Why is rad onc so competitive?

[drowsy12]

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i dont get why rad onc is so competitive? is it the small amount of spots? Other competitive fields have high salary correlations but

http://www.salarylist.com/all-radiation-oncologist-real-jobs-salary-1.htm?order=2

the salaries in the field don't seem to correspond to the competitiveness of the field. thoughts anyone? thanks.

 

[hot sauce]

There are several things to take into account. First I do not believe your link is a very accurate gauge of rad onc salaries. Maybe look at http://www.aamc.org/students/cim/pub_radoncology.htm or other sites that compare physician salaries (http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm or http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm).

I believe the competitive nature also comes from the academic nature of the field and that it is a small field. It tends to attract people who may be more academically inclined and therefore more md/phd and people with high board scores and research background. Of course it may also be self sustaining in that people looking at charting outcomes and are less likely to apply if they feel they don't have a good shot.

Additionally, radiation oncology has a better lifestyle (both for residents and attendings) than many other fields of medicine.

 

[bragmt]

After spending several years in Rad Onc it has become extremely clear why this field is arguably one of the three most competitive that exists. For starters the salary list you posted is definitely in the “starting” range. I think more accurate estimates can be found here:
http://www.allied-physicians.com/salary_surveys/physician-salaries.htm
http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm
Assuming people on the forum agree with these numbers Rad Onc is one of the highest compensated fields of medicine.
That alone however is not enough to make it extremely competitive. What really sets Rad Onc apart, if you compare it to the other highly reimbursed specialties , are several key differences. First of all Rad Onc is unique in the sense that you truly have an extremely predictable schedule. Nights and weekends are free. Its amazing. This is so unique in medicine, extremely rare, and IMHO absolutely priceless. In addition to having a regular schedule you still have the role of an actual doctor. You see patients in long term follow up, develop outstanding patient relationships, and get the reward of helping to cure cancer every day. In addition to actually seeing patients regularly and discussing your management with them, you get to use amazing technology that works incredibly well. Overall our treatments are unbelievable, and the best thing is they work extremely well. Radiation is the future of cancer care, its importance increases every year, and its side effects decrease. There is almost nothing negative you could say about Rad Onc. For these reasons lots of extremely highly qualified medical students are interested in it, which will only advance the field further in the years/decades to come.

 

[Gfunk6]

Wow bragmt that was an incredibly eloquent post. I may have to steal it for the FAQ (giving you credit, of course) if you agree.

 

[drowsy12]

thanks for the info! well said.

 

[Palex80]

There is almost nothing negative you could say about Rad Onc.

Except for the psychologic stress.
IMHO this is one problem for many med. students looking into their future work field.
Radiation oncology can be quite stressful, because a sizable part of our patients are on palliative care and we treat them during the last motnhs of their lives. Patients often die during or immediately after their rad. onc. treatment. I think this is a major factor, that has to be taken into account.
One can cope with this and the more experience you gain, the better you can cope with it.
Other fields share this problem, but we are the ones that generally treat (more or less only) life threatening diseases (other than med. oncs).

 

[medgator]

After spending several years in Rad Onc it has become extremely clear why this field is arguably one of the three most competitive that exists. For starters the salary list you posted is definitely in the "starting" range. I think more accurate estimates can be found here:
http://www.allied-physicians.com/salary_surveys/physician-salaries.htm
http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm
Assuming people on the forum agree with these numbers Rad Onc is one of the highest compensated fields of medicine.
That alone however is not enough to make it extremely competitive. What really sets Rad Onc apart, if you compare it to the other highly reimbursed specialties , are several key differences. First of all Rad Onc is unique in the sense that you truly have an extremely predictable schedule. Nights and weekends are free. Its amazing. This is so unique in medicine, extremely rare, and IMHO absolutely priceless. In addition to having a regular schedule you still have the role of an actual doctor. You see patients in long term follow up, develop outstanding patient relationships, and get the reward of helping to cure cancer every day. In addition to actually seeing patients regularly and discussing your management with them, you get to use amazing technology that works incredibly well. Overall our treatments are unbelievable, and the best thing is they work extremely well. Radiation is the future of cancer care, its importance increases every year, and its side effects decrease. There is almost nothing negative you could say about Rad Onc. For these reasons lots of extremely highly qualified medical students are interested in it, which will only advance the field further in the years/decades to come.

