Why does rad onc salary remain so high if the job market is so bad?
Started by odyssey2
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the stickiness of prices/wages per Keynes ?
Rad onc has had the biggest reimbursement cuts over the last 20 years of almost any specialty and the biggest residency expansion; 2026 is a MURDEROUS year for our specialty’s reimbursement. (Rad onc is also incredibly poorly funded for new-treatment research within oncology in general.) The usual thinking is “past performance doesn’t predict future gains.” Yet I’ve been in rad onc long enough to know we are the outlier… in everything. I see past performance being a strong predictor for us. Worst reimbursement. Worst job market. But best salaries! We are like the cockroaches or tardigrades of medicine.
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No, it’s not holdovers driving it. Our salaries are by and large still pretty high. It’s important to note that the number you quoted ($588) is representative of total compensation (base, bonus, retirement matching, fringe) of someone mid career. I can speak more for academics than PP. That number is pretty achievable at many, but not all centers. I’m 8.5 years in and my total comp is just a touch under that. I should get promoted to full professor in about 3 years a which point I’ll be a bit over it. Where I worked previously, pay wasn’t quite as good but it was still pretty decent (total comp was pushing $475 as an associate) and cost of living was low so I was not hurting at all. I can name (but won’t publicly) places that pay much better and much worse.
That’s the good. The bad is that there are pressures pushing compensation down and it’s hard not to see that affecting us more directly eventually. If we don’t get pay cuts it will almost certainly mean working leaner and a tighter job market. There are also plenty of academic satellites that are downright predatory in their compensation structures and those were virtually non existent before. Anyone in PP will tell you that our high end cap is absolutely less than it was previously.
So yes, despite all of our challenges, pay is still pretty good for most of us. For people who are very flexible for location and tolerant of uncertainty, we are still a great field. I just encourage people to make sure they don’t underestimate the value of a flexible job market. Life changes especially when you add in kids and spouses. Even free spirits often (usually I’d wager) eventually find themselves rooted to a limited number of geographical areas.
Literally every radiologist I know makes much more than that.
The surveys don't capture private practice or private practice ownership. The surgical specialists, radiologists, anesthesiologists, dermatologists, IM specialists with equipment, ASC, real estate, or practice ownership are not taking the Doximity, Medscape, MGMA, AAMC, various recruiter or job placement-based salary surveys. MGMA and AAMC are all big institution, slave-job surveys. Rad onc has some of the highest rates of employment amongst medical specialties, here is your 588k to sit down, listen to your admins, serve on your committees, keep your sleepy 4 consult a week practice humming along. We are higher than rads and derm most likely because financially ambitious rads and derms docs are not working for big institutions. Our ceiling is low, as a whole so is our job mobility and prospects for advancement, so is the dynamism of our field.
The consolation is that it's a good salary and better than the average American, subject of course, to the job market and the machinations of your corporate overlords. It's worse than past rad onc generations and much more difficult to have any ownership or equity, which is something that many other educated professionals, small business owners, and physicians have, and which they're not reporting to the data aggregators.
The consolation is that it's a good salary and better than the average American, subject of course, to the job market and the machinations of your corporate overlords. It's worse than past rad onc generations and much more difficult to have any ownership or equity, which is something that many other educated professionals, small business owners, and physicians have, and which they're not reporting to the data aggregators.
While I would normally agree, this is what seems like someone below the level of Rad Onc resident based on posting history who would then be unable to participate. Maybe a med student.
Tag me in say a week and I'll move it over for posterity.
@odyssey2 please let mek now when you are 'done' with this thread.
In short, 588k total comp is not impossible. W2 paycheck that amount is less likely. Some folks are making 7 figures and are certainly driving the average (if it is mean and not median) figure up.
The nightmares are the jobs that make you do the work of someone who used to get paid 1 mil but pay you 325k. Especially worse if there's no bonus structure.
The SDN specialty forums are meant for residents or attendings. The specialty forums are not intended for questions that are controversial or sensitive from others outside those groups. So I think we should just shut this one down.
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