Why?
The fact that they’re rad onc’s is, frankly, irrelevant to their success.
Why?
The fact that they’re rad onc’s is, frankly, irrelevant to their success.
What are the appealing IM subspecialties in your opinion? GI and med onc? I feel like everyone on this forum trashes on IM
Also:
‘The academics who publish on nomograms, machine learning, big data on Lupron duration using retrospective studies, those rad oncs probably would be PI’s of phase 3 trials and heads of phase I/II centers if they’d gone into med onc.’
Seems a bit like magical thinking.
Also ignores the vast majority of what academic med oncs do. Very few are heard of phase I centers.
Nope, you're right. At least at major academic medical centers, the average medical oncologist will have significantly easier/more opportunities to get industry sponsored research going.Is it?
At the same career level, I see med onc’s have more opportunities and doing more substantive work in academics than their rad onc counterparts.
If you take the top or most senior 5% of academics in both fields, what I said is ballpark correct. Feel free to disagree. I don’t work in academics so I may be wrong or outdated.
UhFWIW, at my academic center the average medonc is making like half as much as the average rad onc. Grass is not always greener
Understatement of the century.Not the whole story
3) While many of us think "home call" is easier than hospital call (myself included), it means you can't really go anywhere or commit 100% to things on nights and weekends. Is your kid having a birthday party on Saturday at 1PM? Ah darn, cord compression page at 12:30PM. Spouse spontaneously suggests camping with friends at a park ~4 hours away? Ah can't, on call.
Agree. Treating on the weekends requires a call schedule of therapists/dosimetrists/physics etc, I've heard of places paying for call for them but logistically, for all intents and purposes, not sure how anyone can do this in the community these days esp if freestanding or smaller hospital with limited staffing/resources.As someone who is on call 24/7 unless I am on vacation, I'm going to disagree with this point. I work in a historically difficult-to-staff place an hour away from a mid sized city (where I live). I put in a ton of work running this department during the week to be bothered on the weekend.
I will generally always answer my phone, buy my "call" doesn't prevent my from doing anything in my personal life. When I leave work, I am off unless the rare patient or inpatient call comes through. If I happen to be doing something personally or with my family when something I truly am needed for comes in, the answering service can wait for me to get back to them or the patient can go to the emergency room (although not preferred) where acute intervention can actually happen.
I can use Epic app to look at images, notes, etc, and decide what is truly important for me to do at that moment. It takes me a minimum of 50 minutes just to get to the hospital if I leave instantly.
I agree with (and am in the same boat as) Metallica. Am I willing to be bothered on the weekdays I cover remotely? Of course. Driving in is no easy feat however.As someone who is on call 24/7 unless I am on vacation, I'm going to disagree with this point. I work in a historically difficult-to-staff place an hour away from a mid sized city (where I live). I put in a ton of work running this department during the week to be bothered on the weekend.
I will generally always answer my phone, buy my "call" doesn't prevent my from doing anything in my personal life. When I leave work, I am off unless the rare patient or inpatient call comes through. If I happen to be doing something personally or with my family when something I truly am needed for comes in, the answering service can wait for me to get back to them or the patient can go to the emergency room (although not preferred) where acute intervention can actually happen.
I can use Epic app to look at images, notes, etc, and decide what is truly important for me to do at that moment. It takes me a minimum of 50 minutes just to get to the hospital if I leave instantly.
Nothing I can do on the weekend that can *actually make a difference is truly that urgent. There are rare situations - treated a bleeding mass just this weekend. The answering service can leave me messages and other inpatient services generally agree with my approach and will send the appropriate patients that need surgical evals where they need to go (bigger more well-staffed centers not too far from me).
Luckily, these episodes are rare. If that ever changes, I will have to strongly consider changing jobs.
One thing that is a holdover from academic/tertiary residencies is this idea that we are available to treat inpatients 24/7 and that it actually matters. Radoncs in those places so desperately want to be relevant and needed they will ruin multiple people's and/or families' day jumping through hoops to treat an inpatient who could have waited until the next day or Monday with no clinical difference. Steroids, pain meds, and surgery can do more over a few days than radiation can in almost all scenarios.
Some of you probably feel differently, but that is the way I approach things and it has done well for my work/life balance being solo.
