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I have a friend who went unmatched when applying to internal this year. There appears to be a plethora of rad onc spots in second round. Are these worth applying to even with no previous electives in it?

 

The reason there's a good number of unfilled rad onc spots is because there aren't many people who were interested in the field this year and so there won't be many left over with previous elective experience. If your friend would consider a career in Rad Onc - and there are many good reasons to do so - they should absolutely apply.

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The reason there's a good number of unfilled rad onc spots is because there aren't many people who were interested in the field this year and so there won't be many left over with previous elective experience. If your friend would consider a career in Rad Onc - and there are many good reasons to do so - they should absolutely apply.

 

I would make the same point :)

 

remember schools have the same sort of "going unmatched" experience that applicants have. They want their spots filled and like people in the 2nd round they now are looking at things they may not have considered as much before. You really have to look at a reason not to apply to a program if you are in the second round I think.

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I would make the same point :)

 

remember schools have the same sort of "going unmatched" experience that applicants have. They want their spots filled and like people in the 2nd round they now are looking at things they may not have considered as much before. You really have to look at a reason not to apply to a program if you are in the second round I think.

I would caution you against calling it the same experience. It's really not.

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I would recommend applying to radiation oncology. You can explain in the letter that you don't have any elective experience but you are interested in radiation oncology because of reason # 1, reason # 2 etc. If your friend gets an interview, ask him/her to try to make it to the interview in person (or skype at least). He/she can decide after the interview whether he/she still wants to rank the program. Interview will be a great opportunity to ask questions about the program, radiation oncology in general. Sometimes we don't explore things and when we get an opportunity by chance, we find out that we were ignoring a gem. Good luck and I wish your friend the very best.

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I have a friend who went unmatched when applying to internal this year. There appears to be a plethora of rad onc spots in second round. Are these worth applying to even with no previous electives in it?

 

Does your friend have the slightest interest in rad onc? If I was in their shoes, I can't imagine myself just applying for any and all second round spots. If you match to a program or discipline in which you have no interest, wouldn't you be miserable? But I guess you could also argue that you could then transfer into a program of interest once matched... 

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I would caution you against calling it the same experience. It's really not.

Poor phasing - particularly with the rather different emotional impact of not matching. My point I was trying to make is that programs quite often have serious issues with having unmatched spots as well. It puts a big strain on call heavy programs to have missing people. Having not by intention unfilled spots doesn't make the PD and selection committee look good either. So just like applicants they are now going to be looking that things that they otherwise would not have considered. 

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Poor phasing - particularly with the rather different emotional impact of not matching. My point I was trying to make is that programs quite often have serious issues with having unmatched spots as well. It puts a big strain on call heavy programs to have missing people. Having not by intention unfilled spots doesn't make the PD and selection committee look good either. So just like applicants they are now going to be looking that things that they otherwise would not have considered.

I know what you meant. Just touchy at the moment. All good.

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There is certainly overlap between internal and rad onc but there are distinct differences. IM tends to be much heavier on the diagnosing where rad onc tends to be focused on treatment only. Learning how to plan radiation is also a skill that has to be learned so it's important to have ideas about what that entails.

 

I will say that Rad Onc programs would really suffer if residents use this as a way to transfer into a different program and so would not be that supportive of residents hoping to do that. Some of the RO programs with spots open have a single spot per year and losing a resident would seriously harm their call pool.

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One thing to consider is that Rad Onc has a reputation for one of the worst job markets of any specialty too. That is an important reason why people don't apply in large #s

The whole job market thing is a little overblown. Yes, the standard is to do a fellowship after residency but the recent stats show around 50% of grads have a staff job after 1 year of fellowship and 90% have a staff job after 2. I would say that's comparable to a lot of surgical specialties. I used to be great but now it's tighter like with everything in medicine but it's not as if rad oncs are never finding staff jobs. It's also projected to improve over the coming years.

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One thing to consider is that Rad Onc has a reputation for one of the worst job markets of any specialty too. That is an important reason why people don't apply in large #s

The reputation is there, although it is unduly deserved in this circumstance. If anyone is on the fence because of job market issues, they should PM me. There is good quality human resources data to suggest that people going in now should have a good selections of jobs available. Heck, I'm seeing it now and I'm already halfway through residency so far and I am personally not concerned in the slightest about employment. The residents who have graduated my program the last few years have all found work, and it's only getting better.