Wow bragmt that was an incredibly eloquent post. I may have to steal it for the FAQ (giving you credit, of course) if you agree.

👍

Completely agree with what bragmt said. I tell me people that the worst day of rad onc residency beats out the best day of internship. Rad onc is a very interesting field that is extremely gratifying from a personal standpoint. It incorporates technology/imaging, patient care/contact, and a generally benign lifestyle in a way that no other field even comes close to doing. It definitely isn't for everyone, but for those of us who are fortunate enough to have stumbled into this field, the vast majority of us are incredibly happy with our choice.

The salary is just the icing on the cake. At the end of the day, you have to like what you do. Lay people on the outside think what we do is similar to radiology and I tell them that I would be bored to tears reading film in a darkroom all day 😴 While our field is in the same tier of competitiveness as derm, the similarities between derm and rad onc end with the lifestyle and the compensation.

 

[CandidateofDerm]

👍

Completely agree with what bragmt said. I tell me people that the worst day of rad onc residency beats out the best day of internship. Rad onc is a very interesting field that is extremely gratifying from a personal standpoint. It incorporates technology/imaging, patient care/contact, and a generally benign lifestyle in a way that no other field even comes close to doing. It definitely isn't for everyone, but for those of us who are fortunate enough to have stumbled into this field, the vast majority of us are incredibly happy with our choice.

The salary is just the icing on the cake. At the end of the day, you have to like what you do. Lay people on the outside think what we do is similar to radiology and I tell them that I would be bored to tears reading film in a darkroom all day 😴 While our field is in the same tier of competitiveness as derm, the similarities between derm and rad onc end with the lifestyle and the compensation.

That is utter foolishness. The so eloquently stated post that says rad onc is great because you get to nights and weekends, role as the actual doctor, long term patient relationships, cure cancer applies in a more academic learning setting applies equally to derm as well. The one thing we don't have is amazing technology though! Although we do have amazing surgical

 

[mpdoc2]

many view dermatologists more as cosmetologists than "real doctors" 😉

 

[hot sauce]

That is utter foolishness. The so eloquently stated post that says rad onc is great because you get to nights and weekends, role as the actual doctor, long term patient relationships, cure cancer applies in a more academic learning setting applies equally to derm as well. The one thing we don't have is amazing technology though! Although we do have amazing surgical

And derm is also competitive but practicing dermatology is going to be pretty different than radiation oncology.

It sounds like you are looking at things as a competition for who can claim the best specialty which is unnecessary. No field is right for everyone. Hopefully derm is good for you while I would not enjoy being a dermatologist.

 

[Palex80]

Hopefully derm is good for you while I would not enjoy being a dermatologist.

"Should I use a steroid or should I use an antibiotic? Oh, what the hell, let's use both!"

 

[clinonc]

"Radiation is the future of cancer care"

I think this is a little hubristic. If anything can be said to be the future of cancer care, it is integrating an understanding of cancer biology into treatment protocols. If radiation oncologists embrace this inevitable trend and use their much-vaunted intellectual abilities to consolidate and expand the role of radiotherapy, then its future is assured. If they get into the field for the money and lifestyle alone, their modality will be furhter sidelined by those who do not appreciate its existing role, and ultimately it will be supplanted.

 

[deleted4401]

Don't see the need to pick on dermatologists ...

I think it's the intellectual nature of the work, the opportunity to work with cancer patients, the utilization of technology that is unparalleled by any other specialty other than dx rads, and of course the routine schedule with very little call responsibility or weekend/night work. The pay is great, but I don't think it's the driving force, since it has always paid well. I think the tremendous shift is most likely due to the technology/imaging aspect of it. I just don't think I would have chosen this field if I rotated in 1983 and had to use grease pencils and bony anatomy. Just isn't as cool.
-S

 

[medgator]

I just don't think I would have chosen this field if I rotated in 1983 and had to use grease pencils and bony anatomy. Just isn't as cool.
-S

Definitely feel the same way. It's just amazing how much this field has changed over the last 20 years.

 

[medgator]

Don't see the need to pick on dermatologists ...