Hahaha there's no disagreement from me on this point actually.As someone who is on call 24/7 unless I am on vacation, I'm going to disagree with this point. I work in a historically difficult-to-staff place an hour away from a mid sized city (where I live). I put in a ton of work running this department during the week to be bothered on the weekend.
I will generally always answer my phone, buy my "call" doesn't prevent my from doing anything in my personal life. When I leave work, I am off unless the rare patient or inpatient call comes through. If I happen to be doing something personally or with my family when something I truly am needed for comes in, the answering service can wait for me to get back to them or the patient can go to the emergency room (although not preferred) where acute intervention can actually happen.
I can use Epic app to look at images, notes, etc, and decide what is truly important for me to do at that moment. It takes me a minimum of 50 minutes just to get to the hospital if I leave instantly.
A lot of hospitals will not let you take call if you don’t live in town, or live more than 30 minutes from the hospital, or both. Functionally this often means if you want to be a rad onc in that hospital you can’t be a “rad onc carpetbagger.” But clearly some hospitals are allowing this now.
SVC syndrome seems to be the best bang for your buck emergency in my experience. Just brought somebody back from the verge of death quickly with 20/5 started emergently.I agree with (and am in the same boat as) Metallica. Am I willing to be bothered on the weekdays I cover remotely? Of course. Driving in is no easy feat however.
But to say you can’t leave town on the weekends because of a possible cord compression sim and treat, ouch. You need to be getting compensated for that, like a lot. If not you are getting hosed.
For other more immediately useful specialties, this policy makes sense. It doesn't for us.
correct. I’ve read GynOnc contracts with a hospital forbidding them to live > 30 min drive away. Have not seen a similar clause for RadOncs, howeverA lot of hospitals will not let you take call if you don’t live in town, or live more than 30 minutes from the hospital, or both. Functionally this often means if you want to be a rad onc in that hospital you can’t be a “rad onc carpetbagger.” But clearly some hospitals are allowing this now.
I believe this phenomenon is dying. It's a real killer for recruitment for a lot of places. There's a good sized city 45 min to 1:15 away with the best schools in the area and a job for your spouse, but you can't live there? It is better to live in the community you serve IMO (sort of like a police officer), but this just isn't always happening with today's hospitals and doctor demographics.correct. I’ve read GynOnc contracts with a hospital forbidding them to live > 30 min drive away. Have not seen a similar clause for RadOncs, however
My hospital has the clause for all medical staff regardless of specialty (it's 45 minutes though).correct. I’ve read GynOnc contracts with a hospital forbidding them to live > 30 min drive away. Have not seen a similar clause for RadOncs, however
I agree as well, lots of radoncs can leave early and don't need to be on-site all the time. that can have other implications with respect to QOL, though, not all of which are positive.You’re very busy. I work weekends sometimes too. MANY don’t.
I think it’s not intellectually honest to say rad onc doesn’t have a good QOL. Is it what it used to be when some were throwing a few wax drawings on and hitting the links? No. But the fact that it’s even possible to not be on site in the current environment or can leave work at 2 fares VERY favorably to many other fields. Can we be honest about this?
Use an office address, or a temp address. Or move after you get credentialed and privileged. They aren't going to enforce this against an RO the same way they might against a surgeon or interventional cardsA lot of hospitals will not let you take call if you don’t live in town, or live more than 30 minutes from the hospital, or both. Functionally this often means if you want to be a rad onc in that hospital you can’t be a “rad onc carpetbagger.” But clearly some hospitals are allowing this now.
This is exactly where I've seen it. Part of medical staff bylaws indicating where you need to resideMy hospital has the clause for all medical staff regardless of specialty (it's 45 minutes though).
IR does stents, not sure how effective, i rec chemo inpatient if heme or small cell/testicularSVC syndrome seems to be the best bang for your buck emergency in my experience. Just brought somebody back from the verge of death quickly with 20/5 started emergently.
