Just wanted to share my own experience as I considered radonc in med school and invested in it quite a bit, but ultimately decided against it after my experiences and talking to several people in the Toronto program. I'm grateful for the honesty of the senior residents regarding the job situation in Toronto, though I can't speak for other parts of Canada where things might be improving somewhat.
1. Location: Many Toronto residents told me they chose the program to be near family but later regretted it. They mentioned that being in Toronto doesn't guarantee a job there, and pursuing a less demanding residency program while building a strong CV is a better strategy. They also noted that Toronto hires many international fellows and staff from the USA, leading to fierce competition and a prevalence of politics and nepotism.
2. Culture. This was the main deterrent for me. The residents said the Toronto program is the most demanding in Canada, requiring long hours and research commitments. They advised against joining the program, recommending London or other friendlier programs instead. The staff in Toronto can be difficult, treating residents poorly and often favoring those with better connections or nepotism. I can definitely see that from what I experienced. The residents felt they couldn't voice their concerns due to the close-knit nature of the department. One of the residents on the selection committee confidently told me Toronto generally doesn't get their top choices on the CaRMS list, and even went empty once.
3. Money. Academic salaries in Toronto aren't particularly high compared to community jobs. Residents suggested considering community positions for a more relaxed lifestyle, better work hours, and decent pay.
4. Quality of life. I was warned that my quality of life would suffer in the Toronto program, and that I should look elsewhere for a more balanced experience.
5. Job market. The residents were honest about the possibility of having to leave Toronto or even Ontario due to tough competition. They mentioned that Ontario is expected to supply radoncs to other provinces without residency programs, which was a red flag for me. Recent news about Ontario making it easier for USA/UK/Ireland grads to practice there only adds to the concern. It seems the Toronto job market might be struggling, but other locations could be better.
The choice is yours and it certainly looks like there are people here who made it work. But it became clear to me that radonc wasn't the right fit for my goals of staying in Toronto, avoiding research obligations, and maintaining a good quality of life with decent pay. I ultimately chose a different specialty and am very happy with my decision and a good job market and reasonably high salary.