That wasn't the intent of my previous post. I just wanted to contrast the nature of what we did, despite the similarities that some may see on the outside looking in. Yes, both field have relatively benign hours and competitive residencies to match in, but that, IMO is pretty much where the similarities end.

Derm is good for some people, and rad onc for others. I certainly couldn't do derm anymore than I could do radiology. There's really no other substitute for this field if you've figured out that this is truly what you want to do.

 

[drowsy12]

thanks for all the replies, sounds like a great field and everyone here seems happy. from what i can tell the pay is still lower than surgical subspecialties, but the lifestyle is better. although something like urology has a pretty benign lifestyle with significantly higher pay

 

[Pewl]

thanks for all the replies, sounds like a great field and everyone here seems happy. from what i can tell the pay is still lower than surgical subspecialties, but the lifestyle is better. although something like urology has a pretty benign lifestyle with significantly higher pay

I don't know if a "benign" surgery specialty exists, and you'd be surprised at how much some of the private practice rad oncs make. RidONCulous! 😱

 

[drowsy12]

ha, well if you don't want to give specifics, which people seem to avoid around here, would you say that the salaries are in line with what the links above show?

 

[TarHeelRadOnc]

ha, well if you don't want to give specifics, which people seem to avoid around here, would you say that the salaries are in line with what the links above show?

Reimbursement in medicine is always in flux... particularly now in the era of health care reform. That said, the quoted links are not accurate for private practice radiation oncology. The upper limit of the range is low compared to a busy, well run private practice which retains al of their professional revenues. For a practice with technical ownership, the salaries are far (ie multiples) higher than those quoted. In community practice, radiation oncologists tend to do much better than Urologists... in fact, this reality is the whole impetus behind Urorads! If Urology had such superior reimbursement, why would Urologists be bending over backward (and in some cases, compromising their ethics) to own radiation machines??? Fortunately, the Urorads model is now under scrutiny and may not be sustainable with the initiation of Stark law investigations...

 

[G'ville Nole]

ha, well if you don't want to give specifics, which people seem to avoid around here, would you say that the salaries are in line with what the links above show?

Given that I hold one of the positions listed in your link (these appear to be from 2007 BTW) for several times the stated salary, no, salaries are not even close to being in line with what the link shows.

 

[Pewl]

ha, well if you don't want to give specifics, which people seem to avoid around here, would you say that the salaries are in line with what the links above show?

I know numerous private practice rad onc docs that makes close to or over a million a year. I wouldn't necessarily call this the norm in private practice but the pay ceiling is certainly much higher in private practice rad onc, especially if there is technical ownership of the machines by the docs.

 

[cdf95cro]

Pewl makes the important observation that most folks don't get: the money is in technical fees, not professional activities. The guys who make bank are the ones who either own the machines or get a share of technical fees. This is where the divergence in Rad Onc income between high (200-400k) and stratospheric pay manifests, as I can tell.

I know of a couple of only a few guys personally who have made 1mil+; all have either owned/co-owned their machines/facilities, or gotten a big cut of technicals. But its important to remember, no matter how much you make in salary, someone is going to be banking all those technical fees (and for most Rad Oncs I've heard potential collectable numbers in the 2-4 mil range annually per doc if you do much IMRT)...it just may not be you😉

 

[medgator]

Pewl makes the important observation that most folks don't get: the money is in technical fees, not professional activities. The guys who make bank are the ones who either own the machines or get a share of technical fees. This is where the divergence in Rad Onc income between high (200-400k) and stratospheric pay manifests, as I can tell.

I know of a couple of only a few guys personally who have made 1mil+; all have either owned/co-owned their machines/facilities, or gotten a big cut of technicals. But its important to remember, no matter how much you make in salary, someone is going to be banking all those technical fees (and for most Rad Oncs I've heard potential collectable numbers in the 2-4 mil range annually per doc if you do much IMRT)...it just may not be you😉

that being said, I've heard that a busy professional practice (40+ on tx over the year) can still get you into the high six-figures, even if you don't own the technical part of it. In the case of things like urorads, I've heard that radoncs make close to a seven figures because of the sheer volume of professional fees they collect on all of those prostate pts on the linac.