This scheme reminds me of that time I went to South Korea, made a clone of myself, and sent him back to the states to directly supervise my radiation therapies. I’m still trying to get that guy approved for the SDN rad onc business forum.Use an office address, or a temp address. Or move after you get credentialed and privileged. They aren't going to enforce this against an RO the same way they might against a surgeon or interventional cards
The way life works, there is usually a price to pay for being too creative (? karma or something).This scheme reminds me of that time I went to South Korea, made a clone of myself, and sent him back to the states to directly supervise my radiation therapies. I’m still trying to get that guy approved for the SDN rad onc business forum.
What are you… a physics enjoyer???We are as competitive as we should be currently. The job market is temporarily better and will not persist. But even not considering that truth (most likely): RadOnc is a very niche field, the majority of people are not physics enjoyers, and there is a real likelihood that the state you want to work in may not have a job for you.
I dabbleWhat are you… a physics enjoyer???
What are you… a physics enjoyer???
If you are looking for a super chill 4 year residency and don’t care about your 40 year career, then rad onc just might be for you!For the lurkers regarding lifestyle during residency- I'm coming up on 30 days of skiing this year while in residency, which is a common number to get to. Could get to 50 if I really wanted to drive that much.
If you are looking for a super chill 4 year residency and don’t care about your 40 year career, then rad onc just might be for you!
A person who skis 30-50 days a year offering to break down the "way things are" also sounds like a skit.A resident telling attendings about their own speciality is certainly unique
I mean this forum is full of disgruntled people
This is actually my main point!!!!!For the lurkers regarding lifestyle during residency- I'm coming up on 30 days of skiing this year while in residency, which is a common number to get to. Could get to 50 if I really wanted to drive that much.
What year are you?I mean this forum is full of disgruntled people, and don't get me wrong, there's plenty that could be improved with leadership and whatnot. But to say rad onc is a bad career is pretty laughable. Feel free to DM me
Honestly most people here are pretty happy with their situation. I do agree that the number of truly unhappy Rad Oncs I know in real life is fairly small (maybe n of 1). I think the concerns are about the future.
A person who skis 30-50 days a year offering to break down the "way things are" also sounds like a skit.
I'm a signed to a great job PGY-5.This is actually my main point!!!!!
All med students and other residents get to see IS THE RESIDENCY LIFESTYLE.
It's generally good!
It's not representative.
And I also don't think anyone here has ever said the attending lifestyle was "bad" either.
It's average. Other than the, you know, geography lock.
What year are you?
I know the skiing was horrible in the Midwest but that's not the case for the entire country. I don't know why you think what I've said is not believable. Did I take some vacation to accomplish 30 days- yes, I did. But I also haven't gone every weekend, and I'm not going during the work week. It's just a ton of driving. It is also all self funded and done frugally.Even with a season pass, no one is self funding 30-50 days of skiing a year (did we even have that many with this pathetically short season?) on a resident's income while also affording rent in what has got to be a HCOL western or northeastern area. This would require night skiing for a decent amount of this time since even skiing every saturday and sunday would not get you to these numbers, and I am suspicious that a rad onc resident anywhere is getting out of clinic early enough to drive to the mountains, gear up, get a couple hours of night skiing in, then drive home and get enough sleep to be at work at 7-8AM the next day. Vail does not have a rad onc residency so we are talking about at least 1 hour from denver in perfect conditions and no traffic, which if you've ever done this is less than half the time. Salt Lake City to the canyons is closer, sure but I've been stuck, and is the only location I can think of off the top of my head where this would even be remotely doable.
If you are independently wealthy and like the work, sure, rad onc is not a "bad career." There is certainly no shortage of people who fit this bill in the field, especially in the heyday of top USMLE scores reflecting the end of the prep school-->ivy league-->family/trust fund supported T10 med school pipeline.
Definitely worse hours in practice than in residency at times, but I'm being compensated appropriately and no scut. Geography is the big elephant in the room, imagine being in a decent area for residency with a cush schedule and then having to move to bfe to work harder with no other options.My residency was totally cush and my wife was an attending physician in another specialty. I could totally have skiied 50 days if I lived in a mountain area. I probably averaged about 30 hours a week of time I had to be physically present.
As an attending life has been different.
Definitely worse hours in practice than in residency at times, but I'm being compensated appropriately and no scut. Geography is the big elephant in the room, imagine being in a decent area for residency with a cush schedule and then having to move to bfe to work harder with no other options.