 

I would chime in on a few things as well, reinforcing a few things above. I will speculate (a dangerous feat) and say that the reason RO had a poor match this year was multifactorial: we are a very small specialty with poor exposure in undergraduate medicine, and that exposure has actually decreased. Usually there is a handful of people from BC interested in the specialty from their previous surgical selective option, and (please someone correct me if I am wrong) however this is no longer an option I understand for their UME program so we didn't get the usual handful of people who want RO and want to stay out West. In addition, there is that pervasive reputation as above which at this point I would say is outdated, and our job prospects are equivalent or better than many other FRCPC specialties at this point for entering into RO.

 

As for what makes a competitive applicant, I would reach out to the program directors at this point and ask them questions (and they can direct you to some residents if you are interested), but it won't penalize you to not have any direct RO experience. I think having a general understanding of the field is useful, especially if you're considering it as a career, but that can be attained by reading and talking to people. I can provide some good quality, brief resources on intro to RO as well if anyone is interested. Very much programs are looking for personable people with good communication skills as it is still very much a communication heavy specialty; the overlap between what makes a good candidate for RO and what makes a good candidate for many other specialties is quite large so don't discount yourself even if you have no direct RO experience.

 

So if anyone is perusing this topic and has questions, I would certainly take any you have over PM.

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While Rad Onc is not my cup o tea, the job is very desirable in the USA and is also a pretty good deal in Canada.  Pay is high, hours are relatively low, technology is amazing.  If there was more flexibility in where jobs were available - the specialty would easily be one of the top 5 in terms of competitiveness in Canada (like it is in the USA).  Few if any expenses, pay around 450 thousand a year (as much as 700K in some cities), 8-5 job hours, little call, cool technology.  Out west, salaried doctors also have pensions and benefits.

 

Sure it's not opthalmology or radiology pay (1 mill a year) so you're not going to be very rich,  not sexy like ortho/neurosurgery (as a male you're not going to attract many women being a rad onc), or flexible like family medicine (where you can work wherever you want) - but it's definitely up there in overall pay/lifestyle if you don't mind where you live.

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I would say this is relatively accurate. It is a great opportunity for people to have a fulfilling and amazing career!

 

While Rad Onc is not my cup o tea, the job is very desirable in the USA and is also a pretty good deal in Canada.  Pay is high, hours are relatively low, technology is amazing.  If there was more flexibility in where jobs were available - the specialty would easily be one of the top 5 in terms of competitiveness in Canada (like it is in the USA).  Few if any expenses, pay around 450 thousand a year (as much as 700K in some cities), 8-5 job hours, little call, cool technology.  Out west, salaried doctors also have pensions and benefits.

 

Sure it's not opthalmology or radiology pay (1 mill a year) so you're not going to be very rich,  not sexy like ortho/neurosurgery (as a male you're not going to attract many women being a rad onc), or flexible like family medicine (where you can work wherever you want) - but it's definitely up there in overall pay/lifestyle if you don't mind where you live.

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Rad onc is a great field. In the scramble of the second round match, get in touch with your local radiation oncology department if you haven't done so already. Try to take a day ASAP to familiarize yourself with what a radiation oncologist actually does, it will show some genuine interest in the field when discussing in second round interviews.

 

The field is amazing and I couldn't be happier. Jobs are not plentiful, but more than sufficient and are only forecast to improve. Doing a fellowship is an expectation, but not an unreasonable one. I personally find rad onc truly rewarding, both in curative and palliative cases, radiation oncology plays a key role. Hours are reasonable (As a resident, 8-5:30 is a standard day, often starting/ending 30 mins earlier/later), technology is cool, research is plentiful. A well trained radiation oncologist will be able to have meaningful discussions with surgeons, med oncs, pathologists, radiologists, respirologists, etc about appropriate management of almost all aspects of oncology, I find the view of a radiation oncologist just as a 'technician' is outdated and well below current expectations. Oncology is rarely true 'flowchart' medicine, and you will utilize critical thinking skills on a daily basis trying to figure out what the 'right' thing to do is.

 

The breadth of opportunities of radiation oncology are only bounded by the diagnosis of cancer (and even then, there are a handful of non-cancer things we deal with). Treatment techniques include hands-on brachytherapy surgical procedures, clinical mark-ups for treating skin cancer, in addition to traditionally planned CT radiotherapy. Radiation oncologists are proficient at examining the entire human body (CNS, head and neck nasopharyngoscopy, gyne, prostate, etc). While it is a field that 'only' treats cancer, there is quite a bit of variability in terms of what the job entails.

 

You will have to learn and further improve your communication skills in radiation oncology. You will have to make peace with the fact that many of your patients will pass away. Even more difficult will be the rare few who suffer severe late complications from radiation (second cancers, fibrosis, etc). The field isn't for everyone, but is a hidden gem in Canada due to the total lack of exposure in undergraduate medicine and perceived (but not factual) lack of jobs. Don't hesitate to send me a PM if anyone has any further questions.

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