mavrik13

It's been a long time since this has been updated. Happy to answer questions. Still happy with my residency choice. Love what I do, most places have a great work/life balance, and you get to make a big difference in peoples lives. Lots of opportunities for research and education interests, and since it is a small field, there are lots of opportunities for developing 'in demand' technical competencies during a fellowship. MR Linacs are likely going to be the Proton's of the 90's... would love to be proven wrong. The job market hasn't panned out quite like I was sold on when I started residency, and I do believe there are too many rad onc residents compared to available jobs (particularly in Ontario), but most people end up with a job after 1 year of a fellowship in a location they are happy with.

Go on electives to the locations you want to match to most. The cost of a flight is just a drop in the entire bucket of CaRMS related costs. Agree with ChemPetE that it is mostly selection bias - people generally want to stick close by to their family, which is why most UBC rad onc residents are from BC initially (but not all). Best of luck!

The job market isn't great in Pathology, but isn't horrific either. My understanding is that there are 'rural' pathology jobs (i.e. not desirable locations) available straight out of residency, with fellowship training (or two) necessary for academic/desirable cities. I have not met a single person who said the pathology job market is good in 4 years of medical school or 3 years of residency.

Talk with your senior residents. Studying without the "study package" at your local school is a waste of time. Most of the stations are recycled from previous...

At CARO this past year, there was some data presented with regards to the Rad Onc job market that is relevant to any medical students interested in the specialty. In brief, the job market is anticipated to open up over the coming years, potentially even leading to a shortage of rad oncs in the medium term future (i.e. 6-10 years). No plans for re-opening the closed residency spots. Things have improved even over the last 1-2 years, though doing a fellowship after residency is still the norm. They aren't my slides so I won't post them publicly, but if any medical students are interested shoot me a message and I'll forward you the slide set. According to the slide set, competition for residency spots in radiation oncology have been trending downwards, likely due to concerns with regards to jobs.

Rad onc varies quite a bit from province to province. Some provinces operate on a salary, others fee for service. To make it more confusing, in Ontario, it is a combination of both. It is safe to assume a salary starting at 300k, and likely higher depending on your patient load. The median salary is above 400k from what I remember (there is a PPT presentation from about 5 years ago showing this, ontario physician data). There are very few outliers (i.e. 600k+). People have often compared it to the salary of a surgeon (~400k) with a much better lifestyle. It is entirely dependent on your work load - radiation treatment planning is the major money maker, and what separates rad onc from most other predominantly outpatient specialties.

Just bumping this up, since there is a new batch of 3rd (and 4th) year clerks who may have questions about one of the best kept residency secrets out there (IMO). Job market is still tight in Rad Onc, but not as bad as some surgical specialties. Doing a fellowship after residency is the norm, but finding a job after a fellowship is very possible. There is a feeling that the job market will be wide open in ~5 years (YMMV as it is based on modeling, but since the specialty is so small, it is easier to model - they did predict the job crunch that has been going on for the past few years) There are a lot of great things about being a radiation oncologist (and a radiation oncology resident), I'm happy to try and answer questions in this thread (or by PM) I see no one answered the above post - there is no clear answer, and ultimately like any job in medicine there isn't a simple equation to finding a job. It is important to realize, just like a residency position, you aren't entitled to a staff physician job - you should have the attitude of selling yourself to obtain a residency position and ultimately will have to go through a much less transparent process to sell yourself as a staff physician to a group. I'm sure you could be a superstar Rad Onc resident at any program across the country and get a job in the US without a fellowship in the right circumstances. Will doing a fellowship or residency in Toronto make a difference? Probably not. Keep in mind, the rad onc community is small, and there is a lot of collaboration across the border.

