... there are a lot of those, true, but I'm skeptical.
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From what I understand there's no way they can do that, as the board certification given to the older docs who were grandfathered in represent contracts that can't simply be broken by the ABR: That is, they will always be board-certified, no matter what. If an insurance company says "we want only board-certified radoncs" the older docs will fit that bill. Forever.
 
xrthopeful said:
what is MOC?
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Maintenance of certification

OTN said:
From what I understand there's no way they can do that, as the board certification given to the older docs who were grandfathered in represent contracts that can't simply be broken by the ABR: That is, they will always be board-certified, no matter what. If an insurance company says "we want only board-certified radoncs" the older docs will fit that bill. Forever.
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It's not the lifetime BC guys that are at risk, but the people who never bother to get BC who perpetually listed themselves as BE. The ABR quashed this practice a few years ago, giving people who graduate from residency long ago five years max to get BC. Most hospitals have banned non-BC/BE from medical staff but insurance plans are getting on board with this practice as well.
 
This scares me... As someone who's interested in rad onc, I don't want to have to think about not getting a job once I finish training (and who knows how much worse it could become in 10 years). I know that the market is somewhat saturated, but are other PGY5s dealing with this same issue at the moment? So is it true then that you need to go to a top program to have decent job prospects coming out?

OP, are you at one of the top rad onc programs?
 
smarts1 said:
This scares me... As someone who's interested in rad onc, I don't want to have to think about not getting a job once I finish training (and who knows how much worse it could become in 10 years). I know that the market is somewhat saturated, but are other PGY5s dealing with this same issue at the moment? So is it true then that you need to go to a top program to have decent job prospects coming out?

OP, are you at one of the top rad onc programs?
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As others have alluded to, the OP has vastly overstated relevant concerns. There are jobs and they are available. This is the feedback I am garnering among the current cohort of PGY-5's. Job situation may become disastrous in the future, who knows?
 
smarts1 said:
This scares me... As someone who's interested in rad onc, I don't want to have to think about not getting a job once I finish training (and who knows how much worse it could become in 10 years). I know that the market is somewhat saturated, but are other PGY5s dealing with this same issue at the moment? So is it true then that you need to go to a top program to have decent job prospects coming out?

OP, are you at one of the top rad onc programs?
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The OP is over the top. I'm a PGY-5 at a mid level program and have already have turned down 2 offers paying over 300K this year.
 
Zeus222 said:
The OP is over the top. I'm a PGY-5 at a mid level program and have already have turned down 2 offers paying over 300K this year.
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If you don't mind me asking, for what reasons did you turn down your first two offers?
 
Yes at a very good program. I'm not sure where these people are coming from that have job offers, but I venture to guess these are the jobs we have mentioned before in remote areas of the country. Just look at websites that have rad onc physician pictures; everyone is young to mid-age. They aren't going anywhere for a while.

I am probably breaking unwritten rules by telling the truth but I don't think anyone would recommend rad Onc right now if you have any specific geog interest other than remote areas.
 
What do you consider remote? Charlotte? Cincinnati?

Trying to figure out how selective you're being here.
 
lets just look at some of the jobs on the astro website right now. weston, wi; lakeland fl; bowling green, kt; scottsdale az; morehead city, nc. When this is all that is posted, even this becomes very competitive
 
The ASTRO website is not a reasonable representation of the available jobs. Graduated recently, had numerous job offers, and was lucky to get a very good job in a desirable location (albeit a 'middle state'). Have many friends who graduated at the same time and don't know one who took a job posted on ASTRO website. There's a reason why they're having to advertise...
That said, get off the high horse. While I'm no desert fan, including Scottsdale AZ as a 'remote location' just screams of ignorance. A quick glance at wikipedia shows "the NYT described downtown Scottsdale as "a desert version of Miami's South Beach" and as having "plenty of late night partying and a buzzing hotel scene"...it's an urban area of >4 million people. It's very myopic to label anywhere that isn't CA or on the eastern seaboard as not worth your while.
Reminds me of the guy I met at a residency interview in Chicago from NYC who was excited to tell us it was his first time west of the Mississippi River...
 
Cancerdancer said:
The ASTRO website is not a reasonable representation of the available jobs. Graduated recently, had numerous job offers, and was lucky to get a very good job in a desirable location (albeit a 'middle state'). Have many friends who graduated at the same time and don't know one who took a job posted on ASTRO website. There's a reason why they're having to advertise...
That said, get off the high horse. While I'm no desert fan, including Scottsdale AZ as a 'remote location' just screams of ignorance. A quick glance at wikipedia shows "the NYT described downtown Scottsdale as "a desert version of Miami's South Beach" and as having "plenty of late night partying and a buzzing hotel scene"...it's an urban area of >4 million people. It's very myopic to label anywhere that isn't CA or on the eastern seaboard as not worth your while.
Reminds me of the guy I met at a residency interview in Chicago from NYC who was excited to tell us it was his first time west of the Mississippi River...
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dude calm down, i know scottsdale is a nice place. just taking the first bunch i saw. scottsdale would be great. hundred of people applied to that position. You're experience from last year is not representative of what is going on right now.
 