It's funny - after doing clerkship rotations in family medicine, I have far more respect for GPs than I ever thought I would. Definitely one of the toughest jobs in medicine, far moreso than specialists. Time consuming, poorly paid, and despite how frustrating some patient encounters are, you always have to keep an eye out for red flags that something serious might be going on, even when you just want to move onto the next patient. And there is constant discussion of how we can convince more medical students to go into family medicine. It seems that a good proportion of those that I talk to that are interested in doing family medicine have a +1 year in mind already.

This is a good report to look at for Ontario physicians. http://www.ices.on.ca/file/ICES_PhysiciansReport_2012.pdf It doesn't take into account overhead (which is pretty low with Rad Onc, i.e. admistrative staff you split with 2-3 other physicians). Mean of about $400k. I have heard that Ontario Rad Onc is often a FFS model, therefore the more technical/procedural parts of the specialty pay better (i.e. brachytherapy). Anecdotally, I've heard starting salaries are generally around $300k, but that could very easily change from centre to centre and I wouldn't be surprised that in the current job market, starting salaries continue to drop.

They should be doing more... I can't believe they are -still- training 11 rad onc residents per year in Ontario, when there simply isn't the job market to support them. Especially when certain programs (Mac, Queen's) haven't attracted a CMG in the first round (or ?second round) for a couple years.

Thanks for the response - it is interesting to hear the point of view from someone in the field. Out of curiosity, is there a centralized resource for American (or Canadian) job postings? Or is it mainly word of mouth?

Hey DubZter, What do you think about the results of the R1 match for Rad Onc? I posted this in the CaRMS forum, but I would be interested in your opinion. There were 8 spots left over (of 21) for Rad Onc this year. Some schools didn't even match a single resident (Queen's, Western) that normally get 2. Reaction to the job market for Rad Onc? I know you painted a rosey picture in your last post, but apparently of 31 2009/2010 graduates who responded to a survey, 22 of them haven't found full-time work. Even if you assume everyone who didn't respond has full-time work, only ~55% are finding full-time jobs http://news.nationalpost.com/2011/09/19/demand-high-but-medical-specialists-not-finding-work-in-canada/

There are always exceptions; that being said, you have to consider the level of competition for these med school spots. Just scraping by the cutoffs doesn't cut it in most cases.

Where are you from? What is your VR score? If you're from Ontario, you're facing an uphill battle, especially since you're doing a MSc (some schools won't consider a second undergrad after you've completed a MSc, I don't know which). Assuming you're not from a preferred residency pool (e.g. SWOMEN, Ottawa, Maritimes, Praries/West Coast)... Mac is always a possibility (but a long shot) if you ace Casper and have a good VR score. U of T is also a possibility if you can really sell the grad student/research side of yourself, but is a long shot. I don't know what Queen's has done with their application system, but you might have a shot with them. I don't think you have a shot at Western, Ottawa, NOSM. Dal will consider your best 2 years + MSc grades if you've completed your undergrad and have taken all of your grad school classes, but if you're OOP it is a long shot (you would need near perfect essay/supplemental scores to make up for your GPA). I don't know of any other schools that consider grad grades. Sorry to be the bearer of bad news, but you're looking at few options. You could try taking a second undergrad (but research this with each school to make sure they will look at these grades). You could consider moving somewhere to gain residency status, and applying in a year/two years (depending on the school). I know that for Dal, you can apply after living in the maritimes for 2 years (i.e. if you moved here in September, you could apply for the class of 2017). Or you're looking at studying overseas.

Consider the opportunity cost of taking a summer off to write the MCAT. This is different for everyone. I worked through last summer, have two potential publications in the works, got some great real-world clinical and public health research experience, and made some money too. I didn't do as well on the MCAT as I could have (good enough to get in though), but for the school I had my eye on (Dal), improving my research and work experience by working far outweighed any small increase to my MCAT score. This will differ for each person - I personally think taking a whole summer off to write the MCAT is ridiculous if you've already taken the relevant courses (for me, it was a review of material I covered 2-4 years ago). This might be different if you're a BA in English and don't have the same experience in science.