Lol there arent hundreds of applicants.
 
mpdoc2 said:
Lol there arent hundreds of applicants.
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Considering there are roughly ~140 graduating nowadays in any given year, I'd tend to agree. Scottsdale is a nice city. I also know people who have gotten jobs in the last couple of years in both SoCal and NorCal/the bay area, along with chicago. You take the salary hit of course, but that comes with the territory. Salaries are better down south and in the midwest.
 
Also you know that at least a 1/4 of the people graduating received offers from their home programs.
 
radonculous101 said:
Yes at a very good program. I'm not sure where these people are coming from that have job offers, but I venture to guess these are the jobs we have mentioned before in remote areas of the country. Just look at websites that have rad onc physician pictures; everyone is young to mid-age. They aren't going anywhere for a while.

I am probably breaking unwritten rules by telling the truth but I don't think anyone would recommend rad Onc right now if you have any specific geog interest other than remote areas.
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I wouldn't recommend RadOnc to anyone ever if they have a specific geographic interest. Just too small of a field to guarantee something will be open in any particular area in any given year.
 
Roughly 175 spots were open last year for new positions, are there really only 14o graduating seniors this year? 30 more spots opened up in just a few years?

Yikes.
 
Yeah, that's what happens when mechanisms of supply and demand are completely unlinked. When the people "regulating" supply are not influenced/concerned by demand (or lack thereof).
Of course a governing body could regulate these forces...but we all know how our societies feel about that.
 
I though rad onc was like derm, numbers kept ridiculously low so graduates can find well paying jobs, thus keeping the field prestigious. If numbers are not kept low, why is it so competitive?
 
EMDO2018 said:
I though rad onc was like derm, numbers kept ridiculously low so graduates can find well paying jobs, thus keeping the field prestigious. If numbers are not kept low, why is it so competitive?
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You use cool technology to cure cancer. 😛
 
EMDO2018 said:
I though rad onc was like derm, numbers kept ridiculously low so graduates can find well paying jobs, thus keeping the field prestigious. If numbers are not kept low, why is it so competitive?
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Things change over time maybe. The field is still interesting and people are still getting decent jobs if their geography is flexible. Even if this field came down to radiology in terms of salaries and job market, I think this would still be a more interesting field with the patient contact and such.

The increase in spots and new residency programs is only a recent phenomenon in the last 5 years
 
You know I have been thinking about this oversupply issue and I think its not as lost a cause as we think. New residents coming into the field require two things. 1. Residency spots and 2. Med students interested in training. Obviously we have tried to address issue no.1 and its just not budging. However, we as residents have a powerful influence on No.2. By sharing our truthful difficult job search stories, and the stories of our colleagues with medical students who rotate through the dept, we can do these students and ourselves a favor by discouraging weak applicants who may be matching into lower tier programs from apply to rad onc. Furthermore, I encourage graduating PGY 5s to post their views on this website. Perhaps we can effect a grass roots change to limit the no. of entrants to our field.
 
Member223232 said:
You know I have been thinking about this oversupply issue and I think its not as lost a cause as we think. New residents coming into the field require two things. 1. Residency spots and 2. Med students interested in training. Obviously we have tried to address issue no.1 and its just not budging. However, we as residents have a powerful influence on No.2. By sharing our truthful difficult job search stories, and the stories of our colleagues with medical students who rotate through the dept, we can do these students and ourselves a favor by discouraging weak applicants who may be matching into lower tier programs from apply to rad onc. Furthermore, I encourage graduating PGY 5s to post their views on this website. Perhaps we can effect a grass roots change to limit the no. of entrants to our field.
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Then we'll just have a bunch of foreign grads in our field. There will always be FMGs who didn't match into family medicine who would rather have a residency position than no position at all. So is that what you want? A field so crappy that it's filled with a bunch of foreign grads?
 
Member223232 said:
You know I have been thinking about this oversupply issue and I think its not as lost a cause as we think. New residents coming into the field require two things. 1. Residency spots and 2. Med students interested in training. Obviously we have tried to address issue no.1 and its just not budging. However, we as residents have a powerful influence on No.2. By sharing our truthful difficult job search stories, and the stories of our colleagues with medical students who rotate through the dept, we can do these students and ourselves a favor by discouraging weak applicants who may be matching into lower tier programs from apply to rad onc. Furthermore, I encourage graduating PGY 5s to post their views on this website. Perhaps we can effect a grass roots change to limit the no. of entrants to our field.
Click to expand...

My guess is that this will backfire and that it will be the strong applicants that run to other fields because they are the ones that have other options. The weak applicants have nothing to lose by applying anyway.
 
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